How to Get the Menopause Help You Deserve

Every single woman who is lucky enough to live long enough reaches menopause.

According to Let’s Talk Menopause, 75 million women in the US are in perimenopause, menopause, or postmenopause, with six thousand more women reaching menopause every day. And yet, too many of us feel that we’re going through this on our own.

Here are the three overarching things I want you to know right now:

1. You’re not crazy.
2. You’re not alone.
3. You’re going to come out on the other side even better than before.

This is my promise to you

Some days will be difficult. You might walk past the mirror and feel that you no longer recognize yourself. Believe me, I understand that menopausal symptoms can undermine our resiliency, but I’ve also learned that in addition to disrupting our daily lives, they also have short- and long-term health consequences—for example, we know that the severity of hot flashes correlates with an increased risk of cardiovascular disease. We not only deserve to feel better on a daily basis but to have access to the information and the strategies that will help us stay healthy well into our old age.

What Your Doctor Doesn’t Know Might Hurt You

I used to think my menopause story was shocking, but after listening to thousands of other women, I realized the only shocking thing about it was how unremarkable it was. Sadly, the crippling severity of my symptoms, the years it took me to find the help I needed, and the less-than-caring attitude of my original doctor when he texted the diagnosis all represent the norm for women across the country and around the world. 

I went to a new gynecologist who told me, “This is just something you have to go through,” before prescribing me antidepressants to “work on my moodiness and help me sleep.” Unfortunately, they resulted in my gaining even more weight than I already had. The next doctor I visited was an endocrinologist who seemed worryingly out of touch; her use of a rhinestone-encrusted calculator did not instill confidence. My journey stalled there for a year and a half during which I truly felt like I was losing my mind. 

I then began working with a holistic health practitioner to try to handle the hot flashes, brain fog, night sweats, and lack of libido, but I still felt like a total mess. I subsequently found a doctor who told me testosterone was the key; desperate, I got pellets and felt great for a few weeks before plunging back to zero libido and lust for life. On the brink of despair, I saw a gyno who told me just to use black cohosh and maca to help with the symptoms and shared unhelpfully that she had “glided through menopause.”Then—finally—I met a clinician certified in menopausal medicine, who gave it to me straight, no BS. She said, “You need estrogen and progesterone. Period.” 

When I said I wasn’t sure about taking hormone therapy—especially because my mom had died of breast cancer (which I now know is not a contraindication)—she said, “You can keep struggling, but I’m not sure why you are doing this to yourself. This will change how you feel and put you back in touch with yourself again.” She put the risks and rewards into a perspective that finally made sense to me. I did my own research and found that the Menopause Society (formerly the North American Menopause Society)—the leading voice on menopause guidelines and treatment in North America—had validated the safety and efficacy of hormone therapy (HT) for the treatment of menopausal symptoms (unless you have one of the handful of valid medical reasons to avoid it). 

One year later, I walked back into her office and was nothing like the woman she had first met. I was alive again. Yes, I still had some symptoms, but they were manageable. I saw six doctors before I finally got the menopause-specific help I needed, and I’m not the only one having this many fruitless appointments. If you get heart palpitations with your hot flashes, you may go see a cardiologist. If you’re feeling anxious as never before, you may see a psychologist or psychiatrist. If you develop acne, you may go see a dermatologist. But now you understand that all these seemingly unconnected symptoms likely have a common root—your declining hormones. It’s time to stop the doctor-hopping.

How to Find a Menopause Practitioner‍

It’s shocking to learn just how little education about menopause medical students receive.

• 80% of medical residents feel “barely comfortable” discussing or treating menopause (these are recent MDs who are completing postgraduate education).
• 58% had received only one lecture on menopause in their training, and 20 percent had received no menopause training whatsoever.
• 57% of practicing physicians were up-to-date on the recommendations regarding hormone therapy for menopause symptoms. 

It’s hard to know whether to laugh, cry, or scream when you read the distressing facts about the state of menopause education in the US.

To get the guidance you need, your first focus should be on finding an experienced menopause practitioner. You might think that a primary care doc or an OB-GYN could help you, but they typically have so little training in menopause that they may not even be considering it as a cause for your symptoms. 

Of course, just like any time you’re looking for a service provider you can trust—whether that’s a hairdresser, a babysitter, or a massage therapist—you should ask your friends whether they’ve seen anyone they’d recommend. No website listing or even online review can substitute for the lived experience of someone you trust. So, don’t be shy—ask.

Another great place to look is on the website of the Menopause Society, which maintains a directory of licensed health-care providers—including physicians, physician assistants, nurse practitioners, nurses, pharmacists, and psychologists—who have passed a two-hour competency test and are certified in menopausal medicine.

I should warn you that even though doctors certified in menopausal medicine do exist, there simply aren’t that many of them yet. While 55 million women in the United States are currently in menopause, there are only roughly 2,300 Menopause Society–certified practitioners as of this writing. 

There is some good news here, though: There are many telehealth companies that can fill a good portion of the gap created by the lack of certified menopause providers. Such companies as Alloy Women’s Health, Evernow, HerMD, Midi, Maven, and Midday are leaders in the space and can connect you with menopause-certified doctors who can see you and treat you. Things are changing fast in this space, and some are already covered by insurance.

Once you find a practitioner, prepare for your office visit by writing down your symptoms—in your journal, calendar, a note on your phone (I have a symptom tracker in my book). You want to track both the severity and the frequency of your symptoms. Give some thought to which ones are bothering you the most, as that will help you and your doctor set priorities. Next, gather up all your medical history, both personal and family. Who had heart disease, high blood pressure, diabetes, cancer, dementia? Having this information will help your provider better understand your unique health risks and suggest treatments that align with your unique profile.

Five Ways to Get the Best Menopause Care Possible

1. Find a certified menopause practitioner. Visit the Menopause Society website 
2. Know thyself. Try to be as prepared as possible with your medical history, including the medications and supplements you are currently taking, your past surgeries, allergies, and the names of your other doctors, plus your pharmacy. Don’t rely on the doctor to gather your past medical history.
3. Know thy family history. Things like when your mother went through menopause and the severity of her symptoms. Any personal or family history of breast cancer, ovarian cancer, blood clots, Alzheimer’s. Talk to your relatives, if you can, and ask questions. It is important to know as much as possible.
4. Come armed with a list of questions. Include this one, which may be my favorite (thank you, Dr. Mary Jane Minkin!): “I think I’m in perimenopause, and I understand that going through menopause puts me at greater risk for osteoporosis and cardiovascular disease. Can you tell me how to protect myself?”
5. Listen. If you hear the doctor say things like, “It’s not a big deal, all women go through this,” or “I’m not comfortable with HRT,” or “It will pass,” you may want to find another practitioner.

Yes, I know it puts a lot of the responsibility on you. But I want to make sure you are prepared to be your own best advocate. You deserve to be not only “seen” but also heard by a doctor who has been trained in perimenopause and menopause.

Tamsen Fadal’s newest book How to Menopause (Balance Publishing, 2025) is the girlfriend-vetted guide to taking charge of your health, reclaiming your life and feeling better than ever before. This selection was excerpted from How to Menopause by Tamsen Fadal. Copyright © 2025 by Tamsen Fadal. Reprinted with permission of Balance Publishing, an imprint of Hachette Book Group. All rights reserved.