Question: I think I’m going through menopause. I’m waking up at night soaked with sweat. I’m always screaming at my kids. Everything bothers me. I don’t think I used to be that way. Should I be seeing my primary care, or a psychiatrist?

Anne Fenton, MD: You may prefer to start with your primary care doctor or gynecologist who can first sort out whether there is anything else besides menopause that may be causing your symptoms, such as thyroid or pituitary problems. If all other possible medical conditions are excluded, and your symptoms are clearly related to menopause, they can also suggest a mild medication for your mood changes. Certainly, the hormonal fluctuations that occur during menopause, just like those in puberty, can affect mood and behavior, and often in profound ways.

Generally speaking, however, most specialists, psychiatrists included, have more expertise in the assessment and treatment of a specific area, and tend to follow their patients more closely. Your treatment can be customized more readily if you see an expert once a month than if you see a generalist once or twice a year for a problem such as yours which can change rapidly over a relatively short period of time.