Considering HRT patch, who to see for evaluation?

If I was just beginning the hrt/bhrt the first thing I would do is research and educate myself about both menopause and the newest thinking on hrt/bhrt. This will help you enormously. You need a context for evaluating both what forms are available, how they work, and a prospective providers training and experience in this area of women's health. There seem to be many more untrained and inexperienced providers than not. Many are still operating with outdated research especially the flawed women's health initiative study.
You might also try a functional medicine provider. Insurance depending on type may not cover some of the functional medicine charges.
Hormones such as estrogen/estradiol, progesterone and testosterone are powerful and we need skilled professionals to get the balance right.
You might look at the work of Dr. Mary Claire Havers and Dr. Susan Hardwick-Smith in print and on YouTube.

Also there are a variety of discussions listed under support group "menopause".
I'm sure you'll be getting lots of input here.

Perfect time, in my opinion, to start HRT. Many docs still believe the WHI report which has been proven to inaccurate. It discouraged use of estrogen. I personally would see a HRT specialist. I do see one

I just have put this out there. I feel strongly that dexa scans should be given to women much much earlier. It is much easier and much much less risky for women to have them early to get a baseline and monitor rather than osteoporosis being discovered and having fewer and riskier options for treatment.
Losing hormones due to menopause begins to put women at risk for bone loss and of course other issues too.

@gravity3

I agree that women should be able to have bone density scan as preventative medicine much earlier than at age 65. Sorry I’m getting off topic from the original question of this post about HRT.

In my research, estrogen loss affects a majority of our bodily functions, primarily our bones and heart.

Doesn’t it make sense that all women will have a loss of estrogen, even if they do NOT have perimenopause or menopause symptoms? If that’s obvious, then it means every woman is at risk for osteoporosis?

My example = my mom says she never had menopause symptoms. Years later she was diagnosed with osteoporosis. I told my PCP that my mom has osteoporosis and is taking medication for it. PCP ordered a bone density scan for me at age 61 and specifically wrote in my chart that she ordered it due to family history of osteoporosis AND because I’m in post menopause and having severe joint pain. Insurance refused to cover the bone density scan. I called insurance and pointed out that the policy states it’s covered at age 65 OR if there’s a family history. Insurance still refused to cover it because doctor had written “family history” as a third reason for bone density scan, instead of writing it as first reason.

I do see the medical community changing and embracing perimenopause and menopause more lately. I pray insurance jumps on board too. 🙏👍

@gravity3

I agree! Do your own research and then come prepared to any medical appointment. Have a written history to show of your symptoms. If your PCP states they don’t have experience with your symptoms and/or dismisses your evaluation, then ask for a referral to someone who can help you. Keep advocating for yourself until a medical professional listens and acts on your behalf.

For me it was a nurse practitioner endocrinologist who listened to my severe menopause symptoms and pointed out that I would benefit from a micro dose of estrogen and progesterone. She referred me to an OBGYN who understood and immediately prescribed estrogen patch 0.05 mg and progesterone 100 mg capsule.

I’m proud of mglayton72 for keeping track of her medical appointments and perimenopause symptoms. I believe this will help lead her to someone who can help.

Plus this menopause support group has been so helpful to me with information like “Google Menopause Society - you can find menopause specialists there”.

In my area of Wisconsin, I believe the medical community is beginning to embrace HRT for perimenopause and menopause. I pray the rest of the country does too!🙏👍

My current Bariatric doctor is currently studying for her boards to be some sort of menopausal specialist. I think she takes her boards next year. There is an OB/GYN who she recommended, but as a new patient, I cannot get in to see her until July 2027.

So today I was at the clinic where I get counseling, psych med management, and see my PCP. It is the same clinic I went to last November for my PAP. The provider I saw last year left the practice. I asked at registration about setting up an appointment with a women's health provider to discuss HRT options and evaluate my symptoms and risk factors. Luckily they had an opening in a couple of days.

I have done a bit of reading and I think I would like to try a weekly bio-identical estrogen patch along with a bio-identical progesterone capsule.

Climara and Prometrium are not covered by my medical insurance because they are brand name products. So, I guess I will have to do generic estrogen and progesterone.

I hope to get some answers during the consultation and perhaps a couple Rx.

@louiserivers
Talk to your state insurance commission office. I found contradictions for a specific procedure in my insurance policy and the state forced the insurance company to pay. Best of luck to you.