Making Menopause Health Decisions

By: Red Hot Mamas

Published: June 25, 2010

I remember a time, back in the day, when going to the doctor for a check-up was a very quick, easy visit usually ending with a pat on the head and a lollipop. If they wanted me to take a daily vitamin, I did it. If they wanted me to come back in two weeks, I made the trip.

I’m older now and although it is still a quick visit and even though I’m healthy, it’s not that simple. Over the years, my personal involvement in my own health care decisions has completely evolved. These days, I am more assertive, more attentive, more inquisitive and much more involved. I go to the doctor bearing a list of questions and try to team up with my doctor rather than have him make all the decisions for me.

These days, being a wise health consumer involves more than committing to the old, “An apple a day” adage. In general, people who are more active participants in their own care have better outcomes than those who are not actively engaged. At menopause, you may face your own set of medical choices. The experience is different for everyone, including the actual decision-making process. At your next doctor’s appointment, use the following guide as a starting-point for conversation.

1. Describe the Problem- What specific problems are you experiencing? Be prepared to accurately describe the symptoms you are experiencing.

• Have you had any other symptoms or signs lately (i.e., fever, blood in urine, shortness of breath, anxiety, insomnia, etc.)?
• Before your appointment, take the Free Menopause Symptom Assessment test . Share your results with your doctor.
• Write down the frequency and time of day you experience symptoms.
• Is there anything that triggers your symptoms?

You will most likely be asked to give information about your health including:

• Your medical history and your family’s
• Allergies you have
• Medications you currently take
• Your daily habits
• Your work
• Stresses/pressures you are under

2. Ask for a Diagnosis- In general, your doctor or health care provider can make a diagnosis for menopause based on the symptoms you are experiencing, physical signs of symptoms and other exams/tests. There’s actually not a single test that will predict or confirm menopause but blood and urine tests are available that measure hormone levels. From these tests, doctors can determine if your symptoms are part of menopause. In general, the lab tests doctors use look for low estrogen levels in the bloodstream and high levels of follicle-stimulating hormone (FSH).

• Ask your doctor to explain test results and the diagnosis in detail.
• Ask how accurate and reliable the test is.
• Ask if the diagnosis increases your risk of any other problems. The most common long-term effects of menopause are increased risk for osteoporosis and increased risk for heart disease. Ask if there are ways to prevent them.
• Ask your doctor how certain he/she is about the diagnosis. Are there other symptoms to look for that would help confirm menopause?
• Ask what books, pamphlets and computer websites they recommend for learning more about menopause.

3. Find Out About Treatment- If your symptoms are severe enough to get in the way of everyday life, explore your treatment options. Start with simple lifestyle modifications . You’ll be surprised to see how far these small adjustments can go. If a few weeks have gone by and your symptoms are still as intense or worse, call your doctor to discuss a different plan. The path on the road of menopause is a personalized travel experience. Menopause treatment options are based on your health history, your family’s, your personal philosophy, your daily habits, cost, etc. Keep these key questions in mind when discussing treatment options with your doctor:

• What sort of treatment do they recommend? Write down the name and frequency or dose of treatment.
• How does the treatment work?
• Is the treatment expensive?
• When, how often and for how long should you use it? When should you start treatment?
• Is this therapy or treatment okay to use with other medications you take?
• Do you take or use the treatment with or without food? Is there anything you should or shouldn’t eat? Can you have alcohol? Quite often, alcohol can exacerbate symptoms of menopause.
• Ask about other options. The more you know, the better.
• And remember, if you are considering hormone therapy as an option, you want to take the lowest dose for the shortest duration possible.

4. Ask About Benefits and Risks- Benefits are the positive effects you expect from a treatment. Risks are outcomes that we’re not looking for. They can complicate the treatment in many ways and can develop into serious unwanted side effects. Certain benefits and risks are associated with any treatment. Prior to starting any treatment, you and your doctor need to weigh all risks and benefits. I found an audio podcast from the U.S. Department of Health and Human Services that is a wonderful resource for explaining exactly what benefits and risks are in more detail.

• Simplify the process of keeping track of them by creating a list with your doctor. Take a sheet of paper. Draw a line down the center. List the risks on one side, the benefits on the other. Use a scale of 1 to 5 (1, not so important; 5, very important) to weigh each item. Add up the columns to see which one has the higher score.
• Are there any side effects of the treatment? Are the side effects manageable?
• Is there anything that may heighten or worsen unwanted risks of the treatment?

5. Find Out Success Rates- In order to make an informed decision on your treatment option, it is important to have scientific evidence. Success rates determine how often a treatment works compared to how many times it is done. For example, if a treatment or surgery has been done 100 times and was successful 80 times, it has a success rate of 80%. The more frequent a procedure or treatment is done, the better. A success rate does not mean that much when it is based on only 5 cases. Your doctor, the internet and/or a medical librarian are all good sources for this information.

• Stay up to date on the latest menopause news
• Pay attention to new, developing therapeutic options and clinical trials
• Garner as much information as possible to bring to your doctor

6. Make a Decision- Tell your doctor if you feel rushed or uncomfortable when you discuss your decision with them. You may discover that it will require several attempts to find a regimen that works for you. It is normal for women to try a few before they find one that is right for them. What works for your sister or your friend may not necessarily work for you. The more information you gather and the more engaged you are, the better. Organizing and managing your options will help you make the best menopause health decisions. Remember, your doctor and you share the common goal of finding the best, most effective treatment option for YOU.

References:

Making Medical Decisions: What You Need to Know, 2006, 7 th ed., American Institute of Preventative Medicine; Farmington Hills, Michigan, 2pp.

“Weighing the Benefits and Risks of a Medication or Treatment”, U.S. Department of Health & Human Services; Audio Podcast 10/11/06; 0:08:58:436.