At your first menopause appointment, ask whether your symptoms fit menopause and whether anything else should be checked. Ask which treatments suit your health history, with benefits and risks in real numbers, and what to do if you prefer to avoid hormones. Cover contraception, bleeding, and bone and heart checks. Choose the questions that matter most to you.
This page is a question bank. For what to track and bring beforehand, and what to do if you feel dismissed, see how to prepare for a perimenopause appointment. That advice applies to menopause appointments too.
Before you choose your questions
Think about what you want from the appointment. Common goals include:
- Understanding what is happening and whether anything else could explain it
- Relief from a particular symptom, such as night sweats or vaginal dryness
- A treatment decision, often about hormone therapy
- Long-term health, including bone, heart and brain
- Practical issues, such as contraception, bleeding or managing symptoms at work
Pick the sections below that match your goals. A focused list of five to eight questions usually works better than trying to cover everything.
Questions about what’s happening
- Do my symptoms fit with perimenopause or menopause?
- Which stage do you think I’m in, and how can we tell? See how to know when menopause has started.
- Could anything else be causing or adding to my symptoms, such as my thyroid, iron levels or medicines? See perimenopause or something else.
- Do I need any tests, and what would the results change?
- Is my age at menopause relevant to my long-term health? See menopause at 40, 45, 50 and beyond.
Questions if you’re considering hormone therapy
- Am I a suitable candidate, given my health and family history?
- What are the likely benefits for my symptoms and for my bones?
- What are the risks for someone like me, in numbers? For example, how many extra cases of breast cancer or blood clots would you expect out of 1,000 people with my profile?
- Would patches, gel or spray suit me better than tablets? The Menopause Society notes that skin-applied routes may carry a lower risk of blood clots and stroke.
- Do I need a progestogen, and which one? Is a hormonal IUD an option?
- Should I have a regimen with monthly bleeds, or one designed to be bleed-free, given where I am in the transition?
- What side effects should I expect in the first few months, and which should I report?
- What bleeding is expected, and what bleeding needs checking?
- When will we review it, and how will we decide whether to continue?
- Is there a reason I shouldn’t take it? Common reasons for extra caution include past blood clots, stroke, heart disease, liver disease and breast or other hormone-sensitive cancers.
If you’ve read conflicting things about HRT, our menopause myths and facts page is a useful starting point. It can also help to ask about decision aids. In the UK, NICE has published a discussion aid to support conversations about HRT. In the US, the Menopause Society provides patient handouts on deciding about hormone therapy.
Questions if you’d prefer not to use hormones
- What non-hormonal medicines could help my symptoms? Are fezolinetant or elinzanetant available to me, and would they suit me?
- What are the side effects and monitoring needs of each?
- Could menopause-specific cognitive behavioral therapy (CBT) help? NICE recommends considering it for hot flashes, night sweats, sleep problems and low mood. Where can I access it?
- What does the evidence say about supplements I’ve heard of, and could any interact with my medicines?
- Which lifestyle changes are most likely to make a difference for me?
Questions about vaginal, urinary and sexual health
These symptoms are common, treatable and often not raised unless you ask.
- Could my vaginal dryness, discomfort or urinary symptoms be related to menopause?
- Would low-dose vaginal estrogen suit me, and can I use it alongside other treatment?
- What moisturizers or lubricants would you suggest?
- Could my recurrent urinary infections be linked to menopause?
- What can help with low sex drive or pain during sex?
See vaginal dryness.
Questions about sleep, mood and thinking
- Could my sleep problems be linked to night sweats, anxiety or something else such as sleep apnea?
- Is my low mood or anxiety likely to be related to menopause, and what support is available?
- Should my memory or concentration problems be assessed?
Questions about bleeding and contraception
- Is my bleeding pattern expected for my stage, or should it be checked?
- Do I still need contraception? When can I stop? See pregnancy during perimenopause.
- If I start hormone therapy, what contraception works alongside it?
Questions about long-term health
- Should I have a bone density assessment, based on my risk factors?
- When were my blood pressure, cholesterol and blood sugar last checked, and are they due?
- Which screening should I stay up to date with, such as breast and cervical screening?
- What exercise would best protect my bones and muscles?
- Is there anything about my family history that changes what I should do?
Questions for specific situations
If your menopause was early (before 45):
- Is hormone therapy recommended for me until around the usual age of menopause, even if my symptoms are mild?
- Do I need tests to look for a cause, or a bone density scan?
- What does this mean for fertility and contraception?
See early menopause.
If you had surgery that removed your ovaries:
- Do I need estrogen only, or combined therapy?
- Is testosterone worth discussing for low sex drive?
See surgical menopause.
If you’ve had breast cancer or another hormone-sensitive cancer:
- Which non-hormonal options are suitable?
- Should my oncology team be involved in decisions?
If you have migraine, a history of blood clots, or heart disease:
- How does this affect my options, and are some routes of hormone therapy safer for me than others?
How to understand risk numbers
Risk is often described in relative terms, such as "30% higher," which can sound alarming without context. Ask for absolute risk, meaning how many people out of 100 or 1,000 like you would be affected, with and without treatment.
For example, a risk that rises from 10 to 13 in 1,000 is a 30% relative increase, but an absolute increase of 3 people in 1,000. Both figures are true, and you need both to make an informed choice. For common misconceptions about HRT risks, see menopause myths and facts.
What your clinician may ask you
Being ready for these questions saves time:
- When was your last period, and how has your cycle changed?
- Which symptoms bother you most, and how do they affect daily life?
- What medicines and supplements do you take?
- Have you had blood clots, stroke, heart disease, liver disease, migraine with aura, or breast, womb or ovarian cancer?
- Is there a family history of breast cancer, blood clots, heart disease or osteoporosis?
- Do you smoke, and how much alcohol do you drink?
- Do you need contraception?
A symptom record helps. Our private Symptom Explorer can prepare a summary for you.
Before you leave
Check that you know:
- The plan. What are you trying first?
- How it works. How and when do you take or use it?
- What to watch for. Which side effects are expected, and which need a call?
- When to review. NHS services commonly review new hormone therapy after about three months, then yearly once it is stable.
- Who to contact if you have concerns before then.
Don’t wait for your appointment if you have:
- Any vaginal bleeding 12 months or more after your last period
- Bleeding after sex, between periods, or very heavy bleeding
- Chest pain, sudden breathlessness, leg swelling or signs of a stroke, which need emergency care
- Thoughts of harming yourself; contact emergency services or a crisis line in your country straight away
Frequently asked questions
What should I ask my doctor about menopause?
Start with whether your symptoms fit menopause and whether anything else needs checking. Then ask which treatments suit your health history, what the risks are in numbers, and what long-term health checks you need.
How do I bring up HRT with my doctor?
You can simply say you’d like to discuss hormone therapy and ask whether it is suitable for you, given your history. Bringing your symptom record and family history helps.
What if my doctor won’t discuss HRT?
Ask them to explain why, and what alternatives they suggest. If you remain unhappy, you can ask for another clinician’s opinion or a referral to a menopause service, where available. Our appointment preparation guide has suggested wording.
Should I bring someone with me?
It can help. A partner, friend or family member can take notes and help you remember what was said.
References
- NICE: Updated menopause guidance includes discussion aid to support conversations about HRT
- NICE guideline NG23: Menopause, identification and management
- The North American Menopause Society: 2022 hormone therapy position statement press release
- The 2022 hormone therapy position statement of The North American Menopause Society
- Harvard Health: FDA removes menopause hormone therapy black box warnings (individual risk factors)
- ESHRE/ASRM/IMS: Evidence-based guideline on premature ovarian insufficiency, 2024
- Contemporary OB/GYN: FDA approves elinzanetant (Lynkuet)
- Worcestershire Acute Hospitals NHS Trust: Your journey through the perimenopause and menopause (review timing)
- FSRH Contraception Choices: Perimenopause and menopause
- Australasian Menopause Society: Bleeding in perimenopause, postmenopause and on MHT
Editorial status: evidence-based educational article; not individually medically reviewed. Last evidence check: September 10, 2026.
