You’ve done the research. You’ve ticked half the symptoms on the list. You’re fairly certain perimenopause is what’s going on — and you have a GP appointment coming up.
And you’re dreading it.
Because you’ve heard the stories. Women sent away with antidepressants. Women told they’re “too young.” Women who cried in the car park afterwards because they felt so dismissed.
This guide is for you. Here’s exactly how to prepare, what to say, and what to do if the appointment doesn’t go the way it should.
Before the appointment
1. Write your symptoms down Don’t rely on remembering everything in the room. Write a clear list of every symptom you’ve been experiencing, how long you’ve had it, and how it’s affecting your life. Be specific — “I wake between 2am and 4am most nights and can’t get back to sleep” is more useful than “I’m not sleeping well.”
2. Track your cycle If your periods have changed — become irregular, heavier, lighter, more frequent, less frequent — note this down. A pattern of menstrual changes is one of the clearest indicators of perimenopause.
3. Note the impact on your life GPs are more likely to take action when they understand how symptoms are affecting your daily functioning. “I’ve had to take three days off work in the past month” or “I’ve stopped socialising because of the anxiety” gives them important context.
4. Download the Still Her Symptom Checklist Bring it with you. A completed checklist is a clear, professional document that helps your GP see the full picture quickly.
5. Know what you want from the appointment Are you looking for a diagnosis? A referral? To discuss HRT? Going in with a clear goal helps you advocate for yourself more effectively.
In the appointment
Start with your most significant symptoms You have limited time. Lead with the symptoms that are affecting you most. Don’t bury the headline.
Use the word “perimenopause” Don’t wait for your GP to suggest it. Say: “I’ve been researching my symptoms and I think I might be in perimenopause. I’d like to discuss that with you.”
Ask specific questions
- “Could these symptoms be related to perimenopause?”
- “Would you consider referring me to a menopause specialist?”
- “What are my options for treatment?”
- “Can we discuss HRT?”
Mention NICE guidelines NICE (the National Institute for Health and Care Excellence) published updated guidelines in 2015 stating that perimenopause should be diagnosed based on symptoms in women over 45 — not just blood tests. If your GP seems reluctant to engage, you can say: “I understand that NICE guidelines suggest perimenopause can be diagnosed based on symptoms alone for women over 45. Would that apply to me?”
If your GP dismisses you
It happens. More than it should. Here’s what to do:
Stay calm and be direct “I’m concerned that my symptoms are significantly affecting my quality of life and I don’t feel they’ve been fully addressed today. What would you recommend as a next step?”
Ask for a second opinion You are entitled to ask to see a different GP in the practice. Some GPs have a special interest in women’s health or menopause — ask if any of the doctors at your surgery have this.
Ask for a referral to a menopause specialist You are entitled to a referral on the NHS. The British Menopause Society has a directory of accredited specialists at thebms.org.uk.
Consider a private menopause clinic If NHS waiting times are long, a private consultation with a menopause specialist typically costs £150–300 and can be significantly faster. Many will also liaise with your NHS GP afterwards.
Try a telehealth menopause service Services like Newson Health, Stella, and Peppy offer online consultations with menopause specialists, often with shorter waiting times than traditional routes.
Change your GP practice If you repeatedly feel dismissed and cannot access the care you need, you have the right to register with a different practice.
A note on blood tests
Many GPs will offer a blood test to check your FSH (follicle-stimulating hormone) levels. This can be useful, but it’s important to know:
- FSH levels fluctuate significantly during perimenopause
- A single “normal” FSH result does not rule out perimenopause
- NICE guidelines state that for women over 45, a diagnosis of perimenopause can and should be made based on symptoms, without requiring a blood test
If your GP tells you your blood tests are “normal” and therefore you’re not in perimenopause — this is not necessarily accurate. Push for a fuller conversation about your symptoms.
You deserve to be heard
The average woman waits over three years from the onset of perimenopause symptoms before receiving appropriate care. That is three years of suffering, confusion, and feeling like something is wrong with you.
You are not imagining it. Your symptoms are real. And you deserve a doctor who takes them seriously.
If you found this article useful, download the free Still Her Symptom Checklist — it’s designed to help you prepare for exactly this kind of appointment.
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional about your symptoms and treatment options.
