Last updated: Nov 19, 2008

We tackle that question and others about menopause with Lauren Streicher, MD, clinical assistant professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University in Chicago and author of The Essential Guide to Hysterectomy.


Q. I feel like my doctor isnt in tune with my changing body. How do I know if its time to shop for a new gynecologist?

A. If you feel like your doctor isnt paying attention, switch now. This is a typical problem since gynecologists are often also obstetricians. Many women are frustrated that the doctor who delivered their babies isnt as involved with them now that theyre dealing with perimenopause or menopause. Menopausal women tell me theyre tired of sitting in waiting rooms with pregnant women and feeling like no one is paying attention to them. Ive been hearing this for years. The bottom line: If you feel that youre not getting the attention you deserve or that your questions are going unanswered, go elsewhere.

Q. If you start hormone therapy can you stay on it for life?

A. It depends on the symptom youre dealing with. For example, if you have vaginal dryness and are using vaginal estrogen, youll use it for as long as you care to be sexually active. If its for hot flashes, most of those stop within five years after menopause begins. Some women use hormone therapy to feel better or have better cognitive function. I have many patients in their 80s who take hormones and have taken them since the onset of menopause. Its extremely individual. In the end, while many women need to take hormones short-term for symptom relief, theres a group of women who take it for life. (See The Estrogen Debate.)

Q. Are there any developments on the horizon that youre excited about on the perimenopause or menopause front?

A. Theres a lot of research going on in hot flash control and more emphasis on the understanding that it has a major impact on womens lives. Its no longer OK to simply say “get out your fan.” For example, one researcher is focusing on developing a nerve block to control hot flashes. Theres also exciting pharmaceutical research going on that is looking at ways to address temperature control centers in the brain.

The second development has to do with vaginal dryness. I think theres more of an emphasis today on the fact that a womans sexuality remains important during her perimenopausal and menopausal life. We have a lot more data on vaginal estrogens and theres an increasing comfort level with these products.