What Your Doctor Isn’t Telling You About Perimenopause

If you’ve ever left a doctor’s office feeling dismissed, told “it’s just stress” or “you’re too young for menopause,” you’re not alone.

For too many women, getting honest answers about perimenopause feels like pulling teeth.

The reality? Most doctors are not thoroughly trained in menopause care. In fact, a 2019 survey found that fewer than 20% of U.S. OB-GYN residency programs offer any education on menopause at all. That means you could be sitting across from a well-meaning provider who has never received in-depth training on the very symptoms disrupting your life.

Why This Matters

Perimenopause isn’t just a few hot flashes and the end of your period. It can affect your mood, energy, sleep, cognition, weight, and overall quality of life for years before menopause actually begins.

But when you bring these concerns to your provider, here’s what often happens:

• They say you’re too young. Many women in their late 30s and early 40s are told this, even though perimenopause can start a decade before menopause.

• Your labs come back “normal.” Hormones fluctuate daily in perimenopause—one blood draw can’t give the whole picture.

• They only address individual symptoms. Sleep meds for insomnia, antidepressants for mood, birth control for irregular cycles—without connecting the dots that these symptoms share a hormonal root cause.

You Deserve Better

Here’s the thing: your symptoms are real. They’re not in your head, and they’re not “just part of getting older.”

If your doctor isn’t taking them seriously, it’s time to take a different approach.

How to Advocate for Yourself in Perimenopause

1. Ask the right questions.

When you meet with your provider, try:

• “What’s your experience with perimenopause and menopause care?”

• “Are you trained in prescribing and managing hormone replacement therapy (HRT)?”

• “How do you determine if symptoms are hormone-related versus another condition?”

2. Screen for menopause-trained providers.

The Menopause Society has a free online directory of certified menopause practitioners. These providers have specialized training in perimenopause, menopause, and midlife women’s health. You can find it here: https://www.menopause.org/for-women/find-a-menopause-practitioner

3. Keep a symptom tracker.

Bring clear, documented patterns to your appointments, including sleep quality, mood changes, cycle patterns, hot flash frequency, and weight changes. The more concrete your data, the harder it is for someone to dismiss you.

You can do this with a simple journal or an app—but if you want to go deeper, there are now at-home hormone tracking devices that measure your actual hormone levels across your cycle. I’ve personally used Mira, and it’s been a great way to see how my estrogen, progesterone, and LH change throughout the month. Having that data gives your doctor far more to work with than a single blood test.

If you want to try it, you can use my code FELICIA at checkout for a discount: https://mira-fertility.pxf.io/N9YrJ1.

4. Know your options for HRT.

HRT isn’t a one-size-fits-all prescription—it’s customizable by dose, delivery method (patch, gel, oral), and combination. A provider experienced in HRT can help you navigate what’s safe and effective for your situation.

5. Get a second opinion (or third).

If you’re brushed off or told “this is just part of life,” find a new provider. Your health in midlife matters, and you deserve a partner in care—not a gatekeeper.

Bottom Line

Perimenopause is not a minor blip—it’s a major hormonal transition that can last for years and affect every system in your body. Unfortunately, many doctors aren’t equipped to guide women through it.

That’s why it’s up to us to come prepared, ask the tough questions, and seek out providers who truly understand this stage of life. You don’t have to suffer in silence. With the proper support, this can be a time of reclaiming—not just enduring—your health.

Pro Tip: Bookmark the MS directory, start tracking your symptoms today, and don’t stop advocating until you find a provider who listens and has the expertise to help.