Patient Stories Archives - Balance Menopause & Hormones

‘Specialists agree I need higher dose oestrogen, so why has it been such a fight?’

Natalie Millman — Wed, 18 Dec 2024 01:00:00 +0000

Wendy, 50, shares her struggle to get appropriate menopause treatment

Advisory: this article contains themes of mental health and suicide.

Newson Health’s new research on absorption, highlighting that some women need higher doses than others for adequate absorption through their skin, can be found here.

It’s taken me 17 years to learn how to manage my menopause symptoms. At 33, I began to feel exhausted, my body ached, I couldn’t think clearly, and I began to experience premenstrual syndrome (PMS). I went from being a hardworking, active woman, regularly travelling around the world as part of my job as a geologist to being completely debilitated.

I was diagnosed with chronic fatigue syndrome (CFS) but over the following year, I developed acne, blinding headaches, tinnitus, skin that was so itchy I would scratch it until it bled, palpitations, UTIs, allergies and my PMS escalated. My periods changed to a 21-day cycle and were so heavy I thought they resembled what the collapse of the Hoover Dam might look like.

My GP diagnosed perimenopause, and I was told if I wanted children, I’d need to get a move on. Fertility tests revealed I had premature ovarian insufficiency (POI) and through IVF, my husband and I successfully conceived our beautiful baby girl.

When I was 41, my headaches became worse and were accompanied by visual disturbances and vomiting. One time I abruptly became unwell with a migraine whilst on holiday in Wales – I threw up in a shop doorway and had to return to the campsite to be looked after by my four year old. By my mid-40s, I had a migraine for 16 days out of every month.

My mental health began to suffer. I’d been struggling with postnatal depression and PTSD after a traumatic birth and the depth of despair during PMS episodes was so uncontrollable it greatly impacted my ability to function.

During this time, I had retrained as a teacher, so life was stressful. I had also relocated so had attended a different doctor’s surgery – my GP never talked about perimenopause, instead I was given antidepressants. Eventually I was referred to a gynaecologist who suggested a drug to quieten down my ovaries – it left me so exhausted I wasn’t able to function, and the migraines became worse.

My blood pressure was high and I experienced my first major palpitation, whilst I was teaching. My colleague took me to the hospital where I had an ECG. Again, this was put down to stress.

After charting my migraines and discovering a cyclical pattern, I learned about the link with menopause and joined the dots. However, my GP didn’t agree as I wasn’t experiencing hot flushes.

In January 2020 I saw a locum GP who got it straight away. She prescribed HRT: 40mcg of Elleste Solo HRT patches and a progesterone tablet. It dramatically reduced my symptoms. However, this only lasted a couple of months, so my dose was increased to 80mcg of Elleste Solo patches.

During the summer of 2020 I was advised to stop HRT because I wasn’t experiencing hot flushes. After I stopped, I did experience hot flushes, so HRT was re-implemented.

I plodded on and between 2021 and 2022, my symptoms began to ramp up and I became extremely anxious. My career as a teacher, in a high pressure, high workload environment exacerbated the situation, but I felt like I was going insane. I thought I was having a breakdown and was signed off work for two weeks.

However, a week into the crisis, the acute anxiety and depression flicked off like a switch. I was suddenly normal again. It lasted for about three days, before the next cycle began. I had no doubt what I was experiencing was hormonal in nature. I asked my GP if I could be referred to a menopause specialist and asked about more HRT but was told that 80mcg was the highest possible dose and that I could not have vaginal HRT and transdermal HRT patches together. When they asked what I hoped to achieve by seeing a menopause specialist, I realised that I wasn’t going to get the support I needed so I turned to a private menopause clinic.

RELATED: HRT doses explained

The day I had my appointment at Newson Health in Easter 2021 was a moment of recognition and hope. I was clinging onto my life, career and sanity. After talking about my symptoms, I was prescribed 100mcg Estradot, testosterone and vaginal oestrogen (I already had the Mirena coil for my progesterone).

Within two weeks, I felt so much better, almost superhuman. I bounced back like Zebedee and was myself again for the first time in a decade. But it didn’t last. After a couple of weeks, the migraines and low mood began to re-emerge. I contacted the specialist who went through my symptoms and recommended increasing the HRT dose. I gradually reached a dose of 150mcg and remained well for several months. I went on holiday without struggling with symptoms and I climbed a mountain for the first time in ten years.

I began the new school year with vigour but in October 2021, I had a mental health crisis that resulted in more time off work. This time, however, I had immediate access to my Newson Health specialist who was brilliant. She recommended lowering my HRT dose over several months to ensure the mental health symptoms I was experiencing were not due to having too much oestrogen.

My GP recommended I take an antidepressant. It was horrific – I was anxious, jittery, and couldn’t sleep. I decided to stop when I started hallucinating.

RELATED: Am I depressed or menopausal?

My symptoms appeared to be uncontrolled, and I felt like I couldn’t do my job. I was concerned that if I didn’t take action to reduce the distress I was experiencing, I may have taken my life, so I resigned from my teaching role.

After investigating my HRT dose and testing absorption, it was decided that I needed more oestrogen, and my dosage was slowly increased. I began to get closer to myself again.

For the remainder of 2022, my medication was periodically optimised by Newson Health and I got better and returned to teaching part-time and an active lifestyle.

In 2023 the financial pressures of private care and the introduction of the HRT prescription prepayment certificate (a one-off prescription fee giving annual access to HRT at a reduced cost on the NHS in England), led me to transition my treatment back to the NHS. My GP expressed concerns about my HRT dose – I was on 350mcg oestradiol patches – and ordered an oestradiol blood test. The test showed that my levels were in the normal range so although I was on a higher dose, I still wasn’t absorbing it all.

My doctor’s surgery said it was seeking guidance on my dose as it was above the licensed levels. My prescription was reduced without consultation – I only discovered the change when I picked up my prescription in May 2024.

I raised concerns about the potential impact of this reduction on my mental health, including the risk of suicidal ideation, and was referred to the gynaecology team. They advised against the drastic reduction in my dose, initiated further tests, including a womb scan and DEXA bone density scan, and confirmed that I was a poor absorber of transdermal HRT. They recommended continuing the 350mcg dose.

However, my surgery refused to prescribe it, citing concerns that this would place their clinicians outside of NICE guidance, which could invalidate their medical insurance. This was frustrating as

NICE guidelines acknowledge that some women with POI may require high doses of HRT for symptom relief. Both private and NHS specialists had recommended a course of treatment that works for my individual circumstances, yet I was having to fight to receive it.

The financial burden of private treatment, combined with the loss of earnings due to sick leave and reduced hours, has left me in significant debt totalling tens of thousands of pounds.

Thankfully, I’ve now been referred to secondary care in the NHS and they are prescribing the agreed dose of oestrogen. I believe 350mcg is the optimum dose for me. I might still have the odd fluctuation of hormone levels, but I can recognise the signs when I need extra oestrogen, which I can apply through my pump pack. These fluctuations are becoming less frequent as I get older and I know I can call my specialist so I’m not alone anymore.

I am living again – I’m achieving things outside of my career that I could only have dreamed of, I’m a much more energetic and engaged mum, and am trying to make as much noise as I can about the impact of menopause.

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

Resources

Newson Health: HRT is not a “one size fits all” treatment

Glynne S., Reisel D., Kamal A., Neville A., McColl L., Lewis R., Newson L. (2024), ‘The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study’, Menopause. DOI: 10.1097/GME.0000000000002459

The post ‘Specialists agree I need higher dose oestrogen, so why has it been such a fight?’ appeared first on Balance Menopause & Hormones.

‘I came off HRT and six months later was baffled by my new symptoms’

Natalie Millman — Mon, 07 Oct 2024 00:00:00 +0000

Samantha Austin, 55, thought she was “through” the menopause after five years on HRT. Here she shares her story

In my late 30s my periods, which had always been regular, started to become heavier and the premenstrual migraines I suffered from started to happen more than once a month. It got to a point where I felt I had more migraines than not and it affected my social life, my family life and my work life as all I wanted to do was take lots of painkillers and lay down in a dark room.

By the time I was 41, my periods were extremely heavy and the migraines off the scale. I also now had very low mood and seasonal affective disorder. On a flight home from a family holiday in Orlando, Florida, I had the most horrendous period and migraine – I could hardly move my head and I struggled to control the blood flow. Two days later my period stopped – and it never came back again.

I had scans, blood tests and pregnancy tests and the GP concluded I had had an early menopause, which took me by surprise. I already had two children, and didn’t plan on any more, but now the decision was taken away from me, I was a bit put out!

Being a nurse, I knew enough to know that oestrogen is essential for healthy bones and the loss of it can lead to a decrease in bone density, so I asked my GP for HRT. He was reluctant and spoke to me about breast cancer risk but agreed to prescribe it for five years.

I took oral continuous HRT (Elleste Duet Conti) with no problems for the next five years. My migraines improved exponentially, my mood improved, and everything was great. However, true to his word, the GP stopped my HRT after five years and, now 46, I naively thought maybe he was right and it was safer to go without the hormones.

Six months later, I was in a very bad way. My migraines were back, and I had mood swings and irritation with my husband and kids. I had very low libido to a point where I prayed my husband would leave me so I didn’t have to keep brushing him off. My joints ached, I experienced dizzy spells and to top it off, I was getting no sleep.

I was waking up umpteen times a night with nausea – it was like being on a rollercoaster or a boat, my stomach was up and down like a yo-yo! But I didn’t recognise that it was menopause symptoms. I thought I had something wrong with my stomach and needed an endoscopy investigation. My GP gave me omeprazole and said it was reflux, oh, and would I like to try an antidepressant?

I didn’t have a clue about the reoccurrence of menopause symptoms so started reading up more.

One day I was doing some clinical research reading on dizziness, and I came across an article on vertigo in menopause and perimenopause. The relationship is not well researched but there seemed to be some evidence that pointed to oestrogen being one of the hormones that play a role in the development of vertigo. The vestibular system (inner ear) can be particularly sensitive to low oestrogen in perimenopause, and it affects blood flow and oxygen supply in the area, causing symptoms such as dizziness, brain fog or full on vertigo attacks such as nausea and vestibular migraine. I wondered if by going back on HRT, I could remedy this crippling problem and get some sleep?

RELATED: Dizziness and the menopause

I went back to the GP, but this time I saw a different doctor and explained my rationale for wanting to go back on HRT. I reassured them that I was aware of any potential risks if I restarted the hormones and it was agreed that I could go back on HRT.

Less than one month later, I was a new woman. I was sleeping through the night, I did not want to run away from home and I even started doing parkrun. I ditched the omeprazole and bought some trainers! I have never looked back.

This experience made me realise that perimenopause and menopause can affect women in so many different ways. I didn’t have a hot flush so that signpost wasn’t there. Looking back, I think I was having symptoms in my late 30s and I feel angry that I suffered unnecessarily for a long time.

However, I’ve vowed that through my work as an advanced nurse practitioner working in women’s health I will help other women navigate the choppy waters of perimenopause and menopause, and access support.

Keep pushing ladies – do your own research and remember that hormones are chemical messengers to all parts of your body and without them many different physical changes can occur.

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post ‘I came off HRT and six months later was baffled by my new symptoms’ appeared first on Balance Menopause & Hormones.

‘My Pilates friends helped me realise I didn’t have fibromyalgia – I was perimenopausal!’

Natalie Millman — Mon, 02 Sep 2024 00:00:00 +0000

Kirsty Graham, 42, from Fife shares her struggle to get an accurate diagnosis

Looking back at all my crazy health issues, I think I’ve been perimenopausal since I was about 34, but I had no clue.

In 2019, I started experiencing pain in my tummy and cold sweats after eating, plus loose bowel movements. My GP diagnosed IBS and prescribed Omeprazole and mebeverine. I also had private food allergy tests and took egg and dairy out of my diet, which helped for about a month or so.

I had crippling joint pain, all on the left side of my body, and mostly in my wrists, fingers and ankles. Painkillers (co-codamol, ibuprofen gel, gabapentin and tramadol) didn’t work, neither did high-strength CBD oils, so I was sent for X-rays on my wrists and ankles.

I was absent from work for months due issues with my jaw, teeth grinding, sensitivity, and pain. I begged the dentist to remove all my teeth – I couldn’t stand the pain. I got a prescription for diazepam to help me relax and get some sleep, and was fitted for a mouthguard, which helped a bit but I still had several teeth removed.

I experienced bouts of thrush and was given Canesten pessaries and creams, but these would burn and make everything feel worse. I was then given a treatment for bacterial vaginosis (BV). I also got lots of urine infections and was given antibiotics, but these would cause thrush. It was a vicious circle that went on for years.

On top of all this I experienced heart palpitations, a loss of motivation, mood swings and I was forgetting so much stuff that I thought I was losing my mind. My periods had become lighter, but I still had them regularly.

The ladies in my Pilates class were the ones who asked, ‘Do you think this could be related to the menopause?’ I was only 38 but they were all in their late 40s and early 50s, and they’d often talk about their health issues.

When I told them about mine, they said it sounded like I was perimenopausal and they recommended I download the balance app to monitor my symptoms and then I’d have proof for the GP. I also listened to Dr Louise Newson’s podcasts and read everything I could to educate myself. I will forever be grateful to my Pilates friends for their advice – it gave me the confidence to know what to say to my GP.

How to talk to your doctor about HRT and get results

However, when I mentioned perimenopause to my GP, she laughed and said I was only 38 so it couldn’t be possible. She told me that my latest round of blood tests and X-rays were fine and she didn’t know what else to say, so ‘let’s just call it fibromyalgia’.

I wasn’t prepared to stand for that, so I asked to change GP and, armed with knowledge from the podcast and balance app, I told the new GP I wasn’t leaving without a three-month supply of HRT.

He said this wasn’t an area he was familiar with, so he wrote to the menopause clinic at the local hospital. He was advised that due to my young age, not trying me on HRT would be more dangerous than trying it and it would give me protection from future health issues. If my symptoms improved in the three months, I could stay on it. By the end of July 2021, I was started on HRT patches and had a Mirena coil fitted.

I felt like I’d finally found the answer to all my issues and I felt ‘seen’. But it was also confusing as I’d always thought menopause was something that happened to older people and it was about hot flushes – not all the other crazy symptoms I’d experienced. I never once felt ashamed that this was my diagnosis, I just needed to feel better.

It then took a year to get off the waiting list for my menopause clinic and have my first phone call with a menopause consultant. I now have a call every three months and it’s been bumpy ride to get my medication right. Although we’re still not there – every time I reach the three-month mark, my body seems to change and my dose needs tweaking – my consultant has been great at listening to me and my ever changing symptoms.

I still have my ups and downs and don’t yet feel like myself, but my husband and 15-year-old son are supportive. They try to understand, but I can be very difficult to live with at times. I just pray one day my son will make a wonderful, supportive husband because he’s seen me struggle so much.

I can’t understand why in school we get taught about periods, sex, pregnancy, giving birth and then nothing. I would urge other women to educate themselves. And the earlier, the better. Please don’t think menopause only happens to older ladies and hot flushes are the only symptom – I’m proof that’s really not the case.

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post ‘My Pilates friends helped me realise I didn’t have fibromyalgia – I was perimenopausal!’ appeared first on Balance Menopause & Hormones.

‘Forty years ago, I experienced severe postnatal depression – why are other women still suffering?’

Natalie Millman — Mon, 26 Aug 2024 00:00:00 +0000

Jean McIntosh reflects on her experiences in the hope that others will be inspired by her recovery and advocate for themselves

I was delighted when I became pregnant when I was 30 years old – my husband Keith and I had always wanted a family. But when I gave birth to Iain on Christmas Day in 1982, it was a traumatic experience – it was a quick birth and I had him breach as there was no time for a Caesarean.

As soon as he arrived, I felt strange. I was uncomfortable because of the birth and I stayed in hospital for a week, but I felt detached from what was going on around me. I wasn’t me anymore, I felt as if I was inside my body looking out.

When I went home, I was abnormally anxious and panicky and would cry most of the time. My sister Anne and my parents lived nearby so they came around every day. This time is very grey, but I saw my doctor and a psychiatrist came to the house. Everyone was looking for a logical reason for me being so ill.

I had no prior history of depression or mental health issues, nor any hormonal issues. Like most women, I got the odd mood swing before my period but no anxiety or depression, so this really hit me like a train.

I was prescribed antidepressants and tranquilisers, and was told to take the diazepam whenever I felt anxious and in a panic, which was most of the time. I didn’t sleep, which exacerbated the problem.

I remember trying to give Iain away to my sister and convince her that he would be better off with her. I thought if I didn’t have him anymore, I would be well again. At no point did I ever think about harming him. I was a good mother but I don’t think I loved and bonded with him for a long while. I wanted to run from everything.

My husband and my sister decided that I should go into hospital. There was a psychiatric unit at to our local hospital with a mother and baby unit. I considered suicide as carrying on feeling as I did day after day was awful. Thankfully, I talked to my husband about my thoughts.

I remained in hospital for several weeks and the doctors suggested that I have electric shock therapy. However, a friend of a friend had visited me in hospital as she had been through a similar experience – she’d had electric shock treatment and told me ‘Whatever happens, don’t have electric shock therapy as I’ve got patches of my life that I can’t remember.’ That frightened the life out of me, as did seeing people go into the ward for the electric shock treatment – it was horrific, like something from the Dark Age.

When I went home, I had a lot of support and a friend suggested I see Dr Katharina Dalton, a pioneer in postnatal depression and PMS. I was worried about mixing doctors and treatments but when I spoke to my GP, she said of Dr Dalton ‘If anyone can help you, she can’.

A few weeks later we saw Dr Dalton at her practice in Harley Street and it was a revelation. She explained why I was ill, and it was simple – my body could not adjust to the total loss of hormones when I had Iain.

She prescribed Cyclogest 400, a progesterone pessary, and I had to complete a chart each day tracking how I felt so she could look for patterns. When we returned a few weeks later, she prescribed a larger dose and explained that when my body had sufficient hormones, it would expel the rest. It was totally safe and there were no side effects.

Quite quickly, the cloud began to lift, and I followed Dr Dalton’s instructions to reduce the antidepressants and tranquilisers. She would call me to check up on me and life got back to normal. It was amazing.

If it hadn’t been for Dr Dalton, I would never have had another child, but she reassured me that I wouldn’t be ill again. I got pregnant two years later and just a few weeks before my second child Edward was born, I began to feel ill again. My world came crashing down and I thought oh no, it’s going to happen again. But Dr Dalton simply put me back on the progesterone and I got better.

Straight after I gave birth to Edward, I had a progesterone injection and continued to have one every 10 days. I did not suffer any of the past horrors.

In 1989 I had my third son William and went through the same process with the injections after the birth and I was absolutely fine.

Katharina Dalton was my saviour and a wonderful human being. She did warn me that because I’d been through such a terrible time postnatally, the likelihood was that whenever I went through a hormonal change, such as menopause, I would have problems. Thankfully, this wasn’t the case – I didn’t really notice any great hormonal fluctuations during menopause.

When I had recovered from postnatal depression, I did some counselling for other women who were going through it. I was told that I had to reinforce what the women’s doctors were telling them – most were being prescribed antidepressants and tranquilisers. But I would tell the women about Dr Dalton and tell them to read her book, Depression After Childbirth. I’d tell them if they recognised themselves in the book to go to their GP and ask for progesterone.

I’ve had a lot of time to reflect on my experiences and I feel sad that in 42 years, very little has changed. We’re in the 21st century now, and women are still having a difficult time in childbirth and postnatally, and it’s not good enough. But I hope that women sharing stories and the work of balance can help to now continue to carry the torch.

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post ‘Forty years ago, I experienced severe postnatal depression – why are other women still suffering?’ appeared first on Balance Menopause & Hormones.

My story: I started HRT when I was postmenopausal

Natalie Millman — Mon, 22 Jul 2024 00:00:00 +0000

Fiona, 62, says her generation of slightly older postmenopausal women have missed out on being offered HRT, but could still reap the benefits

‘During my late 40s and 50s, I considered myself lucky that I did not suffer from any menopausal symptoms. But back then, I thought symptoms were limited to sleep disturbances and hot flushes.

‘I’m unclear on when my actual menopause was because in my mid-40s I had a Mirena coil fitted to control heavy bleeding, which I’d experienced for 10 years. I think my menopause was probably sometime in my early 50s.

‘When I was 47, we moved to Canada, where I registered and worked as a pharmacist. I am utterly amazed at how little I knew about hormones considering I worked in a pharmacy. It just seemed of no relevance to me, and I was busy navigating working in a new healthcare system.

‘Now when I reflect on this perimenopausal time, I can now see that I actually did suffer many issues, including recurrent UTIs, burning mouth syndrome, travel anxiety and a plethora of IBS symptoms, all of which were new to me. However, I didn’t realise their significance and I dealt with them myself.

‘We returned to Scotland in 2019 when I was 57 and all was well until November 2021 when I started to develop pelvic and abdominal pain radiating down my legs, which was severe enough for me to admit defeat and speak to a GP.

‘The GP thought I had developed diverticulitis and prescribed me antibiotics. This made me feel worse and did not resolve my pain. I knew it was not gut related. Over the next six months, I was sent for two ultrasounds, an MRI and a referral to gastroenterology. I was given multiple prescriptions for codeine and amitriptyline, hyoscine and mebeverine.

‘The pain in my thighs and legs was the worst symptom, but nothing was really helping. I didn’t take many of those medications as they didn’t help or just made me more tired.

‘By February 2022 I thought I was going to have to give up work, aged 60, but I struggled on and just came home to bed every night with a hot water bottle. It was a very grim time.

‘In May, I got a letter to say I’d been referred to the persistent pain clinic and a recommendation, in the meantime, to try the low FODMAP diet. I cried when I got that letter as I knew I had no gut issues and felt abandoned.

‘We went on holiday with my daughter’s young family and I remember sitting on the plane thinking I wouldn’t care if we crashed as at least the pain would be gone.

‘In July I was desperate for help. I have a good friend who is a GP and although I don’t like mixing friendship with health needs, he offered to see me privately. We had a great talk about persistent pain and got to the subject of HRT. At the same time, one of the pharmacy technicians I occasionally work with said to me ‘you need HRT!’ and told me to download the balance app.

‘My GP friend prescribed Oestrogel and Utrogestan and within a week, I was completely better! All my pain had gone and my life resumed! My palpitations, which I hadn’t realised were a symptom, disappeared too.

‘I was worried my own GP wouldn’t continue my HRT, but she agreed to continue it. She wouldn’t give me Utrogestan as she said it wasn’t transdermal and increased stroke risk – I knew she wasn’t correct, but I thought I’d rather have her on board than argue at this point.

‘I’ve been on Evorel Conti for almost two years and it suits me perfectly. Since I started HRT, I have lost about two stone with the Full Diet, but it was honestly pretty easy as I’m a very healthy eater. I feel full of energy too, so I’m not going to retire yet.

‘In autumn 2022, I did the Confidence in the Menopause online course as I realised I have so many opportunities in my job to help peri and postmenopausal women. Many of my friends have now got HRT as I can’t stop myself talking about it.

‘In Scotland, community pharmacists can prescribe Trimethoprim/Nitrofurantoin as appropriate for UTIs, however I find most of the UTI consultations I have involve women between 40 and 70 so I take this opening to discuss use of vaginal oestrogen and genitourinary syndrome of menopause (GSM).

‘I do worry about the 60-80-year-old group as they totally missed out and so many suffer from pains, insomnia and GSM. I know there isn’t much research in this age group but many are being denied even a trial of HRT if they are over 60.

‘I cannot believe I was so ignorant for so long, and I’m a bit ashamed of my lack of awareness. I am making up for lost time now though and spreading the word. I get colleagues calling me now asking for advice and am encouraging lots of conversations about it. I’m pretty passionate about all this and would like to share my tips with other women:

Talk to other women – a lot!
Educate yourself – balance is a great resource
Talk to the next generation down so they will recognise the less common symptoms.’

To find out about the Confidence in Menopause course see https://newson-health.teachable.com/p/confidence-in-the-menopause

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post My story: I started HRT when I was postmenopausal appeared first on Balance Menopause & Hormones.

My story: internal tremors and the menopause

Natalie Millman — Mon, 30 Oct 2023 07:00:54 +0000

An anonymous account of this little-known symptom

‘I’d experienced perimenopausal symptoms such as dry eyes and brain fog from the age of 37, but I had young children so I just thought I was tired. I was also going through a stressful period of my life with a lot of serious illness in the family.

‘In November 2021, I went to see my GP as I had been feeling very tired, with no energy or appetite. I asked to have my bloods tested and apart from low vitamin D levels they all came back normal.

‘But in December 2021, at age 42, I started to experience what I would now describe as internal tremors. They started in my abdomen and moved down my legs. It felt like a mobile phone was going off inside my body. Over the next week or two, it became more frequent but would come and go, and I could experience it anywhere in my body. When it was in my head, it felt terrible and when it happened in my chest, I thought it was my heart racing so I’d take my pulse but it was normal.

‘I thought it might be due to the COVID booster I’d just had and went to see my GP again in early January 2022. I was tearful and frightened as I didn’t know what was happening to me and they didn’t know what could be causing the sensations. Nobody could see them happening. This GP was great. He took it seriously and contacted the JCVI and raised a yellow card in relation to the vaccine. An urgent referral for a neurological review was made and I spent the next few weeks waiting and thinking there must be something terribly wrong with me. When I saw the neurologist, all the tests they performed were fine and they put my symptoms down to the stress I had experienced over the previous year.

‘I tried to deal with the problem as anxiety so spent the next few months trying the likes of CBT, yoga, and meditation but four months later, there was no improvement. The stress of our family circumstances had reduced but I still had internal tremors. I felt like my body was betraying me.

‘The tremors were worse in the mornings and evenings, and I experienced them multiple times in a day. If I kept busy it wasn’t as bad, but as soon as I’d sit down to relax, I’d feel it and by the late afternoon I was exhausted. I couldn’t enjoy any down time and sank into this horrible, scary place where I couldn’t see a future.

‘I had thought for a while that I was perimenopausal but nobody had connected my symptoms to this. In fact, about six months before all this started, I was told by a gynaecologist that I couldn’t be perimenopausal because I was too young and still having regular periods. However, one day, it occurred to me that there might be a connection so I Googled ‘perimenopause and tremors’.

‘Suddenly, I could see there were women out there talking about this exact thing on social media and the balance app. These women would describe the tremors in different ways – using words such as buzzing, vibrating, shakes, trembling – but it was what I was experiencing. I decided I needed to figure out what was going on with my hormones.

‘I made an appointment at Newson Health and was given a low dose of Estradot and cyclical Utrogestan. Over the next few weeks, I saw a gradual improvement. It was like a sense of peace descending, and I’d not felt peace in my body for months. It felt amazing.

‘After a year of being on HRT, and gradually increasing my dose of oestrogen during that time, I can say that oestrogen has vastly improved my symptoms. The internal tremors often seem to be worse at certain points in my cycle – usually around my period and sometimes around ovulation. But I can now go days at a time without feeling them and, when they happen, they tend to be less strong. I’m not as tired and feel much better in myself physically and mentally.

‘As well as HRT, I find movement, such as yoga, helps give me a sense that I’m still in control of my own body. Stress seems to make them worse – I think it’s related to my balance of oestrogen and cortisol.

‘Today, I still feel tearful when I think about my experience. Although the first GP tried his best to help me, the knowledge just wasn’t there for him to draw on. I’m not the first woman to experience this and it’s not been nice for my kids to see their mum go through this. This isn’t on my medical record as being related to perimenopause – I could still go to a GP about my symptoms and I’m told I need psychological help to deal with anxiety. Yet I know what a massive difference balancing my hormones has made to my physical symptoms.

‘But I do also feel triumphant. Under very difficult circumstances, I kept going and empowered myself by learning from the experiences of other women. I am stronger for it.

‘So for any women experiencing internal tremors, I’d first advise them to go to their GP to rule out causes – a lack of vitamin B12 could be the cause or it might be a thyroid issue, for example.

‘Also, don’t panic. There are lots of women who have this symptom – you’re not alone. I’ve read that it doesn’t last forever for most women. Do something about it because you don’t need to suffer.

‘Finally, talk to other women – ask them about their perimenopause. This week I told someone who I’d never met before that I have this weird symptom and she said, “Oh my god, I have it too”. I wanted to hug her! I’d never met anyone in real life with it. Having these conversations is so important – if we don’t keep talking about the menopause, we won’t reach an understanding of the full range of experiences and we won’t have a large enough voice to make the changes we all need.’

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post My story: internal tremors and the menopause appeared first on Balance Menopause & Hormones.

My story: hormones affect everything!

Natalie Millman — Wed, 25 Oct 2023 00:00:00 +0000

When Adele discovered how much her hormones were impacting her health and her attention deficit hyperactivity disorder (ADHD), she not only transformed her own life but set up a clinic to help other women too.

‘I always thought I had a healthy lifestyle – I was doing keto, intermittent fasting, exercise, all the things that are touted as being good for you. But when I was 37, my period vanished.

‘At the time I had a full-on job as a senior manager in a local authority with high levels of stress and responsibility. I’d be at my desk at 7.30 in the morning and not have time to get up and go to the toilet – it was go, go, go. I also had a toddler and a baby so it was a fast-paced life, but I felt that I had things in place to protect my health so my body could navigate it. I had insomnia but, looking back, I don’t think I was even aware of it – it just seemed normal. I felt that I could handle the pace and I loved my life.

‘So when my period stopped, at first I thought, well, that’s one less thing to worry about. But inside I knew this wasn’t right, something wasn’t working. I was also aware that I had ADHD. Because of my work in children’s services, I had a robust understanding of ADHD. I used to joke flippantly how I was ADHD and laugh it off but I didn’t think I needed a diagnosis. I thought, I’ve done really well in my life so what’s the point?

Learning more about hormones

‘But I did decide to take a leap of faith and leave my job to set up a holistic clinic for women. I had specialised in female offending and had a desire to work in the female arena, but I was also interested in working in health. I practiced reflexology and Reiki but when the pandemic hit, I trained with an incredible woman in the States called Nicole Jardim, who mentored me to understand more about women’s hormones. I learnt how I had put my body under incredible stress through activities I thought were healthy – because so much health advice is based on what works for male physiology.

‘As soon as I started nourishing my body with the right foods, moving my body in the right way, and using menstrual cycle awareness to restore myself, my period came back. I felt passionate about sharing my knowledge so I also set up an online clinic to support women with hormone imbalances.

Getting a diagnosis of ADHD

‘Several years ago, at the age of 41, I decided to get a diagnosis of ADHD. My work had taught me that hormones affect everything, plus when I started to see traits in my children, I wanted to roll model the diagnosis process for them. Receiving the diagnosis was the most validating experience of my life. It allowed me to have compassion for myself. I suddenly understood the amount of energy that I had subconsciously put into all of these strategies to be “normal”. For instance, I have lists and reminders everywhere otherwise things will drop out of my brain. And I’ll do things like when I get in the car, I’ll think: Did I turn the oven off? Did I turn the hair straighteners off? And it’s not OCD behaviour. It’s because genuinely on various occasions I’ve been distracted doing other things and I have forgotten to turn the hob or straighteners off, so I have strategies to cover myself.

‘I brought my knowledge of ADHD into my work and combined it with my understanding of women’s hormones to create a space for ADHD women to understand how their hormones affect their traits. I run an in-person clinic with a GP so it’s an integrative approach. On a personal level, my job enabled me to have an awareness of my perimenopause. I was suffering from sleep disruption, getting anxious and feeling overwhelmed about things and even the fun stuff felt like a chore. I call it inner scratchiness – no matter what it was that I was doing, it just felt like another thing for my to-do list.

‘These are all things that can come up with ADHD too so it’s about deciphering what’s an ADHD trait and what’s a hormonal imbalance. I knew that I was experiencing progesterone deficiency and I needed to have a progesterone-only HRT prescription within the understanding of my ADHD. I was fortunate to know an incredible GP in women’s health, who’s trained functionally too, and I worked with her to get the right prescription. She invested a lot of time in understanding ADHD and she looked at the work Dr Louise Newson has done around ADHD and menopause. I’ve responded really well to the progesterone.

Helping others

‘For any woman facing the dual challenge of ADHD and perimenopause, I’d advise them to track their traits against their hormonal fluctuations. I am not medicated for ADHD and I’ve believe one of the reasons that I’m able to operate like I do is because I understand the impact my hormones have on my traits. I know when I’m optimal, when I need to step back. So understand your unique rhythm, your unique ebb and flow, through tracking. Once you have that evidence, if you need to see a healthcare professional you can say, this is what’s going on for me. And if you are medicated, you can choose to have it tailored around your hormonal fluctuations.

‘Often when women with ADHD enter perimenopause, the lid comes off all the strategies that usually help. Many women don’t realise the protective benefits hormones have on our cognitive function and our executive function so when they go awry, it can feel like you’re going crazy.

‘So I truly believe that HRT should be a fundamental part of the discussion, at least in the treatment of perimenopausal women’s ADHD.’

Learn more about Adele, her clinic and online clinic at Harmonise You

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post My story: hormones affect everything! appeared first on Balance Menopause & Hormones.

My story: menopause and taking my employer to tribunal

Caroline Roberts-Garth — Tue, 17 Oct 2023 14:17:11 +0000

In September 2023, Karen Farquharson, 49, was awarded just over £37,000 after winning her employment tribunal case. The office manager successfully sued her employer for harassment and unfair dismissal. She had suffered debilitating bleeding, pain, brain fog and emotional anxiety but was told she used the menopause as ‘an excuse for everything’ and ‘to just get on with it’.

At the hearing, her boss Jim Clark dismissed the remarks as ‘innocent’. Upholding Karen Farquharson’s claims of unfair dismissal and harassment, the panel, chaired by Employment Judge JM Hendry, said: ‘Jim Clark can best be described a blunt, self-made man and successful businessman. He no doubt has many admirable qualities but empathy for others is not among them… He expressed no sympathy for the claimant’s health problems.’

Here, Karen shares her story.

Content advisory: this article includes themes of mental health

Seven years ago, when I was 42, I began to experience perimenopausal symptoms – my skin was itching, I was tired and my periods were getting heavier. I started taking antihistamines and tried to sleep as much as I could. But in August 2020, there was a drastic change in my period. I started flooding and bleeding far more regularly – I was bleeding for longer than when I wasn’t bleeding. At first my doctor thought I had an ectopic pregnancy but I knew that wasn’t the case.

So they put me on the mini pill and I tried all sorts, but I was still experiencing bleeding, pain, night sweats, joint pain, pins and needles, brain fog and weight gain. The impact of my symptoms was life changing. I just never thought this kind of thing would happen, and neither did my husband. I brought books and made him read them as well so we could both understand what was going on.

Even though I’d worked for my company for 27 years, I was nervous about telling my employer. But I was upfront with them and explained the situation. They seemed to be fine about it, and I asked if I could work from home if needed – I worked an hour’s drive away and driving with symptoms was uncomfortable. I worked more with the younger director but I knew the older director didn’t like people taking time off work – he called people who needed time off ‘snowflakes’.

In January 2021 I was given HRT – oestrogen patches and progesterone. I continued to experience symptoms but at work they thought I was joking half the time, and I would make a joke out of it sometimes. But one time I was called up as a witness for a court case to do with my work and I told them I couldn’t do it as the stress would kill me – they thought it was hilarious. If I ever got overwhelmed at work, I’d shut myself in the toilet and have a good cry until I’d calm down. And any time I worked from home because I wasn’t feeling well, I had this terrible guilt. I would try and make up for it – I was putting myself under more and more pressure because I didn’t want them to think that I wasn’t capable. I’d work harder or longer to compensate.

I got my HRT upped in September 2022 and they referred me to the gynaecologist [I later learnt I have adenomyosis, which is where endometrial tissue grows in the muscular lining of the womb, causing heavy periods and pelvic pain]. I didn’t feel like I was getting anywhere with my symptoms with my local GP – they still wanted me to have a bleed, but I couldn’t cope with the bleeding anymore, I wanted it to stop – so I got a private consultation, which was a great help.

At work I had this nagging feeling that something just wasn’t sitting right with them, and I felt they thought I was a pain in the backside. But I couldn’t pinpoint it and I didn’t want them to think that I was being paranoid or making a fuss.

Things came to a head one Thursday afternoon in December. I had been working from home on the Tuesday and Wednesday because of heavy snow and I was experiencing heavy bleeding. When it was possible to travel, I came in and my boss Jim Clark said sarcastically, ‘Oh I see you’ve made it in.’ I explained about the snow and my bleeding but he gave me a disgusted look and walked away. I was upset and angry so went to see the other director, Jason Clark. A discussion took place between all three of us where my boss accused me of strolling in whenever it pleased me. He questioned how many days off sick I’d taken that year then said ‘menopause, menopause a’biddy f****** get’s it, just get on wi’ it, that’s your excuse for everything’.

I burst into tears, I couldn’t believe it. I was angry and emotional and told them this was discrimination – they had no understanding of what I was going through. They had previously dismissed the menopause as ‘a’biddy has aches and pains’.

I said I was going to get legal advice and I was asked to calm down. I had to get away from the situation so left. The next day I felt too upset and unwell to return to work and I expected to receive an apology but I heard nothing. I wrote a grievance letter and saw my GP, who signed me off work. My grievance letter was ignored and my remote access to the accounts system was cut off so I couldn’t work from home. I felt I had no choice but to resign.

I used an HR consultant to represent me rather than a solicitor and he was brilliant. He was very supportive and would speak to me at all hours. But I didn’t think that it would get this far, I thought they would settle out of court. Instead, it took six months to get my case to tribunal and I spent a whole week in court being cross examined.

The emotional impact has been huge. It’s the lowest I have ever felt. I didn’t want to be here a couple of months ago… I’d have conversations with my husband about not being here. I can’t see the actual word, but he was just devastated that I didn’t want to carry on. I rang the Samaritans at one point, but I really needed help with the whole process. I gave 27 years to my company, only to be treated like a piece of dirt. It devastated me.

Now that the verdict is in, I feel empowered that I’ve done it. I’ve never stood up for myself before, I’ve always been some sort of a doormat. I didn’t think I was anyone special, but there must have been something inside that kept me going. I am not going to be pushed around anymore, bullied or spoken to like rubbish and just accept it.

I hope that my case will help other people as well. For any woman going through this, I think they need to have a coach or somebody there to help them through it. Employment lawyers are taking on a lot of these cases but the women need to have coaching and support to go through it. I’ve now got a new job and thankfully my stress levels are much lower.

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

The post My story: menopause and taking my employer to tribunal appeared first on Balance Menopause & Hormones.

Learning disabilities and the menopause

beth — Tue, 20 Jun 2023 07:16:57 +0000

On this week’s episode of the Dr Louise Newson podcast, Dr Louise welcomes Sharon Saunders.

Sharon is a menopausal woman with learning disabilities and is a wheelchair user.

During the episode, Sharon talks about when she first learned about the menopause from her mum, and her menopause symptoms, including joint aches and pains and headaches. She describes how these symptoms make her feel and the impact on her daily life, and Dr Louise and Sharon also talk about treatment options.

Finally, Sharon offers some important advice to other women with learning disabilities who are going through the perimenopause and menopause: speak up about how you are feeling, and don’t give up.

Sharon is supported by Dimensions, a not-for-profit organisations supporting people with learning disabilities, autism, behaviours of distress and those with complex health needs.

Click here for more information more about Dimension or on Twitter @DimensionsUK.

And click here for an easy read booklet on the perimenopause and menopause by balance and Dimensions.

Transcript

Dr Louise Newson [00:00:09] Hello, I’m Dr Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of The Menopause Charity and the menopause support app, balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. Today on my podcast, I’m really excited and very privileged actually, to have with me a very inspirational, wonderful person called Sharon, who I’ve recently met. Sharon has learning disabilities, but she’s incredibly clever and very kind and very cunning as well. She knows exactly what she wants and she really wants to be in control of things, which is absolutely the right way to be. So welcome Sharon, it’s really good to see you and to be able to talk to you today.

Sharon Saunders [00:01:18] Yeah. Thank you very much.

Dr Louise Newson [00:01:20] So just if you don’t mind, it’s a very personal question. Do you mind telling me how old you are?

Sharon Saunders [00:01:28] I wouldn’t mind five and three.

Dr Louise Newson [00:01:36] Okay, so you’re 53. So you’re similar to my age, actually so most people in their fifties are menopausal or perimenopausal. So the hormones that we have in our fifties are not the same as the hormones that we have when we’re younger. And I know that you know about the menopause and you’re learning about the menopause and like lots of people, you didn’t really know so much about it before. And you have been experiencing some symptoms, haven’t you, which have been affecting you. And it can be quite hard to know when your body is changing what’s going on. Are you able to describe some of the symptoms that you’ve had Sharon?

Sharon Saunders [00:02:19] I think that’s quite interesting. When I get really hot and sweaty and pain.

Dr Louise Newson [00:02:32] Yes. And you’ve been getting some muscle and joint pains, haven’t you?

Sharon Saunders [00:02:38] Yeah, in my back. And my legs.

Dr Louise Newson [00:02:40] Mm. And have they been troubling you at night-time as well?

Sharon Saunders [00:02:44] Yes.

Sharon Saunders [00:02:46] All over my body.

Dr Louise Newson [00:02:48] And that’s really difficult, isn’t it, when you’re in pain and you’re not sure what’s happening. Did you know what was causing the pains at all or the feeling hot?

Sharon Saunders [00:02:58] No.

Dr Louise Newson [00:02:59] So when did you start to think it could be related to your hormones?

Sharon Saunders [00:03:03] Summer.

Dr Louise Newson [00:03:05] So a few months ago. So did someone tell you about the menopause, or how did you find the information?

Sharon Saunders [00:03:12] My mum did.

Dr Louise Newson [00:03:13] Your mum told you about it?

Sharon Saunders [00:03:15] Yeah.

Dr Louise Newson [00:03:16] That’s very good. And what did you think when she told you about it?

Sharon Saunders [00:03:21] I don’t know.

Dr Louise Newson [00:03:24] Were you surprised to know that your hormones go lower when you get older or not?

Sharon Saunders [00:03:31] Yes.

Dr Louise Newson [00:03:32] Yes, Because a lot of us and me as well, didn’t realise the effect of hormones in our bodies and sometimes it’s not until they’re low when we start to get symptoms that you think, Oh right that might be related to my hormones. And a lot of people, when we think about hormones, we think about maybe if we’re having periods, but we don’t think about our muscles and joints and not being able to sleep very well. So it can be quite hard to know and sometimes quite scary to know what’s going on can’t it?

Sharon Saunders [00:04:07] Sometimes I just take paracetomol if it’s a nasty headache that will sometimes sort it out. Then as soon as I’ve sorted that out then they will come and check on me and see how I’m feeling or else I can tell them and I can go to them they just can just say ‘Sharon what’s wrong’ and I say I’ve just got a little bit of pain in my forehead. That’s very hurtful and sometimes I can’t feel it. Sometimes if I get all pains all over, sometimes it is like that with everything I have so when I’ve done that. Then I’ll come in here and just lay on my bed and have some sleep. Now if I have the stronger parecetomol, the big white ones, because you can get the stronger ones and they help you even better.

Dr Louise Newson [00:05:29] So that helps you with the pain if you take stronger painkillers.

Sharon Saunders [00:05:33] Yeah, when you got pains all over, because it makes me feel pain, then. In the morning when I wake up I have pains in my back and everything else. So one of the staff have to explain a bit clearer because sometimes, I don’t like being in that sort of pain. So it’s different like that isn’t it, and it it’s different for other people because I’m in a wheelchair but that’s why somebody comes in to help me up.

Dr Louise Newson [00:06:13] Yeah.

Sharon Saunders [00:06:15] And then the second bit is, if you have like the warm hot water bottle you think that’s a good idea to use a hot water bottle?

Dr Louise Newson [00:06:27] Sometimes people find using a hot water bottle can help. One of the things is, you know, and people listening know that our hormones work all over our body and they can actually help reduce any pain and inflammation in the muscles and the joints. And so actually muscle and joint pain everywhere is a very common symptom of having low hormones and a lot of people don’t realise that and actually it’s better to think about having the hormones back than taking lots of lots of painkillers, which certainly the strong ones can sometimes cause side effects as well. But I know you had spoken or you thought about HRT before, hadn’t you? But you weren’t sure whether you could take it because you’re in a wheelchair. Is that right?

Sharon Saunders [00:07:13] Yes.

Dr Louise Newson [00:07:14] So what had you been told about HRT before we met.

Sharon Saunders [00:07:18] A little bit, but I didn’t…now you have explained it at the start because I was finding it a bit complicated, but now I’m really confident but until we sort it, then I know what I’m doing because it’s a new thing for me.

Dr Louise Newson [00:07:43] Yes. And it is really important when you start any treatment, you have a full understanding of what it is and what it can do and to be in control. And I’ve spoken to quite a few people in the past who have been told that they can’t take HRT because there’s a risk maybe of clot. And if you’re in a wheelchair and you’re not walking, then that can increase your risk. Whereas actually the types of HRT we usually prescribe doesn’t have an increased risk of clot and it’s very safe. And a lot of people in wheelchairs find that their muscles and joints can be bad. But also sometimes sitting down for periods of time can actually be quite uncomfortable if you’ve got some vaginal dryness.

Sharon Saunders [00:08:27] I wasn’t comfortable now.

Dr Louise Newson [00:08:29] Yes or some urinary symptoms as well. Some people are more likely to have urinary tract infections and having hormones can really make a difference with that as well. So it’s really important, I feel for my work is to try and give information to everybody in the way that they understand it. And actually we’re doing a huge piece of work for people with learning difficulties so they can understand. Because I know sometimes when we speak, you use sign language and we’re doing some work with people who can sign as well because that’s a really important way. We’re actually using more pictures and trying to make the language really simple, because I know as a doctor we often use quite complicated language that can be really difficult to understand.

Sharon Saunders [00:09:17] Yeah.

Dr Louise Newson [00:09:18] So what we want to do is to allow people to have the understanding before they become menopausal so that when you were in your thirties and forties you could understand more, so you’d know what to expect. Do you think that would be a good idea?

Sharon Saunders [00:09:35] I think it’s a good idea.

Dr Louise Newson [00:09:38] So doing this podcast is actually really useful for other people to think, because for many years we’ve not been told much about the menopause or we’ve always been thinking it won’t happen to me because I’m not the right age or I’ve got different symptoms or I’m experiencing symptoms, but I don’t know who to ask. So I think having it so that you can ask and you know, you’re someone that wants to know about what’s going on, which is really important, but you need to be given it in a way that you can understand. So then you can make decisions about what to do. Don’t you think that’s right?

Sharon Saunders [00:10:21] Yeah.

Dr Louise Newson [00:10:21] Whereas a lot of people are just told, well, you just have the symptoms put up with them, you can’t do anything about it. And I feel that’s really sad.

Sharon Saunders [00:10:30] I think it’s more important just say how you feel for yourself.

Dr Louise Newson [00:10:40] Yes, and it’s also really important for people that care for you. I know you’ve got some fantastic carers. You’ve got one sitting next to you now, but it’s really important that they understand as well. So when you’re feeling different.

Sharon Saunders [00:10:53] Yeah, like it’s important with other people as well. So you can explain to them because they would like to know about it as it makes me feel like I’m coming out of my shell.

Dr Louise Newson [00:11:15] Yes. Yeah. Because actually, the more we talk, the better it is, isn’t it, as well.

Sharon Saunders [00:11:22] But then I don’t have to get wound up or anxious just say it how you think it works.

Dr Louise Newson [00:11:32] Yes. And I think that’s so important that you can talk about it and people understand as well, because I’ve worked with some people with learning difficulties who can’t speak and then their behaviour gets worse because they’re menopausal, because they don’t understand that they’re in pain or they’re getting other symptoms and they can’t express it. So actually then if a carer understands that what else is going on in this person could it be related to their hormones, then that’s really important for them to pick up because, you know, some people we’ve spoken about it before have flushes and sweats, some people have pain, some people feel very, very anxious or very low in their mood, but they can’t express why they’re feeling like that. And so to have the ability for others around to understand means that those people suffering are more likely to get the right help, aren’t they?

Sharon Saunders [00:12:29] Yeah, because sometimes in the mornings when I wake up, I always lay on my tummy for 5 minutes or more, just stretch my legs out at the back as that does help. Friends can help me.

Dr Louise Newson [00:12:52] And that’s really important with this conversation. A lot of my work is trying to help people who haven’t got the help or support or they haven’t got the knowledge and through balance, the app. we’re doing a lot of work in translation, so people that speak in different languages can understand, but also people that have different accessibility needs. So people who can’t hear, who can’t read properly, who need things explained in different ways, that’s something that we’re working on really carefully. So everybody has the ability to understand because as women, we’re all going to become menopausal and it will affect us in different ways. But it’s important that we know so then we can get the treatment that we want, can’t we? So you have obviously we’ve spoken before and you’re going to start taking some HRT.

Sharon Saunders [00:13:43] Yeah.

Dr Louise Newson [00:13:44] Which you’re quite excited about, aren’t you? And what’s really important is that you are in control because you like being in control of everything that you do, don’t you?

Sharon Saunders [00:13:55] Yeah.

Dr Louise Newson [00:13:56] And I know when we spoke, it’s also important for you to know that with HRT, you’re the one that’s going to be putting the patches on, and you can decide whether you continue or not. But it’s really important to try so that you can decide whether it’s helping you or not. And I feel very strongly as a doctor, I’m not forcing you to do something. You’re doing it to try and see if it helps, which is really important, isn’t it?

Sharon Saunders [00:14:24] Yeah.

Dr Louise Newson [00:14:25] And you’ve got support of your carers and people around you as well is also really important, isn’t it?

Sharon Saunders [00:14:32] Yeah.

Dr Louise Newson [00:14:33] And I think you’re very lucky with the carers that you have and to see the relationship you have is really special isn’t it.

Sharon Saunders [00:14:41] Really.

Tatjana [Sharon’s carer] [00:14:41] And she is one special lady.

Sharon Saunders [00:14:45] Oh always, always special.

Dr Louise Newson [00:14:48] But some people aren’t so lucky are they. Some people with learning disabilities don’t have. Yeah, I know you are.

Tatjana [00:14:55] That’s why, that’s why you want to help others too.

Sharon Saunders [00:14:59] Yes, so I can help other people too.

Dr Louise Newson [00:15:03] Yes. And that’s really important. So I would really like to ask from you, Sharon, three things that you think other people with learning disability should do if they’re struggling and think they might be menopausal, what things do you think would be really helpful for them to do?

Sharon Saunders [00:15:24] Ask for help.

Dr Louise Newson [00:15:25] Ask for help. That is a really important thing, isn’t it? And if people don’t get help from the first person they ask, then it’s probably worth asking someone else as well, isn’t it?

Sharon Saunders [00:15:40] Yes and the other people that speak up.

Dr Louise Newson [00:15:43] Yes. Because you’re not shy of speaking up, are you? But others might be might they.

Sharon Saunders [00:15:50] Yeah but I can explain to them and help them and ask.

Dr Louise Newson [00:15:56] Yes. So I think that’s really important. So three things really is asking for help. The second thing would be if you’re not getting the help, then you should ask someone else. And the third thing is asking for someone to explain so that you completely understand. Would you agree with that, Sharon?

Sharon Saunders [00:16:18] Yeah.

Dr Louise Newson [00:16:19] That’s very great. I love for those people who obviously, you can’t see Sharon talking, but signing as well. And then putting your fist from up to down is a very definite yes, isn’t it?

Sharon Saunders [00:16:31] Yes. And I feel a lot of confidence about what we are doing then it helps me to understand more.

Dr Louise Newson [00:16:43] Absolutely. And I’m really grateful for you talking because I know it’s hard doing this podcast and speaking to me, but I know it’s going to help other people to think. So we’re not ignoring people. If people work with people with learning difficulties and their behaviours changing or you feel that things aren’t quite right, then it’s always worth thinking about hormones and trying to allow that person to be able to explain and to try and get the help that they need is is really crucial.

Sharon Saunders [00:17:13] Speak up.

Dr Louise Newson [00:17:14] Speak up. Yeah. So before I finish, Sharon, is there anything else you’d like to say to the people that are listening?

Sharon Saunders [00:17:22] Don’t give up.

Dr Louise Newson [00:17:24] Very good. Very wise words. Don’t give up. And I think that should be for everybody. Actually really important that we don’t give up and we use our voice and our determination too.

Sharon Saunders [00:17:37] We need more voices.

Dr Louise Newson [00:17:40] Indeed, so it’s lovely having your voice today. I feel very privileged and happy that we’ve spent this time together, so thank you ever so much.

Sharon Saunders [00:17:47] Thank you, see you soon.

Dr Louise Newson [00:17:53] For more information about the perimenopause and menopause, please visit my web site. Balance-menopause.com, or you can download the free balance app, which is available to download from the App Store or from Google Play.

END

The post Learning disabilities and the menopause appeared first on Balance Menopause & Hormones.

Managing menopause while living with physical disabilities

kat keogh — Tue, 06 Jun 2023 08:52:24 +0000

Laura Bibby joins Dr Louise to share her experience of managing the perimenopause shortly after a life-changing spinal cord injury.

A senior nurse and an ambulatory wheelchair user, Laura shares her struggles to have urinary symptoms, crippling anxiety and joint pain recognised as being due to her perimenopause, and not just attributed to her injury.

In an empowering conversation, Laura and Dr Louise discuss the importance of persistence, and speaking out to help women with disabilities overcome barriers preventing them getting the menopause care and treatment they deserve.

Laura’s three tips:

Be persistent – If something doesn’t feel right with your health, keep pushing and seeking for the right treatment. Even if a healthcare professional dismisses your request, keep going and explore other options
Speak up and don’t feel ashamed. Menopause affects everyone
Normalise conversations around women’s health, don’t have them in secret. Discuss periods and the menopause openly so that it is easier to go and ask for help when needed

Follow Laura on Instagram @blue__brick_disability and you can read more about her story in this article on the balance website.

Transcript

Dr Louise Newson: [00:00:09] Hello, I’m Dr Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the Menopause Charity and the menopause support app called balance.

On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause.

So today on the podcast I’ve got someone called Laura with me remotely. Someone, like a lot of my guests, I’ve never met in real life. One day I’m going to have a podcast party and meet all the guests. So Laura was a nurse and reached out to me, like a lot of people, on social media. Her story resonated with me and I’m sure it will resonate to many of you listening, and she’s agreed to come and talk about it and her, and the events that have led on since various things have happened. So welcome, Laura today. Thanks ever so much.

Laura Bibby: [00:01:15] Thank you for inviting me.

Dr Louise Newson: [00:01:17] So you’re a nurse. I’m a doctor. If I’d met you straight after your training and asked you about menopause, how much would you have been able to answer?

Laura Bibby: [00:01:25] I would have looked at you blankly and not been able to answer at all. I’ve had no medical training at all, it just wasn’t something that was on the radar. I’m actually an advanced nurse practitioner, so I’ve done advanced nursing skills at masters level, I’m a prescriber, and no one has ever, ever talked to me about menopause.

Dr Louise Newson: [00:01:46] It’s sad, isn’t it? I mean, if you could go back in time, do you think it would have been useful knowing about the menopause?

Laura Bibby: [00:01:52] Oh, absolutely. My background is A&E, so I spent ten years working in A&E where, I’m sure looking back now, there were patients that would have come in, whether they presented with a mental health problem or a gynae problem. But that disconnect, it just would have been completely off radar. And why would you present in A&E with a menopausal problem? However, now, knowing the symptoms and knowing how desperate I’ve got, I can understand why someone would rock up.

Dr Louise Newson: [00:02:19] Yeah. And in fact, a patient this morning told me that she had gone to A&E and in fact, it was with crippling anxiety. She had a panic attack and she’s not a panicky person at all, really level headed. And she’s 54. Her periods had stopped and she didn’t really know what was going on at all. Went to A&E and they said, oh, I think it’s your menopause, so that’s really good. But then they said, well, you just need to go home because nothing we can do for you. And she said, well, I wouldn’t expect A&E to really help. And I thought what a missed opportunity, actually, because even if they felt they couldn’t prescribe, they should still give information. And certainly, this lady wanted HRT. So if she had more information and wanted it, then I really feel that she should be offered a prescription because we give prescriptions in A&E for all sorts of things, don’t we? If we diagnosed an underactive thyroid gland, we would give thyroxine. So, there’s lots of missed opportunities where women are being neglected, really, I can’t think of another word for it, but I spend a lot of my time obviously thinking about the menopause, but I spend lots of time thinking about women who are really underserved when it comes to the menopause. And I think most women are actually. I’m a fit, well-educated woman, and I still struggle to get the HRT and the treatment and the holistic care that I should have from the NHS. But I think about those women who have various reasons why they can’t or they either can’t get the treatment that they want or they don’t realise that they need treatment or sometimes it’s a combination of those things. And we’ve done various work with various charities looking at minority groups. I’ve just done a podcast which has come out for people with learning disabilities, which is really important. But doing that work made me think more about physical disabilities as well because it’s hard enough when you’re able bodied and physically well to cope often with a menopause. But when people have physical disabilities, everything can be amplified and so much worse. So I’m leading in, obviously, to ask you about what’s your sort of story before the menopause, if you don’t mind explaining what happened to you, Laura.

Laura Bibby: [00:04:32] Yeah, absolutely. So prior to my menopause, I’ve always been very into health and fitness, looking after my body. I used to run 40-50K a week. Yoga I would practice a couple of times a week, my practice would be in the morning before starting work. So really active, looked after my body, looked after what I ate to make sure that I was healthy. I had a sports massage back in 2019 where unfortunately a freak incident happened where the therapist put their lower weight through the lower spine and actually broke my back and the fragments of the bone embedded into my spinal cord and caused me to have something called cauda equina syndrome, which resulted in me being completely paralysed and I needed to have spinal surgery to repair the damage, removed fragments of bone and to get me back walking. Unfortunately, with cauda equina syndrome, when the nerve is touched you can cause permanent damage, which happened because of the fragments of the bone, but also when the surgeons went in to remove it there’s also risk of the spinal cord being damaged. I was left with left-sided paralysis to my left leg. And also urinary problems associated with an L3/L4 spinal cord injury. I was discharged, I was told that, you know, my GP said you may never walk again and kind of, off you go kind of thing.

So I had intensive therapy, I was given morphine, I was given gabapentin, I was given a cocktail of drugs to help with my pain. And as a prescriber myself, I wasn’t comfortable taking gabapentin, so I didn’t take it. I struggled for probably about eight months before I was seen in the pain clinic. When I went to the pain clinic, I was offered a Butran slow release patch for pain relief, which I’m still on now, diazepam and paracetamol. So I’m still on a strong cocktail of pain relief. So that was at the beginning of my journey with a spinal cord injury. You have urinary problems, so you have retention. The signals that fire my bladder don’t always work properly, so I’m not always aware when I need to go to the toilet. So I’m at huge risk of getting a UTI and I kind of really have to work that area to make sure that I look after my bladder and drink plenty of fluids and bits and pieces. So, there is a bit of a disconnect with those neurones that fire the bladder.

I’ve got pain from spinal cord injury, I’ve had major surgery and you’re told it can take up to two, three years for that all to settle down. So COVID hit and I just carried on doing my rehab, taking my medication. And it wasn’t until sort of probably about 18 months ago, I suddenly just become completely overwhelmed with anxiety like crippling anxiety going on the school run and being too anxious to get out of the car, being nervous going into shops, talking to people, making decisions, just a complete lack of confidence which didn’t fit comfortable with me. I kind of held it together and it got to the point where I think over the Easter period, I just physically couldn’t leave the house. I just couldn’t stop crying. Anybody who knows me knows that I am not someone who cries. I’m not a crier. I’m a resilient person. I think working in A&E for ten years, you have to be resilient. And if I cry, I probably cry two or three times a year. So for me to be uncontrollably crying just wasn’t me. So I went off to the doctors and explained how I was feeling, and they said, oh, you’ve got depression. And I didn’t fit comfortable with me. I said, this isn’t me, I’m so resilient. I don’t understand why suddenly two-and-a-half years later after having my accident, where I’m so positive about it, some really positive things have come out of me needing to use a wheelchair and use mobility aids. I don’t feel that that’s why I’m feeling like I’m feeling. The pain was still increasing. I’d kind of reached a plateau and I was beginning to wonder whether I’d just become resistant to the medication I was on and did I need to increase the morphine? Was that why I was in so much agony? My hips were just on fire. I would be lying in bed gyrating my hips, I would wake up gyrating my hips to try and alleviate the pain. I couldn’t lay on either side. It was impacting on my walking, on my rehab and my therapy because the pain had just got to a level that was actually reducing me to tears and the brain fog that I was then starting to experience coincided with COVID and everyone’s talking that COVID causes brain fog.

So I had all these things going on, which was making me feel even more anxious and depressed. I’ve got a quite stressful job working as a senior manager in the NHS, having to make decisions, having to have team calls and suddenly the words just weren’t coming out of my mouth, which really knocked my confidence. I kind of felt a bit withdrawn and didn’t want to verbally speak out in meetings for fear that the words would come out wrong. I was beginning to wonder whether I had dementia. I had recently read the book, Still Alice. I don’t know whether you’ve read the book, and I think anyone who’s read the book, Still Alice, will absolutely, these feelings will resonate with them. And actually in the book, Still Alice, she talks about menopause and she thinks maybe her dementia is menopause. She was 50. I was coming up 45. And then there was lots of hype on social media that made me think, hang on a minute, is this menopause or, you know, have I got dementia, Have I got, you know, long COVID? Have I just got chronic pain because of my spinal cord injury? So all these factors are going on. So I went back to my doctor and suggested that I’d like to discuss taking HRT, and they just said, no, no, you’re too young, you don’t need HRT. It was suggested, this was a telephone consultation with a locum GP, it was suggested to help with my low mood that I took up some form of exercise and I said what maybe like something like running? And they said, oh, that would be a fantastic idea. And I just was gobsmacked that my GP, who clearly hadn’t read my notes, had no understanding that I was an ambulatory wheelchair user, that running wasn’t an option. I couldn’t run. I’m in a wheelchair. It was suggested that I take up some form of exercise because it would help with my low mood. So I decided there was no point pursuing the conversation with this person, that I had to go to my research, which is what I did. So I’m eternally grateful for the work that you’ve done raising the profile and, you know, giving people like myself and actually friends and colleagues that the information that we are being deprived from. So I did my research and I then remembered that I had health insurance, so I went to my private health insurance and I was told, nope, sorry, menopause is the ageing process and you’re not covered.

Dr Louise Newson: [00:11:53] That’s right. You’re not covered. Yeah.

Laura Bibby: [00:11:56] Which I was gobsmacked because, you know, the whole point of having health insurance is to help you with conditions. So they weren’t interested, but they did give me a consultation to talk to a GP, and this GP was amazing. She absolutely understood the menopause clearly had had training and she just boosted me and went, right, Laura, this is what you need. You know, you’re a clinician, you know what you need to do and this is the information. So she just laid it out for me. She gave me some apps, some support apps that I could use via my health insurance. And I went back to my GP and I had a list in front of me so that I wasn’t going to, you know, get starstruck and become, you know, brain fog and not ask those questions. So I listed exactly what I wanted and reluctantly my GP said, well, we need to take bloods from you, even though I’m over 45, and then we would discuss it. So I went back after my bloods and they said, no, your bloods were normal. It’s not indicating that you’re perimenopausal. And I said, well, despite that I would still like to have some treatment, so I am on some low dose HR. I don’t believe I’m on the right dose. I don’t believe it’s tackling everything. So I do need to go back and address that, I’m early on my journey. It was that lightbulb moment when I suddenly I went, it’s not because I’ve got a spinal cord injury. This is perimenopausal and I’m kicking myself that I didn’t, I wasn’t more proactive. And I sat with it for so long. And I think you picked up on one of my social media posts I did, where I linked all the symptoms of spinal cord injuries and menopause. And they’re actually the same. So, yeah, it’s about understanding that menopause is complicated and there are so many symptoms. But don’t be fobbed off because it’s very easy for someone to say, well, if you’re depressed, then you’ve got a mental health problem and if you’ve got a UTI…

Dr Louise Newson: [00:13:58] Yeah. And I think that is part of the problem. And sometimes I go to meetings and they say, well, we wouldn’t want to put every palpitation, for example, due to the menopause because some people have palpitations due to heart problems. And I completely understand that. And it’s really easy to shoehorn women and patients sometimes into a box thinking it’s that’s all related. And I think, for example, the urinary symptoms that you describe can be very common when people have spinal injuries, and urinary symptoms can be very common during the perimenopause and menopause. But actually the two can coincide together. And sometimes what’s happened in medicine and I think it’s been a real problem and it is a real problem for women, is that we compartmentalise medicine and we try and tick too many boxes and then we don’t think about other things that can be happening at the same time. And lots of people can have two things together. So when I see someone who, for example, has muscle pain or joint pains, of course they might have an arthritis. And some people I see have already been diagnosed with an arthritis, but some of their pain could be related to their low hormones as well. And, you know, I see a lot of patients and women who have multiple sclerosis, MS, and that often gets worse during the perimenopause or menopause, and they’re often given other biological agents and drugs, but they’re also menopausal. So I will give them HRT if they want it, of course, to help their future health, knowing that some of their symptoms might be not related at all, but knowing there’s no contraindications to taking HRT and the number of women that come back when they’re on the right dose and type of HRT with MS saying my goodness me, I don’t need to take this extra biological agent. Actually, the deterioration in my symptoms were due to my hormones and we know that estrogen and testosterone are very important on nerve function as well. And testosterone can build the myelin sheath and reduce inflammation and work as a neurotransmitter. So it can be very helpful actually in repairing any nerve damage, but also, you know, nerve pathology.

So it’s really crucially important that we don’t just ignore women because they’ve got other physical, mental, psychological disorders, if you like, as well. And I think when you think about urinary symptoms, vaginal dryness, I often think about people who are sitting in wheelchairs because we know around 80% of women have symptoms related to vaginal dryness, urinary symptoms – about 8% have treatment. So the majority of women aren’t getting help. A lot of women I speak to find it hard sitting down for long periods of time or they find that they’re going to the toilet far more frequently. And actually, if you have to sit down because you’re in a wheelchair for a lot longer, it must be very uncomfortable. And plus, just the effort of going to the toilet for a lot of people is a huge effort. You know, we take our health for granted, as you know, and our mobility for granted when we are mobile. But actually it’s not so easy for a lot of people and people who are very physically disabled who need a hoist and they need carers and or they’ve got incontinence pads, they don’t want to be leaking and urinating when they don’t need to. And without anyone thinking about, well could some local estrogen, vaginal estrogen, help some of the urinary symptoms? Might not help them all, but even if they’re 20% better, for a lot of people that’s really going to improve their quality of life.

Laura Bibby: [00:17:29] Absolutely.

Dr Louise Newson: [00:17:29] And like you say, looking at the systemic side of things as well, because, you know, you’ve been given all sorts of drugs and actually they can have an effect. But if we can replace some of those drugs with some hormones that have less side effects and better long-term effects on future health, then I would much prefer to swap estrogen with gabapentin, for example. And that’s what happens quite a lot. You know, we see a lot of people who are being medicalised for the wrong reasons for their individual symptoms rather than someone taking a step back and thinking, could this be related to their menopause? There’s a lot of people who think it’s awful that people take HRT and that we’re medicalising the menopause, but it’s been medicalised already with other medications. So in medicine, it’s so much better if we can treat the underlying cause, and it’s just not happening with the menopause, is it?

Laura Bibby: [00:18:21] No, it isn’t. We know that, you know, the highest suicide rate in women is if their aged 45 to 55. That’s a huge stat. And when we can treat it with medication, if someone had diabetes, we just wouldn’t question it, we would give them insulin to support them. But there is just that taboo around the whole subject.

Dr Louise Newson: [00:18:42] And have you spoken to other people at all, Laura, who’ve been, who have physical disabilities, who are struggling with the menopause or is it a conversation that’s coming out more, do you think, in general?

Laura Bibby: [00:18:53] Absolutely. So I’ve done a few social media posts on my disability platform and I was really taken aback by the amount of people that privately reached out to me and said, thank you, I’ve now had that lightbulb moment as well, thanks to your posts. So that was really sort of inspiring to know that actually I wasn’t alone going through disability and menopause. That actually, I think we have to talk about it. The more we talk about it, the more we empower people. You know, I’m confident and I’m quite happy to come somewhere like this and talk about some of those subjects like urinary infections and vaginal dryness and stuff where so many people wouldn’t. But unless we speak up about it and actually by you talking about treatment that will help that, that will empower someone to go, no I’m not just going to accept this and I am going to go and get treatment. So talking on my platform, people have reached out to me. I’ve had a couple of people have said, oh, you’ve just given me the kick that I need to go back and be a little bit more sort of forceful about what it is I need, And interestingly when you first reached out to me, I was out with a schoolfriend and we were having lunch. We were just paying and I said, I need to hurry. I’ve got a phone call with someone from Louise’s team, and we start talking about the menopause. And the lady that was serving us said, oh, I’m so sorry to interrupt your conversation. She said, but I’ve been listening to you while you’ve been queuing. She said, I think I’m going through the same. What you’re talking about is exactly what I think I’m going through. She said, everyone’s put it down to the fact that I’m going through a divorce, and she says, but I’ve now moved on from my divorce and the symptoms are still there. She says, thank you for talking so openly. And I said, I didn’t realise we were being so loud, but there you go. So I think having these conversations inspires other people to go, actually, I’m not going to settle for second best, I’m not just going to accept this. It isn’t as – when I went to my private health insurance to ask for support – it’s not an ageing process that we just have to suck up. Let’s get that help.

Dr Louise Newson: [00:20:57] Yeah, absolutely. And it’s been really amazing actually watching and listening to how people help each other. I think I’m very fortunate that I’m doing something that affects women rather than men because I know how hard it is. I’ve got some male colleagues who work with testosterone replacement in people who have testosterone deficiency. It can affect around a third of men, but it’s a really closed conversation. And men don’t like talking about their own health or hormones. We know that just looking at how people present with disease and men and women are different, but women like to talk, but they also really like to help each other. I’m not saying men don’t want to help each other, but there is this sort of almost sisterhood that’s going on, and I can feel it even more with lower generations. So I did a survey recently looking about how we talk about the menopause, and I presented it at a European conference and people are far more likely to talk to their daughters than they are to their mothers about the menopause, which is no surprise. But actually then daughters and younger people get so much more empowered and then can help and start that conversation. And it’s not even about normalising the conversation. It’s about allowing people to think about what they’re going to do about it. Because I think for so long people haven’t been talking because they thought there was no treatment. I might as well just carry on. What’s the point of moaning? But now I feel like the nation is waking up, people are understanding their body, they’re allowing to understand. But actually then the next step is how? How do I get treatment? And like you say, it’s helping people to support that. And I know a lot of the pushback I get from my, some of my fellow healthcare professionals, is because I’m creating work for them, because all these women are now coming to the surgery. And I, I understand and I feel that’s difficult on a flooded system. But actually, at the same time, I feel, isn’t that great that we can improve the future health of women and women can understand what’s going on and women are allowed to have a choice. And the number of people that I see once they’re on the right treatment that’s right for them, they’re not needing to go back to a doctor to complain about their pains or their headaches or their poor sleep or their low mood or their urinary symptoms. So it won’t take long for the future health improvements to really kick in, which will not only save time, but also save money and help people to lead better lives.

But this work that goes on behind the scenes, you know, in coffee shops, on social media with DMs, you know, there’s all this that’s going on which we can’t monitor, we can’t assess by fancy research with big trials. But I feel it is having such an effect. And I couldn’t have done this work 30 years ago without social media. I mean, there’s a lot of Twitter I can’t stand because it’s very toxic often. But on Instagram, it’s almost like people really want to help and we can help people that we don’t know, but in a very positive way, in an empowering way. And just when I first came across you on Instagram and you could feel this this energy, this sort of support for you when we don’t know you, which I think I can’t imagine what it must have been like and still is like for you having such a freak accident. But none of us need social media friends. But just to have support actually is really useful, isn’t it?

Laura Bibby: [00:24:22] Yeah, absolutely. And it’s kind of the talking out and reaching out. And actually now I’ve got some people on my Instagram account, who I’ve never met most of them, but actually every now and then, I actually came off social media for about three months last year and it was because I just couldn’t, everything was just too overwhelming for me. I had incredible insomnia and just that anxiety that I completely came off of social media. And when I went back on, I was inundated with messages from people that had noticed, had noticed I hadn’t been on and were checking up, are you okay? We wondered whether your health had deteriorated or, you know, just a friendly kind of message. And it really boosted me. And I then decided that, yes, I was going to come back onto social media because it is a good platform. And if one post could inspire someone to go to their GP to get help, whether it be for a mental health problem or for a menopause problem or for a long-term chronic problem, if that one person inspired somebody, then actually it’s worth doing it.

Dr Louise Newson: [00:25:25] Absolutely. I think, yeah, please don’t stop, because I, we, all sometimes get quite inward looking and think, woe is me. And then you look at other people who are more inspirational saying, no, come on, stop complaining, let’s just get on. And I think it’s wonderful watching what you’re doing and listening to your inner strength, because your inner strength is definitely there, even when you have wobbles. So I’m really grateful for your time. Well, I’d really like to finish with Laura, actually, is I always do three take home tips, as you know, the three things that you have learnt as somebody who does have a physical disability that have made a really big difference to try and get the treatment. And I know you’re saying it’s not quite optimal yet, but just starting on that treatment journey, what three things have you found that have been really useful?

Laura Bibby: [00:26:16] I think for me the most three important things is actually if you’ve got a niggling voice in your head, then go with it. They often say, yeah, as a mum, if there’s something that’s not quite right with your child that mum knows best. I think it’s the same with our health actually. If there’s just something that’s just doesn’t fit right. If you go to one GP and they say no, you’re fine, then explore other options and do your research. And there’s a wealth of information on social media, you know, take some of it with a pinch of salt. But if you’ve got someone like yourself that is a clinician and it’s very much verified, then take that information and speak up. Don’t feel ashamed, I think is probably the biggest one is not to feel ashamed. I did a big speech, a team away day a couple of weeks ago in front of my whole of my team. There was 60-odd people, very senior people working in the NHS and I did a talk on menopause and how it actually affects everybody in that room whether they were husbands, whether they were females. As line managers, it affects everybody and we need to start talking and we need to start articulating these conversations and not feeling embarrassed about it because it’s, you know, historically it was, you know, a problem that we just didn’t talk about. And when I was younger, you had your periods and you had your period chat with your mum, you know, in closed doors. No one would know about it. I’ve got four girls and we openly sit around the dinner table and we talk about periods and we talk about menopause and you know why we’re talking about, you know, periods and menopause, the conversation is pass the salt, pass the pepper. It is just part of those conversations that I think normalise women’s health, men’s health, talk about it and go and seek advice.

Dr Louise Newson: [00:28:03] Perfect.

Laura Bibby: [00:28:04] Absolutely. Don’t live with it.

Dr Louise Newson: [00:28:06] Very good. So thank you ever so much for sharing your knowledge and your story and your positivity as well. So thanks so much for your time today, Laura.

Laura Bibby: [00:28:15] Thank you for inviting me to discuss it. And, you know, acknowledging that people with disabilities have this struggle.

Dr Louise Newson: [00:28:20] Oh, thank you.

For more information about the perimenopause and menopause, please visit my website www.balance-menopause.com. Or you can download the free balance app, which is available to download from the App Store or from Google Play.

END

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