Why a Once-a-Year Checkup Isn't Great for Perimenopause Care
Here's what perimenopause healthcare looks like for most women:
Annual physical. You mention you're tired or your periods are irregular. Your doctor runs basic labs. Everything comes back "normal". You're told to come back next year.
Or maybe a prescription for birth control to make you “regular”.
That's it. No follow-up. No ongoing support. No plan.
Here's the problem: perimenopause is the most hormonally volatile decade of your life (psst: did you know perimenopause can last 10+ years?). And a once-a-year checkup won’t give you the support you need, as your hormones may be rapidly changing month to month.
Why Annual Visits Fall Short
Perimenopause is wild hormone roller coaster ride. Estrogen might surge one month and crash the next. Ovulation becomes irregular, so progesterone production shifts, and generally lessens. But, some months feel fine! Then, a super heavy or long cycle hits you out of nowhere. And maybe you’re stuck with random symptoms that you think may be related to perimenopause, but no one to ask. And certainly you have no clue how to handle treating it!
In a system designed around annual checkups and 15-minute appointments, there's no space to track these changes over time. Most conventional appointments look like:
Brief symptom discussion
Basic lab work (often just TSH)
Generic advice ("exercise more, manage stress")
Prescription for antidepressants or birth control
"See you next year"
What Top-Notch Perimenopause Care Requires
After 10 years of treating women through this transition, I can tell you that effective care requires:
Symptom tracking over time: Patterns over weeks and months—not just a snapshot of how you feel today.
Comprehensive lab analysis: A full picture of thyroid, metabolic health, stress hormones, nutrient levels, and sex hormones (when appropriate), regularly, following up if you find something abnormal or are monitoring treatment efficacy to monitor changes.
Understanding hormone patterns in context: Lab results mean nothing without your symptom history! You have to look at someone’s WHOLE HEALTH, not just a piece.
Ongoing support and adjustments: What works in early perimenopause might not work in late perimenopause. Your care plan needs to adapt as your needs change.
A provider who knows what to look for: Not all doctors are trained in hormone care. While some menopause treatments are research-backed, honestly, the research in women’s health isn’t sufficient. A lot comes down to clinical experience!
Why the Healthcare System Isn't Set Up for This
There are a few reasons conventional medicine fails women during perimenopause:
Education gap: Most doctors receive minimal menopause training—often just one chapter in medical school. And perimenopause is a brief definition, not clinically grounded.
System design: “Healthcare” systems are designed to treat disease, not foster great health. Perimenopause is technically "normal," so symptoms get dismissed or suppressed.
Time constraints: Let’s just be honest. There's no time for a comprehensive assessment in a 15-minute appointment.
What the Process Actually Looks Like
Here's something most women don't realize: getting a handle on perimenopause care takes time. For most women, it takes a full six months to really dial things in. (Some women need 4 months, others need 8—it really depends on how complex your health history is and how severe your symptoms are.)
This isn't a one-and-done situation. It's a process of:
Initial comprehensive assessment
Running the right labs
Starting treatment (whether that's hormones, supplements, lifestyle changes, or a combination)
Monitoring how your body responds
Adjusting the plan as your symptoms shift
Fine-tuning as your hormones continue to change
And then? Quarterly check-in visits as your hormones and symptoms evolve.
Because here's the reality: perimenopause is a moving target. What works beautifully in month 2 might need tweaking in month 5. Your body is changing, and your plan needs to change with it.
When you work with someone who really knows you—your body, your history, your goals—they can guide you with precision. You're not starting from scratch every visit. You're building on a solid foundation, adjusting and refining as you go.
That's what comprehensive support should look like: a partnership that evolves with you.
Taking the Next Step
Perimenopause is a years-long transition. You need a provider who understands what you're going through and a plan that actually addresses what's happening in your body.
Ready for comprehensive perimenopause care? Book a consultation here. We'll review your symptoms, run the right tests, and create an individualized treatment plan that supports you through this transition. And we’ll be here for you when things change!
Meet Your Doctor
Hi, I’m Dr. Caitlin Fanning, ND (Naturopathic Doctor),
I help women who are struggling with hormone changes, fatigue, and infertility optimize their hormones and get their life back so they can feel like their best self.
If you're ready to take charge of your health and make real, lasting changes to your energy, your hormones, or your overall well-being, I would love to talk more!