4 weeks before
1. Symptom diary
For 4 consecutive weeks, record daily:
- Menstrual cycle: start date, duration, intensity, skips
- Hot flushes: count/day, intensity (1-10), interference with sleep/activities
- Sleep: bedtime, time to fall asleep, wakings, quality (1-10)
- Mood: short notes — anxiety, irritability, sadness, brain fog
- Urogenital: dryness, pain during sex, urinary urgency, UTIs
- Other: joint pain, palpitations, fatigue, weight changes
2. Gather your history
- Recent blood/urine tests (last 12 months)
- Imaging (mammogram, ultrasound, bone density)
- Surgeries and dates
- Current medication and supplements
- Family history: mother/sisters' menopause age, relevant cancers
10 key questions to ask
- "What stage of menopause am I in?" — Ask for STRAW+10 classification.
- "Am I a candidate for hormone therapy?" — Discuss absolute risks for your case.
- "What non-hormonal options exist for me?"
- "I have genitourinary symptoms. Are there local treatments I can start?"
- "What tests should I do regularly?"
- "When should I have a bone density scan (DEXA)?"
- "What warning signs should I monitor?"
- "Should we see a menopause-certified specialist?"
- "When do we follow up?"
- "Can I get a second opinion without affecting our relationship?"
What NOT to accept
- "It's just your age, it'll pass" — partly true. Symptoms have treatment.
- "Hormones are dangerous, I don't recommend them" without discussing your individual risk
- Compounded bioidentical hormone cocktails without regulatory evidence
- 5-minute dismissal without listening to your diary or questions
- "There's nothing to be done" — there always is. Get another opinion.
Your rights
- Time — a serious menopause consultation takes ≥30 minutes
- Clear information — risks and benefits in absolute numbers
- Shared decision-making — you decide, with information
- Second opinion — without guilt, without notice
- Access to a differentiated specialist
- Re-evaluation — any treatment can be adjusted, paused or changed