A Shopping List of Symptoms

Sometimes someone comes into my room with what feels like a shopping list (or usually!)

Hot flushes. Low libido. Vaginal dryness. Weight gain. Poor sleep. Not being able to exercise like you used to. Borderline blood pressure. A history of gestational diabetes. And then, almost as an aside: “Actually, this flatness feels a bit like I did after I had my baby.”

So we go through it.

One by one.

Very occasionally, someone tells me afterwards that they felt a bit overwhelmed by how much we talked about. And I do understand that.

There can be a lot of information.

But if you have waited months for an appointment, paid a lot to be there, taken time away from work or family, and finally have an hour to talk about everything that has been bothering you, I want you to tell me.

All of it.

And if you ask, I will usually answer.

If there are options you might not know about, I will usually tell you about those too.

Not because you need to do everything.

Not because I think every symptom needs fixing immediately.

But because you can’t ask about an option you don’t know exists.

That is the balance I am always trying to get right.

What matters most today?

What can wait?

What should we keep an eye on?

And what do I want you to know about, just in case the first plan does not quite get you where you want to be?

Sometimes you know exactly what the biggest problem is.

Sometimes I think I know.

Sometimes neither of us really knows at the beginning, and we have to work it out together.

That is why I write a plan.

What to do first. What can wait. What to watch. What we might investigate. And what we could try next if things do not improve.

Because after an hour talking about hormones, sleep, mood, sex, bleeding, weight, bones, cardiovascular health, work and family, you are probably not going to remember every word I said.

And honestly, I do not expect you to.

The plan is there so you can come back to it.

And so your GP or other healthcare professionals can see where we are going next.

One of the biggest privileges in my job is actually being trusted with the whole story.

The small print.

The things that feel awkward, random, embarrassing or completely unrelated.

Quite often, once we put it all together, it starts to make a lot more sense.

I will not always get the balance right.

Sometimes I will probably give you more information than you needed that day. Sometimes I may not realise which part mattered most to you.

Please tell me.

I am much better at doing this now than I was a few years ago, and I hope I will keep getting better.

So bring the shopping list.

I will listen.

And we will work out what matters most first.

This version feels warmer and more conversational, without losing the bit where you are gently defending why you give people a lot of information.