Top 10 Things LGBTQ People Should Discuss With Their Healthcare Provider About Menopause
1. Track your symptoms
Changes in mood, mental clarity (aka “brain fog”), sleep, libido, energy, or periods can all be signs of perimenopause. Tracking symptoms for about 90 days can help you and your clinician see patterns. Even small changes can be meaningful.
2. Know what perimenopause is and when it can start
Perimenopause is the hormonal transition leading up to menopause (defined as 12 months without a period), when estrogen and progesterone decline. It commonly starts in the 40s, though for some it can begin earlier or later. If you are taking testosterone, the changes may be harder to recognize but still deserve attention.
3. Hot flashes and other Vasomotor symptoms
Hot flashes are one of the most recognizable symptoms of menopause. But there are others like: heart palpitations, fatigue, anxiety, irritability, depression, and dizziness. Hot flashes are the sudden sensations of heat that can be mild to severe and last between 1 to 5 minutes. Some research suggests they may be more frequent or intense among lesbians.
4. Vaginal and urinary health
Lower estrogen can affect vaginal, vulvar, and urinary tissues, leading to dryness, discomfort, or recurrent UTIs. These symptoms are extremely common and very treatable. No matter how you use your parts, or what language you use for them, these tissues deserve attention and care.
5. Hormonal and non-hormonal treatment options
The good news is that menopausal symptoms can be treated in a myriad of ways. One way are hormonal therapies such as local and/or systemic (body-wide) estradiol (aka estrogen) and/or progesterone. These can reduce hot flashes, improve sleep, and support vaginal health. Research has shown estrogen started during perimenopause can make a difference in longer term health. Your clinician can help you understand the timing, risks, benefits, and other treatments available, including several non-hormonal therapies (i.e. therapies that don’t involve estrogen or progesterone).
6. Low dose Testosterone
Testosterone is a naturally occurring hormone in everyone and decreases with age. Recently, more interest has been shown among cisgender women and nonbinary people in using low doses as a menopause treatment with or without taking other hormones. While research is limited, improvement in libido has been shown. Finding a clinician who can help you understand the best dosing, side effects, and potential benefits is important.
7. Sex and intimacy
Menopause can affect sex drive, arousal, and comfort. A good provider should be able to discuss queer sex, libido changes, and better ways to experience pleasure during midlife. You are not stuck with low libido!
8. Preventive screenings and vaccines
Midlife is a good time to refresh the focus on preventive care. This may include cancer screenings like: breast/chest, skin, lung, and colorectal, as well as vaccines (like shingles) and monitoring bone and cardiovascular health, vision, and hearing.
9. Strength training and long-term health
Hormonal changes during menopause can affect bone density, muscle mass, metabolism, and cardiovascular health. Strength training, resistance exercise, and adequate protein can help protect long-term health. Strength takes many forms, and building yours supports your health and ability to support others.
10. Shared decision-making and trust
Many LGBTQ+ people came of age when healthcare systems were a lot less safe and welcoming. We also have fewer examples of menopause in queer and trans communities. Work with clinicians (try the LGBTQ+ Healthcare Directory) who respect your experiences and want to help you thrive during this stage of life.
Written by Jessica Halem and peer reviewed by Gabrielle M. Mayer, MD, April 2026. For more information: The Menopause Society at menopause.org.