Lesson 7 of 7 · about 15 minutes

What matters to you: a reflection before your visit

We’ve covered a lot: what perimenopause and menopause are, the words you’ll hear, the myths, how to build and read a log, and how to prepare for the conversation. This last lesson slows down. It’s a guided reflection to help you connect all of that to the most important piece of information in any health decision: what matters to you.

The Menopause Society describes good treatment decisions as shared ones, where your symptoms, history, and personal preferences are weighed together with the evidence. Your clinician brings the medical knowledge. You bring your life, your values, and your goals. This reflection helps you put words to your side of that table.

Find a quiet ten or fifteen minutes. You can write in a notebook, type on your phone, or just think it through. There are no right answers, and you can come back to these questions as often as you like. If you’re doing this as a caregiver, try answering together, or answer from what you’ve heard your loved one say, and then check with them.

Part 1: Looking back at where you started

Find the note you wrote at the end of Lesson 1.

1. Reread the change you were curious or concerned about. How do you understand it differently now?
2. Look at the question you wanted answered. Did this course answer it, or did it turn into a better question for your clinician?
3. What’s one thing you’ve learned about your own body by paying attention to it these past weeks?

Part 2: How symptoms are touching your life

Symptoms matter most in how they affect your days. Think about these areas and note anything that’s changed:

• Sleep: How rested do you feel most mornings?
• Work and daily tasks: Are any symptoms making work, caregiving, or chores harder?
• Relationships and intimacy: Are hot flashes, mood, or vaginal discomfort affecting closeness with others? (This is common and completely okay to name.)
• Mood and sense of self: Do you feel like yourself most days?
• Activities you enjoy: Is there anything you’ve stopped doing because of how you feel?

Now ask yourself: If one thing could feel better three months from now, what would I choose? Write that down. It’s your main goal.

Part 3: What you value in a plan

People weigh choices differently, and none of these answers is better than another. Rate how important each feels to you (not important, somewhat, very):

• Relief that’s as strong as possible
• Avoiding daily medicine if I can
• Trying a non-medicine approach first (such as cognitive behavioral therapy or clinical hypnosis, which The Menopause Society’s 2023 statement found effective for hot flashes)
• Understanding the risks clearly before deciding
• Cost and insurance coverage
• Convenience (how often, how it’s taken)
• Something else that matters to me: ____________

Then reflect:

1. What worries do I have about treatment, if any? Where did they come from? (Sometimes worries come from older information. Lesson 3 is a good place to revisit.)
2. What would help me feel confident in a decision: more information, time to think, talking with family, a follow-up visit?
3. Is there anything in my health or family history I want to make sure my clinician knows?

Part 4: Checking in on safety

Take a gentle look back through your log and your memory, and ask:

• Have I had any bleeding or spotting between periods, after sex, heavier or longer than usual, or any bleeding after menopause? If so, have I contacted my clinician about it? (ACOG and the Office on Women’s Health both say these are worth getting checked.)
• Has my mood been low, with loss of interest or trouble concentrating, most of the day, nearly every day, for two weeks or more? If so, that’s a reason to reach out to a healthcare professional now rather than at a routine visit.
• Have I had any thoughts of harming myself? If yes, please call or text 988 (the 988 Suicide & Crisis Lifeline, free, confidential, and available 24/7) or chat at 988lifeline.org. If you’re in immediate danger, call 911. You deserve support right now.

Part 5: Your next small step

Big changes start with small, doable steps. Choose one (or write your own):

• Keep my log for two more weeks before my visit
• Fill out the appointment prep sheet from Lesson 6
• Schedule an appointment I’ve been putting off
• Ask someone I trust to come with me or help take notes
• Share one thing I’ve learned with a friend or family member who might be going through this too
• Write my medicine and supplement list

Write it down along with a date: “By ____, I will ____.”

Part 6: A note to yourself

Last prompt. Write two or three sentences to yourself as if you were writing to a good friend going through the same thing. What would you want her to hear? Many people find they’re much kinder to friends than to themselves. Try offering yourself that same kindness.

A closing word from me

Midlife changes can feel like the ground is moving under your feet. Paying attention to your patterns isn’t about getting everything right. It’s about understanding yourself a little better and walking into your next appointment feeling more prepared and more like a partner in your own care. Wherever you are in this, you’re not behind. Come as you are, and keep asking good questions. If you’d like to talk about what you’re noticing (in general terms), the Poéma Circle is a great place to compare notes with others.

Sources

• The 2022 hormone therapy position statement of The North American Menopause Society
• The 2023 nonhormone therapy position statement of The North American Menopause Society
• Perimenopausal Bleeding and Bleeding After Menopause (ACOG FAQ)
• Menopause basics (Office on Women’s Health, HHS)
• Mental Health (The Menopause Society)
• 988 Suicide & Crisis Lifeline

This reflection is a personal planning exercise and general education. It isn’t a care plan; your own clinician can help you turn your goals into next steps.

Something here not seem right? Report a concern privately to the Poéma team.