Talking to Your GP About Perimenopause: What to Say and How to Prepare
Many women leave GP appointments feeling unheard about perimenopause. Learn how to prepare, what to say, and how to advocate for yourself effectively.
Why So Many Women Leave the GP Feeling Dismissed
Countless women have sat in a GP's office describing fatigue, sleep problems, irregular periods, and mood changes, only to be told it is stress, told to exercise more, or offered antidepressants with no mention of hormones. This is a well-documented problem. Perimenopause is significantly under-recognised in general practice, and many GPs received limited training on menopause during their medical education. This does not mean your GP is incompetent, but it does mean you may need to be more direct and more prepared than you might expect. Coming to the appointment with specific information and a clear sense of what you are asking for will give you a significantly better chance of a productive outcome.
What to Bring to the Appointment
The most useful thing you can bring to a GP appointment about perimenopause is a symptom log covering at least two to three months. This should include your cycle dates and flow levels, as well as any other symptoms you have been experiencing: sleep disruption, mood changes, hot flushes, brain fog, joint pain, or anything else that has been affecting your daily life. Writing down how symptoms are affecting your functioning is also valuable. Not just 'I feel tired' but 'I have been waking at 3am three to four nights a week and cannot get back to sleep, which means I am struggling to concentrate at work.' Specific, concrete descriptions are much harder to wave away than vague complaints. Bring a list of your current medications and any supplements you are taking, as these are relevant to treatment decisions.
How to Open the Conversation
Starting the conversation clearly and directly saves time. You do not need to build up to the topic gradually. A straightforward opening works well: 'I think I may be in perimenopause and I would like to talk about my symptoms and what options are available to me.' If your GP seems uncertain or redirects to other explanations, you can be clear that you would like perimenopause specifically to be considered before other causes are explored. Mentioning your age (if you are in your 40s), the fact that your periods have changed, and that you are experiencing multiple symptoms simultaneously is important context. Some women find it helpful to say explicitly that they have done research on perimenopause and the symptoms match their experience, which signals that you are not looking for a general check-up but a specific conversation.
Understanding What a GP Can and Cannot Do
Your GP can assess your symptoms, discuss whether they are consistent with perimenopause, and if appropriate, prescribe HRT or refer you for further investigation. They can run blood tests to check thyroid function, anaemia, and other conditions that can cause similar symptoms, though it is worth knowing that FSH tests are not reliable for diagnosing perimenopause because they fluctuate too much during this transition. In the UK, NICE guidelines state that perimenopause should be diagnosed based on symptoms in women over 45 without the need for hormone testing. If your GP insists a blood test is needed to diagnose perimenopause in someone over 45, you are within your rights to mention this guideline. If you feel your concerns are not being taken seriously, asking for a second opinion or a referral to a menopause specialist is a reasonable and acceptable thing to request.
What You Can Ask For
At a perimenopause appointment, it is entirely appropriate to ask for: an explanation of what treatment options are available to you, including HRT, non-hormonal medications, and lifestyle-based approaches; a referral to a menopause clinic or specialist if your symptoms are complex or you have conditions that make treatment decisions more complicated; investigation of any symptoms that might need ruling out (such as heavy bleeding, which warrants an ultrasound); and information about contraception, since pregnancy is possible in perimenopause until menopause is confirmed. You can also ask your GP to check whether your practice has a GP with a special interest in menopause, as this person will typically have more up-to-date knowledge and more time to discuss your options.
After the Appointment: Keeping the Conversation Going
A single appointment is rarely enough to fully address perimenopause, and that is normal. If you are starting a new treatment, schedule a follow-up three months later to review how it is going. If you did not feel the appointment was productive, it is worth writing to your GP or booking a longer appointment specifically for this topic. Continuing to log your symptoms between appointments means you have fresh, accurate data each time you go in. If you try a treatment that does not work well, your log gives you the evidence to show why a change is needed. Managing perimenopause well is often an iterative process that takes several conversations and adjustments. Approaching it as an ongoing relationship with your healthcare provider rather than a single fix is a realistic and useful mindset.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.