Too many women leave their GP appointment feeling dismissed, confused, or with a prescription for antidepressants when what they actually needed was a conversation about hormones. This is not always the GP's fault — menopause training in medical schools has historically been minimal, and a 10-minute appointment is rarely enough time to cover the complexity of perimenopause. But there are things you can do to make the conversation more productive.
Before Your Appointment
Track Your Symptoms
Come prepared with a written symptom log — even just two weeks of notes. Include: which symptoms you experience, how frequently, how severely (1–10), and whether they follow a pattern (worse before your period, worse at night, etc.). A GP who can see a clear pattern of symptoms is far more likely to take a hormonal explanation seriously. Our free Perimenopause Symptom Checker generates a printable report you can bring to your appointment.
Know What You Want to Discuss
Be specific about what you are asking for. 'I think I might be in perimenopause and I would like to discuss my options' is more effective than 'I have not been feeling well lately'. If you have done research and want to discuss hormone therapy specifically, say so.
The Conversation Script
💡 💬 Opening: 'I have been experiencing symptoms that I believe may be related to perimenopause — including [list your top 3 symptoms]. They have been affecting my [sleep/work/relationships/quality of life] for [timeframe]. I would like to discuss whether perimenopause is a likely explanation and what my treatment options are.'
If Your GP Suggests Blood Tests First
In women over 45, NICE guidelines (UK), the Menopause Society (US/Canada), and Jean Hailes (Australia) all recommend that perimenopause should be diagnosed based on symptoms, not blood tests. FSH levels fluctuate widely during perimenopause and a single 'normal' result does not rule it out. You can say: 'I understand that FSH levels can be unreliable during perimenopause — I would like to discuss a trial of treatment based on my symptoms.'
If Your GP Suggests Antidepressants
Antidepressants are sometimes appropriate for perimenopausal mood symptoms, but they should not be the default response when hormonal treatment has not been tried. You can say: 'Before trying antidepressants, I would like to explore whether my mood symptoms might be hormonal and whether hormone therapy might be more appropriate as a first step.'
If You Feel Dismissed
You are entitled to a second opinion. You can ask for a referral to a gynaecologist, a menopause specialist, or a GP with a special interest in women's health. In the UK, you can use the British Menopause Society directory. In Australia, Jean Hailes lists menopause-trained practitioners. In the US, the Menopause Society maintains a certified practitioner directory.
Questions to Ask Your Doctor
- 'Based on my symptoms, do you think perimenopause is a likely explanation?'
- 'What are my treatment options, including hormone therapy?'
- 'What are the risks and benefits of hormone therapy for someone in my situation?'
- 'If I try hormone therapy, how long before I would expect to notice a difference?'
- 'Are there any tests you recommend to rule out other causes?'
- 'Can you refer me to a menopause specialist if needed?'