We get it! Suddenly, you’re feeling unfamiliar symptoms and you are worried. A little online investigation led you here (that’s great!) but that same “research” also has you looking at some worrisome information that might or might not be true about your body and menopause overall. So, you might be asking (and you are smart to do so) what is the next logical medical step to take? Finding the right doctor would be our advice which of course leads to more questions (so glad you keep asking!).
- What kind of doctor can guide me through this new maze?
- Who can help me feel comfortable, heard, and respected and is well trained in the hormonal changes my body is going through?
- Who has experience treating symptoms of perimenopause, menopause, and post menopause?
- Who has experience with hormone replacement therapy (HRT) or bioidentical hormones (BHRT) (customized or compounded medications that are designed to meet my body’s unique needs)?
These questions are precisely what you should be asking, and we are here for them! So come along with us as we explain every option available to you, helping you make the best practitioner choice based on your unique needs.
Types of Doctors, Training and Their Medical Approach to Menopause
The more a doctor knows about hormones and the phases of menopause, the better prepared they will be to help you make informed decisions about your options for hormone replacement therapy. There are distinctions that are important to understand when considering a medical doctor (MD), Doctor of Osteopathic Medicine (DO), naturopathic doctor (ND), or a nurse practitioner (NP). All four prescriber types must be licensed and must meet strict educational and training requirements before they can care for you. The main differences among them are their approaches to practicing medicine and the training they receive. Read on my friend and remember this is YOUR journey and you can do this in a way that makes sense for YOU! No two women have to follow the same course of action to find success in relieving symptoms.
- An MD is a medical doctor who has attended four years of medical school where they have engaged in classroom, clinical and community work. From there, they choose from 120 specialties which leads them to work for three to seven years in residency training. Some residents choose to undertake an additional fellowship after completing their residencies, adding one to three years of study in a subspecialty area. A physician must obtain a state license to practice medicine. After completing residency, many physicians also become board certified in their chosen specialty. Medical doctors give advice on preventative care, examine patients, prescribe medications, order, and interpret diagnostic tests and keep medical histories. They generally focus on treating specific conditions with medications. Something to note is that physicians often play key roles at wellness centers that treat all aspects of women’s physical, mental, and emotional health; a resource to be considered as you move through your various menopause stages. Telehealth options are growing as well and can expand your options for finding physicians who specialize in all phases of menopause and hormone treatments.
- A DO is a doctor of osteopathic medicine who must attend four years of osteopathic medical school where courses typically last four to five years and are a combination of academic, research and over 1,000 hours of hands-on patient-facing clinical training via internships, residencies, and fellowships. They are trained in all the same basic sciences as an MD. A DO’s training lasts three to eight years and prepares them to become licensed and board-certified. While an osteopath is a medical doctor and can prescribe medication, this medical professional takes a more natural and holistic approach to treating your problems where the focus is on integrative medicine. An osteopath also doesn’t turn to surgery as a first choice in caring for patients. In fact, osteopathic medicine can be a great option for someone who doesn’t want to consider surgery but isn’t responding to other treatment options.
- Naturopathic doctors (NDs) attend a four-year, federally accredited graduate-level naturopathic medical school and are educated in all the same basic sciences as an MD, but they also study holistic and nontoxic approaches to therapy with a strong emphasis on disease prevention and optimizing wellness. Upon graduation, they must take and pass the Naturopathic Physicians Licensing Exam (NPLEX). This exam covers basic sciences, diagnostic and therapeutic subjects, and clinical sciences. NDs additionally complete rigorous education in pharmaceutical drugs during their four-year, science-based medical education, and they may prescribe medications when indicated as allowed by state regulations. However, naturopathic doctors typically don’t prescribe drugs at the first sign of symptoms or trouble.
- Nurse Practitioners (NPs) are an Advanced Practice Registered Nurse (APRN) who are trained to assess patient needs and order and interpret diagnostic and laboratory tests. NPs must attend four years of school to become a registered nurse (RN), hold a Bachelor of Science in Nursing (BSN), complete an NP-focused graduate master’s or doctoral nursing program, and successfully pass a national NP board certification exam. Treatment plans are developed by the NP to provide the best plan of care for each patient which includes prescribing medication without physician supervision.
While experience in treating hormonal health concerns is essential from any of the health professionals mentioned above, so too is in-depth formal training because not all primary care physicians and specialists are knowledgeable about traditional or bioidentical hormone replacement therapy. Surprisingly enough, there is no specialized training required to administer hormone replacement therapy (HRT) or bioidentical hormone therapy (BHRT), and the training that is available can vary widely in approach and quality. For example, some doctors take only a single short course in hormone replacement, whereas others participate in fellowships, multiple years of ongoing education, and board certification. For example, BodyLogicMD affiliated practitioners, a growing network of highly trained practitioners specializing in bioidentical hormone replacement therapy, are required to meet six rigorous requirements, including completing the Fellowship for Anti-Aging and Regenerative Medicine, being an active member in the American Academy of Anti-Aging Medicine, and taking part in at least 150 credit hours of continuing medical education. The big point here is that it’s ok to ask questions about your doctor’s background when it comes to menopause and hormone therapies. Being the empowered woman that you are, embrace that you can and will make the right decisions for yourself and your body. You may also find that your provider indicates that they were trained by The Institute for Functional Medicine (IFM) and/or Age Management Medicine Group (AMMG). Both organizations are highly respected for their educational quality and have strict certification standards. The differences in education are very slight in approach to finding the root cause of your symptoms.
Check with your provider and inquire about their continued education on female hormones and menopause. The education they’ve received in medical school is certainly important but likely not relevant and individualized for the information that is now available in 2021.
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