Researchers from Carleton University in Ottawa spoke in depth with 60 women aged 45 to 61 for a new book, “We Need to Talk About Menopause: Real Stories from Women’s Lived Experiences.” Here’s what they found about their experiences discussing this issue in doctor’s offices.
Get a group of random women together and ask them to talk about their experiences with medical practitioners. You’re likely to hear a number of complaints about everything from the difficulty of even getting a family doctor, to the 15 minutes that you’re allotted per appointment, to the feeling of not being listened to.
While there is still relatively little empirical data on the relationships of women with their doctors, there’s a lot of anecdotal evidence that, particularly if you are experiencing a “women’s disease,” you don’t get heard, so you don’t get adequate treatment.
Women’s conversations with their doctors about menopause are coloured by women’s general experiences with the medical field. In her book “Unwell Women” (2021), Elinor Cleghorn traces the history of women and their interactions with doctors. She argues that “women’s pain is more likely to be seen as having an emotional or psychological cause, more than a biological one.”
She goes on to state that menopause remains “under researched, misunderstood and shrouded in myths and misconceptions.” She notes that symptoms of perimenopause, notably depression and anxiety, are frequently misdiagnosed because family physicians tend to focus on the stereotypical symptoms of hot flashes and night sweats, despite the evidence that there are many symptoms in perimenopause and there is no universal menopause experience that all women go through.
The limited research that exists reports a consistent pattern of women’s dissatisfaction with their doctors. Research from the mid 1990s reports women being dissatisfied by their physicians not understanding them and having their complaints dismissed as “women’s affairs” (Defey et al., 1996). Hampson and Hibbard (1996) reported that women were particularly dissatisfied with their doctors with respect to menopause and symptom management.
Given that this research is 30 years old, we were interested in how women speak to their doctors about menopause and their doctors’ responses. Was the situation getting better?
The women we interviewed had lots to say about their symptoms and their experience of the menopause transition. But interestingly, they had much less to say about their conversations with their doctors, possibly because these conversations are infrequent.
Why women don’t talk about menopause with their doctors
To our surprise, some of our participants, both in perimenopause and in menopause, had never discussed menopause with their doctors. They said: “I’ve never spoken to a doctor about it” (Natalie, 51) and “Nothing. I’ve mentioned nothing about it” (Annick, 51). Some of the women said that they felt uncomfortable with a male doctor and didn’t want to talk to him about something this personal. As Sunshine (54) said, “I haven’t really heard anything (about menopause). I think I’d be more comfortable talking to a woman about it.”
Others never brought menopause up because they believed the doctor wasn’t going to mention it either. “Never talked about it with my doctor. I suspect that doctors don’t offer a whole lot of information. And if you want it, you’re going to have to ask for it.” (Consuela, 50)
We aren’t the only researchers who found this. Merrill (2020) reported that women are more comfortable asking their mothers, sisters, and friends about menopause, rather than their doctors. She theorized that this is related to decades of shame surrounding women’s bodies.
Dahlgren et al. (2023) tested this idea and found that 37% of women felt shame related to menopause symptoms and that “shame and stigma are commonly reported for concerns related to ‘women’s health.’” Shame is a result of stigma. It occurs when other people make people feel bad for who they are.
Doctors may misinterpret shame as embarrassment. Farhat and Henriksen (2021), in research published in the Proceedings of IMPRS from the Indiana University School of Medicine, summarized their interviews with 16 family medicine physician faculty and residents about what they perceived as barriers to conversations with their women patients about menopause. The doctors listed the top two barriers as patient embarrassment and cultural/religious norms and said that the reasons women felt like this was a lack of sexual education.
It is noteworthy that these researchers place the responsibility for the lack of communication about menopause primarily on women patients themselves. This framing of their findings overlooks the deeply ingrained cultural stereotypes about women’s bodies — particularly those surrounding menstruation and menopause — that view these natural biological processes as shameful or defective. Physicians, socialized within the same cultural narratives, may not even recognize how these biases influence their assumptions and clinical interactions.
When menopause is implicitly understood as a sign of decline or a personal failing, it becomes easy to attribute silence or discomfort to women’s supposed sensitivities rather than to a systemic lack of openness or empathy within medical practice. As Farhat and colleagues (2021) demonstrate, there is a striking mismatch between how many family doctors perceive discussions about menopause and how women themselves experience those conversations.
Thankfully, other research out of Indiana University has a different perspective on women’s conversations with their doctors about menopause. Simic Stanojević and her team (2024) interviewed 23 perimenopausal women about their sexual health. Their participants said they did not receive much information from health care providers because these professionals were uncomfortable holding conversations regarding sexual health and sexual pleasure. In their research, they found that women had to be the ones initiating conversations about menopause with their family physicians and their gynecologists, but even then, the women were dissatisfied because they didn’t get all the information they were seeking.
Similarly, Flanagan et al. (2005), using data from 665 women research participants, reported that more than half of these women left their medical appointments with unanswered questions about menopause and hormone therapy.
It is clear that women have questions about menopause for their doctors, and not only are they not getting the information they need, but they are also often getting brushed aside.
It is also important to consider that some women don’t talk about menopause with their doctor because they don’t have a general practitioner. According to Statistics Canada (2020), in 2019, 4.6 million Canadians reported they did not have a regular health care provider.
In fact, the shortage of physicians is worldwide. According to a 2022 study in The Lancet (Haakenstad et al., 2019), there are approximately 16.7 physicians per 10,000 people globally. For effective health care coverage, there should be at least 20.7 physicians per 10,000 people. This means that, at the time of their study, there needed to be 6.4 million more physicians around the world. It’s no wonder people are having a hard time finding a family doctor who is accepting patients.
It also means that many women simply don’t have access to physician led information on the menopause transition and their options for managing their symptoms.
Positive experiences with doctors
We were pleased to hear several women describe positive experiences with their doctors. Sometimes they had known the doctor for a long time and built trusting relationships. In these cases, the doctor appeared to feel free to talk openly with the women. Lizzie (50) happily said:
“She’s pretty good, I guess, partly because she’s been my doctor for 25 years. So, she knows me. And so, when we do have an appointment, we talk about whatever. And she’ll say, ‘OK … what? Anything troubling you?’ She’s pretty good.”
There were also some physicians who were actively seeking training in menopause and related issues.
“So, my doctor has been helpful in that he would provide information about medications, which I’m now on, and anything regarding some of the information he would get when he would attend workshops that were geared toward physicians who wanted to hear about menopause.” (Sachi, 53)
Similarly, Tracey (57) said: “I have a great doctor, a very progressive female doctor. Very cool. Great to talk to, just to kind of give me some ideas and stuff like that.”
It is possible that many doctors in their 40s and 50s, who are either going through perimenopause themselves or who have loved ones who are, are seeking answers for themselves, and realize first hand that there needs to be more information available to women.
There could also be a new generation of physicians who are taking a more holistic approach to medicine and thinking about the physical, emotional, and social aspects of health.
Excerpted from “We Need to Talk About Menopause: Real Stories from Women’s Lived Experiences” by Anne Bowker, Janet Mantler, Chizorom Ogbuagu and Emma Bider (Routledge).
