Check-up Checklist: What to ask your doctor about menopause treatment

Menopause and perimenopause can be a whole-body experience, not just a reproductive one. The hormonal shifts of midlife often affect both the body and brain, with symptoms ranging from hot flashes and joint pain to brain fog, mood changes and sleep disruption.¹

Because symptoms can vary widely, and because there are still gaps in how menopause is understood and discussed,² it can be hard to know what to raise with a healthcare provider. But going into an appointment prepared can help you have a more productive conversation about your symptoms, treatment options and overall health.

Here, Dr. Farzana Haq, Physician Lead of Women’s Health at Cleveland Clinic Canada,  which is Manulife’s Medical Director for Group Benefits, and Shyna Asaria, a Registered Nurse with Maven Clinic, a virtual service specializing in support for women’s and family health, share advice on navigating menopause treatment options and discussing symptoms with your healthcare provider.

Track your symptoms. Keeping a record of physical, mental and emotional changes can help identify patterns over time. “I encourage women to write down what they’re feeling, mood-wise and physically, from head to toe,” says Dr. Haq.

Bring a full list to your appointment. You don’t need to know whether every change is hormonal before you raise it. Sharing a fuller picture can help your healthcare provider assess whether your symptoms may be related to menopause, or whether another health issue could be contributing.

Prepare to advocate for your needs. While clinician understanding of menopause is evolving, many healthcare practitioners have had limited formal training in menopause care.³

Ask whether HRT may be right for you. Talk with your healthcare provider about the potential risks and benefits based on your symptoms, health history and treatment goals.

Ask about the different types of hormone therapy available. Treatment may include estrogen, progesterone or a combination of both, and can be delivered through patches, gels, pills or localized options.

Ask whether prescription medication might help. If you can't or prefer not to take hormone therapy, options may include SSRIs, which can help manage symptoms such as hot flashes,⁴ sleep disruption and mood⁵ changes. Another option is a new type of medication, either fezolinetant or elinzanetant, that acts on the brain’s central thermoregulatory system.⁶ “It's a great option for women with significant hot flashes and night sweats who can't or don't want to take hormone therapy,” says Dr. Haq.

Ask whether supplements could play a role. “Some women find relief through targeted supplements that modulate the nervous system and support mood regulation, like magnesium glycinate,⁷ B-complex vitamins⁸ or herbal remedies,"⁹ says Asaria. Before starting a supplement, check whether it's appropriate for you or might interact with your other medications.

Ask how lifestyle factors may affect your symptoms. "Nutrition, movement, sleep hygiene, alcohol use and recreational drug use should all be part of the conversation," says Dr. Haq. "We don't want to prescribe a medication without understanding the broader context."

Ask whether counselling or psychotherapy may help. If menopause symptoms are affecting your mood, stress levels or overall well-being, your healthcare provider may be able to recommend appropriate supports. “You are navigating an invisible neuroendocrine shift that deserves recognition, resources and care,” says Asaria.

Ask whether workplace accommodations may be appropriate. If symptoms are affecting your ability to work, discuss whether a note for modified hours, schedule adjustments or other accommodations may help. 

^{This article is for informational purposes only. It is not intended to diagnose or treat a condition. If you have questions or concerns about your specific situation or are seeking medical advice, contact your medical doctor or your healthcare provider.}

^{A note about gender:}

^{While we use the terms "women," "female," and "men" and "male" in this article, we recognize that these terms are not inclusive of all gender identities and that the health issues addressed here may be relevant to individuals across the gender spectrum.}

^{Cleveland Clinic Canada}

^{Manulife is proud to have Cleveland Clinic Canada on board as Medical Director for our Group Benefits operations. Cleveland Clinic Canada has a wealth of global healthcare expertise and shares our goal to help Canadians live longer, healthier, and better lives. Cleveland Clinic is a nonprofit organization that has been at the forefront of modern medicine since 1921. In recent years, Cleveland Clinic has worked with progressive companies in Canada and around the world to prioritize the health and well-being of their employees, customers, and communities}

^{Maven Clinic}

^{Maven is the world’s largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven’s award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs.}