I’ll never forget the day I found myself sitting on the other side of the desk, not as a nurse, but as a patient. A Black woman in her forties, with over 25 years of experience in healthcare, heart pounding, palms damp, memory shot to hell!  I truly wondered  if I would get the help that I needed. I had been to several doctors appointments over the years as a caregiver and a patient.

But this time felt different! I felt more vulnerable. I was fatigued. My brain wasn’t as sharp and quite frankly I felt a fear that I never felt before. Because if I’m honest, I’d never showed up to a doctor's appointment without at least some clue of what was happening in my body or my loved one’s body. 

It was at that moment that I realized that I needed a ME! I needed someone to advocate for me. And I thought about the women who don’t have a Me! I thought about one of my former patients, a 45-year-old Black  woman who came to a women’s support group that I was facilitating. She reported feeling like her healthcare providers were not listening to her. She described feeling frustrated and hopeless.

After the meeting, I talked with her in whispers in the corner of the auditorium. Coaching her on what to ask on her next visit and developing a short task list of what she could do to help herself and how to look for another provider if this one did not meet her needs.

By the end of our talk,  she had a plan and most importantly, she had been heard.

That was the day I said, “No more shrinking.” If I, a nurse, felt uncertain about speaking up in a 15-minute appointment, what about every other Black woman navigating midlife, trying to make sense of hot flashes, fatigue, brain fog, and irregular periods?

Back to my appointment. I whispered to God to help me and to show me what to do! I told God that I would work to help women feel more confident in their health journey - especially when it comes to self-advocacy in perimenopause - and that I would create the space I needed but didn’t have. That was the seed for what would become My Sister’s Advocate.

Why Preparation is Power

Black women are more likely to be gaslit in healthcare settings—told our pain is normal, our fatigue is from stress, and our hormonal changes are “just part of aging.” That’s the heart of self-advocacy in perimenopause: knowing your symptoms, preparing your questions, and confidently asking for the care you deserve. But showing up prepared can flip the script. When we bring clarity, confidence, and the language that demands attention, we stop being passive recipients and start being respected partners in care.

Here’s what that sounds like.

Advocacy Scripts That Work

These aren’t just words. They are boundary-setting tools. These are scripts I’ve personally used, shared with clients, and refined from decades of experience:

Instead of saying: “I feel tired all the time.”

Try: “I’m experiencing persistent fatigue that’s affecting my work and relationships. It started six months ago, and it’s getting worse.”

Instead of: “My periods are weird.”

Try: “I’m noticing changes in my menstrual cycle—heavier bleeding, longer duration, and spotting between periods. Could this be perimenopause? What are my options?”

Instead of: “I think I’m having hot flashes.”

Try: “I’m having intense hot flashes multiple times a day and night sweats that are interrupting my sleep. It’s been going on for X months.”

When You’re Not Being Heard

Let’s keep it real. Sometimes, even with preparation, you’ll encounter providers who want to move you along, dismiss your concerns, or downplay your experience.

If they say: “That’s just what happens at your age.”

You say: “I understand this can be age-related, but I’d like to explore treatment options to improve my quality of life.”

If they say: “Just try to reduce your stress.”

You say: “I agree that stress plays a role, but I’d like to talk about medical treatments in addition to lifestyle changes.”

If they still dismiss you, say:

“Please document in my chart that you're declining treatment for these symptoms and explain your clinical reasoning.”

This one stops folks in their tracks. When providers know you’re keeping a record, the tone often shifts immediately.

Documentation is Your Proof

Ask for everything. You are entitled to your records. That includes notes, labs, and any decisions made about your care.

Say this:

“Please include my symptoms and your assessment in the chart.”

“I’d like copies of all test results sent directly to me.”

“Can you document my request for hormone testing and explain your decision not to order it?”

Questions That Get You Better Care

Asking direct, informed questions is a core part of self-advocacy in perimenopause and can lead to more accurate diagnoses and effective treatment plans. Start with questions that show you’re engaged and informed.

For hormone testing:

“With my symptoms and age, what hormone labs do you recommend, and how will those guide treatment?”

For treatment options:

“What are all of the available options, both hormonal and non-hormonal? What are the risks and benefits?”

For follow-up:

“If things don’t improve, what’s our plan? What signs should I track and when should I return?”

For a second opinion:

“I’d like a referral to a menopause specialist for another perspective.”

Build a Follow-Up Strategy

After the appointment, don’t lose momentum.

Within 24 hours: Send a portal message summarizing what was discussed and confirm your next steps.

Keep records: Note what the provider said, what was recommended, and what the outcomes were.

Track progress: Log your symptoms and responses to treatment to prepare for your next visit.

When It’s Time to Walk Away

You don’t have to stay where you aren’t respected. You deserve a provider who:

• Listens without interruption
• Validates your experience
• Clearly explains options
• Has knowledge of perimenopause in Women of Color
• Makes you feel seen

Your Voice is an Act of Advocacy

Sis, when you stand up for your needs, especially through self-advocacy in perimenopause, you’re doing it for all of us. You’re showing your daughter, your niece, your friends, and the next woman in the waiting room what’s possible. You’re setting a new standard.

So let’s keep building that generational health - one question, one appointment, one boundary at a time.

Have you had a moment where you had to speak up for yourself? What language worked for you? Drop your stories in the comments so we can keep learning from each other.