Why Don’t Doctors Take Women in Menopause Seriously? (Gaslighting, Dismissal & What To Do About It)

There's an explanation for why so many women experience gaslighting and dismissal from medical providers when they seek out care for menopause related symptoms. Fortunately, that climate is starting to change. But I'm here to help you understand it, prepare for it, and advocate for yourself.

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Transcript

Tonight's episode is "Why Don't Doctors Take Us Seriously?" 

Alright, raise your hand if you've ever been told "it's just stress" while you are literally falling apart inside. Let's talk about the gaslighting and what we need to do about it. 

Welcome my friends to the Unmute Your Midlife podcast, where we take you from
foggy and forgotten to focused and lit up. I'm Joyce, your nurse-turned-midlife-
resurrection strategist and the cheerleader in your pocket, and I'm here to remind you that your next season in life is your power era. 

So let's set the stage because this one is personal and systemic. Probably two to three years ago I was at my doctor's office for my annual primary care visit. My fasting blood sugar was over a hundred. My A1C was barely acceptable. I had gained 40 pounds. Everything hurt. That was probably my biggest complaint: was that I couldn't sleep because I would sweat through the night, and I would wake up to pee all the time, and I would toss and turn because my hips hurt so bad. And then when I did wake up in the morning, it was so hard to get out of bed because everything hurt. My feet hurt. Like halfway through the day (well sometimes it didn't even make it to halfway through the day), but at some point during the day, my second toe in each foot would start to hurt, and then my toes would get like these cramps, which I now know it was from low magnesium, but like my feet would like get these weird cramps and kind of like get stuck in strange positions like a half flexed position. Or, you know, two of the toes are pointed out sideways and I mean, what do you do? It's like when your foot falls asleep and you got to get up and jump up and down on it! And I would try that and I'd be walking up and down the hallway trying to get my feet to the straighten out. Tons of pain! Anyway, so I asked my doctor. "Well, what can I do?" Like I'm not asking for for pain medicine I'm saying what do I do? And she said, "nothing this is just part of aging. Are you taking a leave twice a day?" Okay, that is not an answer. You can't take Aleve twice a day every day for your whole life. I'm pretty sure that would tear up your stomach. maybe I'm wrong?! I mean I'm not a doctor, but I'm a nurse! But her answer to anything I would ask about was "no." No, I'm not going to run more labs.  No, we don't need to check you for rheumatoid arthritis because your titers were negative three years ago. No, our insurance doesn't cover GLP -1, so I can't prescribe them 'cause how are you gonna pay for them? 

And I'm not the only person who's experienced this. My best friend - who's very healthy - I mean, she runs marathons, she runs ultra marathons,
she lifts weights, she coaches fitness stuff, she coaches runners, and she
coaches college athletes. And she's very mindful of what she eats. She started having this horrible anxiety attacks where she sometimes didn't even want to leave the house or talk to people. And they wanted to put her on an antidepressant because in their mind, since she was still having sporadic periods, well, it's not menopause. Hello! There's this period of time before you hit actual menopause called perimenopause and that is sometimes worse than menopause. 

There's a systemic problem where healthcare providers don't understand how to treat women who are in menopause, and to be fair, it's not entirely their fault. The training that they go through in med school lacks some serious menopause curriculum. A Yale University review of insurance claims from more than 500 ,000 women in various stages of menopause showed them that while 60% of women with significant menopausal symptoms sought out medical attention,
nearly three quarters of them were sent away without treatment because their providers didn't know how to treat them. While they're in med school they get maybe one class, one lecture each year and then when they are least on the world, to practice medicine, they feel ill-equipped to take care of the issues that a menopausal woman is having. There's actually no sub-specialty in obstetric care that fully focuses on perimenopause and menopause. The residents that go through those programs receive whatever their institution deems appropriate for menopause education. 

Now, I will say that is changing, but we're still experiencing providers who want to
default to anti-depressants or birth control. That's what my OB /GYN gave me. She
gave me a progesterone-only birth control to take for about five years to help with
my symptoms, to try and help with the night sweats and the hot flashes. They only
get to spend like 20 minutes with you at your appointment. It's not enough time to
educate you. So, it's up to us to seek out the education on our own, and that's fair. But we can start expecting them to get the continuing education they need to make a proper diagnosis or to offer effective treatments that actually work and make a difference. Because let's be honest, antidepressants, while sometimes
people do need them, they are not a substitute for estrogen. and birth control also
does not equate to hormone replacement therapy. Birth control is meant to prevent conception. 

So as you may have already experienced, there is an emotional toll that
accompanies being unheard. For me, it made me feel invalidated. But as a healthcare worker myself, it made me feel ashamed for wasting their time because they send you away telling you, nothing's wrong with you, or there's nothing I can do for you, and so you feel bad that you even scheduled the appointment and bothered to unload on them. Other people, you might feel defective because you're not magically adapting to the changes of life, or you could start to feel some doubt about your own personal strength or sanity, because after all, they said nothing was wrong with you. Some of the things that we tend to hear when we hit this phase of life is, this is just normal aging. You're probably having a lot of stress. Maybe you just need to lose weight. Have you tried journaling? And then of course when we complain about like libido or some of the dryness in our nether regions, we hear, well maybe you just need some gel and some new lingerie. Right...

Fortunately for all of us, there seems to be a renaissance of sorts happening in
the arena of menopause treatment and, I, for one, I'm here for it. Whether it's
through innovative research or tech breakthroughs, there are some highly visible
advocates stepping into the void to cast some light on the areas where menopause impacts a woman's body, which includes her brain, her heart,
her bones and her VaJJ. It is not just, as I've said before, about sex hormones.
Estrogen is such a protective hormone. It protects our heart, it protects our brain, it helps us to prevent Alzheimer's or dementia later in life. When we lose that estrogen, that's when the brain fog starts setting in, that's when we start moving towards dementia. There are way more women with dementia than men after a certain age. 

So some of these voices are Dr. Sharon Malone, Dr. Mary Claire Haver, Dr. Vonda Wright, the newscaster, Tamsen Fidel, Dr. Kelly Casperson, who was just before Congress or some special hearing, some special session, trying to help plead our case for testosterone because there is no accepted dosage of testosterone for women. We don't need a lot. We need a miniscule. But if it's not an approved use by the FDA, then chances are your insurance won't pay for it. Chances are the average health care provider is not going to prescribe it. And then you're going to have to go find someone who specializes in menopause. But there's another lady, a social worker named Donna Klassen, who had a horrible period of menopause experience and so she started a non-profit and a podcast and a website and it's called Let's Talk Menopause .org. There is the Menopause Society, it's also a non -profit and they have a website called MenopauseSociety .org. That's a good place to go to look for providers who are educated in menopause care. But I'm jumping ahead of myself. 

So today I wanna talk about how to self advocate when you're in that exam room with your doctor. First of all, you wanna come prepared. I recommend you bring a list of questions. Don't make your appointment for tomorrow if you're wanting to go see them. Give yourself some leeway time, make your appointment for a week or two out If you can and honestly if you're gonna go see a provider chances are you might be like on a three-month wait list. I know for my own provider who I've been seeing for years (my GYN), you know, I'm supposed to see her once a year, but she's already booking 15 months out! Like at my last checkup they said, "I know you're supposed to come back in a year, but her earliest appointment is in 15 months." Oh Okay, sure. (laughing) So come prepared. Bring a list of questions. And when you go to the appointment, write down the answers that you get. Be ready to share what you've tried, whether it's supplements, whether it's, you know, the snake oil from a TikTok website that you found, whether it's a medication that another provider prescribed, whether it's all homeopathic stuff or naturopathic. If it's just mindset, if it's just changing your diet or changing your exercise plan. Whatever it is that you've done to try and help yourself to cope with your changes and your symptoms, write that down because you need to share that with them. So they know what you've already tried and how effective was it. (They'll want to know that too.) You're going to want to know what bothers you most because they're probably not going to be able to fix everything on your list. So pick your top one, two, maybe three things that you're like, if "I could just get relief for these things, I think I could keep my sanity." 

And if you've been doing some research and you know of some treatments that you wanna try, write those down too on your little paper that you're gonna take in. Because chances are you're gonna get white coat syndrome. Couple things happen when you get white coat syndrome. I mean, think about it, You're probably sitting there in a gown, may or may not be cold in the room, so you get distracted and then you can't think straight. Or hello, you're in perimenopause, you get brain fog! So you can't always remember all the things you want to talk about. This is why I say write it down and take the paper with you. 

Another thing that could be really helpful for you is tracking your symptoms. When you can go in and show them on paper, I've been tracking my symptoms for two weeks, two months, or two years, whatever it is. It makes you sound more, let's say, clinical. It helps them to see that you're not just pulling stuff out of thin air. There are plenty of symptom trackers out there. I actually have some free ones at my website that you can download. Or if you want me to just send them to you, you can send me a message and I'll email them. 

Let me just encourage you right now. It is okay to fire your doctor. If they don't have the knowledge they need to treat you for this phase of life, even if they've been the best doctor up until now, it's okay to happily part company. You don't have to hate on them. You know, cancel any upcoming appointments and then go find your new doctor. You don't even have to tell them that you're firing them if you don't want to. You can be completely passive about it. You don't have to be aggressive. You don't have to be overtly verbal about it. You don't have to send them a letter saying, "I'm not coming anymore." You just quit going. And then when you go to your new doctor, they'll send for your records for you. There
are supportive options out there. There are midlife or functional health providers.
There's peer support. There's nurse based education like what I offer. There's online websites, there's telehealth. And like I said, you can go to that menopausesociety.org. You can put in your zip code. I've used it to help my friend find a provider for herself. And then she likes that provider so much that she's like, "I need to find one for my mom." So we put in her mom's zip code and we found one for her mom. The main thing I want to encourage you to ask yourself is what symptom have I downplayed that deserves attention. And make sure you write that down. Bring it up at your next appointment.

One of the things I offer my clients is private coaching. I have a six -week
program where you get private coaching. You get supplements, you get meal plans, weekly one -on -one coaching sessions, and a guided plan to help get you back to your best self. It's a very transformative program. Personally, I think it's an amazing program. It's basically everything that I did to help get myself back to feeling like a new woman. Now, if you aren't ready for a full transformation or you're kind of like a dip your toe in the water kind of person, there is a do -it -yourself version where I have an online course that you can enroll
in and you watch the videos at your own pace. You still get access to most of the
same information, but I don't print it for you. You have to print it yourself. And
if you decide after you get halfway through that you're like, "No, I want the one -on
-one coaching," anything you've invested up to that point, you get it discounted off of the private coaching. 

If you're not ready for either one of those, there's plenty of free resources on my website, and there's these podcasts, and there's my blog that has articles once a week. Because my goal is to help women feel their best. My goal is to help every perimenopausal or menopausal woman feel seen and heard. I found a plan that worked well and I am sticking to it and I am not just here to cope I'm here to create. I'm not just gonna coast through this back half of life. I'm gonna thrive through it. And I just think that every woman should be able to say the same thing. There's so much opportunity. There's so much joy. I think it's funny that I never liked my name growing up. I thought it was a name for an older woman. Probably because I was named after my great grandmother. But now I'm excited about it because I'm like if it suits me perfect I'm in a very joyful phase of life and my name is Joyce and so like we're just gonna rejoice Okay, and that's might sound silly and corny, but I think the whole world could use a little more joy these days a little more Love and understanding from each other and when your hormones are going crazy Sometimes that's a little bit hard to do, but trust me there is a way and we can find it together. And yes I was born in the 70s, but no, I am not a hippie. I'm just proof that healing yourself and building a business can happen at the same time, and that you're never too old to learn new tricks.

All right my friend that is today's dose of mid -life truth. Remember you are not
foggy, forgotten, or finished, you are just getting lit up for your next season. And
if today's episode hit home, don't keep it to yourself. Share it with a sister who
needs some unmuting in her own midlife. If you want to go deeper and move from
just listening to actually living out your own transformation, send me a message. But until next time, keep unmuting, keep rising, and remember, your midlife resurrection starts right now.