11 Essential Questions to Bring to Your In-Person Menopause Visit
For most of your life as a woman, you will have a clear path when it comes to healthcare and health appointments. Monthly breast self-exams. Annual paps from OBGYN or PCP. Visits to your OBGYN or a reproductive specialist, if parenthood is part of your plan. And then comes perimenopause sneaking in from left field, and hormone changes, irregular periods, weight shifts, brain fog, and other mystery symptoms often start arriving.
Over 1 billion women around the world will have experienced perimenopause by 2025. Yet, menopause and perimenopause are still taboo topics in many homes and workplaces. The lack of open discussion and education leaves you unprepared and unnecessarily suffering. If you're angry about the lack of understanding and acceptance surrounding menopause, it’s warranted.
Menopause is not a one-day event. It’s a years-long transition that can start in your 30s or 40s and hit harder than you expect. The symptoms can feel random—until you realize they’re all connected. As a gynecologist specializing in menopause care, I get asked a lot of the same questions. So I’m answering them here, plainly and honestly.
Whether you’re wondering if that weird period is a sign of perimenopause, or you’re trying to figure out if hormone therapy is safe (spoiler: it often is), this one’s for you.
What are the signs that I’m entering perimenopause?
Periods start getting weird—heavier, lighter, closer together, further apart. You might also notice night sweats, mood swings, trouble sleeping, or feeling “off.” If your cycle’s gone rogue and you’re over 40, that’s your first clue.
What are the best ways to handle symptoms like hot flashes and mood swings?
First, you’re not imagining it. Second, you don’t have to suffer. Hormone therapy can help—safely, when prescribed correctly. Also: stay cool, cut back on alcohol, and consider mindfulness or cognitive behavioral therapy (CBT). (Yes, really—CBT works for mood swings and sleep, by teaching coping strategies and modifying negative thought patterns). And talk to a menopause-informed clinician. That matters. Another key element is exercise, or more broadly put, physical activity and movement. Women who stay active with structured exercises, sports, and other physical activity report fewer unwanted symptoms.
Are there lifestyle changes I should think about to ease my transition into menopause?
Yes. Strength training (hello, bones and metabolism), protein-rich meals, sleep hygiene, and cutting back on sugar and alcohol all help. Basically: treat your body like it’s changing—because it is. And give it what it needs to thrive in this new phase.
Can I still get pregnant during perimenopause?
Yes. Until you’ve gone 12 months without a period, your ovaries can still surprise you. Birth control is still on the table if you don’t want a baby at 47.
What is MHT? What is HRT? How does it help menopausal women?
MHT (Menopause Hormone Therapy) and HRT (Hormone Replacement Therapy) are the same thing—just different names. They replace the estrogen (and sometimes progesterone) your body stops making. The goal? Fewer hot flashes, better sleep, stronger bones, and long-term protection for heart and brain. When used correctly, for most healthy women under 60, it’s safe and life-changing.
What should I be looking for in a gynecologist or MSCP when I’m over 40?
Someone who listens, stays current on menopause research, and doesn’t dismiss your symptoms with “It’s just aging.” If they haven’t mentioned menopause or hormone therapy options—and you’re in your 40s or 50s—it might be time to find someone who will.
How could menopause affect my mental health?
Estrogen impacts serotonin, so anxiety, depression, irritability, and feeling unlike yourself are real and common. You’re not broken. You’re hormonal. The good news: there are medical and therapeutic options that help.
Is hormone therapy right for me?
Maybe. It’s not one-size-fits-all, but for many women it’s the gold standard for symptom relief and long-term health. If you’re under 60 or within 10 years of menopause and healthy, odds are good you’re a candidate. Let’s talk specifics.
Will I still need to get regular pap tests and mammograms?
Yes. Pap tests every 3–5 years (depending on your history), and annual mammograms after 40 unless otherwise advised. Menopause doesn’t get you out of routine care—it just changes the conversation.
Will my sex drive change as I enter menopause?
Possibly. Hormone shifts, vaginal dryness, sleep issues, and stress can all tank libido. But sex can still be great—and pain-free—with the right support, including vaginal estrogen, pelvic floor therapy, and open conversations about what you need.
Is my loss of libido due to hormonal changes?
Very likely. Estrogen and testosterone both impact desire. But it’s also about sleep, mood, relationship dynamics, and how your body feels. We can address all of it—and we should.
These questions are a good start, but don’t forget to include any specific questions you have about your own experience. The best question to ask is the one that’s on your mind the most.
If you’re curious about menopause wellness solutions, I encourage you to schedule a consultation. You deserve to thrive in menopause.
Dr. Cothran
Founder of Meno-Start