Practicing the art of polite persistence
In celebration of Women’s History Month and International Women’s Day, we aren’t just looking back at the past—we’re looking forward as we help shape the future of healthcare.
Too often, women in midlife are told their symptoms are “just stress,” or “normal aging,” This isn’t just dismissive, it’s damaging. And we’re working hard to change this so all women can get the care they deserve, with dignity and respect.
The data behind the dismissal
The statistics on women’s healthcare experiences are a sobering reminder of why self advocacy is often so crucial for successful outcomes.
- In a recent survey, nearly 50% of women reported that a healthcare provider had dismissed their concerns or told them their symptoms were “all in their head.”1
- Roughly 40% of Canadian medical schools have no formal menopause curriculum.2
- Less than 10% of residents in key specialties (family medicine, internal medicine, and OB/GYN) feel prepared to treat menopausal women upon graduation, with one study showing only 6.8% felt adequately prepared.2
- A 2019 survey found that 20.3% of residents received no menopause lectures during their training.4
Your self-advocacy toolkit
Advocating for yourself isn’t being “difficult”—it’s being diligent. Here are some ideas to help support you during your next appointment.
5 questions to ask your clinician
If you suspect your symptoms are hormonal, these 5 sample questions will help you determine if you’re in the right place.
1. “The most recent MHT guidelines have really changed the conversation around safety. What are your thoughts?”
Why this works: It frames you as an informed and engaged partner in your health and checks to make sure they are up on the latest hormone therapy research.
2. “I’ve been feeling [insert your symptoms here] lately. Could we explore if this is related to my hormones?
Why this works: It clearly states your symptoms and signals that you want to get to the root cause.
3. “I want to be proactive about my heart and bones now. Can we look at more than just a basic cholesterol panel—maybe an ApoB test and a baseline bone density scan?
Why this works: It is an empowering way to shift the focus from “fixing a problem” to “preventative longevity”.
4. “Some of my blood work is in the “normal” range, but I still don’t feel well. Do you treat based on the numbers or my symptoms?
Why this works: This is the ultimate “vibe check.” You need to know if they are a “treat-the-paper” or a “treat-the-person” doctor.
5. “I’m not a “wait and see” kind of person when it comes to my health. Can we talk about what we can do now to stay ahead of potential issues?
Why this works: It sets a clear expectation for the relationship. It tells the doctor that you aren’t looking to suffer in silence until “full” menopause hits.
Polite persistence: How to not take “no” for an answer
If you feel dismissed or are told “your labs are fine” when you don’t feel fine, here are a 3 productive replies to keep the conversation open:
1. When they say: “It’s just stress/normal aging.”
The pivot: “I understand that stress/aging can play a role, but these symptoms feel new/different and are affecting my quality of life. Can we assess whether they’re related to hormonal fluctuations and discuss possible treatments?”
2. When they say: “You’re too young for perimenopause.”
The pivot: “I understand that perimenopause can begin in the late 30s or early 40s. Given that I am experiencing [your symptoms], I would like to move forward with treatment regardless of my age.”
3. When they refuse a test or treatment:
The power move: “I understand you don’t feel this test is necessary right now. Could you please document my request in my chart and that it was declined? I’d like to have a record of our shared-decision-making process.”
You’re worth it!
As we celebrate the progress of women everywhere, we’d also like to acknowledge that self advocacy takes effort and energy. It’s not always easy–but your long-term health is worth it! At Coral, we believe that the best healthcare happens when the patient is an equal partner in the process. You deserve a provider who listens to your “why” just as much as your “what.”
References
- Source: KFF (Kaiser Family Foundation) Women’s Health Survey (2022).
- Sperry, S. L. C., et al. (2020). Menopause Education in Canadian Undergraduate Medical Curricula. Journal of Obstetrics and Gynaecology Canada.
- Kling, J. M., et al. (2019). Menopause Management Training in Residency Programs. Mayo Clinic Proceedings.
- Shen, W., et al. (2019). The Menopause Gap: Residency Training in Menopause Management.
- Chen, E. H., et al. (2008). Gender disparity in analgesic treatment of abdominal pain in the emergency department. Academic Emergency Medicine, 15(5), 414–418.
- NAMS (2022). The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause, 29(7), 767–794.
- Sarrel, P. M. (2013). The Mortality Toll of Estrogen Avoidance in Younger Postmenopausal Women. American Journal of Public Health, 103(9).
Disclaimer: The information provided here is for informational purposes only. It is not intended as medical advice. Always consult with your doctor or healthcare provider to determine what is best for your individual health needs.
