For the first half of our lives, there are clear marching orders for women’s health appointments: Time for your pap? Go to your OBGYN or your PCP. Having a baby or want one? See an OBGYN or a reproductive endocrinologist and they’ll put you on an appointment schedule.

But into our 40s, it can feel like someone forgot to hand out the memo. Hormone changes, irregular periods, mammogram recommendations–a lot of new variables come into play, and what changes and what stays the same isn’t always obvious. We talked with OBGYN Emily Hu, MD, EverNow’s Medical Director, about what to do and think about at the doctor’s office.

What should I be looking for in a GYN when I’m over 40?

For the most part, this should be the same criteria as for when you’re under 40! Your doctor should be someone you are comfortable talking to about your symptoms, and you should feel like communication is working well both ways.

That said, one great question to ask is, “Do you treat women who are going through menopause?” Likewise, "Do you specialize in a certain area of women's health?" And lastly, “Is there an area in which you have a special interest or expertise?" It’s totally okay to ask your doc these kinds of specific questions.

Also worth noting is that most doctors will specify their scope of practice on their websites (eg: “Dr. X does not do OB care.” Or, “Dr. X has a special interest in menopausal care”). So feel free to check there to get some background.

What are some questions to ask, information (or people!) to bring, and things to keep in mind in order to get the most out of my appointment?

When meeting with a new provider, be honest about your medical history and your symptoms. Also, bring up goals of treatment if there are any.

You should feel comfortable asking as many questions as you like, and feel free to write them down beforehand so you can be efficient in your visit.

If you feel like you want to bring another person to the appointment then you should be welcome to do so, but know that your provider will also interview you privately.

If I’m not sure I agree with my doctor’s suggested course of treatment, should I get a second opinion?

Yes, it’s totally fine to get a second opinion. You should never feel like you have to hide that from your first provider. In my practice, we often encourage patients to consult another doctor if desired in order to help with decision-making about treatment.

For even more context, you can also ask your doctor about the latest studies and medical group opinions surrounding your question or condition.

When making an appointment for a second opinion, do I let the office know that?

Yes, transparency definitely helps. But if you want to keep it to yourself, then that’s OK too.

How often should I be seeing or communicating with a GYN if I’m over 40 but have yet to go through perimenopause/menopause?

You should be seeing a medical provider every year if possible. Your communication and visits with your provider depend on your symptoms and issues.

How often should I be seeing or communicating with a GYN if I’m over 40 and am experiencing perimenopause/menopause?

For patients starting hormone replacement therapy, I usually schedule a check-in of some sort 6-12 weeks after they’ve begun. Following that, we do it on an as-needed basis. It’s worth noting that these check-ins don’t need to be done in-person; telehealth can be an efficient way to make monitoring more frequent and efficient when needed.

What other health concerns should I be monitoring when I’m over 40?

Once you’re over 40, you should start mammography screening along with a set of screening labs for general health. You should also be taking a multivitamin, as well as calcium supplements for bone health.

When you’re over 50, you should start colon cancer screening. And when you’re over 65, you should start getting bone density screening.

What health concerns should I be monitoring when I’m approaching or in menopause?

If you’re beginning to have irregular periods, you should check to make sure there is not some other medical reason for this (for example, a thyroid disorder).

If you’re in menopause (no periods for 12 months with no other biological cause defined), bone health becomes even more important. Continue your calcium supplements, and make sure you’re doing some form of weight bearing exercise.

What do you personally do to take care of your health?

I exercise, try to eat right and get enough sleep, and take a multivitamin and calcium every day. I also see my GYN provider yearly for checkups (paps/mammograms/screening labs), and I stay up to date on medical literature. I live my life with gratitude.

This article was reviewed by Emily Hu, MD