Why Your Doctor Won’t Test You for Menopause (and How to Get the Answers You Need)

Why Your Doctor Ignores Menopause Symptoms (and How to Take Control of Your Health)

I’m in my mid-40s, and let me tell you something that’s been frustrating me for the last few years. Every time I go to the doctor for a routine check-up or even bring up specific symptoms—hot flashes, brain fog, irritability, sleep issues—and ask if they could run tests to see if I’m in perimenopause or menopause, they brush me off. They’ll say things like, “You’re too young for that,” or “We don’t need to test for menopause; it’s just part of aging.”

If you’ve been there, sitting on the exam table, clutching one of those scratchy paper gowns, feeling dismissed or unheard, you’re not alone. This is happening to women everywhere, and it’s not your fault. You’re not imagining it. And it’s not because your symptoms don’t matter—because they do. The problem? The medical system hasn’t caught up to the reality of what women in their 40s, 50s, and beyond are experiencing.

So, why won’t your doctor test you for menopause symptoms? And what can you do to advocate for yourself? Let’s break it down.

Why Doctors Often Dismiss Menopause Symptoms

1. Outdated Medical Practices

Let’s face it: medicine hasn’t always prioritized women’s health. Historically, menopause was treated like a taboo subject, something to be endured quietly, rather than a major life transition deserving of medical support. Even now, many doctors are taught the basics of menopause in medical school—but not much beyond that.

For years, the prevailing attitude was that menopause wasn’t a “medical condition” but a natural part of aging. While that’s technically true, the reality is that the hormonal shifts during perimenopause and menopause can wreak havoc on your body, your brain, and your quality of life. Unfortunately, if a doctor’s training or their practice guidelines haven’t been updated, they may not see the need for detailed testing or treatment.

2. Lack of Training in Hormone Health

Here’s something you might not know: Many general practitioners and even OB-GYNs don’t receive extensive training in hormone health. If your doctor isn’t comfortable interpreting hormone test results or doesn’t know how to prescribe hormone replacement therapy (HRT), they might avoid addressing the topic altogether. It’s not fair to you, but it’s a systemic issue in how medical professionals are trained.

3. Misconceptions About Testing

Some doctors believe hormone testing isn’t useful for diagnosing menopause. They’ll tell you that hormone levels fluctuate too much during perimenopause to provide a clear picture. And while it’s true that estrogen, progesterone, and FSH (follicle-stimulating hormone) levels can vary throughout your cycle, patterns in those fluctuations can still provide valuable insights—especially when combined with your symptoms.

4. The Age Myth

Many doctors are stuck on the idea that menopause starts in your 50s. But here’s the thing: perimenopause—the transition leading up to menopause—can start as early as your late 30s or early 40s. If your doctor dismisses your symptoms because you’re “too young,” they’re missing the bigger picture.

5. Symptom Overlap

Another reason doctors hesitate to test is because many menopause symptoms overlap with other conditions. Fatigue, mood swings, and weight gain? Could be thyroid issues, depression, or stress. Instead of connecting the dots, some doctors might send you down a rabbit hole of unrelated tests—or worse, tell you it’s all in your head.

What Tests Should You Request?

If you suspect you’re entering perimenopause or menopause, asking for the right tests can make a big difference. Here’s a list of common tests to consider:

1. Follicle-Stimulating Hormone (FSH)

FSH levels tend to rise as you approach menopause, as your ovaries produce less estrogen. While a single FSH test isn’t definitive, high levels combined with symptoms can indicate that you’re in perimenopause or menopause.

2. Estradiol (E2)

Estradiol is the primary form of estrogen in your body. Declining levels of estradiol are a hallmark of menopause and can help confirm the transition.

3. Progesterone

Progesterone levels can also decline during perimenopause, especially if you’re not ovulating regularly. Low progesterone levels can contribute to irregular cycles, mood changes, and sleep issues.

4. Thyroid Panel

Because thyroid dysfunction can mimic menopause symptoms, it’s important to rule out conditions like hypothyroidism or hyperthyroidism. Ask for TSH (thyroid-stimulating hormone), T3, and T4 tests.

5. Testosterone

Though often overlooked, testosterone plays a role in energy, libido, and mood. Declining levels can affect your quality of life and are worth checking.

6. Vitamin D

Low vitamin D levels can exacerbate menopause symptoms, including fatigue and bone loss. Testing your vitamin D levels can help ensure you’re getting enough.

7. Comprehensive Metabolic Panel (CMP)

This panel provides insights into your overall health, including liver and kidney function, blood sugar levels, and electrolytes, which can help rule out other potential causes of your symptoms.

8. Bone Density Scan (DEXA)

Menopause increases your risk of osteoporosis due to declining estrogen levels, which can weaken bones. A bone density scan can help assess your risk and guide preventive measures, like calcium and vitamin D supplementation or medications to protect your bone health.

When requesting these tests, explain how your symptoms align with potential hormonal changes and ask your doctor to consider these tests as part of a broader diagnostic approach.

What You Can Do to Advocate for Yourself

If you’re feeling dismissed or unheard, it’s time to take charge of your health. Here’s how:

1. Educate Yourself

Knowledge is power. Learn about the symptoms of perimenopause and menopause, and understand how hormonal changes can affect your body. Make a list of the symptoms you’re experiencing and track their frequency and severity. This will give you a clear picture to share with your doctor.

2. Ask Specific Questions

Instead of asking for a general menopause test, request specific tests like FSH, estradiol, and progesterone levels. If you suspect thyroid issues or other conditions, ask about testing for those, too. The more specific you are, the harder it is for your doctor to dismiss your concerns.

3. Bring Up Guidelines

The North American Menopause Society (NAMS) and other organizations have clear guidelines for diagnosing and managing menopause. Familiarize yourself with these and mention them during your appointment. Say something like, “I’ve read that NAMS recommends considering hormone testing for women experiencing these symptoms. Can we explore that?”

4. Find a Specialist

If your doctor isn’t supportive, it might be time to look for someone who is. Seek out a menopause specialist or an integrative medicine practitioner who has expertise in hormone health. NAMS has a directory of certified menopause practitioners, which is a great place to start.

5. Be Persistent

Advocating for yourself can be exhausting, but don’t give up. If one doctor doesn’t listen, find another. Remember: You are the expert on your body, and you deserve to feel heard and supported.

6. Consider At-Home Testing

If you can’t get the tests you need through your doctor, there are reputable at-home hormone testing kits available. These can provide a snapshot of your hormone levels and help you start a conversation with your healthcare provider.

7. Use Your Network

Talk to other women who have been through this process. Join support groups or online communities focused on menopause. You’ll find valuable advice, recommendations for supportive doctors, and, most importantly, reassurance that you’re not alone.

What to Say When Your Doctor Dismisses You

It’s easy to feel defeated when a doctor brushes you off, but you don’t have to accept it. Here are some phrases you can use to push back respectfully:

• “I understand that hormone levels can fluctuate, but I’d still like to explore testing to get a clearer picture of what’s happening in my body.”

• “I’ve been tracking my symptoms, and they’re affecting my quality of life. Can we discuss possible treatments?”

• “I know that perimenopause can start in your 40s. Based on my symptoms, I think it’s worth investigating. Can you help me with that?”

• “If you’re not comfortable running these tests, can you refer me to someone who specializes in menopause?”

Moving Forward: You Deserve Better Care

Let’s get real: Menopause is a major life transition, and it deserves as much attention as any other stage of life. You don’t have to suffer in silence or accept that this is “just the way it is.” The medical system might still have a long way to go, but by educating yourself, advocating for your needs, and seeking the right support, you can navigate this journey with confidence.

Remember, you’re not alone in this. Millions of women are walking this path, and together we can demand the care and respect we deserve. If your current doctor won’t listen, find one who will. Because your health, your quality of life, and your future are worth fighting for.