Which doctor should I see?

When I had my hysterectomy at 44, I had already begun experiencing some symptoms of perimenopause (hot flashes, night sweats, dry skin and hair, depression, fatigue, etc.).

Two months after my surgery, extreme fatigue sent me back to my gynecologist in tears, thinking I was simply not recovering from my surgery well. She read me a list of symptoms of low estrogen, ran some blood tests to learn that I was still ovulating but my ovaries were probably in a post-op sleep, and prescribed me a low dose (.9 mg) of estradiol. Within several days, I began to feel like me again.

At about nine months post-op, I felt like my ovaries were waking back up again as I began to experience my usual PMS symptoms of breast tenderness and monthly mood swings. I have continued with the estradiol, as my doctor had said to take it for a year and then re-evaluate.

Now, at almost 14 months post-op, I'm once again feeling less PMS and some of the same symptoms as before. The worst is vaginal dryness. It's time to see the doctor again to re-evaluate the hormone situation.

My question (finally) is, which doctor should I see? The gynecologist who prescribed the estradiol has moved out of the area, but I could see another doctor in the practice. My primary care physician is someone I like well enough, but I've never seen her for gynecological issues.

Since I don't have a preference based on an existing relationship with either doctor, I'm hoping to hear whether others have had better experiences with menopausal issues with gynecologists or family doctors. Does it make a difference?

for your help!

Hi Chris!

It really doesn't matter which doctor you go to, providing the doctor is knowledgeable about prescribing hormone therapy. That's the tricky part--finding out if the doctor knows enough about it to prescribe.

I suggest calling ahead of time to ask if the doctor is experienced in prescribing hormone therapy and go from there. One way women find a doctor knowledgeable about prescribing hormones is to contact a compounding pharmacy to ask which doctors use their services. It doesn't mean that you will have to switch over to compounded hormones but a doctor who is aware of that option generally is a good one to partner with for that aspect of well-being. There's a free locator feature for compounding pharmacies in this link from the site Resource Database: www.iacprx.org.

The doctor who did my surgery is still my gynecologist and is who I rely on for my hormone prescriptions. At one point in my first year post-op I had some concerns, so I asked my family doctor for her input. She had no idea what to suggest other than to refer me back to my gynecologist. At least she admitted she didn't feel confident in helping me with that area of my well-being. I appreciated her honesty.

Hopefully others will be along to share their experiences, too.

Chris,

I found that my gyn was sorely lacking when it came to hormone issues so I went in search of another doctor to handle those issues. I still saw my gyn for my annuals and when I began having other problems, but I didn't bother to ask him any hormone questions since all I got was a pat on the arm and a "there, there, it will be okay" response when I inquired about what was happening to me.

It did take me awhile to find another doc for hormones, but I was lucky to find a very kind, caring and knowledgeable compounding pharmacist who was very helpful to me in the beginning.

I now have an excellent Osteopathic doctor who handles my annual exams and my hormones.

All this to say, it really doesn't matter whether it's a gyn, internist or gp, what matters is that the doctor has taken an interest in and is knowledgeable about women's health and hormone issues.

Thanks so much (((sisters)))

Your suggestions and experience help a lot and give me some ideas what questions I want to ask while I decide where to go to talk about my hormones

Hi (((sisters))),

I was thinking about your support while I was sitting talking with my the nurse practitioner and my primary doctor's clinic. I decided to start there since I also needed to talk about some changes in other medications I'm on.

She was such a great listener, and I was able to talk with her about all sorts of things that have been going on in my life during the past year. We talked about each medication and how it was contributing to (or taking away from) my general sense of well-being, and then we developed a new plan for me.

I was so happy to have someone treat me as a whole person and not just someone with hormone issues. The only change we are making in the hormones is the addition of Vagifem, which is already making some improvements.

Thank you so much for your replies!