Finding a Menopause Doctor

Remember, the information on my website, podcast, Instagram, and any other ways I communicate and/or produce content is educational information only and not medical advice. Always check with your qualified medical professional before making any changes to your treatment plan for endometriosis or any other health problems. See my full disclaimer here.

Your doctor should have knowledge and experience in hormones and HRT

Here’s what I’ve learned in the few years navigating my own menopause journey: Most gynecologists do not have sufficient information about menopause, especially not to guide a patient through through decisions regarding HRT. Many are not up to date on the latest information that has come out of reanalysis of WHI data and 20 more years of study since then. Just like with endometriosis, patients need to empower and inform themselves, to help them have informed consent and realize when they may need a new provider.

The Menopause Society (formerly known as the North American Menopause Society or NAMS) has a “find a provider” section. You can search by zip code, and it lists doctors who have passed a competency examination developed by NAMS and have been awarded the credential of Certified Menopause Practitioner. It lists gynecologists, endocrinologists, physician assistants, naturopaths, and other types of healthcare professionals. Of course, that doesn’t mean every doctor in their database can treat you for your specific case, so you still need to look into them as you would for any doctor, but it can be a good starting place. If a doctor doesn’t have the NAMS certification, it also doesn’t mean they aren’t qualified to help you. You may also want to be careful with private hormone clinics because some use unregulated hormones.

Ask your doctor questions to see their expertise and treatment approach

• What is your stance on HRT?
• What are the risks vs the benefits?
• Does HRT generally help with symptoms like mine?
• How long will I be on it?
• Do you use bioidentical or synthetic hormones?
• Will you test my hormones? If yes, how will you test them?
• How do you prescribe them? Will it be oral, a patch, a cream, etc?

Virtual Menopause Clinics

Some people are going to virtual clinics because they can’t find an in-person provider locally. Although I’ve never used these personally, a few I’ve heard recommended are:

• Evernow
• Midi
• Alloy

Like with any doctor you’d choose, make sure to look up costs, patient reviews, and other important information.

Hormone Testing

Is it necessary?

“It is not necessary to check blood, urine, or saliva hormone levels to find the right [HRT] dose. During reproductive life, estrogen levels vary throughout the menstrual cycle and during each day, so there is no perfect hormone level for any [person].” (Source: NAMs menonote on bioidentical hormone therapy.)

Usually HRT treatments are based on your symptoms, because treatment is prescribed to improve perimenopause or menopause symptoms, and not to aim for a certain level on blood tests. However, some doctors may do an initial blood test to see your levels. If after a few months on HRT it doesn’t seem like you are responding to it, they may check your levels again to gauge if you are absorbing the hormones you are taking and if you need to change the dose or delivery method. However, many doctors treat solely on symptoms and do not do any blood tests. 

There are different types of hormone testing

 The most common and reliable are blood tests, which are often covered by insurance.

“Salivary and urine hormone testing to determine dosing are unreliable and not recommended.” (Source: NAMS position statement)

The DUTCH test has gained popularity among naturopaths and functional medicine doctors. Not only is it not covered by most insurance and can cost $400 or more depending on the practitioner, but the criticisms on the DUTCH test are that it’s unnecessary and even that the info is clinically meaningless for guiding HRT. Most of the same info can be gathered from blood tests with an endocrinologist or gynecologist for a fraction of the price, and as mentioned above, most HRT treatments are based on your symptoms, not on your hormone levels. If you’re working with a doctor who wants you to get the DUTCH test, definitely read unbiased reviews on it before dropping a ton of money on the test and don’t be afraid to ask your doctor to explore using the blood testing options with you. If they won’t or can’t, this could be an indication that they are not fit to treat your hormones or that you may need to work with a different doctor for your HRT.

Here’s a helpful, independent review of the DUTCH test from Abby Langer, RD.