Early menopause care: Women’s experiences with specialists and other health practitioners

The women we interviewed had received care and treatment for early menopause (EM) from a variety of medical specialists. Most also consulted GPs (see Women’s experiences with GPs), and several were treated by allied health practitioners such as psychologists, exercise physiologists, and occupational therapists as well as nurses and counsellors. (For information on mental health practitioners and complementary medicine and alternative therapy practitioners see Psychological therapies for early menopause, and Complementary medicines and alternative therapies for early menopause.)

The type and number of specialists and other health practitioners women consulted depended on the cause of EM, and whether or not they had co-existing health conditions.

Experiences with specialists

Specialists consulted by women who experienced spontaneous EM or medically-induced EM for non-cancerous conditions such as endometriosis included endocrinologists, gynaecologists, and/or fertility specialists. Women with cancer-related EM (or menopausal symptoms resulting from ovarian suppression therapy) described being cared for by oncologists, breast surgeons, gynae-oncologists, haematologists, and/or fertility specialists. If they consulted endocrinologists or gynaecologists, this was usually through a menopause clinic (see Experiences with health services). Women with multiple or complex, chronic health conditions tended to seek help from a broader range of health practitioners, including allied health practitioners.

Vicki, who had Turner Syndrome, described her ‘awesome holistic care team.’

Experiences with specialists – women with non-cancer related EM

Most women with spontaneous EM, medically-induced EM for non-cancer conditions, or Turner Syndrome had received care from either a gynaecologist or an endocrinologist – only a few women had been cared for by both a gynaecologist and an endocrinologist. Within this group, fertility specialists were consulted by those women who did not have children but had wanted them.

As with GPs, women described highly valuing specialists they perceived as having knowledge or expertise in EM, who were ‘straightforward’ with them with information about their diagnosis and treatment options, or who took their symptoms seriously. As Melinda said of her endocrinologist, ‘I remember feeling like, ‘She just gets this, she just understands’.’

Mary, who experienced early menopause after repeated surgeries to remove ovarian cysts, contrasted her ‘amazing’ endocrinologist with her ‘dismissive’ gynaecologist.

Natalie, who experienced EM after a hysterectomy for endometriosis, found her gynaecologist’s ‘black and white’ approach helped her make decisions.

Some women with non-cancer related EM described struggling to find specialists with EM expertise, or who seemed able to provide care for EM alongside coexisting conditions, including thyroid problems or endometriosis. Sonia recalled wanting to discuss her fertility and menopausal symptoms with her endocrinologist ‘but she was focused on the thyroid.’ Other women said it took them a long time to find the ‘right’ specialist, and a few commented that they simply gave up searching (see Women’s experiences with health services).

As a private patient in her home country in South America, Lorena found it difficult to find a specialist with the ‘interest’ and ‘background’ to be able to help her with HRT.

Experiences with specialists – women with cancer related EM or menopausal symptoms

Women with EM as a result of cancer treatment or risk-reducing surgeries mentioned receiving care from oncologists, breast surgeons, haematologists, and gynae-oncologists. A few reported attending menopause clinics where they saw gynaecologists or ‘menopause specialists.’

Experiences of EM care from oncology specialists ranged from specialists who ‘took menopause very seriously’, as Alex said of her gynae-oncologist, through to those who women felt were focused on their cancer care rather than the after-effects of treatment, including EM.

Kate shared her experiences of changing oncologists to get better care in relation to her menopausal symptoms following breast cancer treatment. 

Information about early menopause was an ‘area that was lacking’ in the care Tracey received through her gynae-oncology clinic prior to having a preventative bilateral oophorectomy. 

While women valued specialists whom they experienced as both caring and knowledgeable about cancer and EM, some acknowledged the challenges for specialists of working in such a complex and difficult area of medicine. As Kirsty, who experienced spontaneous EM commented, ‘the reality, of course, with medical science is that [doctors] may not be able to sort it out. [Treatment for women with spontaneous EM and the BRCA 2 gene mutation] is still a new space, and evidence is not conclusive. … And it’s true that sometimes medical professionals, amazing humans that they are, probably need to have a bit of emotional and mental resilience themselves which means they can be a little bit disconnected emotionally from their patients.’

Experiences with fertility specialists

Women described varied experiences with and expectations of fertility specialists. Some wanted realistic discussions about their chances of conceiving. Kirsty said of the first IVF clinic she attended: ‘I felt they were out to get my money.’ She appreciated a fertility specialist at a different clinic telling her that for her, IVF ‘would be more challenging than for others.’ Other women, however, wanted to feel as though they had ‘done everything possible’, as Julia put it, to try to have a baby. (See also Emotional impact of early menopause and fertility loss and IVF, fertility preservation and other paths to parenthood.)

Louise said that encouragement from her gynaecologist prompted her and her husband to try to have a second child with the help of IVF and donor eggs, after treatment for borderline ovarian cysts. 

Allied health practitioners, nurses and counsellors

Women also mentioned seeing allied health practitioners such as psychologists, exercise physiologists, and physiotherapists, as well as nurses and counsellors (see Psychological therapies for early menopause). Some health practitioners were perceived as having a more ‘holistic’ approach than others.

Most women who mentioned experiences with nurses described them as ‘caring’ and as ‘having time’ for their patients. As Yen-Yi said of the oncology hospital she attended: ‘our nurses are really lovely. They’re all always only just an email away.’

Eden, who was undergoing adjuvant endocrine therapy after breast cancer, shared her views on the difference in perspective between different health practitioners. 

Further information:

Talking Points (Women)

Talking Points (Health Practitioners)

Other resources