Leslie Duffy 00:00:00 Are you feeling confused, rushed, or dismissed every time you go to the doctor’s office? Do you feel like you’re not being heard? Or do you feel like your doctor just isn’t listening to you? In this week’s episode, we’re breaking down how to talk to your doctor about perimenopause. By the end of this episode, you’re going to feel empowered to speak effectively and be understood. In your 15 minute visit, you’re going to know how to explain your symptoms so that they are understood. You’re going to also have a go to script to practice and try out when you’re talking about your perimenopause symptoms and requesting hormone help. And by the end, you’re also going to know whether or not it’s time to ditch your MD. Welcome to another episode of the Hormone Shift Show. I am your host, Leslie Duffy, registered nurse and functional wellness practitioner. Even though half of the adult population is female, less than 15% of us are getting the effective treatment for our menopausal symptoms. Experts are calling for more research into women’s health and menopause while we wait for more research.

Leslie Duffy 00:00:59 I’m going to show you how to make the most of your doctor visits. How to advocate for yourself when you’re requesting hormone therapy, or even if you’re requesting a deeper look into your symptoms. All right, let’s get started. I’m going to give you five tips and a script to use during your appointment so that you are more comfortable asking for what you want. Now don’t worry. Ever have everything ready in your show notes and it is ready for you to download first. Do not take it personally if you feel that you are not being heard. This is not a reflection on you, not in any way. And comedian Leanne Morgan said to Oprah Winfrey when they were in a menopause summit, she said to her that her itty bitty doctor was really good at prescribing antibiotics for sinus infection, but not so great for her perimenopause symptoms. So I want you to keep that in mind. In medical school, doctors are not taught about hormones. They’re not talking about menopause. And they’re not really aren’t really taught about nutrition other than maybe one class.

Leslie Duffy 00:01:55 So it really depends on who you go to and what you’re seeking out for. You may need to get another opinion, so please keep that in mind. The lesson is, is that you know your own body better than anyone else. You are. You know your your people also better than anyone else. Your mom, whoever you’re taking to the doctor or your husband. So don’t hand over that knowing to someone else just because they have the credentials. Trusting your doctor completely. That is a very Western. It’s a patriarchal kind of mindset, and I want to encourage everybody who I cross paths with, even if I’m the clinician and they are the patient. You want to trust yourself first. You want to ask questions and you want to stay curious. All right. Let’s talk about those doctor’s visits. You want to come prepared. Bring your list. So you want to put it in your phone and you want to pick probably 2 or 3 things that you can focus on during the visit. And you don’t want to leave there completely forgetting what you wanted to actually talk about.

Leslie Duffy 00:02:51 Brain fog is the real deal. We are suffering with too many things to do and too many things on our plate. And here’s what I also encourage you to do. Make your list early, because sometimes what happens is you might think of something that you wanted to bring up, and you don’t want to do that after your appointment. So give yourself a little bit of wiggle room two days before your appointment. Start writing down your questions because some of them are going to come later on when you’re like, oh, I forgot. I wanted to ask that. Go right to your list and write it down. Make sure you do that. A lot of people get very nervous in front of doctors and they call it the white coat phenomenon. It literally there’s research on it. Your blood pressure could go up, your heart rate could go up. So you want to give yourself enough wiggle room to write down your questions and give yourself enough breath and time to think about what you want to say. Throughout your appointment, you can start to sprinkle in your questions, and that’s why it’s so important that you have it with you.

Leslie Duffy 00:03:43 All right. Number three, you want to be specific and accurate when they ask you a question. Be specific. For example, if they say how has your sleep been? You do not want to say fine. You don’t want to say normal because normal. There is no context as to what is normal. Normal for you might be normal for somebody else. I once had a client who was like, oh yeah, it’s normal. And she was having a bowel movement every other day and that is not normal, my friend. So I had to explain. You need to have a Belmont every single day, and in fact, more than once would be great. That kind of information is very specific. The other thing I want you to explain how it affects your activities of daily living, and that’s an acronym that we use in the medical field, ADLs. Because if you walk into your appointment and you look fine and you look, you know, put together, it’s going to be harder to understand and give context to what you’re going through to your doctor.

Leslie Duffy 00:04:32 So you want to explain, I might look good today. Today is a good day, for example. Or I had a good night’s sleep last night, but I’m not. I’m not sleeping well. This is how I usually sleep. This is what I’ve been experiencing. And how is it affecting me on a daily basis? Is it affecting your job? Is it affecting your your functioning? Is it affecting your cognition? Is pain affecting you? And you can’t carry groceries, for example, are you unable to bathe yourself? Are you unable to take care of your house? And when you travel, how does that affect you? So things like that are going to be very context based, and give your doctor a lot more details and qualities of what you’re actually going through. And from the medical perspective, and I can speak to this is your doctor is assessing you the entire time that they’re using something called Soap notes, which which stands for subjective objective assessment and a plan with subjective. This is where you’re going to shine.

Leslie Duffy 00:05:26 This is where you’re going to tell them everything specific. And this is where you want to bring your symptom tracker. I’m going to put a symptom tracker in the show notes. It’s really very valuable for you to bring to the doctor’s appointment so that they can see it with their eyes and see how often this is affecting you. That’s very, very powerful. So that’s subjective. And now that subjective checklist becomes objective. They can even upload it to your file. And that’s so important. So now it’s actually become objective. These are the facts of the story. Your blood pressure, your vitals, your weight, your O2 sats all of these things. Now you have your tracker in there too. Now they’re going to do an assessment. That’s the A of the scope note. The provider is going to take all of this information and make an assessment using their clinical judgment. And they’re going to blend it with their clinical knowledge. And they’re also going to take other things that you really can’t track necessarily. They’re going to look at you.

Leslie Duffy 00:06:19 Top to bottom. They’re going to look at your neurological presentation. They’re going to look at your gait. They’re going to look at things that you might not even realize your movement, your appearance, your hygiene. All of this is like that big picture look so that they can make a really good assessment. And then the next step is plan. Okay. So now when it comes to the plan, you want to co-create a plan with your doctor so that you don’t just blindly follow. We want to be the co-creator of the plan, because you do have a say on whether or not you want to follow that plan. You want to make sure that you’re on board. You want to go over the plan so you’ll understand the specifics and bring up your questions right then and there. Now the doctor wants to help you, and they’re probably going to help you with prescriptions. And this is where you’re going to come in with your questions. Could we try this? I understand this and that about the issue that maybe you’ve brought to the table.

Leslie Duffy 00:07:09 I’d like to try this hormone, this vitamin, this prescription along those lines, this is where you’re going to come in and be part of that planning process. I also encourage clients to come in with an article that they can share with their doctor. Now you want to maintain harmony in your relationship, so please do not come in with that article and just throw it at them. You want to make sure that you bring out the article when it’s the right moment. When you’re talking about something that you want to try, you want to experiment with, make sure that you bring out the article when it’s appropriate. Now you have to be the judgment of that. Don’t take it just on my word. You have to be the judge. You’re in front of your provider. If you’re coming up with some resistance, you don’t understand the plan. You can also reference your article. Hey, I read this article. I wanted to see if you could look at it. I was thinking maybe I was experiencing some of these things.

Leslie Duffy 00:08:01 What are your thoughts on it? And you might even just do it just so you can get a better understanding of what they’re seeing and what you’re seeing. Make sure that you guys are on that same page. We also want to understand that this doctor is part of your team and we are trying to maintain a relationship with them that hopefully is going to be a long lasting relationship. If it is a provider that is saying things that you know what, this is normal, or do you feel like you they didn’t on your honor, your request or that they’re telling you, well, this is what getting older is all about? I’ve actually heard other providers say, I don’t believe in menopause or perimenopause. I want you to, you know, just put that in your back pocket. You want to be persistent. You want to follow up. And that might be your clue to go get another opinion. Okay? It might be the time where you’re like, oh, actually, maybe I’m not in the right office.

Leslie Duffy 00:08:52 All right. So your final tip is the idea of I tried that and it didn’t work. Do not come in with the assumption that you already did it for like two weeks. If they come in with a plan and you’re like, well, I did that and it didn’t work, or I tried that medication and you tried it for two weeks, or I tried that vitamin and you didn’t really give it a go. you want to tell your provider if you did something that they had requested you to do or that you had agreed to do. Tell them how long you did try it and and tell them why you think it didn’t work. I’ve had clients come into my office and we’ve talked about, you know, maybe giving up dairy, maybe giving up gluten. And some people even say, you know what, I did that. I did it for a couple of weeks. But what people don’t understand is that medication needs time to work, vitamins need time to work. You got to give it a good amount of time.

Leslie Duffy 00:09:38 Things will affect how medications work. Also, it could take up to three months for something to work. That actually did help him with my mother. She did try medication. She gave it 30 days. And when we went to the doctor, the doctor said, well, let’s actually the longer you take it, the longer the better it works. So it was. She has to start from ground zero with one of her medications. So that’s just an example there. But we want to make sure that you are willing to give any sort of recommendation the right amount of time when it comes to my clients. And if they’ve been in a meeting with me, sometimes I might suggest something or I might say, hey, have you tried this or have you tried that? And they’ll say, oh yeah, I tried that and it didn’t work. But I come to find out that maybe they gave up dairy for two weeks, or maybe they gave up gluten for a few days and they didn’t feel any better.

Leslie Duffy 00:10:25 So even when you take things away, it takes a while for things to get out of your system. And that would be like dairy. It takes at least 21 days to get out of your system, and then you’re going to start feeling better, but you have to give it that kind of time and room for things to work. I’m going to give you a script for when you think it might be perimenopause, but they haven’t really mentioned it yet, so sometimes you do have to bring it up. First you might want to say I’ve been having and then you list your symptoms. Could this be perimenopause? Is it possible? What I’m experiencing? Heart palpitations. Poor sleep, brain fog. Could it be hormonal? And I want you to be ready to educate gently if necessary, and bring a few studies, but only pull them out if you feel that you’re not getting any clarity, not necessarily resistance, because you want to preserve your relationship first, you want to advocate for yourself, but you also need to preserve your relationship, especially if this is your only option and you want to be able to be ready to leave an article with them if they’d like to look at it.

Leslie Duffy 00:11:26 But you know what? This is where my brains at. This is what I’m thinking. What do you think of this and have an ongoing conversation? The the longer the conversation, if needed, the better. But you are definitely advocating for yourself when you’re doing that. In the show notes, I will have more conversations and scripts for you. For example, I’m I have how to talk to your doctor about supplements when you want to try progesterone, when you want to request a more comprehensive lab study or lab work, for example, thyroid. And when you want to have hormone therapy conversations and what to do if they offer you birth control pills. Now, this is not obviously an episode on hormone replacement therapy, so I want you to take that into consideration. But this is really just for you to open the door and have these scripts ready so that you can go in there prepared. Okay. Final word when to fire your doctor. Now you are the consumer. I want you to remember that your doctor works for you.

Leslie Duffy 00:12:22 Not the other way around. If your doctor dismisses your symptoms, if they mock your questions or gets defensive when you advocate for yourself. It’s not you, it’s them. I want you to remember that, but it might be a time to seek help elsewhere. Now, functional medicine, integrative medicine and women’s hormone specialists do exist. And if your gut says this is not working, you want to trust that you want to trust that gut. You’re not being dramatic. You’re being wise, and you’re advocating for yourself. In the show notes, I have some other articles, but don’t forget to download your listener guide, which has all of the other scenarios that I mentioned, so that you are prepared for your doctor’s appointment. There you have it, my friend. How to talk to your doctor about your perimenopause symptoms and you have it all in your show notes. Don’t forget to download that so you have your scripts ready to go and you are prepared for your next appointment. I will see you next time.

Leslie Duffy 00:13:16 Don’t forget to like, follow and rate this this podcast and share it with a friend.