As a woman in midlife prepares for her annual physical she asks Jessica, what are the important perimenopausal symptoms to discuss with doctors and how do you know when to have that conversation? Jessica lays out many of the most prominent perimenopausal symptoms and then offers an approach to use with doctors.
Ask Jessica is an advice column for women in midlife. We cover all things related to midlife from changing bodies to career transitions to parenting teens to sandwich generation challenges to shifts in marital or life partnerships and everything in between. My hope is that in sharing these questions and answers I can women as we face the midlife journey together. Got a question or challenge you would like me to address? Fill out this form to submit your issue! Want to see the answers to other questions, check out our archive here.
What are the important perimenopausal symptoms to discuss with doctors?
HEY JESSICA: I have my annual physical scheduled for a few weeks from now and while I don’t think my perimenopausal symptoms are too terrible, I am aware that my body is changing, so I feel like I should talk to her about it, but don’t really know what to focus on since I’m not struggling thus far. What are the important perimenopausal symptoms to discuss with doctors? Or should I just wait until symptoms are making me miserable to talk to her about these issues ? ~Feeling Lost
DEAR FEELING LOST: First, I want to commend you on being proactive about this. Doctors tend to be so busy that it doesn’t always occur to them to ask about things that you aren’t bringing up as specific complaints—so thinking about engaging with your doctor on these issues is awesome! Second, even if your symptoms aren’t “too terrible,” it does sound like you are starting to experience symptoms and that is important information for your doctor to have. And, who knows, there may even be things your doctor can recommend that might help with whatever you are experiencing, so discussing those symptoms with her would be a good idea.
Next, I thought it might be helpful to share a list of some common perimenopausal symptoms that you should keep in mind as you move forward. This is by no means an exhaustive list, but it might help you to get an idea of what are the important perimenopausal symptoms to discuss with doctors. Common perimenopausal symptoms include:
- Irregular periods (they can come irregularly, but can also be lighter or heavier in flow or shorter or longer in duration)
- Increased cramping
- Breast tenderness
- Vaginal dryness
- Increased need to pee
- Pain/discomfort during sex
- Decreased sexual desire
- Hot flashes
- Night sweats
- Difficulty sleeping
- Brain fog
- Trouble with memory
- Mood changes (increased anxiety or depression, increased anger/frustration)
In terms of how to approach the conversation with your doctor, I think I would start by just noting that now that you are entering the time of life when perimenopause happens, you thought it would be helpful to have a conversation about what to expect. I would then share whatever symptoms you have been experiencing, even if mild. At the very least, this will give your doctor a baseline to work from should your symptoms intensify.
After that, I think I would ask if there are things that your doctor thinks you should look out for, especially if your medical history might make certain symptoms more of an issue. For example, if you have experienced depression or anxiety in the past, mood changes during this transitional time might be something to keep a closer eye on.
Then, I’d ask about any symptoms that you know were an issue for your female family members (if they ever shared them with you). For instance, if osteoporosis or heart problems run in your family, this would be a good thing for your doctor to know so that they can begin to proactively screen you for such issues.
More than anything, though, I think your main goal should be to get the conversation started. Perimenopause is a long process (7-10 years) during which time a lot will change, so establishing a baseline and showing that this is a priority for you is a great place to start!