"My OB says it's just stress": a script card to print

Many Filipinas hear it. On Reddit women write that "walang doktor na naniniwala sa mga sintomas ko", that they were diagnosed with "muscle pain, migraine or stress" and given a pain reliever, or that their OB simply "does not prescribe" HRT (r/AskPinay). Add a culture that raises women to be matiisin and calls complaints "maarte or OA", and it is easy to go home and keep enduring.

Stress is real and can make symptoms worse. But perimenopause is also real, common in the 40s, and diagnosed from your age, cycle changes and symptoms (NICE NG23 summary). You are allowed to ask the question.

• Bring your symptom diary or Health Report. Facts on paper help.
• Read the lines out loud if your mind goes blank. That is fine.
• Keep your tone calm and curious, not combative. You want a partner, not a fight.
• If the answer is still no, ask for a reason and a referral. Then find a second opinion: see find a doctor.

Want the longer version with more scripts? Read how to talk to your doctor.

1. Say what is happening, with facts "For the past ___ months I have had ___ (for example: night sweats 5 nights a week, waking at 3 am, rage I don't recognise). It is affecting my work and family."

2. Name the question "I'm ___ years old and my periods have changed. Could this be perimenopause?"

3. If you hear "it's just stress" "Stress may be part of it. But I'd like to rule out perimenopause too, because these started with my cycle changes. What would make you think it is or isn't?"

4. Ask about options "If it is perimenopause, what are my options, with and without hormones? I'd like to discuss HRT."

5. If the answer is no "Can you help me understand why? Is there a menopause specialist you could refer me to?"

6. Close the loop "What should I watch for, and when should I come back?"

1. Sabihin ang nangyayari, may detalye "Doc, ___ months na po akong may ___ (halimbawa: pinagpapawisan sa gabi 5 beses a week, gising ng 3 am, mabilis mag-init ang ulo ko). Naaapektuhan na po ang trabaho at pamilya ko."

2. Itanong nang diretso "___ years old na po ako at nag-iba na ang regla ko. Pwede po kayang perimenopause ito?"

3. Kung sabihin na "stress lang yan" "Baka nga po kasama ang stress. Pero gusto ko rin pong ma-rule out ang perimenopause, kasi nagsimula ito nung nag-iba ang cycle ko. Ano po ang magpapa-sigurado sa inyo kung oo o hindi?"

4. Itanong ang options "Kung perimenopause po, ano ang options ko, may hormone at wala? Gusto ko pong pag-usapan ang HRT."

5. Kung "hindi" ang sagot "Pwede po bang i-explain kung bakit? May menopause specialist po ba kayong mare-refer sa akin?"

6. Bago umalis "Ano po ang dapat kong bantayan, at kailan po ako babalik?"