Health · Menopause

Ask Dr. Pat: Help! My Ob-Gyn’s Treatment Isn’t Helping My Menopause Symptoms

Dear Melissa,

It is clear that you have significant menopausal symptoms, primarily vasomotor symptoms, that you have been unable to manage without hormone therapy in spite of real effort on your part.

You can’t change your doctor’s practice pattern. She is no doubt incredibly busy with the demands of an obstetrical practice and may not have the time to be empathetic about the symptoms you describe. She is likely focused on patients who are pregnant, patients who are in labor, patients who need contraceptive care, patients who have issues with fibroids, endometriosis, infections or cancer. And you don’t fit into this practice. By the way, these are the real pressures facing most ob-gyn doctors these days who are often employed by hospitals or large clinic practices. Many have little control over their schedules and must stick to the allotted time set aside for each patient.

So, look for a new doctor, preferably one who does only gynecology and may also have an interest in menopause management. Hopefully you will also find a doctor who has more time to spend with you. The patient-doctor relationship is part of the healing process. This relationship requires both a “a good fit” and takes time to develop. Doctors need to listen to the patient’s story and understand that not all gynecological problems are diagnosed by ordering tests or doing procedures. Ask other doctors you may see or friends who are in the menopausal stage for referrals.

Do your homework before the first visit with the new gynecologist. List all your symptoms and rate them on a scale of 0 (not an issue) to 10 (the house is on fire!). Type up your symptoms with the rating scale along with length of time you have had the symptoms and add the non-hormonal treatments you have tried. Give the doctor this information in writing so that it is clear that you know what your symptoms are and what has not worked. Include the good news that you are fit and healthy without any known contraindications to the use of hormone therapy.

RELATED: In Her 40s: Menopausal Symptoms After an Endometrial Ablation

Menopausal hormone therapy is the broad term used to describe unopposed estrogen use for women who have undergone hysterectomy  or combined estrogen-progestin therapy for women with a uterus who need a progestin to prevent estrogen associated endometrial hyperplasia. The goal of menopausal hormone therapy is to relieve or greatly diminish the symptoms that you find so troubling.

You may want to let the doctor know that you have done your homework and that you know that estrogen is the most effective treatment available for relief of menopausal symptoms, most importantly, the hot flashes and night sweats that are the root cause of your overall decrease in quality of life.

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  • LK August 24, 2016 at 7:59 am

    I had the same experience. My doctor also leaned more towards obstetrics and I went for three years suffering with painful sex before I finally went to a gynecologist in another system, who prescribed a treatment right away. I was also suffering from recurring bouts of genital herpes until the new doctor prescribed Valcylovir, which saved me!

  • Andre Leonard August 22, 2016 at 10:35 am

    “I don’t see many older women in her waiting room. I get 15 minutes of my doctor’s time when I can get an appointment”

    I agree, it’s time for you to find a doctor who’s practice is more geared towards treating menopause and ‘not’ delivering babies.

    Hope you find the doctor who is attentive and you getting better soon.