SOS: Finding the Right Medical Care During Perimenopause
Navigating perimenopause doesn’t just feel like stepping into unfamiliar territory. It is stepping into unfamiliar territory —physically, emotionally, and logistically.
One of the most important (and often frustrating) steps during this transition is finding the right medical providers. Whether you're looking for a primary care doctor, OB/GYN, naturopath, or hormone specialist, the process can feel overwhelming—especially when you’re already dealing with fatigue, mood changes, brain fog, and the unpredictability of shifting hormones.
For many women, this isn’t just a matter of logistics. Choosing a provider during perimenopause can stir up complex emotional layers: anxiety about being dismissed or misunderstood, frustration from past medical gaslighting, or even unprocessed trauma from previous health care experiences. Women deserve better—and with a bit of guidance, it is possible to assemble a supportive care team that truly sees you.
Here's the good news: We have way more power than we think we do. Let’s get into it.
Why is finding Perimenopause Help So hard?
1. Lack of provider education about perimenopause
Despite affecting half the population, perimenopause is poorly covered in most medical training programs. Many providers still default to outdated scripts: "You're too young," "It’s just stress," or "Let’s wait and see." This can be deeply invalidating, particularly when you’re struggling with symptoms that are disrupting your life.
2. Dismissal or minimization of symptoms
Midlife women are often gaslit by the medical system. You might walk in with concerns about memory, sleep, or mood and leave with a prescription for an antidepressant—without any mention of hormones, lifestyle changes, or root causes. This cycle can erode your trust and make it difficult to seek care again. I want to be clear that taking an antidepressant medication may be the right choice for you, but it should be talked about an option and in context.
3. Logistical barriers
Finding a provider who specializes in perimenopause can feel like searching for a unicorn. Just because a doctor is an OBGYN does not mean they have advanced training in perimenopause/menopause. If you’re in a rural area or a healthcare desert, the options may be even more limited.
4. Medical anxiety and trauma
Many women carry invisible wounds from earlier healthcare experiences: being dismissed during childbirth, not believed about chronic pain, or enduring invasive exams without adequate communication or consent. These experiences live in the body and can resurface during midlife medical appointments, making it hard to advocate for yourself.
Strategies for finding Perimenopause Medical Support
Let’s flip the mainstream medical model on it’s head for a minute.
While it may not be the norm, you do get to “interview” providers and make decisions about how to proceed. That’s right, I said it. YOU ARE IN CHARGE HERE.
If clients feel anxious about meeting with a new provider, I encourage them to make a list of questions ahead of time - a great resource for this is Dr. Lara Briden’s book, The Hormone Repair Manual – where she includes guidance on how to talk to your doctor about different issues. Also think about whether you’d like to first meet with your doctor dressed and in their office vs an exam room. You do have these options and can advocate for yourself.
Some other things to consider:
1. Clarify your needs
Do you want a provider who will partner with you on hormone therapy? Are you looking for someone who takes a holistic approach? Knowing your priorities—hormonal, emotional, spiritual, or lifestyle-based—will help you narrow your search and ask the right questions.
2. Ask for referrals from trusted sources
Start with your own circle. Ask friends, therapists, doulas, or local support groups if they’ve found a provider who “gets it.” The Menopause Association offers training and certification for menopause-knowledgable providers and provides a directory for patients. That link can be accessed here. It’s also worth noting that mental health support is often no better. Many therapists are generalists and aren’t trained to recognize the emotional toll of hormonal shifts, or to validate the existential upheaval this time can bring. It’s also why I offer trainings for other therapists in perimenopause so they can recognize early signs of perimenopause, as well as be more aware of what their clients may be experiencing.
3. Trust your gut during the first appointment
The initial consult can tell you a lot. Does the provider listen without interrupting? Do they take your symptoms seriously? Do they acknowledge your emotional wellbeing as well as your physical symptoms? If you leave feeling dismissed or uncertain, it’s okay to keep looking.
4. Advocate for yourself—but don’t go it alone
Prepare questions or bring a symptom tracker to appointments. If it feels too vulnerable, bring a friend, partner, or even a therapist’s notes. You don’t have to be the perfect advocate every time—you just need someone in your corner. I work with clients on preparing for office visits all the time.
5. Consider integrative and allied providers
Naturopaths, acupuncturists, pelvic floor therapists, and nutritionists can all offer meaningful support for midlife health. They may help fill gaps left by conventional care—especially when it comes to holistic hormone balance and nervous system regulation.
A Final Note
As we wrap up here, I want to underscore that choosing a provider in perimenopause is not just a medical decision—it’s a reclaiming of your voice.
You’re not being “too sensitive” or “too demanding” for wanting compassionate, informed, whole-person care. You’re advocating for a future you deserve.
If you're struggling to find the right provider—or just want a place to unpack the emotional and spiritual shifts of midlife—you’re not alone. My therapy practice offers specialized support for women in California and Louisiana navigating perimenopause with care, creativity, and clarity.
We were made for this. And you don’t have to do it alone.
Till Next Time Wishing You Health & Ease,
Jessika
Support for women’s healing, growth + Wellness in New Orleans and San Francisco
A little about me …
Hi, my name is Jessika Fruchter LMFT and I’m a feminist psychotherapist, expressive arts therapist, writer and educator. I provide online holistic psychotherapy for women in California and Louisiana who are navigating the perimenopause transition and all things midlife. Together we tend to matters of the mind, body and spirit.
I believe personal healing is a revolutionary act. I say it often. And in these (continued) turbulent times, I believe it now more than ever.
If you think spiritually-integrated therapy might be right for you, and you live in the states of Louisiana or California, I’m here to support. Here are a couple of steps to move forward …
Schedule a free initial consultation here
Of if you have questions … Let's chat.I’m happy to answer any questions you have.
Also please know there are directories where you may seek out other feminist therapists in your area. Inclusive Therapist and Therapy Den are two great places to start.
