How do you tell your doctor you want HRT? A patient's guide

September 28, 2025 •

5 min read

Approximately 1.3 million women in the U.S. enter menopause annually, making conversations about hormone health increasingly common. Knowing exactly how do you tell your doctor you want HRT? is key to a productive appointment and a clear path toward symptom relief.

Quick Summary

Start by tracking your symptoms and researching your options, then schedule an appointment specifically to discuss your hormonal health. Be direct and honest about your desire for HRT, using your symptom log and research to advocate for your needs, and don't hesitate to ask for a referral if your doctor is unsupportive.

Key Points

Document Symptoms: Before your appointment, keep a detailed log of your perimenopause or menopause symptoms to provide your doctor with concrete evidence of your struggles.
Do Your Homework: Research different types of HRT and understand the basic risks and benefits to engage in a more informed discussion with your physician.
Be Direct: State your purpose for the visit clearly and confidently, explaining that you want to discuss starting hormone replacement therapy.
Engage in Shared Decision-Making: Frame the conversation as a partnership, expressing your goals for HRT while respecting your doctor's professional input.
Know Your Options: If your doctor is resistant, understand the reason and be prepared to seek a second opinion from a menopause specialist or discuss non-hormonal alternatives.
Come Prepared with Questions: Write down a list of specific questions about HRT to ensure all your concerns are addressed during the appointment.

Preparing for Your HRT Appointment

Before you ever sit down in the doctor's office, preparation is your most powerful tool. The goal is to present a clear, compelling case for why HRT is the right option for you, backed by your own health data and knowledge.

Document Your Symptoms

A symptom diary is invaluable. Many people experience a wide range of symptoms during perimenopause and menopause, and it can be hard to remember them all on the spot. Track the frequency, intensity, and timing of your symptoms for at least a few weeks leading up to your appointment. Include symptoms such as:

Hot flashes and night sweats
Irregular or absent periods
Changes in mood, such as anxiety or irritability
Sleep disturbances
Vaginal dryness or discomfort
Joint and muscle pain
Brain fog or difficulty concentrating

Do Your Homework on HRT

Arm yourself with basic knowledge. You don't need a medical degree, but understanding the basics will help you have a more informed discussion and show your doctor you've taken this decision seriously. Research the different types of HRT, such as oral pills versus transdermal patches or gels, and the hormones they contain (e.g., estrogen-only, or combined estrogen and progesterone). You can find reliable, evidence-based information from organizations like the Menopause Society (formerly NAMS). Knowing a bit about the risks and benefits can help you contextualize your personal health profile for the doctor.

Create a Medical History Summary

Have a concise summary of your relevant medical and family history ready. This includes any past or current conditions, surgeries, and family history of blood clots, heart disease, or breast cancer. Your doctor will likely have this in your file, but having a clear, prepared list will save time and ensure you don't forget important details.

Prepare Your Questions

Write down specific questions to ask your doctor. This ensures you cover all your concerns and feel heard. Example questions include:

"Based on my symptoms and health profile, am I a good candidate for HRT?"
"What are the benefits and risks of HRT for someone in my situation?"
"What are the different types of HRT you would recommend, and why?"
"How will we monitor my progress and any side effects?"
"Are there other treatments we should consider, including non-hormonal options?"

Leading the Conversation with Your Doctor

Navigating the conversation with your doctor can feel intimidating, but remember that you are your own best health advocate. Your role is to present your case clearly and confidently.

Start with a Direct Statement

Begin the conversation with a clear, concise statement about your purpose for the visit. For example, “I’ve been experiencing significant menopause symptoms and would like to discuss starting hormone replacement therapy.” This sets the tone and immediately focuses the discussion. Avoid apologizing for your research or being direct.

Use Your Symptom Log as Evidence

Instead of vague complaints, use your symptom log to provide concrete evidence of how your health is being affected. For example, instead of saying, “I have hot flashes,” you can say, “My hot flashes and night sweats have increased significantly over the last three months, now occurring almost nightly and severely disrupting my sleep.”

Engage in Shared Decision-Making

The best medical care is a collaboration between you and your provider. Frame the discussion as a partnership. Instead of demanding a prescription, say, “I’ve researched HRT and feel it could significantly improve my quality of life. Can you help me understand how we can safely navigate this treatment plan?” This approach shows respect for their expertise while clearly stating your intentions.

Address Concerns and Obstacles

If your doctor expresses hesitation, don't be afraid to ask for clarification. Questions like, “What are your specific concerns about HRT for me?” or “Could you explain the risks you see in my particular case?” can help you understand their perspective. If their concerns are based on outdated information, you can present your own research from reputable sources respectfully. Be persistent, but stay polite and calm throughout the discussion.

What to Do If Your Doctor Refuses HRT

Sometimes, even after a thorough discussion, a doctor may be unwilling to prescribe HRT. This doesn't mean your journey is over.

Understand the Reason for Refusal

First, make sure you understand the doctor's reasoning. It may be a valid medical concern based on your unique health history. If so, discuss alternatives. However, if their reasoning seems dismissive or based on outdated fears, you have options.

Seek a Second Opinion

It is your right as a patient to seek a second opinion. You can ask for a referral to a menopause specialist or find one on your own. Specialists often have more up-to-date knowledge on HRT and may offer different insights or treatment options. The Menopause Society offers a directory of certified menopause practitioners on their website: https://www.menopausesociety.org/.

Explore Non-Hormonal Alternatives

Even if you are set on HRT, it's wise to discuss non-hormonal alternatives with any doctor, particularly if there are strong medical contraindications to HRT in your case. Medications like SSRIs, SNRI's, and other targeted therapies can sometimes help manage specific symptoms.

Comparative Options for Menopausal Symptoms


Feature	Hormone Replacement Therapy (HRT)	Non-Hormonal Medications	Lifestyle Changes (Diet/Exercise)
Mechanism	Replenishes hormones (estrogen, progesterone)	Targets specific symptoms (e.g., hot flashes with SSRIs)	Promotes overall health to reduce symptom severity
Effectiveness	Highly effective for moderate-to-severe symptoms	Can be effective, but often less comprehensive	Varies significantly; may only help with mild symptoms
Symptom Coverage	Broad relief for hot flashes, night sweats, vaginal dryness, bone density, mood, etc.	Addresses specific symptoms but not the root cause	Can improve sleep, mood, and overall well-being
Risk Profile	Increases risks for some conditions, varies by age/formulation	Varies by medication; may have side effects	Generally low risk, high reward
Monitoring	Requires medical supervision and regular check-ins	Varies, depends on the medication	No specific monitoring required

Conclusion

Taking control of your menopausal health starts with an informed conversation with your doctor. By preparing a symptom log, educating yourself, and being an active participant in your care, you can effectively communicate your desire for HRT. Whether you ultimately pursue hormone therapy or another path, a clear, confident discussion will lead to better health outcomes and a more satisfying patient-provider relationship.

Frequently Asked Questions

To effectively tell your doctor you want HRT, start by tracking your symptoms for several weeks. During your appointment, state your intentions clearly, such as, "I'm here to discuss starting HRT for my menopausal symptoms." Use your symptom log to provide specific examples of how your quality of life is affected, demonstrating that you have given this decision careful thought.

You should bring a detailed symptom journal, a list of any medications and supplements you are currently taking, a summary of your personal and family medical history, and a written list of specific questions you have about HRT. This preparation ensures a comprehensive and efficient discussion.

Yes, it is perfectly acceptable and often encouraged. Many doctors appreciate patients who are proactive about their health. Mentioning your research shows you are informed and serious about your health. Be sure to use your research as a starting point for a conversation rather than a demand for a specific treatment.

If your doctor is hesitant, ask for the specific reasons behind their concerns. This allows for a deeper conversation about your personal risks. If their reasons seem unfounded or if you are still uncomfortable, you have the right to seek a second opinion from another doctor or a specialist in menopause.

For most individuals over 45, blood tests are not required for a menopause diagnosis, as hormone levels fluctuate significantly. Diagnosis is typically based on symptoms. However, a doctor may order blood tests to rule out other medical issues, such as thyroid problems, or to check for specific conditions.

You can find certified menopause practitioners through The Menopause Society's online directory. Search for healthcare professionals who specialize in menopausal care, as they will have the most current knowledge and comfort level with prescribing HRT.

Start with a simple, direct statement like, "I'd like to dedicate our time today to discussing my hormonal health and the possibility of starting HRT." If you're nervous, bringing a written list of your symptoms and questions can help keep you on track. Remember, it's a conversation about your health, and you have every right to bring it up.

Yes. HRT can be estrogen-only (for those without a uterus), combined estrogen and progesterone, and can be administered in various forms like pills, patches, gels, or vaginal rings. Some are systemic (affecting the whole body), while others are local (for vaginal symptoms). Your doctor will discuss the best option for your specific needs and health history.