Perimenopause, HRT & How to Advocate for Yourself at the OB-GYN | Dr. Wendy Goodall McDonald
As physicians, we spend a great deal of time talking to our patients about prevention. We encourage annual exams, healthy habits, routine screenings, and paying attention to changes before they become serious health concerns. Prevention has long been one of the cornerstones of good medicine, and yet during my conversation with Dr. Wendy Goodall McDonald, I found myself thinking about prevention in a way I hadn't before.
Before we can expect women to recognize when something isn't right, we first have to ask whether they've ever been given permission to truly know their own bodies.
It sounds like such a simple concept, but for many women, it isn't. Many have never looked at parts of their own anatomy. Many have grown up believing that discomfort is simply something women are expected to tolerate. Others have had symptoms dismissed as "normal" without ever fully understanding what normal actually means.
Dr. Wendy Goodall McDonald has built her career around changing that narrative. As a board-certified OB-GYN, educator, author, entrepreneur, and the creator behind Dr. Everywoman, she has become known for making women's health approachable through humor, music, and storytelling. Her content is entertaining, but underneath every parody song and every funny video is a very intentional mission: helping women become more comfortable with their bodies, more confident asking questions, and more informed about their health.
As an orthopedic surgeon, I spend much of my day helping patients recover from injuries, arthritis, and musculoskeletal conditions. Recovery often begins with understanding the body, how it moves, why it hurts, and what can be done to restore function. Listening to Dr. McDonald reminded me that understanding shouldn't begin only after something goes wrong. It should begin much earlier, with simple curiosity about our own bodies and the confidence to ask questions before problems become crises.
That theme surfaced over and over again throughout our conversation, reminding me that education isn't simply about giving patients information. It's about giving them permission to become active participants in their own health.
Curiosity Is Where Good Healthcare Begins
One of the things I appreciated most about Dr. McDonald's story is that her journey into medicine didn't begin with someone telling her she should become a physician. It began because she was genuinely fascinated by the human body.
As a child, she wanted to understand how everything worked together. That curiosity eventually led her to become the first physician in her family, but what struck me most wasn't simply the path she took. It was the fact that she has never lost that childlike curiosity, and now she encourages her patients to develop it too.
Too often, we unintentionally teach women that certain parts of their bodies are off limits for discussion. Conversations about reproductive health become uncomfortable. Questions about vaginal health are whispered instead of asked openly. Many women reach adulthood having never really understood their own anatomy because no one ever encouraged them to learn.
That lack of familiarity has consequences.
If you don't know what's normal for your body, it's much harder to recognize when something changes. You may overlook symptoms that deserve attention, dismiss discomfort that isn't actually normal, or delay seeking care because you assume everyone experiences the same thing.
During our conversation, Dr. McDonald spoke passionately about helping women become familiar with their own anatomy. She created the Every View mirror specifically to encourage women to perform vulvar self-examinations, not because she wants patients to become anxious or constantly searching for problems, but because she believes women deserve to know their own bodies as well as they know every other part of themselves.
When she framed it that way, it felt surprisingly obvious.
We examine our skin for new moles. We notice when our eyes become irritated. We look inside our mouths when something feels sore. We don't consider those actions strange or embarrassing. Yet many women have been taught that looking at their vulva somehow crosses a line.
It doesn't.
Body awareness shouldn't feel taboo. It should be viewed as one of the simplest forms of preventive healthcare available to us.
Small Changes Can Have a Big Impact
Another part of our conversation that stayed with me centered around something surprisingly ordinary: underwear.
Dr. McDonald shared that she spent years wearing men's boxers because traditional women's underwear simply wasn't comfortable for her sensitive skin. At first, she assumed she was the only one experiencing that kind of discomfort. It wasn't until years later, after caring for countless patients with similar concerns, that she realized many women were quietly living with irritation, friction, moisture, and discomfort without recognizing that simple changes could make a meaningful difference.
I found that conversation fascinating because it challenged something we often see throughout medicine.
Many people assume discomfort is simply something they have to live with.
Whether it's joint pain, chronic back pain, pelvic discomfort, or skin irritation, patients frequently normalize symptoms that deserve a closer look. Sometimes those symptoms signal an underlying medical condition. Other times, relatively small lifestyle adjustments can dramatically improve quality of life.
As physicians, we're trained to diagnose disease and recommend treatments, but prevention often happens in much smaller ways. It happens through conversations about sleep, nutrition, exercise, stress management, clothing choices, skin care, and countless everyday habits that influence how our bodies feel.
What I appreciated about Dr. McDonald's approach is that she isn't simply trying to sell products. She identified common concerns she repeatedly heard from patients and asked herself whether there were practical solutions that didn't require another prescription or another office visit.
That philosophy reflects something I think many physicians strive for.
Our goal isn't simply to treat illness. It's to help people stay healthy enough that they need us less often.
Annual Exams Are Conversations, Not Checklists
As physicians, we often encourage patients to prepare for appointments, but Dr. McDonald offered advice that I think every patient could benefit from hearing.
Come with a list.
Write down your questions before you arrive. Keep track of your symptoms. Notice when they occur, what makes them better, and what seems to make them worse.
That preparation doesn't make a patient difficult. It makes the visit more productive.
We've all experienced that moment when a patient remembers their biggest concern just as the appointment is ending. Understandably, life gets busy, and it can be difficult to remember every question in the moment. Having notes allows patients to communicate more clearly while also giving physicians valuable information that can help guide testing, treatment, or follow-up.
I also appreciated something else she said that challenges a common misconception.
She loves when patients come in having done research.
Many people apologize for searching online or using ChatGPT before their appointment. They worry they've somehow done something wrong by trying to educate themselves.
Dr. McDonald sees it differently.
She views those conversations as opportunities.
Patients who have spent time learning about their symptoms are often more engaged in the discussion. They ask thoughtful questions, and even when they've encountered misinformation, those misconceptions become opportunities for education rather than frustration.
I couldn't agree more.
Medicine works best when patients and physicians work together. The internet should never replace medical advice, but curiosity shouldn't be discouraged. In many ways, it creates the foundation for better conversations.
Advocacy Starts With Understanding
As our conversation shifted toward healthcare disparities, particularly those affecting Black women, Dr. McDonald shared something that I think extends far beyond one community.
Self-advocacy doesn't have to be confrontational.
Instead, she described advocacy as understanding your body well enough to recognize when something deserves further evaluation and feeling confident enough to ask additional questions when the answers don't seem complete.
That distinction feels important.
Sometimes patients worry that advocating for themselves means arguing with their physician or questioning every recommendation. That's not what good advocacy looks like.
Good advocacy begins with curiosity.
If you're experiencing unusually heavy bleeding, ask why.
If you're told something is normal, ask what has been done to rule out conditions that are not.
If symptoms continue despite reassurance, continue the conversation.
Medicine is filled with nuance. There are certainly situations where symptoms truly are within the range of normal variation, but there are also times when further evaluation changes everything.
The strongest physician-patient relationships aren't built on blind trust. They're built on communication, mutual respect, and shared decision-making.
Patients deserve to understand why recommendations are being made, and physicians should welcome those conversations.
Menopause Deserves Nuance, Not Fear
There may be no topic receiving more attention in women's health right now than menopause and perimenopause.
That increased awareness has been incredibly valuable. More women are finally talking openly about symptoms that previous generations often suffered through in silence. Research is expanding, conversations are becoming more honest, and women are recognizing that many symptoms they've experienced have biological explanations.
At the same time, Dr. McDonald offered an important reminder.
Awareness should not become anxiety.
She shared that many women now arrive in her office worried about symptoms they haven't even experienced yet. They wonder whether they should begin hormone therapy simply to prevent future problems.
Her answer reflected the nuance that good medicine requires.
Every woman experiences this transition differently.
Some women have significant symptoms that meaningfully affect quality of life and benefit greatly from treatment. Others move through menopause with relatively few symptoms. The goal isn't to place every woman on the same treatment plan. The goal is to understand each patient's experience and tailor recommendations accordingly.
That individualized approach resonated with me because it's something we strive for across medicine.
There is rarely a one-size-fits-all solution.
The best care begins by listening carefully to what each patient is experiencing rather than assuming everyone needs the same intervention.
Resilience Isn't About Doing More
Because this podcast explores resilience, I asked Dr. McDonald how she defines it after balancing clinical practice, entrepreneurship, motherhood, content creation, and everything else she has built throughout her career.
Her answer has stayed with me ever since.
She described resilience as the intentional pursuit of rest and self-care.
Not something we fit in if time allows.
Not something we earn after exhaustion.
Something we actively protect.
As physicians, we spend so much time encouraging our patients to sleep more, reduce stress, exercise regularly, and prioritize their well-being. Yet many of us struggle to extend that same grace to ourselves.
Dr. McDonald spoke about teaching her children that no one will ever prioritize their well-being more than they will. Waiting for someone else to give us permission to rest often means that permission never comes.
I found that perspective incredibly refreshing because resilience is often portrayed as endless perseverance, as though strength means continuing no matter how depleted we become.
In reality, sustainable resilience requires recovery.
It requires recognizing that caring for ourselves allows us to care more effectively for everyone else.
Whether we're physicians, parents, caregivers, or simply navigating busy lives, we cannot continually pour from an empty cup.
Final Thoughts
What stayed with me most after speaking with Dr. Wendy Goodall McDonald wasn't simply her creativity, her entrepreneurial spirit, or even her remarkable ability to make women's health genuinely entertaining.
It was her belief that education begins by making people feel comfortable enough to ask questions.
For generations, women have often been taught to tolerate discomfort, minimize symptoms, and quietly accept experiences they assume are simply part of being a woman. Dr. McDonald challenges that mindset with every patient she sees and every piece of content she creates. She reminds women that understanding their bodies is not embarrassing, advocating for themselves is not confrontational, and asking questions is not a sign of weakness.
Those ideas may seem simple, but they have the power to transform healthcare.
When patients understand what is normal for their bodies, they are more likely to notice meaningful changes. When they feel comfortable asking questions, they become active participants in their care instead of passive recipients of information. When they build trusting relationships with physicians who welcome those conversations, healthcare becomes a partnership rather than a transaction.
As physicians, we will always diagnose illness, perform procedures, and prescribe treatments. Those responsibilities will always remain central to what we do. But perhaps one of the most meaningful things we can offer our patients is something much simpler: the confidence to know their own bodies well enough to recognize when something deserves attention and the reassurance that their questions are always worth asking.
After my conversation with Dr. McDonald, I was reminded that some of the most important work we do in medicine doesn't happen inside an operating room or an exam room. It happens when we replace embarrassment with education, uncertainty with understanding, and silence with conversation.
Because when women truly know their bodies, they are better equipped to care for them throughout every stage of life.
Want to Learn More?
For more conversations like this, subscribe to The Resilience Factor wherever you get your podcasts, and find me @dr.pamelamehta on social media.
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This episode is brought to you by The Pinnacle Podcast Network! Learn more about Pinnacle at learnatpinnacle.com
