In this week’s episode Dr Louise is joined by one of her patients, Lesley Henry, a nurse who lives in Northern Ireland. Lesley shares her experience of menopause, which started before she received a diagnosis of endometrial cancer.

Her treatment for cancer led to a surgical menopause, which she found debilitating. Lesley explains she feared her brain fog and fatigue would prevent her from returning to work and from caring for her mother.

A firm believer in the importance of quality of life, Lesley decided to resume taking HRT. She hopes to help other women who are going through similar experiences and shares the things that have given her the strength to make decision about her treatment and her life:

1. I have a faith. Not everybody will have the same faith as I have, and that's fine, but I think having a faith helps.
2. Be proactive and find support groups. Through Action Cancer I learnt about scar therapy, which has helped, plus I completed a positive living programme to learn how to re-energise and rebuild my life.
3. Be prepared to say goodbye to the old you. She's not coming back and in a way, she needs to go.
4. Trust in yourself and listen to your heart. You are worthwhile and your life matters.

Click here to find out more about Newson Health

Menopausal women are the fastest-growing demographic in the UK workforce, yet a 2022 survey by the Fawcett Society found one in ten women leave work due to their menopause symptoms.

This week, Dr Louise is joined by Oonagh Ferson, who researched the experiences of perimenopausal and menopausal women in the workplace as part of her MSc in HR management at Queens University Belfast.

Oonagh shares her research findings and some of the stories of women she interviewed, and with Dr Louise discusses the impact of perimenopause, menopause and other conditions such as PMS and PMDD in the workplace.

Oonagh offers advice on how women can thrive at work, including the three things she believes would make the biggest difference to women in the workplace:

1. A bottom up approach, where employers sit down with women and ask them: what would help you? What can we do?
2. Even though it may be difficult at times, advocate for yourself: be open with your employer to secure the support or adjustments you need
3.  Having open discussions, using clear language and avoiding terms like ‘the change’, can help dispel the stigma around menopause  

There is a chapter dedicated to menopause and the workplace in Dr Louise’s bestselling book, The Definitive Guide to the Perimenopause and Menopause. Order your copy by clicking here.

Click here for more about Newson Health.

About 28 million people in the UK are thought to be living with chronic pain – that’s 43% of the population, according to the 2011 Census.

But what is chronic pain, and how can it overlap with the perimenopause and menopause?

In this week’s episode Dr Louise is joined by Dr Deepak Ravindran, a consultant in pain medicine and author of The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain.

Dr Deepak unpicks the science behind chronic, or persist, pain and the two discuss the relationship between hormones, inflammation and pain.

Dr Louise and Dr Deepak have co-authored a new article which offers 10 top tips for primary care practitioners on improving care for women with fatigue and/or pain. You can access the article here.

Follow Dr Deepak on YouTube, Instagram, LinkedIn and X.

Click here to find out more about Newson Health

Content warning: This episode contains discussion of suicide

Vanessa had always suffered with PMS and struggled with her mood and emotions after the birth of each of her children. After her fourth child was born, Vanessa’s mental health took a severe turn and she became suicidal. When her husband intervened and insisted she received specialist care, a psychiatrist realised how unwell Vanessa was and this was the beginning of an eighteen year journey of taking medication and receiving mental health support, including spells of inpatient care. It was all Vanessa could do to wake up every day and look after her children. Vanessa had wondered whether her mood was linked to her hormones as she would have 2 good weeks in every month before two bad weeks would inevitably creep in. In more recent years, friends persuaded her to see a menopause specialist and begin topping up her declining hormones and, as Vanessa explains, this has been lifechanging.

Vanessa’s advice:

1. You may not be well enough to go and ask for help yourself, allow family and friends to support you with this.
2. Don’t always accept everything you’re told by healthcare professionals, challenge thoughts and negative attitudes towards mental health and the link with hormones.
3. We develop lots of coping strategies to mask how we are really feeling. Don’t carry on hiding how you really are, speak to someone.

Help is available if you are struggling. Please contact the Samaritans by phone on 116 123, download the Samaritans Self-Help app or email jo@samaritans.org

Dr Taher Mahmud is a rheumatologist from London who has the ambitious plan of eradicating the bone weakening disease osteoporosis by 2040. Osteoporosis is a common disease, particularly for women around the time of the menopause, but with the right nutrition, exercise and hormone supplementation it is possible to prevent loss of bone tissue and even reverse osteoporosis if it has developed.

The experts discuss this worldwide preventable problem and some common misconceptions about bones. The discussion covers the challenges of current healthcare systems in getting accurate information about your bone health and the importance of raising awareness of how preventable osteoporosis is to all individuals.

Dr Mahmud’s tips:

1. Take time for yourself, think about your body and your health and value it
2. It is easy to diagnose osteoporosis and treat it, however…
3. It is far better to learn about your bone health and do what you can to prevent osteoporosis

To learn more about your own risk of osteoporosis, visit www.sticksandstones.org.uk

Dr Mahmud is based at the London Osteoporosis Clinic, for more information visit www.londonosteoporosisclinic.com

Janet Birkmyre began her career racing as a track cyclist in her mid-30s and won her first elite medal at the age of 40. She went on to win three elite National Championship titles and multiple masters World and European titles.  Now at 55, Janet is continuing to improve her times and fitness, and she is a champion of women continuing to enjoy and excel at sport at any age.

In this episode, the conversation covers Janet’s experience of perimenopause and menopause and taking HRT. As an elite athlete however, there are sanctions for Janet if she takes testosterone replacement as there are currently no exemptions to the regulations for therapeutic use in women, only for men. Janet shares her frustration at the unfair choice imposed on her of continuing with the sport she loves and excels in or replacing her low testosterone levels to help with her ongoing menopausal symptoms.

Janet’s three positive steps to improve health through exercise:

1. Enjoy being active – make it fun
2. Exercise with a friend – you will motivate and encourage each other
3. Don’t be self-conscious or compare yourself with others – we come in all wonderful shapes and sizes.

So whatever you look like, whatever you’re wearing, be active and enjoy it!

Follow Janet on Instagram @janbirkmyre_torq_track_cycling

Dermatologist, Dr Sajjad Rajpar makes his third visit to the podcast this week to separate the facts from the fiction about skin changes in perimenopause and menopause and debunk some of the messaging around recent skin products marketed for menopause.

Dr Rajpar explains the importance of estrogen for skin and how HRT can prevent and heal damage to skin tissue such as leg ulcers, for example. The experts discuss the negative impact of skin product marketing on initially younger women and now menopausal women, and unpick some perceptions about what a ‘menopausal’ face cream will and won’t do for your skin.

Dr Rajpar’s three tips for problematic skin:

1. For dry and irritable skin, avoid foaming and detergent based cleansers and use very gentle cleansing products or even a moisturising lotion to wash with. They may not lather or bubble but they do adequately remove dirt from your skin.
2. Use a good moisturiser once or twice a day, consider a lotion in the day as it is lighter and use a cream at night.
3. There are creams containing active ingredients that don’t have to rob the bank. Look for ingredients like retinol, vitamin C, and sunscreen.

You can visit Dr Rajpar’s website here www.midlandskin.co.uk and follow him on social media @dr.rajpar_dermatologist on Instagram.

This week offers a chance to revisit a previous podcast conversation – or perhaps hear it for the first time. Lucy Holtom is an experienced Ashtanga yoga practitioner who has a particular passion for helping with women throughout all cycles of life whether it’s to help manage the fluctuation of hormones during menstruation, postnatal recovery, or perimenopause and postmenopause.  In this episode, Lucy and Louise discuss the different types of yoga, individual practices and the benefits they can bring. Lucy explains how her interest and experience in well woman yoga evolved and how she supports women in the perimenopause and menopause.

Lucy’s 3 tips for those interested in trying yoga for the first time:

1. If you want to try a class, look for recommendations from others and chat to different teachers to find what’s right for you.
2. Wear comfortable clothing – you don’t need to spend money on new yoga outfits, just wear whatever you can move freely in.
3. Go with an open mind and enjoy!

Visit Lucy’s website at www.livingyouryoga.co.uk

Follow Lucy on Instagram @xxlivingyouryogaxx

This podcast episode was first released in October 2019

Advisory: we would like to apologise for the sound quality in this episode, which was due to technical issues experienced during recording.

Dr Pooja Saini is a Chartered Psychologist and Reader in suicide and self-harm prevention based at Liverpool John Moores University. Her work has a particular focus in suicide prevention in primary care and developing community-based interventions for high-risk groups.

Since connecting, Louise and Pooja have been discussing the impact of perimenopause and menopause on mood, mental health and suicide and the many research gaps and unanswered questions in this space. In this episode, Pooja explains more about what is known and unknown regarding the effect of hormones on suicidal thoughts and outlines the research plan for a PhD funded by Newson Health Research and Education.

Pooja’s tips for those with suicidal thoughts:

1. Early intervention is key; seek help as soon as you feel you are not yourself
2. Change your habits to do more of what you really enjoy
3. Talk to your loved ones, family and friends. Don’t try and hide or mask it.

If you need support, you can call the Samaritans on 116 123 for free from any phone or email them at jo@samaritans.org

Pooja's Social Channels

Twitter

Work Website

Reference for BMJ article discussed:

McCarthy M, Saini P, Nathan R, McIntyre J. Improve coding practices for patients in suicidal crisis. BMJ. 2021 Oct 15;375:n2480. doi: 10.1136/bmj.n2480. PMID: 34654729.

Dr Anna Chiles is a GP and works in an NHS practice in Gloucestershire and at Newson Health as a menopause specialist. In this episode, the experts discuss the range of symptoms that can occur in the perimenopause and menopause and the impact of these on daily life, and they highlight what can be done for women when symptoms persist for many years.

Anna’s 3 tips for women who have struggled with symptoms for many years:

1. It’s never too late to start HRT and have that discussion with your health practitioner. If you choose to try it, you don’t have to continue with it if you don’t like it.
2. You don’t have to stop taking HRT when you reach a certain age
3. It’s so important to keep active, for your independence, your balance, joints, and muscle strength. This goes hand in hand with hormone replacement.

Margaret Reed Roberts is an experienced social worker and educator who noticed a change in how she felt in her late 40s. Along with more obvious symptoms of perimenopause, such as hot flushes and migraines, there came a deterioration in her cognition – she struggled to initiate, plan and complete daily tasks and the mental load became unmanageable. A friend suggested there may be more than perimenopause going on and questioned if Margaret was neurodivergent.

In this honest and insightful conversation, Margaret shares of the ‘relief and grief’ of being diagnosed with ADHD as an adult and the impact she now understands ADHD has on her daily activity, home life and relationships.

Margaret’s three tips for those who have ADHD or think they might have it:

(provided after the conversation)

1. Be informed. Knowledge is a game changer. You feel more confident when you understand and are better able to advocate for yourself. Challenge others where necessary, using your acquired knowledge and pass that information on.
2. Don’t be alone; join support groups, talk to empathetic friends and family.
3. Tell your story. You and your story are valuable, not everyone will listen or care, but the more we talk, the more we break taboos and stigma.

Follow Margaret on Facebook

Twitter: @geordiereed

Susie Crowe is a consultant obstetrician and gynaecologist who is passionate about advocating for and empowering women to understand their bodies and supporting them to make choices about their medical care and their lifestyle.

In the midst of the pandemic, Susie noticed fatigue creeping in and put it down to burnout from her busy job. When she began having night sweats and saw her doctor, the menopause was the initial diagnosis suspected but there were no other symptoms of perimenopause occurring. Susie became more unwell and after months of having normal blood tests, further investigations revealed that she had non-Hodgkin lymphoma – a type of blood cancer. In this episode, the experts discuss women’s experiences of sudden onset menopause after treatments for cancer and the benefits and safety of HRT.

Susie’s advice to healthcare professionals:

1. Listen to your patients as they know their bodies best
2. Have empathy for a women’s menopausal symptoms (as they may be worse than those from the cancer or side effects from treatments) and she may feel very vulnerable
3. Prioritise personalisation and choice by providing the right information and encouraging your patient to make their own decision based on what’s important to them and their life.

Follow Susie on social media:

Twitter @susannacrowe

Instagram @theholisticobgyn

Farhana is an accredited family law specialist and mediator working with Family Law Partners in London. During her 20-year career, Farhana often noticed an unspoken element at play when helping women through divorce, but it wasn’t until she identified perimenopause within her peer group and those close to her that she appreciated the extent of the problem and was able to professionally decipher the impact of menopause on relationship breakdown. Farhana launched the Family Law Menopause Project to see whether any other colleagues in family law were factoring in this important element  and to raise awareness of perimenopause and menopause when it comes to family cases dealing with divorce, splitting the assets, children issues or domestic abuse.

Farhana’s tips for family lawyers:

1. Listen, enquire, and communicate. Look for cues and don’t be afraid to ask questions
2. If you think a client is experiencing peri/menopausal symptoms affecting their relationships and wellbeing, invite them to see their doctor
3. Factor the menopause into your cases. Pick a family process that suits the client, for example arbitration or mediation, and be sympathetic.

Visit Farhana’s family law practice at www.familylawpartners.co.uk

Follow Farhana on Twitter at @ShahzadyLaw @LawMenopause or lawmenopause on Instagram

Content advisory: this podcast contains themes of suicide and mental health.

This week on the podcast, Dr Louise is joined by Andrea Newton, a postmenopausal woman whose own experience of mental health during the menopause lead her to train as a tutor with the National Centre for Suicide Prevention Training. Over the last six years, Andrea has trained thousands of people in suicide intervention skills and she is now training to become a menopause coach.

Andrea explains how her work in the corporate world has allowed her to share the importance of educating line managers, HR managers, and everyone about the menopause. She is also the author of the book, Could it be Your Hormones Love? (And Other Questions Not to Ask a Menopausal Woman).

Andrea shares her tips on widening the conversation about menopause:

1. Women need to educate themselves more about how the menopause affects all aspects of their health and be better at advocating for themselves.
2. Let’s take the conversation to the wider audience and stop the awful, narrow, stereotypical view of menopause. Instead, educate people so we can avoid tribunals, retain talent and have more menopause-friendly businesses.
3. Get comfortable with the uncomfortable and have conversations about things like menopause, mental health, suicide risk. We need to stop waiting for people to reach out, and we need to get better at reaching in and being proactive.

You can follow Andrea on LinkedIn, Instagram @in.her.right.mind and Facebook @InHerRightMind  

Click here to find out more about Newson Health

Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email jo@samaritans.org.

Related articles

Westlund Tam L, Parry BL. (2003), ‘Does oestrogen enhance the antidepressant effects of fluoxetine?’, J Affect Disord. 77(1):87-92. Doi: 10.1016/s0165-0327(02)00357-9

Ibrahim WW, Safar MM, Khattab MM, Agha AM. (2016), ‘17β-Estradiol augments antidepressant efficacy of escitalopram in ovariectomized rats: Neuroprotective and serotonin reuptake transporter modulatory effects,’ Psychoneuroendocrinology. 74: 240-250. 10.1016/j.psyneuen.2016.09.013

Until a few years ago, Jill was in denial about her age, the menopause and what that meant for her future health. She had worked for 30 years as a fitness instructor and sports massage therapist; she was incredibly fit and had never given her heart health a moment’s thought. This abruptly changed in 2021 when Jill had sudden and severe pains in her chest and after some doubt and misdiagnoses by the medical team in A and E, she was found to have had at least one significant heart attack, possibly more. Since then, Jill has had ongoing intermittent chest pain, especially when having hot flushes, and she realised her continued cardiac symptoms were potentially linked to her changing hormones.

Dr Louise Newson explains the link with estrogen deficiency and cardiac symptoms, and the increased risk of heart attacks after menopause. Together they discuss gender bias in heart research, the difficulties diagnosing heart attacks in women, the possible reasons for poorer outcomes compared to men and the cardiovascular benefits of HRT.

Jill’s 3 tips to women if worried about your heart:

1. Listen to your body, you know it best
2. Do your own research, such as balance-menopause.com, Blood Pressure UK, British Heart Foundation websites
3. Have someone with you at appointments, or over the phone if not in person
4. If you know there’s something wrong with your heart, ask for a troponin blood test

You can read Jill’s story here

Dr Devika Patel joins Dr Louise Newson in this episode of the podcast to share how a chance encounter when overhearing an educational webinar on the menopause was a light bulb moment for her practice as a psychiatrist. Devika takes us through her journey of how this knowledge from learning about menopause has transformed the psychiatric care she now offers to her patients.

Devika’s 3 tips for those with mental health challenges who are in perimenopause/menopause:

1. Don’t forget the important lifestyle changes (healthy diet, exercise, reduce stress, improve sleep and have meaningful connections with others) apply to mental health just as they do with menopause.
2. When seeking help, go with your own data to your healthcare appointment. Track your moods with your cycle and really make any links clear to your clinician.
3. If you don’t feel your healthcare professional is the right match for you, see someone else and advocate for yourself.

Website/socials details – Instagram @drdevikapatel Twitter @drdevikapatel

Podcast: “Our Extraordinary Stories with Dr Devika Patel”

Victoria Jones is a community pharmacist at Bonnybrook Pharmacy in Coolock, Dublin. She received very little education on the menopause when training and became more interested in hormone health after her sister experienced severe symptoms at 40 and began taking HRT. The dramatic return of her sister’s health and wellbeing prompted Victoria to move away from running a chain of pharmacies to set up her own independent pharmacy with a focus on women’s health. When Victoria experienced her own perimenopause and she saw the profound benefits of HRT for herself, her passion escalated and Victoria now takes a very active role in raising awareness in her community with the public and local healthcare professionals, and in educating others through her social media.

Victoria’s advice to women:

1. Ask your pharmacist if they’ve done any training on the menopause and if not, mention the resources available such as on balance website and the Confidence in the Menopause course on fourteenfish.com. Find the right pharmacist for you.
2. Don’t be fobbed off by healthcare professionals, if you aren’t listened to the first time, go in more empowered with information the next time. Ask for a specific clinical reason why they will not prescribe HRT, and ask them to write it down for you.
3. Your pharmacist can explain how and when to take your HRT medication if your doctor wasn’t sure, or you didn’t have time to discuss thing fully.
4. Your pharmacist can also help with information on improving health through lifestyle measures such as nutrition and exercise.

Victoria’s pharmacy website is www.BonnybrookPharmacy.ie

Follow Victoria on Instagram and Facebook @The_menopause_pharmacist

Dr Heather Hirsch makes a welcomed return to the podcast this week. Heather is an internal medicine physician, specialising in women’s health and menopause care at the Brigham and Women’s Hospital in Boston Massachusetts, USA. Her clinical work and research centres on inequalities or unanswered questions in the field of women’s health, specifically in menopause education.

In this episode the menopause experts discuss the bigger picture of menopause care as a gender issue, women’s role in society and in the workplace, perceptions of women’s suffering and the menopause as a medical specialty. Louise and Heather share the challenges they each continue to face to educate and inform the public and healthcare professionals on the perimenopause and menopause and the benefits and safety of HRT.

Heather’s 3 tips:

1. Know what’s going on in your body by keeping a journal and tracking your symptoms. I recommend the free balance app to my patients for this.
2. List your own priorities and what matters most to you, whether that is your sexual health, your hair or skin, your sleep and so on.
3. Understand the three strands of menopause management: lifestyle changes, non-hormonal treatments and HRT, and know the pros and cons for all to realise what choices are best for you.

Follow Heather at:

Instagram @hormone.health.doc

Website: heatherhirschmd.com

YouTube: Health by Heather Hirsch

Podcast: Women’s Health by Heather Hirsch

Dr Saira Hameed is a consultant endocrinologist working at the Imperial Weight Centre and at Imperial College London. Her work focusses on researching the drivers for appetite, obesity, and regulation of body weight to develop science-based interventions that help people manage their weight and lead healthier lives.

In this episode the experts discuss the impact of obesity on individuals’ health, on the NHS and wider society, and the science behind sugar, fats, and processed foods. Dr Hameed’s book, ‘The Full Diet’, explains the weight loss programme that is used in the NHS by clinicians and patients and was developed and trialled at Imperial College.

Saira’s 3 tips:

1. Short term – do everything you can to remove ultra-processed foods from your environment
2. Medium term – look at all the factors that contribute to your weight such as your stress levels, sleep, activity levels and seek to address those too
3. Longer term – be your own biggest fan. Feeling good about yourself will have a positive ripple effect on other areas of your life.

‘The Full Diet’ book is available now and published by Michael Joseph.

Find her on her social channels on Instagram https://www.instagram.com/drsairahameed/ and Facebook https://www.facebook.com/thefulldietbook 

Dr Sharon Malone is an eminent American physician who has worked as an obstetrician and gynaecologist for over 30 years in Washington DC. After 15 years of working mostly as an obstetrician, Sharon changed to specialise in menopause care around the time of her own perimenopause. She is passionate about educating women to understand their own hormone journey and empower them with evidence based information about hormone treatments.

The experts discuss the challenges of influencing and persuading medical colleagues on the benefits of hormone replacement, the importance of patient choice and agency, and the lack of menopause research and need for government funding.

Dr Malone’s advice to women:

1. Find your community of women who will support you and understand what you’re going through
2. Be active, keep exercising regularly
3. Maintain a healthy diet and eating habits; processed foods negatively affect so many aspects of your health

To read or listen to Dr Malone’s Washington Post op ed, visit https://www.washingtonpost.com/opinions/2022/04/28/menopause-hormone-therapy-nih-went-wrong/

Dr Malone is the Chief Medical Officer at US based menopause company Alloy, to find out more visit www.myalloy.com

Dr Clare Bailey is a GP and health columnist with extensive experience in helping people lose weight and improve their health. Dr Michael Mosley is a science presenter, journalist and executive television producer. Together, they have authored several bestselling books on weight loss, diet and diabetes and created the popular 5:2 and fast 800 diets.

In this episode, the guests describe the evidence showing the positive effects of incorporating principles such as the Mediterranean style diet and time-restricted eating into your lifestyle and how the fast 800 diet can dramatically improve your health outcomes, particularly in reversing type 2 diabetes. The ‘metabolic car crash’ of poor sleep, low hormones, poor diet and weight gain for women during the perimenopause and menopause are also discussed.

Clare and Michel’s top tips:

1. Enjoy olive oil. You don’t have to be stingy with it – it’s good for you!
2. Eat oily fish – remember SMASH: Sardines, Mackerel, Anchovies, Salmon, Herring.
3. Avoid snacks (especially in the evenings) or if you have to, reach for a few nuts.

For more information on Clare and Michael’s diet books and the fast 800 diet, visit thefast800.com

Follow Clare’s recipes on Instagram @drclarebailey

Rupa Lyall is a clinical pharmacist who works in a GP practice in Buckinghamshire seeing patients with minor illnesses and prescribing medications. In this episode she tells Dr Louise Newson how she became interested in the perimenopause and menopause and how, through the training on fourteenfish.com and resources on the balance website, Rupa now supports and educates other clinicians in HRT prescribing.

Their conversation covers raising awareness among professionals, working with patients from BAME communities, the importance of empowering women to improve their quality of life and the transformational effects of hormone replacement.

Rupa’s 3 tips for pharmacists interested in the menopause:

1. Go to fourteenfish.com and do the ‘Confidence in the Menopause’ course
2. Don’t be frightened of the menopause, learn more and talk to others
3. Speak to patients about their HRT, ask them how they’re doing, especially in the community. You will learn a lot by doing this.

In this episode, Dr Thulasi Naveenan talks to Dr Louise Newson about her experiences as a 3rd year GP trainee working in a central Manchester practice and learning on the job when it comes to HRT prescribing. The conversation covers working with patients from different cultures and with interpreters or family members, challenging misinformation, health risks after menopause and gender differences, and introducing the topic of hormones at 40-year health checks. Thulasi gives an honest and reflective account of what she has learnt about women’s health and hormones in her last 7 years of practising as a doctor.

Thulasi’s advice to clinicians learning about menopause:

1. Always have hormones in the back of your mind and there is no younger age limit cut off. Don’t be afraid to ask patients about their periods, vaginas and symptoms.
2. Don’t be afraid to ask about what you don’t know, use resources like the balance app and NHMS to find out more information. Find your local expert and seek out their knowledge and experience.
3. If you’re ‘junior’, don’t be afraid to challenge more senior clinicians – they may not be as up-to-date on the latest practice.

You can follow Dr Thulasi Naveenan on Instagram at @tnaveenan and on Twitter at @ThulasiNaveenan

Since the recording of this podcast, there has been further discussions with Cancer Research UK.

Consultant Gastroenterologist Professor Barbara Ryan and Clinical Dietitian Elaine McGowan are The Gut Experts, passionate about digestive health and helping women with debilitating bloating and irritable bowel symptoms.

In this episode, the experts discuss why more women are troubled by gut related symptoms compared to men, how gut and bowel problems have a very real impact on women’s lives, and why eating the right type, amount and variety of foods is so important for your gut health and overall wellbeing. The Gut Experts also talk about their new book written for women of all reproductive ages experiencing gut and bowel related symptoms.

Barbara’s tips for improving your future digestive health:

1. If you’re having digestive symptoms seek a correct diagnosis rather than self-diagnosing
2. Don’t look at your gut and digestive health in isolation, take a whole-body approach. Remember TEAMS: Total gut and body health, Exercise, Alcohol (reduce/cut out), Mental health, S

Elaine’s tips for improving your diet:

1. Fibre is a superfood for your gut microbiome – find the right amount of fibre intake for your own gut as everyone is different
2. Variety and diversity of foods is crucial, eat the rainbow, following a Mediterranean style diet.

Visit the Gut Experts website at https://thegutexperts.com/

The Gut Experts book, ‘What every woman needs to know about her gut’, contains solutions for bloating, IBS, and digestive symptoms and is out now, published by Sheldon Press.

Follow Barbara and Elaine on instagram @thegutexperts

This week on the podcast Dr Louise meets comedian Anne Gildea, who will be joining Louise on her 34-date theatre tour this autumn, Hormones and Menopause: The Great Debate.

Anne, a founding member of Irish musical-comedy trio The Nualas talks to Louise about her diagnosis of breast cancer, aged 45, and her ensuing menopausal symptoms, which she was unprepared for. She explains how her research inspired her to create her own show, How to Get the Menopause and Enjoy It.

Louise and Anne discuss why they’ve come together to create a new show that will take you on a journey through the history of women’s health and lead you to see menopause and hormones in a whole different light.

Finally, the pair share some of the reasons they think people should come to the show:

1. It'll be a wonderful night out - a real sharing experience where you can also have a laugh.
2. There’ll be lots to learn with new content and a sharing of knowledge.
3. You’ll be able to ask questions and gets answers. Some shows will also have doctors available in the interval but Louise will answer questions on the stage as well.

You can follow Anne on Instagram @annegildea  

To buy tickets to the show click here

Click here to find out more about Newson Health

Dr Rajvinder Khasriya is a urogynaecologist who leads the Lower Urinary Tract Symptoms clinic at the NHS Whittington Hospital in North London, and is also involved in research work at University College London.

In this episode, the experts discuss urinary tract infections (UTIs) and the role a lack of hormones play in their occurrence and ongoing recurrence. Dr Khasriya explains how common and debilitating UTIs can be for women in the peri/menopause, why traditional methods of testing and treatment are often unsuccessful, and she outlines the benefits of using vaginal hormonal treatments as part of a holistic approach for managing UTIs.

Dr Khasriya’s tips for women with UTIs:

1. As always, do your own research and find patient groups for support and information.
2. Understand all the factors that can contribute to UTIs such as weight gain, your general health, your diet and stress levels, as these are also important.
3. Be generous when using your vaginal estrogen, it is completely safe to use and in the long term.
4. Trust yourself, you know your body best.

The patient groups:

Embedded/Chronic UTI Support Group

Do you suffer from reoccurring UTIs? Many of us have been previously incorrectly diagnosed with Interstitial Cystitis (IC) and have come to learn our condition is actually an embedded or chronic UTI...

Home - CUTIC

1 in 3. women will have a UTI by the age of 24 1. 90%. of chronic urinary tract infections are missed by the standard MSU culture test 2. 70%. the risk of recurrence within a year 3.

Bladder Health UK

Women asked if bladder drug should be available to buy. A pill to help treat an overactive bladder - which affects millions of women - could soon be available to buy in the UK without prescription.

Dr Jan Smith is a chartered psychologist, executive coach, author, campaigner and the director of Healthy You Ltd. She has over 15 years’ experience providing psychological support to those affected by injury and clinical negligence. In 2014, Jan developed a birth trauma service and campaigns to improve safety in maternity services for families and staff and provides training in the UK and internationally to maternity students and healthcare professionals on birth trauma and its impact.

In this episode, Jan describes to Dr Louise Newson how women can feel after a difficult birth or medical experience, and how trauma related emotions can resurface many years later at peri/menopause when psychological and genitourinary changes occur, often affecting relationships and intimacy.

Jan’s 3 pieces of advice:

1. If you had a difficult birth or healthcare related experience that affects how you feel about your genitals and intimacy, it is never too late to get help, even if it is years down the line.
2. Workplaces need to view women’s health as a continuum, not separate stand-alone events like pregnancy or menopause.
3. Think about ‘reaching in’ to help other women going through it – to listen, to validate and let them know they are heard and seen. This can be hugely beneficial for everyone’s mental health.

For more about Jan and Healthy You, visit https://healthyyoultd.co.uk/

In this episode, Dr Louise Newson speaks to Dr Abbie Laing about why she now specialises in menopause care and what she has learnt through her research and writing on the subject. Together the experts discuss clinical hot topics where misinformation and misunderstandings are rife such as what the evidence shows about the risk of clots and breast cancer with HRT, and treating symptoms of genitourinary syndrome of menopause (GSM) with vaginal estrogen.

Abbie’s 3 tips for women with symptoms of GSM:

1. Seek help early and use vaginal estrogen; persist with treatment options if the first one doesn’t suit you. The benefits are huge, and treatment should be long term.
2. If you have recurrent UTIs, consider vaginal estrogen treatments .
3. For elderly, frail, or very busy women, the vaginal estrogen ring (Estring) is a very effective and safe option.
4. Vaginal estrogen treatments are very safe and do not have any associated risks, including for people who have had cancer.

To access the treatment pathways discussed in this episode, become an associate of the Newson Health Menopause Society at www.nhmenopausesociety.org

For more information on any of the treatments discussed, visit the balance website at www.balance-menopause.com

In 2004, Dave and Steve Flynn started a fruit and veg shop, with the aim to create a happier, healthier world. The Happy Pear now has vegan food products in nearly 1,000 stores in Ireland, 2 cafes and a farm, and their five cookbooks have all been no.1 bestsellers. The Happy Pear online health and lifestyle courses – in which they partnered with plant-based experts from across the globe – have helped over 50,000 people from 120 different countries.

In this episode, Dr Louise Newson chats with Dave and Steve about how they came to realise in their early 20’s that eating plant-based and whole foods would transform their own lives and those in their community. The lads energetically describe the different ways in which they have helped others turn their lives around, reduce risk of heart disease, feel happier and lose weight.

Dave and Steve’s 3 tips to improve your diet and future health:

1. Try to eat more whole foods, if you don’t like many vegetables, start with fruit.
2. Be more intentional about your food choices
3. Find your community, create an environment around you that will support you to make healthy choices.

For more information about the Happy Pear cookbooks and lifestyle courses, visit https://thehappypear.ie/

Dr Robert Lustig is Professor emeritus of Pediatrics at the University of California, San Francisco. He specialises in the field of neuroendocrinology and his research and clinical practice focuses on childhood obesity and diabetes. Dr Lustig has led a global discussion of metabolic health and nutrition, exposing some of the leading myths that underlie the current problem of diet-related disease. He is the author of several books including the books Fat Chance and Metabolical: The truth about processed food and how it poisons people and the planet.

In this episode, Dr Lustig talks to Dr Louise Newson about the influence of sugar, fats, and processed foods on our brains and health, changing minds of the public and health professionals and challenging the food industry. And – just as with changing public perception of HRT – challenging misconceptions about sugar and processed food starts with education.

Dr Lustig’s 3 tips to improve your diet:

1. Yoghurt is good but make sure it doesn’t have any added sugar
2. Juice is not healthy. Fruit is healthy and has fibre which is the good part. It’s food for your microbiome.
3. Trans fats are not good for you at all, try and avoid them at all costs including watching what oils you cook with.

Dr Lustig’s website is https://robertlustig.com/ and you can find out more about all his books here.

Ava Vanderstarren is a performing artist, actor and public speaker. She is the co-author of Blossom Living With Premature Ovarian Insufficiency / Early Menopause Journal and is the co-founder of the charity Innocence Lost Foundation. She has over 10 years lived experience of POI & mental health maintenance.

In this episode, Ava discusses her experiences of her POI diagnosis when she was 17 and how confused and isolated she felt at the time. Ava has co-authored a supportive journal for young people to help readers through diagnosis of POI or early menopause and to provide clear information and help them feel less alone.

Ava’s 3 tips:

1. Advocate for yourself, even though its frustrating and exhausting
2. Remember self-care and your own health come first
3. Don’t underestimate the impact of hormones on your physical and mental health

For more about the Blossom Living with POI / EM Journal: https://amzn.to/3HZx4Cr

Connect with Ava on social media:

Instagram & TikTok: @avavanderstarren

Twitter: @AVAnderstarren

YouTube & Facebook: Ava Vanderstarren

Ava’s professional website: http://www.avavanderstarren.com/

Ava’s charity working with child soldiers in Sierra Leone https://innocencelostfoundation.com/  

Vicki is 39 years and has struggled with heavy periods and related pain since she was 10 years old. She was eventually diagnosed with endometriosis at 22 but continued to suffer with severe pain, heavy bleeding and UTIs, despite treatments and multiple surgical interventions. As a last attempt to be pain free, Vicki chose to have a hysterectomy when she was 35. Even though her ovaries were not removed, she realised she was entering menopause after the operation when she began having night sweats, insomnia, anxiety and very dry hair and skin. The ‘cure’ Vicki was hoping for didn’t materialise – another battle just began instead, as it took 18 months to access the treatment she now needed for her menopause.

Vicki shares some of the struggles younger women have when trying to get help for endometriosis and/or a surgical or early menopause, and reflects on the decision she made and the lack of information provided to her at the time. Dr Louise Newson advises women in this situation to speak with their doctor about the likelihood of surgery triggering menopause and to find out about the symptoms and benefits of HRT in advance, so you are prepared.

Vicki’s tips if you have, or think you have, endometriosis:

1. Do your own research and be your own advocate, push for answers
2. Keep pushing your GP, make them listen to you, show them your pain diary and take someone with you who sees you when you have pain
3. Learn as much as you can about endometriosis; treatments are not just surgical, there’s exercise, diet, physiotherapy, and others
4. Understand that hysterectomy isn’t a cure for endometriosis but if it is the right decision for you, learn about the menopause and benefits of HRT in advance.

You can read more about Vicki’s experience here and follow her on Instagram

Vicki helped contribute to the booklet, ‘Endometriosis and You’

For more about endometriosis, visit Endometriosis UK

Jonathan Wolf is the CEO and co-founder of ZOE, a health technology company that focusses on personalised nutrition. ZOE runs the world’s largest nutrition science study with universities such as Harvard and King's College London, investigating the gut microbiome and how nutrition can improve overall health and wellbeing. During the COVID pandemic, their valuable technology was utilised to help scientists understand more about the virus. The COVID-19 symptom study app was designed at record speed and had a million users within 24 hours of launch.

Dr Louise Newson speaks with Jonathan about the latest understanding of how the gut microbiome affects our health and weight, how much our genes our to blame (or thank) for our body shape, and about ZOE’s latest study into the menopause and metabolic responses, nutrition and the microbiome.

For more information on ZOE’s research and products, visit https://joinzoe.com/

The podcast mentioned and hosted by Jonathan is ‘ZOE Science and Nutrition’.

In this episode, Dr Louise Newson is joined by two women, Rhona and Tanya, who share their experiences of fertility support, pregnancy, and having symptoms of low hormones after the birth of their children.

Rhona asked the fertility specialists whether the hormone treatments she was taking to become pregnant would affect the onset of her menopause and she was told that it wouldn’t. 18 months after giving birth while still breastfeeding, Rhona experienced severe symptoms due to low hormones and spent 2 years suffering and seeking help before a friend suggested it could be her perimenopause. After seeing a menopause specialist and finding real improvements with HRT, Rhona wants other women to be aware that problems after childbirth might not simply be ‘baby blues’ but could be the start of perimenopause.

Tanya also had a child with the help of fertility treatments in her 40s, and during screening tests it revealed that indications of perimenopause had begun. The IVF was successful, but after the birth of her baby and a relocation, Tanya’s mood plummeted and she experienced a range of symptoms caused by low hormones. Her GP offered antidepressants, but Tanya didn’t think it was postnatal depression and knew her hormones were involved. Tanya is now pregnant again and is apprehensive about what will happen due to low hormones after her next birth.

Louise explains what is – and isn’t – known about hormones during pregnancy and in the postnatal period, and why this can affect women so much in the months and years after birth. She describes the benefits of topping up those hormones with HRT and the multiple improvements it could bring to women at this challenging time.

Rhona and Tanya’s advice for women thinking about pregnancy and perimenopause:

1. do you own research and seek medical help if you have perimenopausal symptoms
2. don’t be scared to try IVF, but know the possible effects of low hormones after birth, especially if you’re in your 40s
3. be aware of what your own body is telling you before you start fertility treatments, are there signs you could be in perimenopause?
4. If you choose to do extended breastfeeding, know that your hormones will be low and this may cause symptoms

For more information on breastfeeding and HRT, postnatal depression and another personal account relating to post-pregnancy hormones:

https://www.balance-menopause.com/menopause-library/breastfeeding-hrt/

https://balance-menopause.com/uploads/2022/02/What-is-reproductive-depressionfinal-with-links.pdf

https://www.balance-menopause.com/menopause-library/my-story-of-hormonal-depression-when-my-hormones-change-i-change/

Content warning: suicide

Peter Smith joins Dr Louise Newson this week in a difficult and emotional episode. Peter lost his wife, Victoria, to suicide a year ago after she experienced a sudden change in her mental health in her late 40s. In their quest to understand how things could have got to such a crisis point for Victoria, Peter and his family have learnt more about the menopause and mental health, and they’ve raised the question of whether Victoria’s perimenopause could have been responsible for, or at least contributed to, her sudden mental illness when she had never previously experienced any such difficulties.

Peter describes the series of events that led up to Victoria’s death and how healthcare professionals dismissed the possibility of hormones playing a part in the worsening of her mental health, both at the time and during a recent inquest. Louise explains the work she is now jointly involved in, with Peter’s help, to raise awareness of the link between mood and menopause both in Pete’s local NHS Trust and nationwide.

Peter’s advice for partners if your loved one is struggling:

1. Go with your partner to see a GP, and if needed, find someone that specialises in the menopause.
2. Talk about it with each other. Listen and try and understand what they’re going through, and support them as best you can.
3. Encourage them to talk openly with friends about it too.

This week on the podcast, Dr Louise is joined by Elin Sullivan, a young woman who suffered a myriad of symptoms for years before getting the right treatment.

Elin first experienced recurring urinary tract infections at 19 years old, and twice required hospitalisation. She also suffered from sweats, sleep disruption and fatigue, shaking and lichen sclerosus. After a chance encounter with Louise, she tried local HRT, which was transformative, and now takes testosterone to balance her low levels.

Elin talks about how hard it can be to experience perimenopausal symptoms at a young age and shares her tips for other younger women experiencing issues that they think might be down to their hormones:  

1. Although it can feel really hard, don't stop advocating for yourself. You may have self-doubt or worry that you’re wrong but keep pushing. My doctor was sick of seeing me, I was there probably every week, but don’t give up.
2. Rather than just giving your doctor a list of your symptoms, show them when they were happening as well. Have a log of symptoms and anything that might have affected them on that day. This will help your doctor rule out things but also show if your diet, etc, has an influence.
3. Don't be scared to try medications or suggestions. It might help but if it doesn’t it can potentially help your doctor decide the next step. I never believed local HRT could make such a big difference but am so glad I tried it.

Click here to find out more about Newson Health.

Sarah Davies is an experienced business coach and trainer who previously spent over 15 years in senior international corporate roles and as a head-hunter for senior executives. Sarah supported her sister, Dr Louise Newson, as business manager, six years ago when Newson Health menopause clinic was launched. Seeing how devastating the consequences of the menopause affect personal and professional lives, Sarah set up Talking Menopause to educate and support men and women across all levels on the impact of menopause at work. 

In this episode, Louise and Sarah look back on starting their respective journeys into menopause care and support services, and discuss the real-life impact of the perimenopause and menopause in the workplace. Sarah shares some of the outcomes of her workshops and webinars and describes how Talking Menopause stimulates cultural change within organisations.

Sarah’s advice to workplaces:

1. Everyone should be aware of the peri/menopause and respond to it as a normal process for their employees and their partners.
2. Consider the practical side; where is the safe space for women to escape to? What are the practical solutions for women suffering at work?

And to women at work:

1. Don’t suffer in silence, talk to a friendly colleague, download the balance app and go and see your healthcare professional if you’re not getting the right level of support. There’s a lot of help out there.

You can learn more about Sarah’s work at www.talkingmenopause.co.uk

Simona Stokes is an experienced counselling psychologist who uses CBT (Cognitive Behavioural Therapy) and EMDR (Eye Movement Desensitisation and Reprocessing) to help people with stress, depression and anxiety. After 20 years working in the NHS and voluntary sector, she then founded her own clinic in Birmingham, and has developed an interest and specialist knowledge in helping women with the emotional and psychological challenges of the peri/menopause. Simona’s personal experience of hormonal changes hit her hard and this led her to develop and successfully implement the psychological tools she had at her disposal to support her own journey and made her realise many women need help to understand the impact their hormones have on their moods, thoughts and emotions.

In discussion with Dr Louise Newson, Simona explains the power of estrogen as our primary fuel and the problems that can arise when estrogen falls. She explains the difference in perimenopausal depression compared to general depression, what CBT is and how it can help women at this time of life that can often be a pinch-point on our emotions. Simona advises how to look after yourself and your emotions and elaborates on why so many women feel a sense of loss of one’s role, of identity, and loss of purpose at this time.

Simona’s advice for women experiencing emotional challenges:

1. Menopause is unavoidable but suffering is optional. CBT helps us to change the narrative we create about the difficulties we’re facing, and allows us to let go of the struggle against the changes we’re feeling. An attitude of compassion, kindness and curiosity to yourself will help you understand your difficult emotion in a more helpful way than being harsh, self- critical, and just wanting a feeling to go away.
2. It’s really important to make peace with all your emotions. We’ve been conditioned to think that difficult emotions are undesirable and we must strive to feel happy and grateful. Increase your openness to difficult emotions and this will help you be more resilient and emotionally ‘fit’ to cope with your peri/menopause.
3. ‘Emotion follows motion’, so engage in physical activity, even if you don’t feel like it, as physical activity is a powerful tool to change how you feel. Use your body to calm down your mind either through breathing and relaxation techniques or getting out there and being active.

Simona’s clinic and website details can be found here.

The ‘Meno D’ rating scale to detect depression that Simona refers to can be found here.

If you would like to access psychological therapies via the NHS explore your options here.

You can find Simona on her social media pages a:

Instagram - https://www.instagram.com/menopausecbtclinic/ 

Facebook - https://www.facebook.com/ThrivingBeyond40 

Dr Louise Newson met Dr Naomi Jiagbogu over a decade ago at Birmingham Medical School when Louise was mentoring students who were studying medicine as a post-graduate degree. Naomi subsequently qualified, began her GP training and moved to Manchester with husband, Aria, who was training to be a paediatrician. Louise and Naomi discuss their memories of the post-graduate course and reflect on how the students were older, from more varied backgrounds and had broader life experiences than you would typically find on an under-graduate course and how these factors enhanced the student’s skills and learning, especially when relating to patients.

After beginning her GP training, Naomi’s husband Aria sadly developed a brain tumour and after surgery, treatments and a yearlong remarkable recovery, the cancer returned and Aria died in 2020.  During his illness, Aria wrote two children’s books for their young son about sickness, loss and family, and he also wrote a memoir for adults titled, ‘Broken Brain: Brutally Honest, Brutally Me’. Together, Naomi and Louise discuss the importance of looking beyond the disease and connecting with the person not just the patient, and consider how personal suffering can transform the way you communicate as a clinician.

For more details about Aria’s story and books please visit his website https://www.ariatheauthor.com/

The books can be purchased from https://theendlessbookcase.com/authors/aria-nikjooy/

Or Amazon https://www.amazon.co.uk/Broken-Brain-Brutally-Honest-Me

The royalties from Arias children's books are going to Brain Tumour Research, Royal Medical Foundation, Society for the Assistance of Medical Families and Royal Medical Benevolent Fund. 

If you have listened to Naomi’s story and would like read more and donate to Brain Tumour Research, please go to

https://www.braintumourresearch.org/stories/in-our-hearts/in-our-hearts-stories/aria-nikjooy You can follow Aria on Instagram at @ariatheauthor64

Medical oncologist, Dr Avrum Bluming makes a welcome return to the podcast this week to re-visit the hot topic of menopause hormone therapy after breast cancer. Avrum has spent decades studying the research on the benefits and risks of HRT in women with a history of breast cancer and is passionate about giving women clear, evidence-based information that dispels myths and combats the misinformation that has unnecessarily frightened women and clinicians for over 20 years.

In discussion with Dr Louise Newson, Avrum clearly explains what his recent review of the literature reveals about the safety of HRT and the benefits it brings for your future health. The experts highlight the gender disparities that are commonplace in how women with cancer are treated with regard to their hormones compared to men, and they also discuss the importance of patient-centred medicine and giving women choice.

Avrum’s 3 tips for women interested in exploring their menopause treatment options after breast cancer:

1. Speak to your oncologist. Tell them about your menopause symptoms, ask to discuss the possibility of starting HRT and have a conversation about the benefits and risk for you individually.
2. When it is available, take Avrum’s article that will be published in the ‘Cancer’ journal in May/June 2022, and show it to your oncologist and GP. Don’t accept a dismissal of your views – engage them in discussion.
3. ‘Oestrogen Matters’ (2018, published by Little Brown) is a book co-authored by Avrum that is for women and clinicians, including a chapter on HRT after breast cancer, and it is heavily referenced to show all the evidence behind the information given.

Links to Avrum Bluming’s upcoming journal article will be published on the balance-menopause.com website when it is released.

Dr Rupy Aujla was in his mid-20s and beginning his career as a doctor when heart problems caused him to re-evaluate what he thought he knew about health, nutrition and medicine. Having previously rejected his parents’ influences of traditional Indian medicine, Dr Rupy began delving deeper into some of those concepts and the science of nutrition that he wasn’t taught at medical school.

In this episode, he talks to Dr Louise Newson about the principles of healthy eating, how a busy lifestyle and your environment often make it challenging to find and choose healthy, affordable foods, and the experts share their concerns around childhood obesity, anxiety around food, and the particular metabolic changes faced by those going through peri/menopause due to a lack of estrogen.

Dr Rupy’s 3 tips for improving your nutrition:

1. Start with making a small change to your diet by adding just one more fruit, vegetable, nut or seed, at every meal if possible.
2. Have a back-up healthy meal that’s easy to prepare, or stored in the freezer, for those times when you are tired and lacking motivation.
3. Try to reflect what foods you really like but find a healthier version of it. For example, if you love pasta, add 3 different vegetables to any pasta recipe.

For details about Dr Rupy’s app, his books and recipe ideas, visit thedoctorskitchen.com

Kate Muir returns to the podcast to discuss her ground-breaking new book on the menopause, which she describes as the most difficult and complex subject she has investigated to date. Dr Louise Newson speaks to Kate about the shoddy science and lies that women have been told over the years and what Kate has learnt about past and current research from speaking to over 100 experts, and the real life impact on women from the conversations she has every week.

In this episode, discussion also turns to the ‘Davina effect’, referring to the impact of Kate’s Channel 4 documentary that was aired in May 2021, presented by Davina McCall, and has been a game-changer in raising the social and medical profile of menopause within primary care and in helping to inform and empower women to seek help.

Kate’s 3 wishes over the next 3 years:

1. A symptom list to be given out at your local GP practice
2. Good quality research into body identical estrogen and micronised progesterone
3. Research happening in the UK into Alzheimer’s and the role of estrogen and testosterone in women’s brains

Kate’s new book is titled ‘Everything you need to know about the menopause (but were too afraid to ask)’ and is published by Gallery UK. A second documentary about the menopause with Davina McCall will be released in May 2022.

Journalist and presenter, Mariella Frostrup, joins Dr Louise Newson for an energetic discussion and a whistle-stop tour through current insights and reflections on the way society approaches the menopause. Mariella talks about why she is ‘still banging on’ about the menopause, why you needn’t be afraid of HRT, and why it’s time to stop the silence and shame that surround it.

In 2018, Mariella presented one of the first documentaries on the menopause and broke the taboo of celebrities speaking honestly about their own experiences. Mariella’s recent book, ‘Cracking the Menopause: While Keeping Yourself Together’, separates the myths from the reality and offers expertise, hope and advice for all affected by the peri/menopause.

Mariella’s 4 hopes to improve the experience of menopausal women:

1. Knowledge is our armour; we each need be more informed individually so we can combat the myths and ignorance we will be faced with.
2. We need a trained menopause professional in every GP practice in the land and an invitation from the NHS for every woman to come for an appointment before the average onset of perimenopause, to let her know what will happen and how she can get help.
3. There should be menopause groups everywhere, so everyone can find support and we should all educate our daughters about it.
4. We need to ensure women are supported in the workplace so they can remain the valuable and experienced team members that they are.

Find out more about Mariella’s work at www.mariellafrostrup.co.uk

‘Cracking the Menopause: While Keeping Yourself Together’ is published by Bluebird.

Popular online personal trainer, James Smith, admits he only read Dr Louise Newson’s most recent book to check out the literary competition when their new books were released back-to-back. He bought a copy and read it on holiday and while he may have got some funny looks for his poolside choice of reading, James discovered many new insights about the perimenopause and menopause that he knew would really help his female clients in their quest to reach fitness and weight loss goals.

Louise and James discuss the common pitfalls many people go through when trying to exercise, perhaps out of obligation or to lose some of that midlife spread around the middle, and they warn against the plethora of misinformation on the internet about nutrition and training.

James’s 3 exercise tips for you:

1.  Ask yourself ‘how much do you want to train on a daily basis out of 10?’ If your answer is below a 5, don’t train but ask yourself ‘why?’ and tackle those things first, whether it be stress, lack of sleep or nutrition. Understand why you’re not motivated and fix that first.
2.   If you want to lose fat and/or manage your calorie intake, figure out your daily allowance and x7 for the week. You can overconsume on the weekend if you wish, but then divide what’s left by 5 for the days in the week and you’ll be surprised by how low it is. You will get a clear picture of how much you’re overeating on the weekend and it may make you think again about patterns of over-restricting then binging.
3.   Pick any exercise that you like and find rewarding, there isn’t a hierarchy of the ‘best’ ones, you have to enjoy it and want to do it.

For help with a personalised exercise programme and meal plans, check out James’ website at www.jamessmithacademy.com

James’ bestselling books, ‘Not a Diet Book’ and ‘Not a Life Coach’ are published by Harper Collins.

Dr Rebecca Lewis, Clinical Director at Newson Health, returns to the podcast for the first episode of 2022 to discuss the perimenopause with Dr Louise Newson. The experts explain what the term means, what’s happening to your hormones during this phase, and how it can be diagnosed. Rebecca offers practical advice on how to speak to your healthcare professional to convey the range of related perimenopausal symptoms and raise the issue of hormones.

Find out what your increased health risks are when your hormones change and what you can do to mitigate these risks. The perimenopause is discussed as an opportunity to take stock and consider introducing some small changes to your lifestyle that will improve both your physical and mental health.

Rebecca’s 3 top tips if you think you might be perimenopausal:

1. Take control and think about balancing your hormones and protecting your future health
2. Get a diagnosis earlier rather than later, download the free balance menopause support app and start tracking your periods and symptoms
3. Consider HRT to help your symptoms and feel better, and then you can look at making changes to your lifestyle that will benefit your future health and wellbeing.

Pharmacist, Jonathan Underhill is a consultant clinical advisor for the Medicines Optimisations team at the National Institute for Health and Care Excellence (NICE). His work is focussed on evidence-based medicine but, as he explains, this is more than simply telling people what to do. One of the particular focuses of Jonathan’s work is the process known as ‘shared decision making’ between the clinician and the patient and he’s interested in how you involve a person in choices and decisions about their own healthcare.

Jonathan outlines some of the reasons NICE was originally set up – to reduce uncertainty and variation in prescribing – and with Louise, he evaluates whether this has been the outcome 6 years down the line, after the release of the NICE guidelines on menopause diagnosis and management.

Jonathan’s tips for shared decision making as a patient:

1. It’s OK to ask questions.
2. If you need it, take someone with you that you trust who can listen and advocate for you

And for healthcare professionals:

1. David Haslam’s (former Chair of NICE) consultation skills advice for doctors were basically ‘shut up and listen, show empathy, and know something’. If you can do these 4 things well it will make a big difference
2. Practice your conversation skills as a clinician. You can learn to communicate better with your patients.

The NICE guidelines on menopause can be read in full here and more about shared decision making can be found here.

If you are a healthcare professional, the following link offers 4 hours of free online learning in shared decision making from NICE and Keele University:

https://www.nice.org.uk/guidance/ng197/resources/shared-decision-making-learning-package-9142488109

This week on the podcast Dr Louise is joined by Dr Felice Gersh, who is double board-certified in OB-GYN and Integrative Medicine, and specialises in female health, with a focus on managing female hormonal dysfunctions.

She is the author of the book PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness, and recently published a paper on oestrogen and cardiovascular disease, and a 2021 paper on HRT.

Here she talks about the family of oestrogens and the important role of hormones on the heart. Finally, she shares three tips on improving heart and whole body health:

1. Eat a lot of phytoestrogen-containing foods - so every kind of plant in all the different colours, including beans, nuts, seeds, fruits, vegetables. They are nature's gift to us.
2. Sunlight is like happy medicine. Try to get sunlight in the morning, midday and watch the sunset every chance you get. This will help you to sleep better, make more serotonin, and help to set your master clock in your brain, which tends to drift when we lose our oestrogen production.
3. Move. Your fitness status is more predictive of healthy longevity than your blood pressure. Think of your fitness, strength, flexibility and balance as a critical part of your life so get active in every way you can.

You can follow Dr Felice on Instagram @felicegershmd.

Click here for more about Newson Health.

In this episode, Dr Louise Newson is joined by Lucy Chatwin, who is responsible for the not-for-profit organisation, Newson Health Research and Education. Lucy has had a portfolio career that has taken her through environmental science and operations, through human resources and management into health, in particular service improvement and transformation roles in the NHS. Her last role in the West Midlands Academic Health Science Network focussed on supporting the adoption of innovation into health services to improve health outcomes for people. Lucy is perfectly placed to bring together the often diverse worlds of industry, academia, and clinical organisations to drive improvements that will make a real difference to the lives of people in the perimenopause and menopause and those around them.

Lucy discusses the range of opportunities for innovation in menopause research, education and management and encourages those working in health and academia to ‘think hormones’ as an integral part of their practice. A key catalyst for this is the soon-to-be launched Newson Health Menopause Society that Lucy is leading on. The society will provide a global arena for integrating and energising research, driving education and upskilling professionals working in the field of menopause care.

Lucy’s tip for women is make time for yourself to unpick what is going on if you think you may be perimenopausal, don’t just assume it’s down to other things. Download the balance app at www.balance-menopause.com to help understand your hormones, the impact they’re having on you and how to get help for your symptoms.

Lucy’s tips for healthcare professionals:

1. Connect with other interested experts outside of your specialty, this is often the best way to expand your thinking
2. Make your mantra, ‘could it be hormones?’ If you treat women, don’t underestimate the influence of changing hormones in so many health conditions and presentations.

Register your interest in joining the Newson Health Menopause Society at www.nhmenopausesociety.org and follow them on Twitter at @NHMenoSociety or LinkedIn at Newson Health Menopause Society.

Dr Richard Hull teaches philosophy at the National University of Ireland, Galway. Due to a coming together of work life and home life in lockdown and his wife’s experience, Richard began thinking and writing about the menopause from an ethical and philosophical perspective. As an issue under our noses all the time, he was astounded that more isn’t written about it, and he queries the lack of ethical concern for women regarding this time of life and the impact on those around them.

Richard discusses with Dr Louise Newson the importance of raising awareness of perimenopause and menopause, sharing accurate information, training healthcare professionals and empowering women with the right knowledge to recognise what is happening to them and to get the help they need through treatment.

Richard’s 3 hopes for change:

1. Personal and public awareness of the impact of the menopause is crucial
2. For everyone to have the confidence to seek support in all its forms and find out about HRT
3. Talk more and spread awareness and knowledge with others. The more people are aware, the less it can be ignored.

You can read Richard’s article on the menopause here. Richard’s wife, Jaany, has written about her experience here.

Gaele Lalahy had a successful career in consumer electronics as Board Member and Head of Brand Communications & Olympic marketing at Panasonic. Having been with the same company for two decades, Gaele became fearful of not having tried a different career, so she decided to take the leap and leave her job without a plan in place. When the opportunity came up to run Dr Louise Newson’s balance menopause support app, it didn’t immediately grab Gaele’s interest because, as she admits, she knew nothing about the menopause or the scale of the problem facing women.

After doing her own research and realising hundreds of thousands of women were suffering and struggling to get treatment, Gaele came on board as the Chief Operating Officer for balance at the start of 2021. Since then, the app has grown ten-fold and is really helping to change the narrative around perimenopause and menopause and empower women with the information they need to get help from their local GP practices. Gaele shares some of the remarkable statistics that show how the app helps women get a diagnosis and treatment more efficiently, and she discusses plans for the app’s future that will make even more of a difference to people’s lives.

Gaele’s 3 reasons to use the balance app:

1. The balance app is a safe space to share and get support from like-minded people who also going through the peri/menopause.
2. All the information on the app is very easy to digest, all medically approved and based on the latest evidence.
3. Come to the app to figure out what is going on with your body and mind and join the dots. You will learn more about the many changes you may be experiencing and can then use this insight in discussions with your doctor to get a diagnosis and treatment.

Find out more information about the balance app on the balance-menopause.com website here.

Read about balance for healthcare professionals (HPs) or share with your HP on their website here.

Look out for balance+ coming in early 2022!

You can follow the balance app on their social platforms at:

Facebook @balanceMenopause

Instagram @balancemenopause

Twitter @balanceMeno

LinkedIn @balance-app