Many ob/gyns seem more interested in the obstetrics side of their practice and don’t seem to have as much time to spare for someone who’s not pregnant. In addition, speaking from experience, it’s sometimes uncomfortable sitting in a waiting room filled with other women your age who are pregnant, when you’re dealing with the unwelcome fact that your reproductive system has shut down. Other doctors, even those who specialize in menopause, often aren’t used to dealing with a young woman coping with this situation. They don’t understand the emotional fallout you’re going through; or are too quick to assume that your situation is just the same as that of a woman in her 50s. Then there are the doctors who just won’t listen. They’ll dispense knee-jerk bits of information along with prescriptions, tell you to come back in six months and you leave the office feeling somehow dissatisfied.

And you should be dissatisfied. Premature ovarian failure and early menopause are special situations that demand a good relationship between patient and doctor. Because this condition combines both physical and emotional issues, you need to feel you can talk honestly to your doctor, ask questions, and get clear explanations. You need a doctor who understands that your situation isn’t a walk in the park, that there is emotional fallout and it isn’t "all in your head" -- as some women have been told. A doctor who knows the consequences of early menopause as opposed to regular menopause and can explain to you what long-term consequences you face, why you need certain therapies and what will happen if you choose not to take them. A doctor who will be there to answer the inevitable questions that will crop up along the way.

The key is not giving up -- and knowing what to look for and how to look for it. As an informed medical consumer, you deserve the best care possible --- and it’s up to you to seek it out.

Step 1: Decide What You Want From A Doctor

The best way to begin finding the right doctor for you is to start with the basics: What do you consider to be a good doctor for your situation? You may want to ask yourself the following (and, keep in mind, there are no right or wrong answers):

• Do I feel more comfortable with a man or a woman?  Some women only want a female gynecologist, reasoning that only a woman can truly understand what another woman is going through. And when you’re going through premature menopause, you often will have to talk about many extremely personal aspects of your life and body -- issues like your sex life. It’s important that you feel able to be totally honest and forthcoming about these issues. Some women feel uncomfortable talking about topics like vaginal dryness or discomfort during sex with a man; others have no problem with this. Would your doctor’s gender make a difference to you?

• Do I want a doctor with a traditional practice or one who is open to alternative medicine? This is an important point to think about. More traditional doctors tend to be wedded to the tried-and-true forms of HRT (Premarin and progestins). Others are open to prescribing newer forms of HRT including natural hormones, and still others incorporate alternative treatments such as acupuncture or herbal supplementation in their recommended therapies. Think about the course of action you would feel best taking. If you think you will be happy with traditional HRT, then a traditional doctor makes sense. However, as more research indicates possible problems with long term exposure to synthetic hormones -- and, since premature ovarian failure or early menopause treatment generally requires many years of HRT -- you possibly are best seeking a doctor who is open to prescribing natural HRT, that is prescription hormones that are bioidentical to those your body makes. Finally, if you are interested in exploring alternative therapies -- such as incorporating herbs and other supplements in your treatment, it makes sense to seek out a doctor who is open to this -- perhaps a holistic doctor or other alternative practitioner.

• Do I want a doctor who specializes in menopause, or, even more specifically, in premature ovarian failure, early menopause or hormonal disorders, a gynecologic or medical endocrinologist -- or will I be just as happy with a regular gynecologist or GP who specializes in women’s health?  Frankly, this can get a little problematic since premature menopause isn’t a common speciality. However, many large medical centers (especially in larger cities) do have doctors who specialize in hormone disorders. And, as more baby boomers enter menopause, more gynecologists are focusing on menopause as a specialty. You may feel more comfortable seeing a doctor who specializes in menopause (premature or otherwise) as opposed to a regular ob/gyn, because you don’t have to deal with the "baby factory" feel of many doctor’s offices. More importantly, a menopause specialist is often more up-to-date in terms of HRT, and usually has a hands-on knowledge of menopause. In general, then, you are probably best seeking a menopause specialist, if not a premature menopause specialist.

• Should I see a reproductive endocrinologist -- someone who specializes in infertility and hormonal disorders? This is a very specific specialty -- and one that may fit the bill for your needs. REs are well-versed in matters of reproductive hormones, so often are much more in tune with premature ovarian failure. This is an especially good choice if you are eager to pursue a pregnancy. In this case, you may want to begin seeing a reproductive endocrinologist as opposed to a regular ob/gyn from the outset.

Beyond these more technical questions, also think about such things as personality -- would you feel comfortable with an authoritarian doctor or prefer one who is more flexible?, age -- would talking with a younger doctor enable you to establish better rapport? Or does age not matter to you at all? size of practice -- would you rather see a doctor in an individual practice or one in a larger practice or clinic?

All in all, at this stage of the game, you should try to get an idea of what you consider to be the ideal doctor for you. This way when it comes time to actually meet with a doctor, you can determine whether he or she meets your criteria.

Step 2: Finding The Best Doctor for You

Once you have an idea of the type of doctor you’re seeking, it’s time to start looking for that doctor. Consider trying one or more of the following:

• Ask other women -- especially, if possible, others who are also in your situation -- that is, they also have POF or have underdone surgical menopause. Friends and family can often give you the best recommendations based on their personal experiences. They’ve got a unique perspective -- from the examining table itself -- and can give you an idea of how a doctor treats her patients, her bedside manner, her medical philosophy, and so forth. However, don’t blindly assume that, just because a friend recommends a doctor, he or she will be right for you. Does the person who recommended the doctor have needs similar to yours? Does she like the same sort of things in a doctor as you? If you don’t know the answers to this, don’t be afraid to ask your friend or relative -- and ask about the doctor she’s recommending as well. It’s best, of course, to get recommendations from other women in menopause -- even better, women in your specific situation. 

• Ask for referrals on line on one of the many menopause message boards or web sites available.. This is the high tech version of getting personal recommendations, and one that’s especially helpful if you don’t know anyone personally going through premature menopause or even menopause. You can post a message asking if anyone can suggest a doctor in your area.

• If you’re happy with your primary care physician, ask her for suggestions. Because your primary care physician, general practitioner or internist knows you and your needs as a patient, often he or she can give you the names of doctors who will fit in with your patient style.

• Ask medical professionals who they see. Sometimes one of the best ways of finding a good doctor is to speak with people who work with doctors -- nurses, physician’s assistants and other doctors. Often they’ll have insight into how a doctor works with patients, what type of medical orientation he or she has (open to natural alternatives or strictly traditional, for example), and so forth.

• Call local hospitals to get names of doctors who specialize in menopause, premature ovarian failure, or hormonal disorders. Another tried-and-true method of locating prospective doctors, this method is especially helpful because you can be sure that doctors are affiliated with hospitals in your area.

• Contact the North American Menopause Society for a list of doctors in your area who have registered as menopause specialists. The North American Menopause Society is a group that offers information on menopause, including answers to frequently asked questions, updates on news and studies, and lists of menopause centers and doctors. While NAMS doesn’t make any claims for these doctors, since these doctors have chosen to register with NAMS as menopause specialists, chances are good that you’ll be able to locate several doctors in your area who are well-versed in treating menopause. One caveat: Since there are no requirements for the doctors who list themselves as menopause specialists, you aren’t guaranteed that these doctors are actual specialists or just general gynecologists with some menopausal patients. So if you do use this resource, do be sure to also interview the doctors or their office staff by phone to determine whether they fill your needs. You can reach NAMS by calling 216/844-8748 or by requesting a directory on line at the NAMS web site -- www.menopause.org.

• Check if major medical centers in your area have specific menopause or hormonal disorder clinics or group practices. Often this is a great way of finding doctors who have experience in premature menopause. In addition, some times these centers conduct studies and if you qualify, you may get free care.

• Don’t necessarily limit yourself to gynecologists. Many women have had good luck with other health care providers, such as physician assistants, nurse practictioners and general medicine MDs. Of course, if you do opt for one of these other health care providers, be sure he or she is a woman’s health specialist. There are to many potential consequences of premature menopause to take the risk of seeing a health care provider who isn’t well-versed in women’s care.

• If you’re part of an HMO, consider going out of network. You may find that the doctor you want or one that’s recommended highly isn’t part of your HMO. In this case, it makes sense to consider paying for optimum health care if possible. More and more specialists are in practices that accept no insurance at all. Keep in mind: your body is worth the extra expense!

• Read menopause books and articles, and check on-line web sites to find the name of doctors who are menopause, POF, or surgical menopause experts. Often books and articles interview doctors -- which can give you a great idea of those doctors’ views on HRT, menopause management, and their general medical philosophy. In addition, many doctors and practices have set up web sites, which list their backgrounds, philosophies, the types of treatments they endorse, and more. By doing a simple search using menopause or premature ovarian failure as your key words on one of the major Internet search engines (such as Google or Yahoo), you can locate doctors who specialize in these areas on line. (Incidently, this is also a good way of finding doctors who specialize in infertility problems -- a help if you’re interested in pursuing a pregnancy either through donor eggs or more experimental treatments.)