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Key Takeaways

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Why do so many OBGYNs lack menopause expertise? Medical training prioritizes more life-threatening situations, which is why perimenopause symptoms affecting otherwise healthy women get minimal attention.

‍What went wrong with hormone therapy education? Generations of doctors were taught to fear and avoid hormone replacement therapy, even when it could help women.

‍How is the approach changing? New research and real-world experience are showing that personalized hormone therapy can be safe and transformative, when properly managed.

‍What does good menopause care look like? Doctors who listen, stay current with research, and treat perimenopause as an active transition (and not just something to push through).

‍The bottom line: Menopause care is finally changing: from "just deal with it" to actually helping women feel better and age confidently.

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Our First Introduction To Perimenopause Care

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When we graduated from OBGYN residency, we received a basic introduction to menopausal care… practically nothing at all. 

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Imagine spending four years learning everything you can about women's health while working 24-hour shifts, sometimes stretching to 30 hours, plus time spent reviewing patients before handoff. Our work weeks regularly exceeded 80 hours. We said yes to every learning experience we could find.

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If you've watched The Pitt on HBO Max, you get a glimpse into how one specialty—emergency medicine—demands everything from its residents. We were fresh out of school, responsible for keeping patients safe on the operating table, delivering babies, and managing patients in both emergency and routine clinic visits. We were cramming in as much information as humanly possible. 

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And perimenopause? Menopause care? Managing otherwise healthy women whose symptoms weren't immediately life-threatening? These issues landed at the very bottom of our priority list.

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The Perimenopause Education Gap in Medical Training

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If you were lucky, you got a breathing room month and happened to study under a truly excellent menopause educator who taught you everything they could. In my residency, I only learned the basics of the WHI study—knowing to prescribe oral estradiol tablets with oral progesterone. 

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I'd read a research paper here and there, but hormone replacement therapy (HRT) was still considered one of the more "dangerous" and "risky" treatments to prescribe during my training years.

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This wasn't coincidental. Years of post-WHI teaching had created an entire culture of fear that affected generations of women. If a patient showed even a hint of a health concern, we steered them away from HRT entirely.

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My Personal Perimenopause Wake-Up Call

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Here's what I'm not proud to admit: for the first years of my practice, I was one of those doctors who said: "Exercise more, sleep more. Oh, you're still having periods and your labs are normal? You're fine."

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But even following my own advice, I kept thinking: I'm still losing my mind. I keep gaining weight. I'm struggling to stay awake after lunch. IT’S NOT WORKING. 

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That's when the real reading and research began. I started changing things. I tried different things, and told patients: “I think this will work better”, “Please follow-up with me because I need to be on this journey with you”.

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And with perfect timing, new research emerged reframing different corners of the WHI data. I would continue to tell women, "Your stroke risk is higher with your elevated blood pressure, BUT there are benefits for heart health here, and it is about timing and dosage”.  

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When a patient said, "I literally cannot continue living like this", I understood our mission: we can make women feel better and mitigate the side effects and risks. 

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A New Era of Perimenopause and Menopause Care

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This is the beginning of a new wave in how we understand perimenopause—not as an affliction to endure, but as a transition to the best years of living ahead. We're going to age differently than our mothers did. And I, for one, am completely here for it.

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The women who come to our perimenopause and menopause clinic leave becoming a well-informed patient. They deserve doctors who understand that managing menopause symptoms isn't just about quality of life—it's about creating the foundation for healthy aging.

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Book a 15-min FREE virtual consultation with us to see if we’re the right fit for your menopause care.

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And don’t forget to visit our Services page to explore our perimenopause and menopause care packages!

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