How to find a hormone health specialist for perimenopause
Uh hello? Is anyone out there?
Does it feel like all of a sudden, you’ve reached the limit of what your primary care doctor or OB/GYN can provide? Are you leaving doctor's appointments with more questions than answers?
You might have arrived at what I’m calling the ‘midlife care cliff’. It’s the point where most women will benefit greatly from seeing someone who specializes in hormone health and treating hormone-related symptoms.
Unfortunately, most of us fall into one or all of these groups:
We don’t recognize that our various symptoms could all be hormone related.
We don’t know where to find clinicians who are hormone health specialists.
We have been dismissed or unintentionally misled by doctors who aren’t knowledgeable in hormone health themselves.
We have run out of time, money, or energy to keep seeking help.
Ideally, we would all seamlessly graduate to a “PERI/GYN” or “MENO/GYN” except for that isn’t really a thing (at least not yet).
We have a significant shortage of peri/menopause healthcare clinicians.
An OB-GYN typically sees 35 patients a day. They are living in a system that forces them to be incredibly efficient. For a 9-hour workday, that’s 3.88 patients per hour. 15 minutes per patient.
15 minutes. That’s the time you have to open up to someone about your worsening bloating and cramps, those weird heart palpitations you noticed, and your hunch that your blurred vision and headaches might be hormone related. It’s woefully inadequate.
Furthermore, 80% of OB-GYNs have no training or expertise in the menopause transition. They are beyond busy and are excellent at helping us deliver healthy babies as well as screen for and detect cancer. But they just aren’t set up to treat the menopause transition in a way that maximizes our quality of life.
The North American Menopause Society (NAMS) has a competency exam for licensed clinicians to ensure high-quality care for women during and after menopause. Those who pass the exam receive the credential of NAMS Certified Menopause Practitioner (NCMP), which is valid for three years.
Let’s take a look at some more numbers:
Thirty-one million US women are between the ages of 35 and 50 - when perimenopause and hormone imbalance symptoms are the worst.
There are currently only 1,300 menopause certified practitioners (NCMP) in North America to treat the fastest growing segment of our population (source).
The ideal average patient load for a primary care provider has been estimated at 1,000 (panel sizes may more realistically be at 1,200 - 1,900 today).
This means that those NCMP practitioners would need to cover over 20,000 patients each to cover the perimenopausal population. This is impossible by several orders of magnitude considering that 85% of us have disruptive symptoms.
There is a huge gap. A care cliff indeed.
So how do you go about finding someone who can help?
How to find someone trained in hormone health and the perimenopause > menopause transition
Starting here will be a huge time saver for anyone living in the US.
Message your doctor for a referral to a hormone health or peri/menopause specialist in your area. Note: my OBGYN recommended a specialist in Seattle who was booking out one year in advance, which was not an option for me.
Search the North American Menopause Society (NAMS) database for a certified clinician in your area.
Check out this collection of individual submissions from women worldwide who have had exceptional experiences. Dr. Mary Claire Haver is one of my go-to experts in this space. The resources available on The 'Pause Life have been instrumental in my journey.
Check out the virtual care clinics listed on my Peri/Menopause Solutions Database that are serving patients nationwide.
Keyword search on Zocdoc for ‘perimenopause’ or ‘menopause’ and see what up in your area. I was underwhelmed, but maybe there’s a gem in there for you.
Ask your friend network who they are seeing and what their experience has been finding good midlife care.
When I searched the NAMS database for clinicians within a 50-mile radius of Seattle I was provided with a list of 56. The most common credentials included:
MD (Doctor of Medicine)
MSCP (Master of Science in Clinical Psychology)
ARNP (Advanced Registered Nurse Practitioner)
CNM (Certified Nurse Midwife)
ND (Naturopathic Doctor)
These clinicians can provide specialty services to help in this phase of life and add to the care you are receiving from your primary doctor, OB/GYN and any other specialists you see. Make sure to do your homework, vet their approach, and confirm they are willing to order labs that will help to build a care plan for you BEFORE your visit. (more on labs later)
What approach to care is best for you?
I’ve found this really depends on the resources you have available to invest in your health.
Are you a “whatever it takes to feel like me again” baddie?
For maximum impact (but what also comes with maximum effort) seek out a functional, integrated or root cause clinician. They will start with labs, and then develop a precision care plan for you to follow. This will likely include lifestyle changes (diet, exercise, sleep, stress management) and some supplements.
Check out the database for offers in this space including Parsley, Midi, Mohana, and Femgevity.
Are you feeling like “I’m drowning and have no time for this BS”?
I see you. I’ve been there. If you are not currently on hormonal birth control or hormone replacement therapy, I think this is the closest thing we have right now to an ‘easy button’ for symptom management (if you are a candidate).
One of the physicians I follow in this space referred to hormones as a life jacket. They won’t solve everything, but they can really help keep your head above water. There are also many cost-effective options available for this course of treatment.
If you are in this group, you can try going direct to the virtual care clinics or pharmacies I have listed in the database including Gennev, Evernow, and Alloy.
Did you find this helpful? Do you have anything to share based on your own experience or expertise? DM me or leave a comment to share with the community.