Vasomotor symptoms: should you get a second opinion?

Menopause is a change in the female reproductive system that marks the end of the reproductive years. Menopause begins exactly 12 months after a person’s final menstrual period. Perimenopause refers to the years leading up to menopause (the term means “around menopause”).

The age when perimenopause begins varies from person to person, but it’s most common for perimenopause to begin between the ages of 45 and 55 years. How long perimenopause lasts and what the experience is like can vary significantly from person to person.

Vasomotor symptoms (VMS) are the most common symptoms associated with perimenopause. VMS are hot flashes and night sweats, episodes of uncomfortable warmth and skin flushing that spread through the chest, neck, and face. Night sweats are hot flashes that occur during the nighttime hours and interfere with sleep. Sweating, rapid heartrate, anxiety, and chills are also common symptoms.

A hot flash or night sweat typically lasts for a few minutes, but the duration can be longer or shorter. The frequency can range from a few times an hour, to a few times a day, to a few times a week.

Should you seek a second opinion for VMS?

While perimenopause is different for every person, VMS are often disruptive to a person’s life and health. Hot flashes can interfere with work, relationships, and personal goals. Night sweats disrupt sleep, one of the most important factors for maintaining good physical and mental health.

VMS can be treated. One treatment option is hormone therapy, medications that restore the declining levels of the hormone estrogen that occur during perimenopause (and drive VMS and other menopause-related symptoms).

There are also non-hormone medications that can be used to manage VMS symptoms. Addressing lifestyle factors that may improve or worsen VMS is another important aspect of treatment.

While treatment options exist, making treatment decisions can be challenging. A person will need the guidance of a healthcare provider to understand what their treatment options are, the potential benefits, the potential side effects, and the factors that should be considered.

In some cases, a person may want to seek a second opinion when deciding how to treat VMS. A second opinion is when you consult a healthcare provider other than your current healthcare provider. Second opinions are common, and getting one can help you learn more about your diagnosis and your treatment options.

Reasons to consider seeking a second opinion

• You feel uncomfortable talking to your current provider about all your symptoms.
• You aren’t satisfied with your provider’s guidance on addressing menopause-related symptoms.
• You have concerns about the treatment that is being recommended. For example, concerns about costs or side effects.
• You do not feel that your concerns are being taken seriously.
• Your symptoms are not responding to treatment.
• You are experiencing menopause-related symptoms alongside another health condition or other health concerns.
• You want to consider treatment options your healthcare provider is not offering.
• You would feel better about your health and your decisions about your health if you had a second opinion.

Steps toward seeking a second opinion

• Friends and family can be a good place to start. If you know someone who has treated menopause-related symptoms, ask if they can recommend a healthcare provider.
• Look for healthcare providers in your area through your insurance company. You may also need to contact your insurance company to inquire about coverage for a second opinion.
• Ask your current healthcare provider if they can give you a referral to a provider or medical center that specializes in menopause-related care.

You may also want to make a list of several potential providers and narrow that list down based on availability, coverage, recommendations, and other factors.

Once you’ve chosen a provider and scheduled an appointment, you’ll need copies of any paperwork related to your diagnosis, including medical records, test results, and any medications you’ve been prescribed. Usually, your healthcare provider’s office will send these records prior to your appointment.

You’ll also want to prepare for your appointment. Write down a list of what you want to discuss, including questions and concerns.

Don’t worry about upsetting or offending your current healthcare provider by seeking a second opinion. A second opinion will give you and your healthcare provider more information about your health, and getting one can potentially lead to better care.