Preparing for your appointment

Preparing for an appointment means arriving with your symptoms, your history and your questions written down, so nothing depends on memory or nerve. You do not need to know the answers, only to give the doctor what they need to find them.

The guidelines help here, because they tell you what your doctor is meant to cover. Prepare along the same lines and you arrive with the answers to their questions.

What your doctor will want to know

The Pakistan Menopause Society's recommendations set out the core history a doctor should take (Table 2). Before you go, note down:

• your age and the date of your last period
• how your periods have changed: heavier, lighter, closer together, further apart
• whether you could be pregnant, and what contraception you use, if any
• your pregnancies, and any operation on your womb or ovaries
• cancer treatment in the past, if any
• every medicine you take, and any herbal or complementary remedies
• whether you would prefer to try hormonal or non-hormonal options first.

The same table asks about family history: heart disease, blood clots, osteoporosis and cancer. Ask relatives if you are not sure. It also asks about your breast and cervical screening, so bring the dates if you have them.

Your symptoms, worst first

NICE NG23 lists the symptoms a doctor should explain can come with menopause: changes in periods, hot flushes and sweats, vaginal dryness, effects on mood, joint and muscle pain and low sexual desire (1.2.2). The PMS checklist adds sleep, memory and bladder symptoms. Note how often each happens, how bad it is and what it stops you doing. The PMS recommendations ask doctors to assess the effect on sleep, work, family life, prayer and intimacy, so say where it hits.

Put the symptoms you find hardest to say on paper. The PMS recommendations note that many women may not mention sexual, bladder or mood symptoms unless asked in private. A written list lets you hand it over instead.

Tools that can carry some of this

Roshara's symptom score rates 27 symptoms in a few minutes and lists them worst first; you can print it or save it as a PDF. If you keep a daily check-in, symptom tracking shows how things have moved between appointments. Signed in, with your email address confirmed, you can also email your record to your doctor or any address you choose: your latest saved score, what you are taking, side effects you have logged, test results, your journal notes and any appointments you have booked, in one message. Roshara adds no diagnosis and does not read your results.

Your questions

Choose three. The questions on this page are a start. NICE NG23 also asks doctors to talk about contraception with women who have menopause symptoms (1.2.3), so if you still need it, add it to the list.

Do not hold a red flag back for a planned appointment. The PMS recommendations list bleeding after menopause, bleeding after sex or between periods, sudden heavy bleeding, a breast lump, chest pain, sudden breathlessness and thoughts of suicide among the red flags that need checking or referral (section 2.3).

After the appointment, write down what was agreed and when you will be reviewed. NICE NG23 recommends reviewing a new treatment at three months, so a score from before and one from three months later gives you both something concrete to compare.

If someone comes with you, decide beforehand which parts you want to say alone. If you would rather see a woman doctor, ask whether one is available when you book. And if Urdu is easier for you than English for the hard words, the symptom pages in Learn give the Urdu words alongside the English a doctor will use.