What Doctor Should You See for Perimenopause Symptoms?

If your hormones are fluctuating and you have no desire to tough it out — or you already sought treatment but didn’t feel heard by your healthcare provider — here’s how and where to find a doctor to help you feel more like yourself again.

If you’re not sure you need help managing your symptoms, consider this: The consequences of not getting care can be significant, says Mary Rosser, MD, PhD, an obstetrician-gynecologist, menopause expert, and the director of Integrated Women's Health at Columbia University’s Irving Medical Center in New York City.

“Vasomotor symptoms (hot flashes and night sweats) can persist for more than a decade, and genitourinary symptoms are progressive without treatment,” says Dr. Rosser. “Additionally, the menopausal transition is associated with higher rates of depression, sleep disturbances, and metabolic changes that increase cardiovascular risk.”

Rosser says women experiencing significant depressive symptoms should also be carefully assessed.

There are several types of professionals who are able to provide care for the menopausal transition. But healthcare access where you live will dictate how many practitioners are taking appointments in your area, as well as how long it may take to get an appointment, says Tangela Anderson Tull, MD, a menopause specialist with Hoffman and Associates, an all-female obstetrics and gynecology practice affiliated with Mercy Medical Center in Baltimore.

• Gynecologist Specialists in the female reproductive system, an ob-gyn is a medical doctor who treats patients from puberty through menopause and beyond.

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• Primary Care Physician These doctors are specialists in family medicine, general internal medicine, or general pediatrics. They provide comprehensive, ongoing care throughout all stages of a patient’s life.

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• Nurse Practitioner (NP) NPs must complete a master's or doctoral degree program and have advanced clinical training beyond what they received when they earned a registered nurse (RN) license. NPs can prescribe medications and other treatments, and their emphasis is on the health and well-being of the whole patient and on health education counseling.

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• Physician Assistant (PA) PAs complete a master's program before they start working alongside doctors, doing much of the same work. They can work in a specific area of medicine, such as gynecology, or they can provide primary care.

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• Midwife Primarily an expert in caring for women throughout pregnancy, birth, and the postpartum period, midwives have a college degree in nursing and a master’s degree in nurse-midwifery. They may also be trained to offer services to women through all stages of life, including menopause.

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The Menopause Society also has a menopause practitioner directory to connect women in this life stage with skilled providers.

Rosser says that a provider who understands the complexity of perimenopause can offer individualized treatment approaches that address not just hot flashes, but the full spectrum of symptoms affecting mood, sleep, sexual function, bone health, and overall well-being.

But if you can’t locate a certified practitioner in your area, that doesn’t mean you can’t get quality care. Dr. Anderson Tull says that while many ob-gyns and other women’s health doctors haven’t done the specialized training, “there are so many primary care doctors who are doing a good job at treating perimenopausal patients.”

At the end of the day, “it’s important to find a provider who hears you,” says Anderson Tull. “Maybe you’ve been dismissed before or told you just need more sleep. Keep looking for the right fit until you find someone who can get you back to where you were before, or at least functional.”

Because the menopausal transition can cause a wide variety of symptoms, it may be necessary to see experts in other medical specialities for effective treatment. Those may include any of the following.

• Endocrinologist Rosser says specialists in hormone imbalances help address osteoporosis and bone health concerns, as those accelerate after menopause. The Endocrine Society also provides menopause resources and offers a doctor finder.
• Dermatologist A lack of steady estrogen can bring changes to your hair and your skin, and a dermatologist is trained to address those very issues.

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• Cardiologist You may need to see this heart specialist to manage cardiovascular risks, as changes in estrogen levels impact heart health and cholesterol levels.

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   “Women with high cardiovåscular risk who are considering menopausal hormone therapy should be referred to cardiovascular specialists, particularly those with expertise in women’s health,” says Rosser.
• Mental Health Professionals The hormones that affect your periods have an impact on your emotions too. Depression and anxiety are both common in perimenopausal women, and receiving counseling or taking medications may help.

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• Ob-gyns, primary care physicians, nurse practitioners, physician assistants, and midwives are all trained to manage perimenopause and can evaluate symptoms, discuss treatment options, and rule out other conditions.
• Finding the right provider matters. If you feel dismissed by your healthcare provider, seek a clinician experienced in menopause care and rule out other possible conditions. Certified menopause specialists have additional training in midlife hormone health.
• Care could involve different specialists depending on your symptoms. You may be referred to an endocrinologist, cardiologist, dermatologist, or mental health professional.