Relationships Archives - Balance Menopause & Hormones

Assessing the impact of menopause and divorce on women

Natalie Millman — Mon, 24 Feb 2025 11:54:00 +0000

Why factoring in perimenopause and menopause is so important in divorce settlements, according to family lawyer Farhana Shahzady

Menopause can negatively affect some women’s careers
Reducing working hours or leaving work owing to symptoms can cause financial difficulties
Family lawyers need to consider menopause when considering divorce settlements

As a family lawyer, my professional observation is that menopause can shake some women to the core, not only in terms of their health (and future health) but their work, wealth and marriage.

Pressures have exponentially grown for women in a world that demands women juggle multiple balls of simultaneous child raising and working – most women are the main carers of children [1] and 72% of women are now in paid work compared to 53% in 1971 [2]. This is on top of women trying to hold their marriages together when they are being buffeted by their hormones.

There is no formal case law in relation to menopause and its impact on family financial cases. It seems to be a blind spot, which is why I originally launched The Family Law Menopause Project in 2022 – to understand what was going on and to conduct a survey of family law practitioners.

The Family Law Menopause Project survey of family law professionals and the judiciary revealed that 81% of family lawyers fail to understand or recognise the impact of menopause and perimenopause during divorce and separation. In addition, 65% of respondents agreed that women are potentially disadvantaged in terms of financial settlements by a lack of understanding within family law to recognise or think about the impact menopause and perimenopause might be having on the ability of their female clients to work full-time or even part-time.

The majority (60% of respondents) felt that it would be unlikely or extremely unlikely that clients (whether as individuals or as a couple) would talk openly about the impact of menopause on their divorce with their lawyer. This highlights a further problem, where not only practitioners but clients are failing to talk about the menopause, even when the impact on their lives might be significant.

Impact of menopause on working life and finance

It is estimated that there are more than 13 million women of menopausal age in the UK, around a third of the female population [3]. One in four of these experience severe symptoms [4]. That is a very high number of women who are suffering and in turn, having their livelihoods affected in a variety of ways including job loss.

The Parliamentary Women and Equalities Committee conducted a large-scale enquiry into this because of the concern that so many women are leaving unemployment prematurely due to lack of menopause support. The feedback given to the committee from the women who participated is compelling.

Organisations also participated in the enquiry since it is being increasingly recognised by employers that more needs to be done to safeguard menopausal women otherwise workplaces are haemorrhaging female talent.

A survey by Newson Heath of 3,800 women found that 99% of respondents said their perimenopausal or menopausal symptoms had led to a negative impact on their career, with 59% having taken time off work due to their symptoms. Worryingly, 60% of women said their workplace offered no menopause support. This has a wider impact on the workforce and economy, with 19% of women reducing their working hours and 12% resigning from the job.

Impact of menopause on relationships and divorce

The peak age at which women in the UK file for divorce is thought to be between mid-40s and 55 – which usually coincides with perimenopause and menopause. Symptoms, such as lack of libido, mood swings and genitourinary symptoms, can have a big impact on a woman’s quality of life and her relationships.

As a divorce lawyer, I have drafted more unreasonable behaviour divorce petitions in the last 20 years, based on a dwindling sex life and lack of communication with their spouse, than any other type of petition although we have now transitioned to no-fault divorces.

Lack of communication can also extend to their lawyer so that family practitioners may not be fully attuned to menopausal women’s needs. This silence is regrettable as it becomes clear that not factoring in menopause can be very problematic – without proper consideration or information regarding their earning capacity and/or medical evidence as to the extent of their symptoms, divorce lawyers and judges will seek to facilitate the much-lauded clean break (i.e no continuing financial ties on divorce).

Setting people free so that they can live financially independently after the breakdown of a marriage is the Holy Grail of financial family work. The clean break is enshrined in law under section 25A of the Matrimonial Causes Act, and if it is not readily available right away on divorce, the law says it should be sought at the first possible opportunity, for example when the children are old enough to fend for themselves so that the woman can get back to work.

The problem is that the clean break culture regularly clashes with women’s biology. Too many women on divorce do not achieve financial independence because they are shackled by menopause and cannot always work or achieve independence in the way that the family court had contemplated. How are these women financially surviving if they are losing their jobs or going part-time when the family court has largely or completely cut them adrift from spousal maintenance?

The financial reality of divorce

Research has shown that divorce makes men significantly richer (boosting their income by around a third) while women lose more than a fifth of their income, a loss that persists for many years [5].

There is also a significant pension gap, which means many women are thrown into poverty on retirement, especially if divorced. One paper found that divorced women age 45-54 who are not cohabiting have an average pension pot of £16,000 compared to similar men’s, while in those age 55- 64 the disparity is £19,000 for similar divorced women compared to £100,000 for men [6].

To compound this issue, women are more likely to have more caring responsibilities towards children and elderly parents, and to suffer mental health problems which menopause can considerably worsen.

The reality, however, for most women is that they have often created homes, raised children and supported their partners while their own careers have stood still, or progressed at a considerably slower rate. It needs to be recognised that the money these women could have earned (lost income) – and consequently their potential to save for their own future long-term needs, including retirement – has been significantly compromised along with their confidence and ability to rehabilitate in their menopausal years.

The continuing aim of the Family Law Menopause Project is to raise awareness of these issues and to make sure family lawyers work hard not to short-change their menopausal clients.

Farhana Shahzady is senior family lawyer, collaborative practitioner and mediator at Beck Fitzgerald as well as being a menopause campaigner and founder of The Family Law Menopause Project.

References

AIG Life research 2019 – 74% of women are the main carer for children
ONS: Employment and labour market (AO2 SA)
ONS: Population estimates for the UK, England, Wales, Scotland and Northern Ireland: mid 2023
Woods NF, Mitchell ES. (2005), ‘Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives’, Am J Med. 118 Suppl 12B:14-24. Doi: 10.1016/j.amjmed.2005.09.031
Marital splits and income changes over the longer term (2008)
Pensions and Divorce Exploratory Analysis (2021)

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Menopausal and getting divorced? How to make your split as smooth as possible

Natalie Millman — Mon, 24 Feb 2025 01:37:00 +0000

Lawyer and mediator Farhana Shahzady explains how dispute resolutions can save time, money and safeguard your mental health

Menopause can bring relationship issues to the fore and prompt the desire to divorce
Divorce litigation can be costly, stressful and emotionally damaging
Alternative dispute resolution methods are well worth considering

It’s becoming increasingly clear that divorce and menopause often go hand in hand. In a poll of almost 1,000 women, 7 out of 10 (73%) respondents blamed the menopause for the breakdown of their marriage [1].

However, many women find divorce and accompanying litigation paperwork extremely burdensome. Menopause symptoms such as brain fog, anxiety, insomnia, mood changes and depression (to name but a few) can make it difficult for women to remember facts of their case or meet court deadlines and deal with complex legal arguments when it comes to splitting the money or sorting arrangements for their children.

Why is divorce litigation so tough?

Divorce litigation is replete with risks – there can be extensive legal costs, it can be emotionally damaging for family and loved ones, and outcomes are hard to predict since you are largely putting your trust in the hands of a single judge at trial.

There are better ways to deal with divorce and its aftermath than court litigation, especially for perimenopausal or menopausal women who want to achieve outcomes with less hostility and better efficacy. The thought of giving evidence in the witness box can be daunting, especially if you are experiencing brain fog, cognitive impairment, and anxiety.

But throwing in the towel is not an option either if that means giving up on splitting the assets fairly or accepting arrangements for yourself or your children that are far from ideal.

What are the alternatives to divorce litigation?

Alternative dispute resolution (ADR) can help you navigate a difficult divorce. Several ADR options are available and worth considering alongside your family lawyer. These include:

Mediation

Mediation is a voluntary process where an independent, professionally trained mediator can help you find solutions to issues you are experiencing when going through a divorce, separation or dissolution of a civil partnership and all the related issues involving finances and children.

Mediation is a safe and constructive place for open and honest conversations to take place and decent mediators can skilfully guide you in discussions to help find a way forward after divorce or separation.

The job of the mediator is to seek to bring everyone together to reach a fair resolution.

One of the key benefits of mediation is its flexibility and lower cost. Mediation can be conducted at a pace that suits both the parties involved, unlike the court process, which can be slow and inconvenient.

It also allows both parties involved to set the agenda and discuss what is important to them in an environment and pace that suits them. Where appropriate, it may also be possible to involve children in the process, enabling their voices to be heard.

Costs of mediation are a fraction of those involved in court proceedings so it’s worth considering mediation in most cases.

Collaborative process

This process involves all parties, including collaboratively trained family lawyers, sitting around a table to discuss and work through the issues surrounding divorce or separation, instead of having decisions imposed upon them by the court.

The collaborative process is completely confidential, and it allows both parties to stay in control of their personal situation. This often establishes a more flexible, creative approach to financial and childcare arrangements than may have been possible with the traditional court process.

Solicitor-led negotiations

Solicitor-led negotiations can take place at any point during a divorce or separation and can often reduce conflict in the relationship, ultimately making the experience less stressful for everyone involved. It can also be used during court proceedings, to help negotiations and to reach settlement before final trial if possible.

Usually taking the form of round table meetings or telephone and letter correspondence, solicitor-led negotiation can be particularly useful for families where children are involved. It offers parents more control, and a chance for them to work together to decide the best care arrangements for their child.

As with mediation and the collaborative process, a family therapist can be used to help with any emotional issues that are causing difficulty in reaching an agreement.

Arbitration

So long as both parties agree on using the arbitration process, an arbitrator can adjudicate on all the issues and can take the time to understand what is involved, whether it’s to do with finances or child arrangements. This will give the parties involved a fair, impartial and binding decision on the specific concerns they have.

Arbitration is an effective alternative to the court deciding the way forward and, like the other dispute resolution processes, offers greater control and the ability to tailor what is needed.

The family courts are currently extremely stretched, and the arbitration process is instead designed around the parties’ needs and timescales.

Emotional support and family coaches

Family consultants, therapists and coaches are regularly used to reduce the emotional stress and impact for clients throughout divorce or separation and often work side by side with the family lawyer in a complementary way. They can help shock absorb some of the added stress that comes from menopause and divorce.

Thankfully there is growing awareness amongst some family lawyers that litigation should be a last resort and it is vital that women find a sympathetic family lawyer skilled in the latest dispute resolution techniques. These techniques are appropriate for many cases that otherwise find themselves in court.

Farhana Shahzady is senior family lawyer, collaborative practitioner and mediator at Beck Fitzgerald as well as being a menopause campaigner and founder of The Family Law Menopause Project.

References

Family Law Menopause Project and Newson Health Research and Education, 2022

The post Menopausal and getting divorced? How to make your split as smooth as possible appeared first on Balance Menopause & Hormones.

How to talk to your children about menopause

kat keogh — Mon, 17 Feb 2025 01:00:00 +0000

Tips on talking menopause with teenagers and younger children

Hormone changes during perimenopause and menopause can impact relationships with your children
Knowing how to broach the topic of perimenopause and menopause with your family can be tricky
An honest approach, with age-appropriate language, can help your children understand what you are experiencing

Your perimenopause and menopause can be a time of significant upheaval, with symptoms which can be challenging in both range and severity.

The chances are this won’t only affect you – your loved ones, including your children, are likely to notice changes.

You may be feeling particularly tired, anxious or irritable, and patience at home can be worn thin. So how much should you share with your children about what you are experiencing as your hormone levels change, and how do you go about it?

Should I tell my children about my menopause?

A survey of nearly 6,000 perimenopausal and menopausal women by GP and Menopause specialist Dr Louise Newson found that three quarters (4,314) of respondents said menopause was never discussed in their home while growing up, and a third (1,931) of respondents said that they never discussed it with their mother [1].

The survey also revealed an encouraging generational shift, with respondents more likely to have conversations about menopause with their children: 87% (2,717) had discussed menopause with their daughters, while 69% (2,210) had discussed menopause with their sons [1].

Unless they are very young, then talking to your children about your perimenopause and menopause experience is generally a good approach, says Dr Louise.

‘It’s important that we all talk about hormone changes more, and this is definitely starting to happen with periods, the menopause and the perimenopause,’ says Dr Louise.

‘It is brilliant that we are able to be more open about these issues and this makes it more likely we can get the support and understanding we need. Our children need to be part of these conversations. It is about breaking that taboo.’

Age-appropriate menopause conversations

So how can you broach the subject effectively?

Information needs to be tailored to their age, as this will greatly influence how much they can understand. Ensuring that children know the correct names of their body parts, including their intimate areas, can help with conversations around what we experience at different stages of our lives, Dr Louise says.

‘You may not want to talk about your perimenopause or menopause if your children are too young to understand. But making sure they have the vocabulary is a start, so that when they have the understanding, you can start talking about your menopause,’ she says.

‘Start very, very small, with just little bits of information, so that they can understand properly and clearly. Always be honest in what you tell them.’

When you are having conversations around puberty, this can be a good time to mention what happens at the other end for women.

‘Touch on what happens when these hormones start to decline, and that this is happening for you’ says Dr Louise.

Understanding the power of hormones

Discussing the power of our hormones and being respectful of their impact throughout our lives is a good approach, says Dr Louise.

‘Try and improve understanding of your hormones, and the impact of their fluctuations,’ she adds.

‘Talk about how changes throughout a woman’s life can bring different symptoms, can lead to postnatal depression, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and, later, the symptoms of perimenopause and menopause. Improving our and our children’s knowledge around the changes in our bodies is an empowering move. It can help them understand their own experiences and changes, and the importance of seeking care if needed now and throughout their lives.’

Highlight that positive solutions are out there

While your perimenopause and menopause experiences are unique, for many women they can bring significant challenges.

These changes can affect most areas of your life, including work and home, so sharing this with your children can help them understand what you are and why you may be different.

For women struggling with symptoms, the first line treatment is usually hormone replacement therapy (HRT), so talk to a healthcare professional to discuss your options [2]. You can also download the balance menopause support app to track the frequency and severity of symptoms to produce a report to take along to your appointment.

Taking the right dose and type of hormones can usually really improve your symptoms. You do not to have to delay taking hormones until your symptoms are unbearable or you have suffered for a length of time. It can sometimes take a while for the right dose and type of hormone for you as an individual.

Dr Louise says: ‘Always be positive and be clear that there are solutions out there, like HRT and hormonal approaches to heavy periods and contraception.

‘Encourage your children to talk to a healthcare professional if they have any hormonal difficulties and demonstrate to them that you do. This shows the importance of getting up-to-date and individualised advice.’

When puberty and menopause collide

In some households, children will be going through puberty as their mother experiences perimenopause or menopause, leading to a potentially volatile combination of hormonal changes.

A 2022 survey by Newson Health and the Family Law Menopause Project found a link between menopause and the rates of relationship breakdown and divorce.

Here, openness is particularly important and beneficial, Dr Louise says.

‘This can be a fraught time for a family,’ she says.

‘Understanding why we, or our children, may be particularly irritable or tired is really important. Maintain and protect that respect for each other, even when sleep is poor, we aren’t feeling great, and emotions are running high.’

References

Newson, L (2024) ‘Women’s experiences of perimenopause and menopause’
National Institute for Health and Care Excellence (NICE) (2024) ‘Menopause: identification and management’

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Emotionally supporting each other when you are perimenopausal or menopausal

kat keogh — Thu, 13 Feb 2025 01:00:00 +0000

How to help restore and build your relationship when everything’s topsy-turvy

Midlife can be a time of great change – and that’s even before you think about hormones. Many of you will be affected by the loss of a loved one, changes in relationships with parents or children who are growing up or leaving home, or a career transition. Leading psychotherapist Julia Samuel MBE, author of This Too Shall Pass, calls these experiences Living Losses – changes that happen to us that are not in our control. They can feel like death and the experience of them is a type of grief.

Perimenopause and menopause is another time of significant change, not just because of the symptoms, but because it can be a time where you may start questioning your sense of self, your purpose and your identity. This doesn’t signal an end – instead it’s an opportunity to discover a new version of yourself. As Julia explains: ‘When life events hit us, as human beings we are wired to adapt, but we want control. To manage that tension, you need to examine it, and to feel supported. The quality of your relationships will help predict the quality of your life.’

Of course, your partner may not be as well versed in all things perimenopause and menopause. Even if they’re aware of your symptoms, they might not realise the impact on you and could be hoping it’s something that will blow over soon. Confusion, resentment, fear and tension can increase, and lead to relationship breakdown. According to a survey of 1,000 women by The Family Law Menopause Project and Newson Health Research and Education, 7 in 10 women (73%) who responded blamed the menopause for the breakdown of their marriage, while 67% claimed it increased domestic abuse and arguments.

Why can couples grow apart during perimenopause and menopause?

Perimenopause and menopause can have a big impact on a woman’s quality of life, and this has a ripple effect on those around her. A lack of awareness of perimenopause and menopause can cause issues that then plant seeds of doubt in even the healthiest of partnerships.

Arguments can occur when our partners don’t offer enough support or understanding, but also because we can let our fears spiral. Julia says: ‘Surges of hormones can act like the threat system in our brain – we go into fight or flight or freeze mode. It’s as if there’s an alarm going off in our heads, which affects all of our actions and the ways that we think. So someone doing something as simple as waving at us can be misinterpreted as an attack and we may respond inappropriately.

‘In some ways it’s a design fault – as human beings, when we’re suffering, we become difficult and intractable and not that easy to have relationship with. Yet when we’re suffering, having a relationship is the thing we need most. It’s paradoxical that when you’re happy, well and calm, people are drawn towards you. The reverse is also true. The communication then shuts down and people blame each other. Misguided beliefs then inform their relationship. “She doesn’t love me anymore.” “She can’t be bothered.” “I’m bad, I’m ugly, I’m fat now. He’s not going to love me.”’

RELATED: Loneliness and the menopause

Julia continues: ‘Menopause can break your relationship – I’ve seen couples who haven’t been able to communicate and work it through together. But actually, the thing that will help couples most is love. Love is not a soft skill. It’s talked about as this easy thing, but love is hard because where you love most, you hate most, hurt most and make our deepest mistakes.’

It’s easy to regard any pain you are feeling about your partner or relationship as purely negative but consider it as a signal or wake-up call that something’s not right and now is the time to adapt and resolve it. It’s perfectly possible to re-establish an emotional connection with your partner during the perimenopause or menopause, but it will require a multi-faced approach.

Consider how you think about yourself

Connecting with your partner will require you both to consider how you feel about yourselves, and how that may be affecting your relationship. ‘Be aware of your own inner critical voices – what I call our Shitty Committee – and turn down the volume on those. Turn up the volume of self-compassionate voices and practice being kinder to yourself. We are wired evolutionarily with a negative bias, and if you have a compound of, say, a difficult childhood or a lot of bad things have happened to you, then you get menopausal and your relationship suffers, it feeds into the story you tell yourself about yourself and your life. You might be thinking, “Well, it just shows I’m a failure, I’m useless”. But the story you tell yourself is the person you become. If you can have a kinder view of yourself, you’ll have more capacity to manage events, including menopause, and find a way to adapt and grow through what is happening to you.’

Learn to work through feelings

It’s unrealistic to expect to be positive all the time but a capacity to be flexible and adapt when going through difficult times will help you weather the storm. Julia says: ‘You can develop a toolbox of mechanisms and behaviours that help you rebalance. Consider the fact that emotions only last 90 seconds. It’s the story you tell yourself that gets you locked in the rumination of them. So if you can acknowledge the feeling, slow down and breathe, then let it pass, you’ll be able to think more objectively about a problem.

‘When a particular set of thoughts get locked in your head, it can be helpful to get outside, move your body, breathe deep, it can shift your thinking. There is also a technique called the Television Screen – put the negative on the TV screen, take a breath, switch the channel and put a positive image on the screen – then take a breath and move your attention to something else. Every time you have the thought, you go back and switch the channel again.’

Calming tips

Work out your calming toolbox – the things you can do that calm you down. ‘It might be exercise, meditation, a breathing regime or yoga. And consider things that give you joy in your life,’ says Julia. ‘Having pillars of regulation – what you eat, how you sleep – will also help build stability in you so you can weather the storms as they come through your body.’

RELATED: How walking can ease your mind

Improve communication

If you’re not used to talking about your feelings or menopause, consider where that comes from – for many of us, there can be a fear of being seen for who you really are. Are you a family that can talk about these things or do you always have to be fine? Be aware of how you’re communicating in your relationship and look at how that might have changed.

‘One way to open up communications is to take 10 minutes each day to say what’s happening. Say, “I am feeling this” and the other person just listens,’ suggests Julia. ‘The power of just being heard and the person isn’t rehearsing what they’re going to say to prove you are wrong is amazingly potent.

‘When you understand fully what’s going on in the other person, you ignite your feelings for them because you have empathy. Your partner might realise, “Oh, it’s not because she can’t stand me or whatever. There’s all this going on.” And then you can slowly build the bridges of connection and understanding and kindness, which can reinvigorate the relationship.’

Have shared rituals

Building in little moments in every day can help forge an emotional connection. Small gestures – such as a cup of tea in bed each morning – can help make the other person feel valued so each agree one little thing you could do for each other every day.

Bring back the memories of the good times you have shared, perhaps by playing songs you used to dance to or looking at holidays or times you were happy together – sharing the memories will evoke those joyful feelings.

Regularly check in with each other. Julia suggests: ‘Walking and talking is really good therapy – being outside, moving your body, not eyeballing each other as you talk. Share how the week has been, what’s been difficult, any symptoms that you’re struggling with. Let you partner share his experiences and just listen.’

Build in regular treats, such as going out for a meal or to the cinema. You might want to do it after your walk and talk so that you have space to process how you both feel.

Rediscover touch

A loss of libido is a common menopause symptom and even if this isn’t one of yours, a strained relationship certainly can cause it! Sexual desire is “use it or lose it” but, as Julia says, ‘you can’t get hot from cold’. In order to build on your emotional connection and create an erotic energy, focus on giving each other more attention and touch in your daily lives – hold hands, snuggle up on the sofa together, etc.

Be kind!

It’s quite normal in a relationship to put each other last, especially when you are juggling children, elderly parents, jobs, etc, and your partner can be relegated to the bottom of your to-do list. That can often mean you take each other for granted. A small way to help validate them is to give each other genuine compliments or positive feedback. For instance, if you notice your partner tries to be supportive about your symptoms, even if it doesn’t quite hit the spot, thank them – knowing your efforts have been noticed can really help. Good relationships are built on hundreds of small moments of kindness rather than grand gestures every now and again.

Seek help

Remember, perimenopause and menopause symptoms can usually improve with treatment, including the right dose and type of HRT with testosterone. Seek advice and treatment from a clinician who is experienced in hormones, and encourage your partner to learn more about perimenopause and menopause – our website has plenty of resources for partners.

Finally, remember that you both have agency about how you manage your feelings and your relationship – by taking some steps you can restore your emotional connection and restore that loving feeling.

Julia Samuel MBE is a psychotherapist, bestselling author and podcaster of Therapy Works. juliasamuel.co.uk

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How do perimenopause and menopause affect my sex drive?

Natalie Millman — Mon, 10 Feb 2025 01:00:00 +0000

The reasons why they can impact your libido, plus tips on boosting it

Sex drive, or libido, is an aspect of perimenopause and menopause that often remains taboo. You may feel comfortable talking about your brain fog or flushes with friends but there’s not nearly the same openness around levels of desire or pleasure from sexual experiences.

Lots of things can affect your libido, including:

Hormones
Medication
Relationship with a partner
Vaginal dryness and discomfort during sex
Stress
Body confidence
Sleep

Which hormones affect libido?

Two hormones are often important for your libido: oestradiol (a type of oestrogen) and testosterone. The amount of these hormones produced by your body declines during perimenopause and menopause, which can reduce your sex drive and lead to irritability and mood changes that can impact on your relationship.

Lack of hormones can also cause vaginal dryness and soreness, which can make sexual intimacy painful. Taking replacement hormones in the form of HRT and/or vaginal hormones can help to tackle these symptoms and improve your libido. Some women also benefit from testosterone to help their libido [1]. Testosterone can significantly improve sexual wellbeing for women, including sexual desire, function and pleasure. Other benefits can include improved energy, stamina, concentration and sleep, which can in turn increase wellbeing.

Does medication affect libido?

Medications can affect your libido in various ways. Some affect the chemical messengers in the brain that are involved in sexual arousal, others can worsen vaginal dryness, which can make sex uncomfortable, while some can impact on your ability to orgasm.

Types of medication that may reduce libido include:

Medications for high blood pressure
Medications for anxiety and depression such as antidepressants like citalopram, sertraline and fluoxetine
Medications to treat psychosis
Medications for allergy, such as antihistamines
Chemotherapy
Aromatase inhibitors

However, it is really important that you do not stop taking your medications without speaking to your GP or specialist first. They may be able to offer an alternative that is less likely to affect your libido.

I’m too tired for sex – what can I do?

Research has shown that poor sleep can reduce your sex drive [2]. It can also exacerbate problems such as depression and anxiety that can reduce libido further.

Lots of symptoms that occur during your perimenopause or menopause can affect the quality of your sleep. These include night sweats, needing to go to the loo lots, hot flushes, anxiety, restlessness and itchy skin. Additionally, the hormone melatonin that helps your body to regulate sleep is affected by the decline in oestrogen and testosterone, which can lead to a bad night’s sleep.

RELATED: Sleep and hormones factsheet

Replacing the missing hormones by taking HRT can improve sleep and some women benefit by taking testosterone as well as oestrogen. Many women take progesterone tablets as part of their HRT, and micronised progesterone (the type used in Utrogestan) is a natural sedative so it can help to get you to sleep. It is usually taken at night for this reason.

Other things you can do to help improve your sleep include:

Sticking to a strict bedtime routine by going to bed at the same time each evening and getting up at the same time each morning
Avoiding caffeine in drinks or foods (including chocolate) in the afternoon
Switching off screens – the blue light from phones, TVs and laptop screens reduces your production of melatonin so try to avoid looking at these for at least an hour before bed
Keeping your room as dark as possible by using blackout blinds or wearing an eye mask
Avoiding alcohol before bed, as it can act as a stimulant and keep you awake at night
Taking a magnesium supplement with Vitamin B to improve your sleep
Doing an activity before bed to clear your mind and relax, such as meditation.

I don’t want sex – it hurts too much!

Sex can become painful during perimenopause and beyond, which understandably may reduce your desire for sex. You may feel dry or tight or notice soreness and burning in and around your vagina during or after sex.

These symptoms can happen due to low hormones, which causes thinning of the tissues of the vagina and reduced natural lubrication, leading to dryness, itching, inflammation and infections such as thrush or urinary tract infections. Lack of hormones also makes the vagina less stretchy, which can cause pain during sex.

HRT can help to relieve vaginal dryness and soreness, which can help to reduce the amount of pain during sex. You may also need topical vaginal hormones alongside HRT to improve symptoms. Topical oestrogen and prasterone is applied directly on the affected area in the form of a pessary, gel, ring or cream. It can be used safely for ever alongside your HRT or own its own with no associated risks.

As well ashormone treatments, you can use moisturisers and lubricants that do not contain hormones but help to hydrate the vaginal tissues and make them feel less sore. These can be brought over the counter.

How lubricants can help

Lubricants are for using just before sex. Recommended brands of lubricants that do not contain irritants are YES OB (oil-based) or WB (water-based), Sylk and Sutil Luxe. It can sometimes be helpful for one partner to use a water-based lubricant and one partner to use an oil-based lubricant. This creates a ‘double-glide’ effect that makes sex more comfortable – however, oil-based lubricants can make condoms less effective.

The ingredients in some lubricants, such as glycerin, glycols or parabens, can worsen vaginal irritation but the recommended brands above do not contain these common irritants. Alongside lubricants, remember to use foreplay, which helps increase natural lubrication, and experiment with different sexual positions to help you find what is most comfortable for you.

Vaginal moisturisers help with general dryness and are long-lasting so may only need to be used every two to three days. Both Sylk and Sutil Luxe can be used as a lubricant and a vaginal moisturiser.

YES also makes a vaginal moisturiser that is low irritant but is different to its lubricant products.

If using the above treatments regularly does not improve your symptoms after three months, then it is important to let your doctor know as sometimes these symptoms can be due to other conditions.

I’m too stressed for sex – help!

Often perimenopause and menopause come at a very busy time in your life when you may be juggling work, relationships and perhaps caring responsibilities, so being intimate after a stressful day may be the last thing you feel like doing! Stress and poor mental health can also reduce your libido.

There are lots of things you can do to try to keep your stress in check:

Make time for yourself: find something that lifts your mood and brings you joy such as a meal with a friend or going for a walk
Prioritise sleep using the strategies above
Keep physically active by doing a mixture of exercise such as swimming, walking or yoga at least three times a week. Exercise releases endorphins in the brain, which reduce stress and help you feel good
Eat well: try to keep processed foods and sugary foods to a minimum and focus on a balanced diet
Reduce or cut out alcohol. Alcohol can change the balance of chemical messengers in your brain, leading to more negative feelings such as anxiety, anger or depression. It can also worsen your menopause symptoms [3].
Stop smoking – research has shown that smoking can actually increase anxiety and tension after the initial immediate feeling of relaxation [4]
Download the balance app to keep track of your symptoms, nutrition, sleep, stress levels and medication. It also has a handy feature that you can use to time your meditation too

How can I improve my relationship and sex life?

Has sex become boring? If you have a partner, do you feel less attracted to them, or feel less attractive yourself? Busy and stressful lives often mean you don’t make time to connect with your partner, and that in turn can affect your libido.

Communication with your partner about how you feel is really important. Connecting without the pressure of sex can reboot your relationship – you can be intimate in other ways such as by cuddling, kissing, massage, spending time together as a couple and talking.

Sometimes relationship counselling can help you identify any issues in your relationship and address them together.

There are many ways you can improve your sexual arousal. Foreplay is important and can boost your natural lubrication to make sex more comfortable. For some women, erotic literature can help with libido. You might want to explore books by Nancy Friday such as Women on Top, Men in Love or My Secret Garden.

Sexual mindfulness has been shown to help people feel aroused more quickly and may help to make orgasms more intense [5]. It helps you to focus on what is happening in your mind and body during sexual activity rather than thinking about the sensations and experiences as being bad or good.

If you have been with the same partner for a long time, sex may have become boring and you may want to spice up your sex life – experiment with lubricants and sex toys, talk to your partner about your sexual fantasies or even try them out. Try experimenting with different sexual positions or changing up the scenery by booking a hotel room. However, sex is about more than just penetration. Many couples can enjoy a satisfying sex life in other ways such as mutual masturbation, genital touching, oral sex and using sex toys.

Psychosexual therapy

Sometimes psychosexual therapy or sex therapy can be helpful. Sex therapists can provide counselling for individuals or couples – they talk to you about the problems you are having to decide if they are psychological, physical or both.

You may be given tasks to do by yourself or with your partner. Some of the problems that they can help with include lack of libido, difficulty achieving orgasm and pain during sex.

Your GP may be able to refer you to a sex therapist, or you can find a therapist privately by visiting the Institute of Psychosexual Medicine website.

Can exercise help my libido?

Regular exercise has been shown to improve levels of desire, arousal, lubrication and quality of orgasm as it increases blood flow and sensitivity of the vagina. Exercise also helps to boost your endorphins – the hormones that make you feel good. This helps to reduce stress, which is often a big factor in low libido. Try to find an activity that you enjoy – any activity is beneficial!

RELATED: The importance of exercise

Strengthening your pelvic floor muscles can improve the quality of your orgasm as well as helping with symptoms of urinary incontinence and vaginal prolapse. You can do this through pelvic floor exercises, plus swimming is also a good form of exercise for naturally strengthening your pelvic floor as you have to use these muscles to help you balance in the water.

Can supplements help my libido?

There is no magic pill to help increase libido – a holistic approach is required.

References

NICE guideline [NG23]: Menopause: identification and management
Kalmbach D. A., Arnedt J. T., Pillai V., & Ciesla J. A. (2015), ‘The impact of sleep on female sexual response and behavior: A pilot study.’ The Journal of Sexual Medicine, 12(5), pp.1221–1232. https://pubmed.ncbi.nlm.nih.gov/25772315/
Shihab S., Islam N., Kanani D., Marks L., Vegunta S. (2024), ‘Alcohol use at midlife and in menopause: a narrative review’, Maturitas, 189. https://doi.org/10.1016/j.maturitas.2024.108092.
NHS: Stopping smoking for your mental health
Leavitt, C.E., Maurer, T.F., Clyde, T.L. et al. Linking Sexual Mindfulness to Mixed-Sex Couples’ Relational Flourishing, Sexual Harmony, and Orgasm. Arch Sex Behav 50, 2589–2602 (2021). https://doi.org/10.1007/s10508-021-02054-0

The post How do perimenopause and menopause affect my sex drive? appeared first on Balance Menopause & Hormones.

Loneliness and menopause

Natalie Millman — Wed, 05 Feb 2025 01:00:00 +0000

In what can be a tumultuous time, many women can feel alone during perimenopause and menopause but it needn’t be this way

Perimenopause and menopause can be a lonely time of life
Loneliness can be detrimental to your physical and mental health
Discover ways of building up layers of connection

In today’s busy world, most of us are surrounded by people – be it at work, home, through social clubs or friendships, or caregiving or volunteering. And yet according to the Office for National Statistics, women (24%) are more likely than men (20%) to feel lonely at least some of the time [1].

When we think of loneliness, we often associate it as something that happens later in life, maybe an old person alone in a care home, or we’ll recall times as a child or a teen when feeling that no-one “got you” was part of the norm. It can be perfectly possible to feel lonely, and it’s something that even social butterflies or successful businesswomen experience. Being surrounded by people is no barrier to feeling lonely.

Is loneliness bad for you?

Make no mistake, spending time alone and enjoying your own company is perfectly healthy – sometimes there’s nothing nicer than shutting the doors on the outside world. But if you feel lonely, that’s been shown to have detrimental effects on your physical and mental health.

Social isolation has been found to rival smoking, obesity and physical activity in terms of increasing risk of premature death [2]. It’s also associated with a 50% increased risk of dementia, plus higher rates of depression, anxiety, and suicide [3].

RELATED: Am I depressed or menopausal?

Even if you are not socially isolated – you have people in your life but still feel lonely – this can have a negative effect on your health, especially during the menopause.

Why can menopause make you lonely?

Midlife can be a liberating, freeing period of life full of possibility and change. If you have children, they may be older and require less of your time; you might be flourishing in your job and feel secure in your relationships. On the other hand, it can also be a time of loss – an empty nest if your children move away, you may have elderly relatives who need care or struggle with their health, and if you’re entering the menopause, you may feel a sense of loss over your fertility or overwhelmed by what the next chapter of life might bring.

Perimenopausal and menopausal symptoms can be challenging. Some women find their mood dips or they have increased feelings of anxiety or irritability. Symptoms can have a knock-on effect on your relationships – with your partner, friends and family, and at work. This can lead to a loss of confidence and you may feel others don’t understand what you’re experiencing. Conversely, it’s been found that as women’s levels of loneliness increase, so too do their menopausal symptoms [4].

How can I tackle my loneliness?

Acknowledging you feel lonely can help – understand that it’s not a reflection on you as a person but is about your circumstances. Consider what’s at the heart of your loneliness.

For some women, it’s menopause itself. In the Department for Health and Social Care’s ‘Women’s Health – Let’s Talk About It’ survey of nearly 100,000 people in England, less than 1 in 10 participants said they have enough information on menopause (9%) [5].

The free balance app is full of resources to help you track and learn about your symptoms. There are also community pages – just knowing other women are experiencing similar things can help you realise you’re not alone.

The same government survey also found that 70% are comfortable talking to friends about the menopause, and 64% are comfortable talking about it with healthcare professionals (compared to 61% with family members). These conversations can help you build up a circle of support.

If your relationship with your partner is a contributing factor to your loneliness, consider if you’ve grown apart or any reasons you might not be connecting. Some couples bond over shared caring commitments of children but then when the children leave home, discover they don’t have as much in common. Your partner also may not understand how your menopausal symptoms can affect you – and they can’t be expected to know unless you tell them!

Similarly, friendships can take work, and that can feel hard when you’re not feeling your best. If you’re feeling lonely, consider your closest relationships. Robin Dunbar is a biological anthropologist and founder of Dunbar’s number, a theory about the number of social relationships a person can maintain. His research suggests most people have an inner circle of five people, usually made up of family members and up to two or three close friends. These relationships need investment to help them to thrive. If you’ve lost contact with a friend and their friendship is valuable to you, pick up the phone or send them a message. It can be tricky to socialise if you’re not feeling your best but you don’t have to be the life and soul of a night out – a walk with a friend can be beneficial for both of you.

According to Dunbar’s theory, we have successive layers of friends, contacts, acquaintances, and people you recognise. These require less work but they can still be of value in combatting loneliness. Saying hello to a neighbour as you walk your dog in the morning, for example, is a connection.

Consider joining a group to help to help find a sense of purpose and of belonging. It might be an exercise group or starting a new hobby or joining a committee at work. Think of your midlife as a time to discover yourself – it’s OK to question who are. What might you like to do or try now?

References

1. NHS Health survey for England 2021

2. National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.

3. National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.

4. Bayri Bingol, F. , Demirgoz Bal, M. , Yilmaz Esencan, T. , Ertugrul Abbasoglu, D. & Aslan, B. (2019), ‘The Effects of Loneliness on Menopausal Symptoms’, Clinical and Experimental Health Sciences, 9(3) 265-270. doi:10.33808/clinexphealthsci.533511

5. Gov.uk: Results of the Women’s Health – Let’s Talk About it Survey

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Perimenopause and menopause: a guide for partners

Natalie Millman — Mon, 03 Feb 2025 14:03:28 +0000

The majority of women will experience perimenopausal and menopausal symptoms that often impact on their physical and emotional health.

Relationships can be put under immense strain during this time and can be made more difficult by the fact that many couples don’t openly discuss menopause. It can be challenging, but it doesn’t have to be – armed with knowledge and advice, you can support each other through this time and towards a new chapter in your lives.

What is menopause?

Menopause is actually one year after a woman’s periods stop. It occurs when the ovaries stop producing eggs and as a result, levels of hormones oestrogen (oestradiol), progesterone and testosterone decline. During perimenopause, these hormones fluctuate so can be both high and low.

The low hormone levels last for ever. These hormones are also made in the brain and other tissues – the have important effects on every cell and organ in the body.

There are four key stages:

Pre-menopause: the time before any menopausal symptoms occur.

Perimenopause: when menopausal symptoms begin due to hormone changes, but periods still happen (even if irregularly).

Menopause: when there has not been a period for 12 consecutive months.

Postmenopause: the time after there has not been a period for 12 consecutive months.

When do perimenopause and menopause happen?

The average age of menopause in the UK is 51 [1]. However, it can occur earlier or later than this – health conditions, medical treatment, genetics, ethnicity and social economic background can influence the age.

Menopause is described as early if it occurs before the age of 45. If it occurs before the age of 40, it’s called Premature Ovarian Insufficiency (POI).

Some medical treatments – such as having ovaries removed, breast cancer treatment, chemotherapy or radiotherapy – can lead to an early menopause.

Perimenopause, which starts when the first menopausal symptom occurs, can vary in length from a few months to around 10 years. Some women start to have these symptoms when they are in their early 40s, others can be younger.

Some women do not realise their symptoms are due to perimenopause – they may put them down to stress or their busy life. There is also not as much awareness of perimenopause as menopause so women can be surprised to learn their symptoms are due to perimenopause.

What symptoms might my partner experience?

During perimenopause and menopause, hormones – oestrogen (oestradiol), progesterone and testosterone – fluctuate and then decline. This change can result in a whole range of symptoms.

Some women have very few or even no symptoms and their periods simply stop happening. However, around 80% of all women experience several symptoms [2]. Around 25% of these women have severe symptoms [2].

Symptoms can include:

Changes to periods: they might become heavier than usual, although for some, they may get much lighter. Periods usually occur more irregularly before stopping altogether.

Hot flushes: these can come on suddenly at any time of day, spreading throughout the face, chest and body.

Night sweats: women can wake up drenched in sweat and need to change their pyjamas and bedding.

Mood changes: they might be irritable one minute and tearful the next. Mood changes may be more common if your partner suffered from premenstrual syndrome (PMS) or postnatal depression in the past.

Fatigue and poor sleep: your partner may be more tired during the day.

Joint pains and muscle aches: all three hormones are important in providing lubrication in the joints and preventing inflammation, so low levels can leave joints sore and muscles aching.

Brain fog: this is a collective term for symptoms such as memory lapses and poor concentration.

Lack of libido: Declining levels of the hormone testosterone can lead to a lack of interest in sex and lack of pleasure from it.

Vaginal symptoms: The tissues around the vagina can become thinner, drier and inflamed. The vagina also expands less easily during sex, which can make intercourse uncomfortable or painful.

Urinary symptoms: The lining of the bladder can thin, and some women have the urge to go to the toilet more often or have recurrent urinary tract infections.

Hair and skin changes: Skin may have reduced elasticity, fine lines and dryness. Some women find their skin becomes itchier, or they develop acne. Hair may become thinner and less glossy.

There can be other, often surprising, symptoms of perimenopause and menopause, including dry eyes, dizziness, altered sense of taste and smell, bleeding gums, and tinnitus.

How are perimenopause and menopause treated?

There are a range of treatments available to help manage symptoms, and in many cases, vastly improve your loved one’s quality of life. Nobody should wait until symptoms are unbearable before they seek help.

The most effective treatment is hormone replacement therapy (HRT), which works by replacing the hormones a woman’s body has stopped producing during the menopause. There are different doses and types – the three hormones oestrogen (oestradiol), progesterone and testosterone can all be prescribed.

In addition, lower levels of hormones are associated with an increased risk of developing other health conditions including osteoporosis (bone weakening disease) [3], cardiovascular disease (conditions affecting the heart and blood vessels) [4], type 2 diabetes [5], dementia and cognitive decline [6], auto-immune diseases [7] and some cancers [8], so speaking to a health professional is really important. They will be able to talk through available treatments to help your partner make an informed decision, based on their individual circumstances and preferences.

If you’d like to read more about the treatment of perimenopause and menopause, NICE (the National Institute for Health and Care Excellence) has released updated guidance. This emphasises the importance of an individualised approach and shared decision making when considering treatment options and choice for menopause care. Find it at nice.org.uk/guidance/ng23

How might menopause affect our relationship?

No man (or woman) is an island so if your partner experiences menopausal symptoms, they’re bound to have an impact on you too. This might be directly – if your partner’s night sweats wake you, for instance – or indirectly, say if your partner seems lower in their mood than usual.

Although most people associate menopause with flushes and hot sweats, these aren’t necessarily the symptoms that have the biggest impact on women. In a Newson Health survey of almost 6,000 women, an overwhelming 95% of respondents said they’d experienced a negative change in their mood and emotions, so you may notice your partner is more irritable, tearful or angry than usual [9].

Menopause also tends to coincide with a time of life where women are going through other transitions – children are growing up and may be leaving home, elderly parents may require care, and work may present new opportunities or even retirement. It can be a time for reflection and even reinvention – your partner might take on new hobbies or be thinking more about her future.

You might feel discombobulated by any changes your partner makes, especially if they come out of the blue, so it helps to understand that she might be embracing a new stage of her life.

How can I support my partner?

1. Learn about the menopause

Read up on the perimenopause and menopause so that you can have a greater understanding of what your partner may be going through. Offer to accompany her to any medical appointments – she might appreciate having someone to take notes or to just be there for her. Don’t be offended if she’d rather go alone though – just offering your support will be appreciated. You can find evidence-based information on everything perimenopause and menopause related at balance-menopause.com.

2. Be patient

If your partner does take HRT or receives alternative treatments, don’t expect it to be an instant magic “cure”. Treating menopause symptoms requires a holistic approach – she may want to make adjustments to her diet and exercise routine, or look into sleep and relaxation techniques. It can take time to get symptom relief and she may need to alter her treatment, for instance with a different dose or type of HRT. Also, keep in mind that although you may want to “fix” your partner’s problems, it’s not always helpful for a woman to feel she needs fixing – again it’s about being a stable presence.

3. Don’t take it personally

It can be hard to not take your partner’s mood swings personally – when someone is suffering, they can be difficult to be with and yet this is when they need their partner the most. Understand that her mood swings aren’t to do with you and that irritability is a common mood complaint for women during perimenopause [10]. Try not to snap back and try to ensure you have coping mechanisms in place for times when you may feel hurt.

4. Go with the flow

Many women feel overwhelmed during perimenopause and menopause and you might be surprised if she seems daunted by making decisions over seemingly trivial things. Don’t put too much pressure on her and offer to help. Some women struggle with self-confidence during this time and may not want to socialise. Or she may feel so tired she’s not able to keep up usual social engagements. Try to be her safe space – there’s a lot of pressure to be “on” at work or with friends and family – but she will appreciate it if she can be herself with you.

5. Factor in libido

Some women notice a change to their sex drive during perimenopause and menopause, and for some, less lubrication can mean sex becomes painful. Your partner may feel more self-conscious about her body, or feel shame that there is something wrong with her, and so avoid physical contact. Your reassurance can help – be sure to tell your partner you love her and don’t underestimate the power behind your words. Conversely, some women can feel liberated once their periods stop and find a confidence in this freedom.

6. Make time for each other

While it’s important to communicate with each other, accept that sometimes your partner might not want a big talk. Try to build in some short amounts of time where you can be together. Date nights can feel pressured – it can be more helpful to have a regular habit where, for instance, you might go for a 10-minute walk together in the evenings. Many people feel more free to talk when they are outdoors, walking side by side, rather than looking at each other. Some nights you might not even need to talk, but the time spent walking together, holding hands, can be an effective way of staying connected.

7. Be her champion

Remember, perimenopause and menopause symptoms can improve with treatment, including the right dose and type of HRT with testosterone. You can be your partner’s advocate by encouraging her to seek advice and treatment from a clinician who is experienced in hormones.

By having an understanding of what your partner is going through, you can support her through the physical and emotional changes of perimenopause and menopause.

References

Born L., Koren G., Lin E., Steiner M. (2008), ‘A new, female-specific irritability rating scale’, J Psychiatry Neurosci, 33(4) pp344-54.
NICE: CKS: Menopause
Woods NF, Mitchell ES. (2005), ‘Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives’, Am J Med. 118 Suppl 12B:14-24. Doi: 10.1016/j.amjmed.2005.09.031
Cheng CH, Chen LR, Chen KH. (2022), ‘Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover’, Int J Mol Sci. 23(3):1376. doi: 10.3390/ijms23031376
Iorga, A., Cunningham, C.M., Moazeni, S. et al. (2017), ‘The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy’, Biol Sex Differ 8, 33 https://doi.org/10.1186/s13293-017-0152-8
De Paoli, Monica et al. (2021), ‘The Role of Estrogen in Insulin Resistance’, The American Journal of Pathology, 191(9) pp1490 – 1498 https://doi.org/10.1016/j.ajpath.2021.05.011
Jett S., Malviya N., Schelbaum E., Jang G., Jahan E., Clancy K., Hristov H., Pahlajani S., Niotis K., Loeb-Zeitlin S., Havryliuk Y., Isaacson R., Brinton R.D. and Mosconi L. (2022), ‘Endogenous and Exogenous Estrogen Exposures: How Women’s Reproductive Health Can Drive Brain Aging and Inform Alzheimer’s Prevention’, Front. Aging Neurosci. 14:831807. doi: 10.3389/fnagi.2022.831807
Desai M.K., Brinton R.D. (2019), ‘Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan’, Front Endocrinol (Lausanne). 29;10:265. doi: 10.3389/fendo.2019.00265
Wu Z., Xiao C., Wang J. et al. (2024), ‘17β-estradiol in colorectal cancer: friend or foe?’, Cell Commun Signal 22 (367). https://doi.org/10.1186/s12964-024-01745-0
Experiences of the perimenopause and menopause, December 2022

The post Perimenopause and menopause: a guide for partners appeared first on Balance Menopause & Hormones.

Thee Third Act: laughter, friendship and menopause

kat keogh — Tue, 21 Jan 2025 07:00:00 +0000

Joining Dr Louise Newson on this week’s podcast are Jane Hajduk and Shari Dolan, the real-life friends behind Thee Third Act, a YouTube comedy series about women’s third act: menopause.

Thee Third Act follows Jane and Shari’s characters, Josephine and Lauren, in their search for answers during menopause. From life coaches to hormone replacement therapy, they strive to conquer or at least ease hot flushes, sleepless nights, and astronomical mood swings.

Jane and Shari discuss their own menopause experiences, their off-screen friendship, and why sisterhood, laughter and honesty are key when navigating menopause.

Catch with Thee Third Act on YouTube here – season two premieres 27 January.

Click here to find out more about Newson Health.

Transcript

Dr Louise Newson: Hello, I’m Doctor Louise Newson, I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on my podcast, I’m very lucky because I have two guests, so I have two for the price of one, as it were, and they’re two ladies from America. I seem to have a little run of American guests, which is great because the menopause doesn’t just affect UK women. There’s 1.2 billion menopausal women globally. They’re in every single country and it’s going to affect all of us. So it’s really important in my mind that it’s the most positive time of our lives, because it lasts a lot longer than many other things that happen to us. So I’ve got Jane and Shari who have known each other for many years, who are going to just introduce themselves, and then we’ll talk about what they’re doing. So welcome to the podcast. It’s very exciting to have you here even though it’s remote. So go on then, Jane, you go first. Explain who you are and where you’ve come from.

Jane Hajduk: Okay. I’m Jane Hajduk, I’m originally from Pennsylvania, and, now I’m in Los Angeles, California, and. Yeah, this is my partner. Go ahead, Shari.

Shari Doran: Hi, I’m Shari Doran and I’m originally from Michigan. And, the quick backstory of Jane and I, we actually met in college in Ohio at Wright State University. We are both working in the industry out here as far as producers, writers, actors, directors, doing a little of everything. And we made friends and are going through menopause like the rest of the world. And, came up with this idea to have a show about menopause. And it’s really about friendship and menopause. It’s about two best friends in the throes of menopause, and they decide to journal it, which is funny as we’re on our phones right now. The exploits of trying to find anything, as you know, in the market, there’s everything out there right now and misinformation and great information to try and ease their pain into what we call our third act. And that’s what the show is called. It’s called Thee Third Act two ees Thee we’re Shakespearean in our menopause, as I like to say.

Dr Louise Newson: Yeah, and that’s on YouTube, isn’t it?

Shari Doran: Yes. So that would be on… it is on YouTube right now. And if you go to @theethirdact. And it’s funny, you know, Jane, tell them, will it actually help them with their menopause symptoms?

Jane Hajduk: Absolutely not. But, you know, laugh and hopefully it’ll open up conversations with your girlfriends and possibly even a male who also has to kind of go through it in a different way. All our, husbands and boyfriends and whoever else we’re dealing with in the male industry. So yeah, but I will tell you too, the episodes are 2 to 5 minutes. So usually and it’s this first season is really about the insane things or the really cool things. We try to just relieve some of the symptoms we have of menopause. So a lot of times my partner Shari, who in the series is, sorry, Lauren, she’s walking out because she’s had enough of it. And so we usually because it is 2 to 5 minutes, we’re usually starting right smack in the middle of a class or of a massage or of, whatever it is that we’re going through, and then we get to the end and, so, yeah, it’s kind of wrapped up quick.

Dr Louise Newson: And it’s great, isn’t it? To have these conversations. So when I started my clinic and I Googled menopause and nothing came up, really very little. And I’ve been a medical writer for many years as well as a doctor. So I set up a website which was then called MenopauseDoctor.co.uk and I set up my Instagram account just because my daughter said, Mummy, you’re telling me all these stories about these women like you’re coming home and saying, you know, this woman feels like she’s been hit by a bus. She feels like the shutters have come down. She doesn’t know what to do, like because she said, this is just awful, right? But why don’t we all know about it? Why aren’t we all taught it at school? Like, why do we have to wait until we’re feeling really awful? You’re telling me these people, their jobs have gone, their partners are leaving them, they’re in crisis, and they’re coming to see you. And it’s the menopause which affects every woman. I don’t want to wait till I’m like, suffering like that. So I decided to set up this website and I literally I didn’t have any money. And I went to the web designer and I said, I all I want is five pages, like, what is menopause? What is HRT, what is testosterone? And just a symptom questionnaire. That was all I wanted on it. And then every week I’d go, Alan, could we just add this for so menopause and younger women, could we add about urinary symptoms? Could we add about brain fog. Could we add and then in the end he’s like, ah Louise you’ve blown your budget like this is ridiculous. So we then that’s when I decided to develop the balance app to get more people out there. So it was just easier. And, you know, the information is increased, but not just my information. Now, if you Google menopause, the first thing that probably come up is some menopause shampoo or some face cream or some supplement or some like, you know, my husband found some menopause chocolate the other day in a health food shop and it’s like, oh my God, oh my God. Like, are we just a marketing commodity? Is it always just something to laugh at and even somebody who’s very high up in finance. Many years ago, they wouldn’t get away with it now saying that the UK economy was menopausal. Like because it’s up and down like, and it’s like, hang on. We’ve always been a butt of jokes and now we’re a butt of jokes in the menopause like. Oh, don’t go near her. She’s a bit moody. She’s got a fan. Well, actually, this poor woman is suffering. She’s got something going on, and she doesn’t want to be moody. She doesn’t want to be shouting at her husband, but she has no idea what’s going on. And for too long, we’ve been told it’s either all in your heads and it can’t be the menopause because you haven’t got to flush or sweat or that, oh well, it’s because of your work or it’s because of something else. So actually, to allow women, the biggest thing that we find when people come to our clinic is they thank us for the time and they thank us because they’ve been listened to and understood. And I think what’s really important, what you’re doing with humour is good, because when you’re happy, you learn more, don’t you?

Shari Doran: Right.

Dr Louise Newson: And so there’s a balance between making fun of something and being happy and entertained and learning through it. And I think what you’re doing is the latter to have this fun. But actually then hopefully women who watch the episodes will feel really empowered and that sort of kick ass generation. Yeah. Come on. Why are we feeling like this? What can we do about it? And and learn, like you were saying from girlfriends who are watching it with you or your partner when you say, actually, I didn’t realise that was a symptom of the menopause. I just thought it was, you know, you were annoying me. But actually, maybe my irritability is due to my hormones changing in my brain and what can I do about it? So it’s really great.

Jane Hajduk: And going through it. If you are that of that, you know, person, you can make the joke. But if you’re not and we’re going through it. So there is laughter but there are tears. And like we said at the beginning, it will open up conversation.

Shari Doran: Right. And I think too another big thing that it opens up is that sometimes seeing other people having the same thing that you have going on or that you tried something really silly and you’re like, oh my gosh, I did that, I did that, I tried yams on my body. I thought it would do something. Yeah. And it just gives you permission to kind of go, oh, I’m not alone. I am not alone in this. Because really, if you think about it, how many women you just said billions, right, are already in menopause? There’s a sisterhood. There’s a sisterhood out here that I think we haven’t touched on. And you had said also about mothers. My mother never spoke of it. Jane, did your mom ever speak about it?

Jane Hajduk: Never, never.

Dr Louise Newson: You see I’m quite lucky because my mother’s on HRT, I can’t…she’s forbidden me to say how old she is. And she’s very strong. But actually, many years ago, when she was in her early 40s, my father died and she went to a GP and said, I’m really struggling. She was a teacher and she said, I just can’t remember things…and the GP said, oh, I think it’s your menopause. He didn’t use the word menopause. He said, it’s that you’re going through the change. And she was like, oh, I don’t know it is, have these tablets. And it was dixarit, which is like it’s not hormonal, it’s called clonidine. It doesn’t really work. But he gave it to her. She went back and then saw a female doctor who said, oh, you don’t want that, you just need some of this. And gave her HRT. And this was in the 80s, so no one questioned the doctor then in the 80s, you didn’t have Doctor Google, you just did what you were told by your doctor. So she went off, took these tablets, and she said within days her memory was back, her mood was back. She felt great. She could carry on. So she’s just carried on taking HRT. Many years ago that was the pregnant horse’s urine HRT, the synthetic hormone. So she has been converted to the natural body identical hormones which are lovely and safe. But many times she’s gone back to the GP for repeat prescription and they’ve said, no, you can’t have it, you can’t have it, you’re too old. And she said, no, no, I’m not stopping it. I am absolutely not stopping it because I know it’s keeping my brain and my body… and now she does sometimes say, do you know who my daughter is? Have you seen my surname? Actually, she knows quite a lot, but it’s still really hard. But she’s…so I know like and I look at some of her friends who haven’t been on hormones and some of them have dementia, some of them have had osteoporotic hip fractures. They’re sort of more crumbling. And I’m sure a lot of how she is is because she was very fortunate. She just saw the right doctor at the right time, but it would could have been very different for her. But we are lucky now that we’ve got access to more information. But there’s also more misinformation as well. And that’s what really worries me. And I hear stories of women who are spending hundreds of pounds a month or hundreds of dollars on hocus pocus stuff, you know, and you think, actually, you should be spending that money going out with your friends or going out with your partner or going on holiday or whatever. Work out is it worth taking? Is it really worth putting yams all over your body? How is it going to really help, you know, but so we can allow women to be educated through these sorts of platforms. It’s really important, isn’t it?

Jane Hajduk: It is. And it’s really not a one size, as you know, fits all. Like what might work for someone doesn’t work for another. And I mean, it’s crazy because I have had exercise in my life throughout so that, you know, it’s not like somebody is telling me at age 57 to go and work out, you know, I’ve already done that. So it can be different things. But even with our show, we do ridiculous things. But then you’ll see Lauren go through…our characters names are Josephine and Lauren. You’ll see her in a boxing class and she’s just it just works. It works. And then all of a sudden, because it works. Because what do we do? We overdo it. And then a few episodes down, you see, she’s ready to kill me and anybody walks in front of her. She is so, so, so it’s it’s things like that. It’s just not a one size, you know, one pill fits all, one activity fits all. So although we’ll make some crazy episodes where it’s like, what are we doing? One where we’re in a class talking about sex and how to have outercourse instead of intercourse, and Lauren leaves right away. I end up staying, but quickly get out of there. So it’s it is fun, but hopefully we’ll also see some things, like the boxing class where oh my gosh, somebody wouldn’t expect at all that connected with her.

Shari Doran: Right.

Dr Louise Newson: Which is great. And I think having these conversations is actually sometimes it’s easier to listen to other people’s conversations that have themselves. And actually, as a doctor, I’m not. I can talk about dry vaginas. I can talk about sex. It doesn’t embarrass me. It’s very easy. But actually, the more I talk to women about sex or usually the lack of sex that they’re having, the more they say, you know, I’ve never spoken to anyone about it. I didn’t realise other people were not having sexual intercourse or not having any pleasure when they had sex or just going through the motions. I had no idea because I haven’t spoken to anyone. And it’s one of those things that you think, actually, they do need to listen and hear that they’re not alone, that other people are experiencing difficulties as well, because the number of relationships that break down during the menopause is huge, and it often can start with a very small thing that escalates, but not being able to listen to other stories or not being able to talk can be really isolating for women.

Shari Doran: And I think too Jane and I have found as we start, every time we tell people oh this show’s coming out, women are just beside themselves to share their story. I was like, oh, I have this going out. Every time I speak to someone, I’m like, oh, that’s an episode. You know, I have a friend that went to, she’s a therapist. She’s a therapist for sex, but it’s a physical therapist. It’s like, how do you get that job? I’d like to know, you know, like, what’s the qualification for that? And my friends, she goes, I don’t even know how to dress. She goes, I took a bottle of water, do I wear workout clothes? Do I, like what do I do? And I go, oh, this is an episode. I mean, here’s this woman, you know, just trying to she’s struggling. She’s dying. You know, her vajajay is not doing well. And she needed help. And she saw a physical therapist for it, which I didn’t know there was. I was like, really? You could. But again, giving permission, you know, and it came through humour of the stories that we hear that Jane and I have heard just blow my mind. Again, starting that conversation, thank goodness. And I think women are better at that, too. I mean, I think we’re a little more open to each other.

Dr Louise Newson: We totally are. I mean, when I started my clinic, I, believe it or not, I was only wanting to do one day a week as menopause work. That was all I wanted to do, and I had no idea. I had no idea the suffering. I had no idea the refusal for treatment for so many women without any evidence base. And I had no idea how sort of education for healthcare practitioners hadn’t caught up with the evidence as well. But I did see somebody and he said, oh, you need a marketing plan for your clinic. I said, no, I only want to do one day a week, I don’t want to market, anyway I haven’t got any money for a budget for marketing plan. I’m a doctor, like I’m not going to market myself. And he said, oh, well, you’ll never get busy. I said, that’s fine. I don’t want to do more than a day a week. And then I said, but you know what? Actually, because this was he was obviously a man. I said, look, if I do well like people will talk. They’ve got all got hairdressers, they all go out for coffee, you know, they, they meet, they socialise. Women are quite sociable, actually. And actually if it doesn’t do very well, that’s because I’m not doing very well and it’s not right. So I don’t want to advertise something that’s not right or if there’s not a need for it. And then my husband met him at a meeting a year later and he said, oh, I can see she’s setting up my own clinic and she’s really busy. But it’s about women. And most people who come to our clinic is from recommendation from a friend or a colleague or this or that. Whereas if I was doing a men’s health clinic, men would just… their pride wouldn’t let them often to sort of admit that they’ve gone somewhere or that they admit that they had a problem. And in men’s health, it’s another conversation. But it can be very difficult for them to come and see us if they’ve got a problem. Whereas I think women, once they’ve know what the cause of the problem is, they’re really eager to get help and talk about it. But in my experience, listening to thousands of stories is that it’s a long journey before they get help because they’ve often not realised what’s going on. They feel very isolated. They’ve got all these psychological symptoms so that they’re feeling low self-worth, low self-esteem, low confidence, anxiety, low mood. They have no idea that hormones even work in their brains, so they’re not aware that that could be a possibility. But then suddenly this light bulb moment, someone says, actually, you sound like you could have some hormonal changes. It’s like, wow, actually, okay, I haven’t got dementia, I haven’t got clinical depression. I don’t have to, you know, my whole family fall apart. There’s something I can do about it. So that is that first journey that you’re really helping with. And after that, it’s up to the women to decide, do I want to take hormones? Do I want to do whatever? It doesn’t for me, it doesn’t matter as long as they’ve got the right information. But it’s recognising those symptoms. Because women in your country, in my country, across the world, are being misdiagnosed with depression, fibromyalgia, chronic fatigue. You know, these labels that we’re giving women without excluding their hormones being a cause, and it’s making women feel even worse, actually, you know, you know what I mean?

Jane Hajduk: I think there is that noise that this is one of my things, when you’re emotional, it’s just like, oh, am I just being a woman? Because of that noise we’ve heard, oh my God, look at her. She’s like getting all hyper and that and I, I really do question when I started to really, you know, like I would just immediately get upset and go, wait, is this just, just a woman thing? And so I think we do hear so much, I’ll call it noise, whatever. I can’t call it information. But another thing that you were talking about is, yes, men don’t come. But how quickly did we have that blue pill out?

Dr Louise Newson: Oh for sure. Don’t even get me started about that. Like.

Jane Hajduk: Okay, good, because I have another friend come to me and say, well, you know, when men go through their menopause, they go, wait a minute, wait a minute. I mean, that blue pill was out so quick. Please find me a pill where I just want to have sex all the time with the man I love, with the man who’s done so much. But I mean, give me that. I’ll take a pink pill. I’ll take a yellow. Yeah, yeah, I’ll take half of your blue pill.

Dr Louise Newson: Well it’s so interesting, isn’t it? Because the blue pill Viagra that we’re talking about is actually very effective. It’s very safe, but it’s still a medication and it does have some contraindications. And since very small risk. But you can buy it over the counter if you’ve got money you can buy Viagra. Now the natural hormones we prescribe are just natural hormones. They are very, very safe. And even if we’re just talking about vaginas because we’ve been talking about sex, vaginal dryness, soreness, irritation, urinary symptoms affects the majority of menopausal women. Putting some hormones in your vagina. Anybody can do it because it they’re such low dose. They’re very safe. Can we get them, can we buy them with money? No. Course it’s really difficult and even to get them prescribed whereas it just doesn’t make sense really. And also we have a really good treatment hormone, testosterone, that we know can improve libido. And 25% of women have what’s called HSDD, which is hypoactive sexual desire disorder. So we have to be diagnosed with this disorder. And you have to have symptoms for a minimum of at least three months, say the guidelines. So it doesn’t even… and you have to be severely psychologically distressed. It has to be no other reason and you have to have done all this. And then I can assess you and say, right, you’ve got HSDD, you could try testosterone, whereas men like HSDD doesn’t really, you know, it’s like, yeah, you’ve just had a couple of nights where you don’t feel great, just try this and it might help get your libido back, your erections harder and you can go forward. For us, we have to prove that we’re really distressed because we’re not having sex. I don’t really understand it.

Shari Doran: Well, and I think I’m kind of going on top of that. And, Jane, I know you’ve found a wonderful doctor right away. So in my experience, you know, in our country, the insurance system, how it works, that’s a whole other, that’s a whole other podcast. But, you know, it’s amazing the doctors that I’ve gone to, three or four, which I’m sure you hear all the time before I found and it ended up being a male doctor, a gynaecologist, and he was about. Let’s talk about the quality of your life. Let’s talk about the things that can make that happen. That’s what we need to get to. And I was like, how can my general practitioner, who’s a woman does not have this philosophy? And she didn’t. And whatever the reason is and it’s not, she’s, I love her, she’s been my doctor for years. But it just it wasn’t there. Whether the knowledge wasn’t there or whatnot. So it’s interesting as women, you know, we kind of have to sift through, sift, sift, keep going. You know, you had to be a detective almost to do it.

Dr Louise Newson: You do. And that’s where women have to be advocates for themselves. It’s really….I was just looking at some guideline pathways that some NHS GPs use with the people, and they’re talking about all the risks of hormones and they’ve got a few symptoms like they’ve got flushes, sweats, vaginal dryness. I think they had low mood, but not many of the thousands or no hundreds of symptoms that people can get. But then we to them what about patient choice? What about what do women want? That should be in my mind, the first part of my consultation is why have you come to see me? What are you expecting to get out of the consultation? And what were you thinking? Because some people say, I just want to make sure that I haven’t got a brain tumor and my headaches are due to my menopause. Other people will say the only treatment I want is X or whatever, and then we can explore that in the consultation. But we’re not just a machine. We’re not a tick box that we can just all go, yes, Mrs smith, you’re going to have exactly the same as Mrs jones, and…Medicine’s not like that. And actually, we can’t blame the menopause on everything. You know, my husband was frustrating me this morning because he just said he’d take my daughter to the bus, and then he didn’t because he was faffing around. So I was like don’t worry. I’ll just do it. It’s fine. And it’s like, I can’t blame my menopause. It’s just because, you know, he was a bit frustrated. But we need to have the right information. We need to listen to the right healthcare professional for us. That’s empathic and holistic and will help us in our treatment decision because like you say, it’s like the third act. It’s not just a couple of days we’re menopausal. For the most women, it’s going to be at least a third of their lives. My youngest patient is 14. Now she’s hopefully going to live for many, many years. So it’s not just like a little thing, like, I don’t know when you’re pregnant. Look how much attention we get in those nine months. But that’s only nine months. You know, this is decades. So it’s so importan the conversation starts and continues, isn’t it?

Shari Doran: Yes. And I want to ask you because we’re going to write an episode probably about it. What is the funniest cure all or something that you heard from a woman? I mean, because you’ve had so much research of something that she’s tried, that you’re just like, this is not really where you want to go.

Shari Doran: Well it’s interesting. So it always sticks in my mind, it’s not really funny. I think it’s a shame, really. So this lady a while ago came to see me and she said, look, I want something natural. I don’t want hormones. I want something very natural. So we have this whole conversation about, you know, there’s lots of natural plants in my garden that I wouldn’t want to eat or have made into tablets. And our hormones are natural because we produce them. And I said, are you on any medication? She was super well, super fit. And but she was getting quite a lot of headaches. But they… and she was feeling a bit sick and I couldn’t quite work out what was going on. So I said, are you taking any other medication? She said, I take vitamin D, I said, great, and she said, oh and I take this menopause support tablet. But it’s really it’s from this amazing health shop up in the wherever and it’s frightfully expensive. I said, well, what are the ingredients? Oh, I don’t know. So okay, well let’s Google it. So we Googled what it was and inside it had.

Shari Doran: Oh no.

Dr Louise Newson: Yeah. It had all sorts of things that I didn’t really know. But they had porcine ovarian tissue. So ovaries from pork. And then it also had bovine pituitary tissue. So, so a bit of whatever and whether it did or not I don’t know. But I said, oh my gosh, just reading that, it’s going to make me feel really sick. Like, so you’re saying you don’t want natural hormones derived from yam plants that are the same biochemical structure as our own hormones. But you’re taking something from. [00:24:45][27.1]

Shari Doran: A pig.

Dr Louise Newson: Like, I just don’t really. And. And she was great because we were just laughing because I thought I can’t laugh at her that’s really rude and disrespectful, but this is absolutely ridiculous to be honest. Like she was so well researched but she hadn’t researched what she was taking.

Shari Doran: Oh I love it [laughs]. But we’ve all done that so she’s not alone in that. I’ve taken things. I’m like, what was I thinking? Yeah.

Dr Louise Newson: Yeah. Well that’s the thing. But we all do because we’re desperate to feel better. And that’s what really saddens me with the sort of commercialisation of the menopause. I sort of feel like I’ve opened this Pandora’s box because I, like I say, the demand is huge. People are thirsty for knowledge, thirsty for information. But if you’re not getting the help that you want from your clinician or your physician, then of course you’re going to go and buy something that’s really beautifully branded or heavily marketed because you feel it might help. And then, you know, there’s the new, I won’t say the product, but there’s another face cream coming out. So the company emailed me to say, are you interested? Could you put a quote? And I said, no, but could you just send me the evidence to support your cream? And a week later I got an email yesterday saying, oh, we just reached out to our research team to see what we can find. It’s like, okay, right. But you’re putting this cream out, and they’re a really well known brand. But I know what will happen it will be one of those stars, you know, research, six out of seven women said that their skin felt glowing after three days of using this cream. It’s like it’s actually quite disrespectful to women. Actually, I think we’re going back in time.

Shari Doran: And I think that’s part of our show too, is that we are just two kind of regular women that made the show. You know, we’re not a star who’s trying to push something or push an agenda. It’s really it helped us get through menopause, and hopefully it’s going to help other women get through and have that conversation and know that there’s a sisterhood. So it’s we’ve had a ball and I have to say, Jane saved me. Yeah, I have friendships. I mean, I’m not kidding there were times I’d I think I was going to jump off a mountain. And she was there, you know, because I had I think I had more symptoms than Jane. I still have belly. I’ve named her. I’ve named my belly. Once, once it came, I was like. And I had done more sit ups than jane, I think at one time, but somehow I got a belly. I was like, what’s just happening? I call her Betty the bitch, Betty the bitch. Yeah, but she’s better now. It’s better now.

Jane Hajduk: Yeah, it is kind of funny because I think as we’ve been writing and doing this and using our own experiences, I don’t we’re we’re very different in what we’ve experienced, you know. Yeah we definitely are.

Dr Louise Newson: And we all are. You know we’re all individuals. If you talk to enough women who’ve been pregnant, they’re all going to tell you different stories. If you have people who have migraines they’re all going to have different experiences. And we certainly all have different relationships. And you know, what are different jobs, different friends. And menopause is individual. And, you know, it should be made into a very positive experience if we get the right support, information and treatments as well. So what you’re doing is part of that help, which is wonderful. So I’m very grateful for you to share what you’re doing. So but before I end, I always ask for three take home tips, and one and a half each is going to be hard, so I will allow you to have two each because I’m feeling quite kind today. So if you wouldn’t mind, just four reasons, so two each, why people should watch the YouTube and what you hope they get out of it. So do you want to go first, Jane?

Jane Hajduk: Yeah, I’ll go first. Laugh. You know, without a sense of humour, it’s hard to get through anything. So, Shari, you want to take a second one?

Shari Doran: I would say friendship and misery loves company: I’m misery. But past that. I mean, we, Jane and I have been through tragedies together. We go through nonsense together. We’ve gone through raising children and all of those things. Without that friend, you know, there’s a sisterhood, there’s billions of women. And I think that sisterhood is the bond.

Jane Hajduk: It is. Shari, give me a third one.

Shari Doran: Well, I think my third for me would be a really good chocolate martini. No, no.

Shari Doran: I agree, I agree with that. Dr Newson I know you don’t drink but we do. But seriously, never underestimate the creative power of a woman. I mean, we give birth, we raise families. We work, we nurture our parents even as they’re getting old and then even out of this world. And I really believe this, and I know my partner does. Shari. We are thriving and creating even more in our third act. And, Shari, you want to end it?

Shari Doran: Well, I think that what women should take away from us and our show, Thee Third Act, is that menopause was the catalyst that made us have this new whole chapter. Menopause is the catalyst.

Dr Louise Newson: Which is wonderful. So it’s a third act for you as well. And I think that is that I mean, I didn’t start my menopause work until I was a perimenopausal woman, so it’s not too late to do something. But having that support, that camaraderie, that friendship is just so wonderful. So I’m really excited to keep watching the episodes and keep doing the great work. So thank you so much for your time today.

Jane Hajduk: Thank you. You guys probably hopefully already saw one. But there’s no problem watching a couple or three at a time because as I said it’s like 2 to 5 minutes. So.

Shari Doran: And we have lots of friends who are having watch parties or they’re five of them and they have all their friends come over because they want to watch them in a row and, and they just laugh and cry and have a ball. So we’re thrilled.

Dr Louise Newson: Fantastic. Thank you.

Jane Hajduk: Thank you for your time.

Dr Louise Newson: You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk, and you can download the free balance app on the App Store or Google Play.

ENDS

The post Thee Third Act: laughter, friendship and menopause appeared first on Balance Menopause & Hormones.

How to cope with Christmas and menopause

kat keogh — Wed, 04 Dec 2024 00:58:00 +0000

Dr Rebecca Lewis shares her advice for surviving and thriving throughout the festive season

With all the organisation that goes into creating the ‘perfect’ Christmas day, the pressure to keep family and friends happy, and the financial burden of paying for the festivities, it’s unsurprising that December can be a stressful time of year.

Add in the hormone changes and symptoms such as low mood, anxiety, fatigue and hot flushes that can occur during perimenopause and menopause, and things can soon feel overwhelming.

So, how can you protect your wellbeing this Christmas? Here, we offer some tips on thriving during the festive season.

Consider your relationships

Christmas is a time for family to gather but this in itself can be stressful. A survey by counselling charity Relate found that 70% of UK adults said they were worried that Christmas put extra pressure on their relationships [1].

Your perimenopause and menopause may also bring additional stressors to your relationship. Menopause has a clear and negative impact on divorce, separation and relationships – a survey of 1,000 women found that more than seven in 10 women (73%) who responded blamed menopause for the breakdown of their marriage [2].

Relate advises you to have conversations with your family and friends about everyone’s expectations of Christmas well in advance. That way you can deal with any difficult demands and make compromises that suit everyone.

How to diffuse or avoid family arguments

If you have a house full of guests and tempers are starting to fray, suggest leaving the house for a walk to break things up a little. This gives everyone the chance to chat to someone different, or even to stay at home if tension is building.

Rebecca Lewis, GP and menopause specialist at Newson Health, says talking about your menopause with your loved ones can help. ‘During perimenopause, you may feel detached and isolated even among your friends and family,’ says Dr Rebecca. ‘Talk to them about what you are experiencing, and explain that it is caused by your hormones changing. This can really help people to understand and respond with empathy.’

Take the pressure off

The notion that Christmas must be ‘perfect’ means you can heap extra pressure upon yourself.

‘We can often feel overloaded by this pursuit of Christmas having to be incredible,’ adds Dr Rebecca.

‘But if your brain is feeling a bit foggy due to perimenopause, and you’re also working, and thinking about all the presents that you need to get, and stocking up on all the food needed, and ensuring the house is ready for guests, you may not be feeling very joyful. It is no wonder we can feel overloaded – it is such a barrage.’

Simple steps can help make your Christmas overload and menopausal symptoms more manageable.

Set realistic goals, try to get some exercise outdoors every day, delegate jobs to others and do one thing at a time, Dr Rebecca says. ‘Take time to do the things that help you. That might be some yoga, practicing mindfulness, a few minutes to meditate or go for a dog walk.’

Also suggest to friends and relatives this Christmas could take a simpler approach. ‘After all, it is your Christmas as well and you should be able to enjoy it,’ says Dr Rebecca.

Alcohol and hot flushes

It may be the season to eat, drink and be merry, but Dr Rebecca advises being sensible when it comes to alcohol. ‘While reaching for a drink feels the right thing when stressed, it often increases tiredness by disrupting sleep, can make hot flushes worse, increases anxiety and lowers mood,’ Dr Rebecca says.

About 80% of women will experience hot flushes [3]. The exact cause of hot flushes isn’t known, but it is thought to be related to changing oestrogen levels impacting on the areas of the brain involved in maintaining temperature [4].

In addition to alcohol, there is some evidence that spicy foods and caffeine can also exacerbate hot flushes, which is worth bearing in mind during the festive period.

Manage anxiety

Falling levels of oestrogen and testosterone in your brain can increase your anxiety. This can make socialising and planning Christmas events harder, especially as your confidence may have dipped, says Dr Rebecca.

If you’re finding this Christmas hard, you might not realise your anxiety could be linked to menopause. ‘Perimenopause and menopause can really affect your self-esteem and confidence, and bring feelings of paranoia,’ says Dr Rebecca.

Pause to think if the way you are feeling could be menopause related. If you’re unsure, use the symptom tracker on the balance app to record how you are feeling, and take this information with you to a healthcare appointment.

Being aware of the issue and informing your friends and family can help. ‘Involving others can help, so be open if you are struggling,’ says Dr Rebecca.

Prioritise your sleep

Get enough good quality sleep is important over the busy Christmas period. Sleep boosts brain power, immunity, heart health and curbs hunger hormones.

But during perimenopause and menopause, declining levels of hormone can have a significant impact on sleep. Some women find it difficult to fall asleep when they go to bed, others struggle to stay asleep for long periods and wake frequently during the night, never feeling they have gone into a deep sleep, while some women find they wake up way too early every morning and can’t drift back off.

Having a regular evening routine, going to bed at the same time, even during Christmas, can help, as can keeping your bedroom cool. HRT will improve perimenopause and menopause symptoms such as night sweats and urinary symptoms like frequent urination, which can in turn improve your sleep.

RELATED: Sleep and hormones factsheet

Resources

Relate

References

1. Relate, ‘Sex at Christmas’

2. Menopause puts final nail in marriage coffin

3-4. Deecher, D.C., Dorries, K. (2007), ‘Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages’, Archives of Women’s Mental Health, 10 (6) pp.247–57. doi.org/10.1007/s00737-007-0209-5

The post How to cope with Christmas and menopause appeared first on Balance Menopause & Hormones.

Friendships and menopause: how conversations can be transformational

kat keogh — Tue, 03 Dec 2024 07:00:00 +0000

Joining Dr Louise this week is Louise Mulley, who shares her experience of anxiety and menopause.

Louise shares the importance of speaking openly about menopause and mental health, and how a conversation with a close friend helped her recognise her symptoms and find the right support and treatment.

She also shares her top three tips on helping friends or loved ones who may be struggling with their mental health during perimenopause and menopause:

Help your friend unburden: ask them ‘would you like to talk to me about it?’. Make it clear they can talk to you with no judgement and in confidence.
Share your own menopause story to encourage your friend to open up about what they may be going through.
Keep an open mind: if you’re a woman of menopausal age and experiencing mood changes, consider that it might be your hormones.

Transcript

Dr Louise Newson: [00:00:11] Hello. I’m Dr. Louise Newson. I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause, symptoms and treatments and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today on the podcast I’ve got someone with me called Louise who kindly has agreed to share her story and everything in medicine or a lot of medicine, I learned through my patients, I obviously have got good background knowledge. I learned the science. But actually when it’s patients that I learn from all the time. And so Louise was recommended to see me a while ago and was not quite as well as she is now, but she’s agreed to share her story. So thanks so much, Louise, for coming on to the podcast. [00:01:31][80.2]

Louise Mulley: [00:01:32] Great. Would you like me to start just from the beginning, how we came across, I came across you? [00:01:37][4.8]

Dr Louise Newson: [00:01:37] If that’s okay. [00:01:37][0.4]

Louise Mulley: [00:01:38] Okay. So I’m Australian and I’ve been on a holiday in Australia and while I was there I was on the Mirena coil, had the brand Mirena coil featured and I’d had that for some years. I’ve had three children and I’d finished obviously having children. I had no signs or symptoms of menopause in any way. But while I was down in Australia, I had this incredibly heavy menstrual bleed, quite, quite unusually heavy, which obviously those of you who have a Mirena coil will know it’s not common. And that got me thinking, gosh, you know, we all have busy lives and I’ve got a job. And these children. And I thought maybe that thing’s expired. I’d better check it out. So when I got back, I started feeling quite agitated. I got in touch with my male gynaecologist and said, Listen, I think this Mirena coil may have expired. And he said, Well, it hasn’t expired for contraceptive purposes, but from a sort of progesterone releasing purpose, it has you’re probably about the age where you should be considering some kind of HRT. And I said, yes, yes, of course, yes, I should. I said, Well, I don’t want any messy creams and potions and I don’t have time for that or patches. He said, Well, take these tablets, they’re very good. And I sort of said, Yes, okay then. And off I went. Anyway, I didn’t, and this is so ridiculous because I am quite an intelligent person, but I just I didn’t even read the instructions properly, nor did he give me any instructions because he just said, oh pop one of these today, You’ll be right, kind of thing. So I was merrily popping them away, but I started becoming more and more anxious to the point where a very good friend of mine who is actually one of Dr louise Newson’s patients, was due to meet me and she rang me up to say, Now what time we meeting, I just can’t meet you. And she said, What’s wrong? I just I can’t leave the house. I’m just so agitated. I don’t know what’s wrong with me. And the next thing, she just turned up at my door. She’s a very good friend, and that worked, actually make me quite teary. Anyway, she said, this isn’t like what’s going on? And I said, I don’t know. And then I just started crying and saying, I don’t want to feel like this. I think something to do with menopause. I don’t know. I’ve been given these tablets. She said, Go and get those tablets. So she looked at them and she said, Well, you’re supposed to be taking them sequentially, which you’re not doing. Obviously they have different hormone levels, she said, but did this doctor get you to do any blood tests? Did this doctor even investigate what sort of hormone levels you had? What’s going on? This is ridiculous. She goes, right, that’s it. I can’t have this anymore. I’m going to call Dr Newson now and I’m going to get you an emergency appointment. Even though she can’t see any more patients at the moment, she’s full, but you can’t leave the house. And this is ridiculous. And I couldn’t stop crying. So anyway, she sat with me for several hours. We had loads of cups of tea. And then very fortunately, I got to speak with you the following week and relayed that story. And you said to me, I can’t believe I’m hearing this. I hear this all the time. We’ve got to get on to this straight away. I’m going to send you some stuff tomorrow. Then in a couple of months, you’re going to go and have blood tests will reassess, re-evaluate. And I cannot tell you, within a matter of weeks I was back to my normal self. It was that fast. It was that fast. The descent into despair. And it was that fast, the track out of it. And it honestly, I know it was because of those hormones. [00:05:02][204.0]

Dr Louise Newson: [00:05:02] And it’s quite scary. And I do remember seeing you. And you’re right, you weren’t as well as you are now. But you actually said to me you feel like you’re on a snakes and ladders game and you’re the snake and you’ve landed on the tail and you’ve gone down. Do you remember saying that to me? [00:05:20][17.2]

Louise Mulley: [00:05:20] I was honestly, it was that fast. In fact, my friend and I were talking about it. She was saying she’d experienced something similar, which is why she was so helpful and supportive. And she said she equates it to being just standing on a trapdoor that opened suddenly and down you go. And I said honestly that I felt like I was in a game of snakes, and that is that I had literally stood on the biggest snake and went right down to the bottom, and I didn’t even know how I was going to climb my way out. I couldn’t find the ladder, if that makes sense. [00:05:48][28.3]

Dr Louise Newson: [00:05:49] It absolutely makes sense and it’s really scary. And obviously there are many symptoms that can occur with our hormones. And as many people who are listening know that our hormones are three hormones, oestrogen, progesterone, testosterone. Affect the way our brains work. They work as neurotransmitters, chemicals that have messages for one part of the brain to another, and they affect other neurotransmitters as well. So when the balance is off kilter, it can really affect people. Sometimes it’s very insidious, it’s very slow onset. People just feel a bit more nervous, a bit more anxious. They might not want to go out with their friends as much. They might not want to drive as much. They might want to go on the tube as much and it can be over a few months. And then they just adapt and think, it’s just because I’m getting older. But for some people, and we don’t know why, but for some people it can be a real, like you say, fall off a cliff moment, you know, you’re fine and then and there’s nothing else that’s happened in your life, you know, to account for that. [00:06:44][55.6]

Louise Mulley: [00:06:44] Well, this was the strange thing Louise, just for other people to understand. I suppose there’s two things I wanted to say on that. The first is so I am a really happy, positive, cheerful person by nature. I’ve got a fantastic husband, great kids who are all doing really well. I live in a lovely home. I’ve got gorgeous friends, I’ve got a great job. There wasn’t something in my life that could have been causing this. Obviously you have your little ups and downs. and things that go on, but nothing serious. And the second thing is, when I was a very young woman in my very late teens, I did suffer an episode of extreme anxiety. And I was quite a late developer too, just to put this in context. And then I sort of got back on track and I almost had the feeling that this whole sort of hormonal thing that happened brought me right back to an episode of when I was in my late teens. And so, so very quickly. And I couldn’t see the way out. I just could not see the way out. And there was no reason in my life that I should be feeling like this. And in fact, I couldn’t even see the hormone thing for myself because I thought I’d done what I needed to do from a menopause view, because I’d this doctor had prescribed these pills to me. But it was when my friend came around who understood and had been there before herself, and she could see it since she’d seen it all before. And she knew it wasn’t normal. That action had to be taken. But also the recovery out of it was just so swift. And that was the other strange thing. Yeah. You know, and I just want people to know the reason I was really keen to come on the podcast actually when we talked about it is I wanted people to know how powerful the change and how quick the change can be, but that a lot of doctors themselves aren’t giving women the sort of help and support that they really need. [00:08:40][116.1]

Dr Louise Newson: [00:08:41] Yeah, and often that’s due to lack of education, not realising the powerful means in our brains. And I was I’ve recently emailed quite a few psychiatrists I know and I do know a lot asking what’s the evidence for antidepressants, for clinical depression and anxiety? And of course there is some evidence, but it’s actually not brilliant evidence. They do help, but not a huge number necessarily. And there are risks of antidepressants. If people are on them long term, we will know about the addictive properties. But we also can increase incidence of osteoporosis, for example, which lots of people don’t realise. But actually when you look even in our clinic data of people who have anxiety and low mood and it’s in the 80s and 90s, it reduces by about 60% within three months at the follow up consultation. Now if I said to you, Louise, I found this new drug that will reduce anxiety by 60%, it would improve sleep by 60%, it would improve memory and also joint pain skin during this, you know, palpitations. It would also improve by about 40, 50%. You’d go bring it on. Can I have some, please? But we’ve got this. But people are avoiding it because they’re so worried about the potential risks, which we know for most types aren’t there. But the other thing that you’re clearly highlighting is that you weren’t on the right dose and type of HRT. And that’s really crucial. About 37% of women who come to our clinic are already taking some sort of HRT and often they’ve been told it can’t be or hormones because you’re on HRT. But that’s like saying you can’t still have a headache because you’ve taken paracetamol and that’s a painkiller. Well, yeah, actually I might need to take brufen as well. It’s not, you know, and there are so many different doses. And if you take a tablet, as you know, oestrogen then gets metabolised differently. The progesterone is usually a synthetic progestogen, which can have detrimental effects because it can block the natural progesterone working in the body. And then obviously testosterone is another hormone and some people respond better to testosterone than oestrogen. You know, we’re all different. And that’s where you said having the blood test afterwards is, in my mind, quite useful. It’s still only a guide, but actually if someone has got low hormone levels being on. HRT it suggests they’re not absorbing it properly through the skin and the dose might need changing. So it’s really crucial that we review people regularly and make sure they’re on what’s right for them at that time. So what you are now, even in a year’s time, could change. If your body changes in some way, you know, you might still be producing hormones. Now that will reduce with time and that’s fine. And we need to know that giving hormones is a dynamic process. It’s not like a one pill, there you go, louise, on you go, you’ve had this, which is what you were really told before, isn’t it? [00:11:35][174.0]

Louise Mulley: [00:11:36] That’s right. Well, not even told how to take them properly, quite frankly. I mean, yeah, and I don’t want to say that he was sort of mansplaining me or anything like this, but it was not. It was more like, just take one of these and off you go. And I was just so naive. And I just thought, yes, he’s a doctor. He knows what he’s talking about. And that was my mistake. [00:11:56][20.0]

Dr Louise Newson: [00:11:57] Well, to be fair, you might have got better, in which case, absolutely, that’s fine. And certainly a lot of my work as an educator, medical writer is to just empower people with knowledge and then know that they we’re all different, know about the different hormones, know that there are other reasons why people can feel like this. But certainly when somebody has a mental health issue without any triggers at a certain age, we’ve got to be thinking rather than, could it be the hormones we should be asking ourselves as practitioners, is there any reason why it’s not her hormones? We should be thinking hormones, top of the list. And it’s a pivot to the way we’ve been taught and the way we’re thinking and the way that I wish I thought for 30 years as being a doctor. Because now in my mind, so much is related to hormones, and I’m usually right. But I didn’t think about it before because no one told me to think about hormones in women of any age because hormones can change. And and it’s really interesting because someone ages ago was pushing back in a lecture that I gave and said, we’ll you’re just medicalising women. We don’t medicalise adolescents or people that have hormonal changes when they’re younger. And it’s really interesting because I’m increasingly doing work for women who have PMS and PMDD, which you could say is just a normal part of their cycle. They’re feeling rubbish a few days before their periods when their hormone levels drop. But actually lot of those women just having hormones on those few days to lift their hormone levels, it can be transformational for the way that they work. And that’s fine as well. We’re allowed to do those things too. [00:13:36][98.7]

Louise Mulley: [00:13:36] Yeah, it’s interesting, isn’t it, because obviously teenagers are going through a lot of hormonal changes and I actually, all through my reproductive life, suffered from terrible PMS, terrible pains, but most significantly horrific, a couple of days of deep, deep, dark depression, really. And then, I mean, I’m such a moron. I literally would feel this way. I’d start crying and two days later I get my period and I’d feel happy again. And I think, that’s what it was. You know, it constantly seemed to surprise me, every month. [00:14:09][33.3]

Dr Louise Newson: [00:14:11] But it’s weird. I think that’s where having such a good friend has been amazing for you because you want someone to recognise it. Because I think so often as women we normalise the way we feel. And actually when you’re feeling low, it’s also your brain often doesn’t process in the same way. So you do think, oh that’s just my life. That’s just it. And many of us felt like that. And actually, even now with my youngest daughter, who’s 13, she’s sometimes she’s really level headed. But every so often she gets very tearful. I’m like, Gosh. And then she has this really heavy period. It’s like, okay, that’s why she was like that. And we can laugh about it. [00:14:47][36.1]

Louise Mulley: [00:14:47] But I mean, I was very lucky to have such an understanding friend, and that is why I was quite keen to talk openly, because I still think there’s such a stigma around mental health issues. Anxiety, particularly with women. So many women I speak to who are in sort of my age bracket, I’m now 54, are suffering from tremendous anxiety and other things and having personality changes and all sorts of things going on. And it needs to be spoken about. At least menopause now is in the conversation. When I was young, my mother and her friends, I didn’t know anything about menopause because I didn’t talk about it. Now people talk about it, but the mental health side of it is still not talked about very often. [00:15:29][42.2]

Dr Louise Newson: [00:15:30] No, you’re absolutely right. And I do a lot of training with psychiatrists, actually. And it’s really interesting because they are waking up to it, which is great, but they haven’t been taught about it before. And I do a lot of training for psychiatrists because we need to recognise it. There’s so many conditions that are now around that there weren’t even 30 years ago when I qualified as a doctor and a lot of these personality disorders, you know, it’s not a personality disorder, it’s a disorder of our hormones that hasn’t been identified. [00:15:58][28.3]

Louise Mulley: [00:15:59] And I suppose, you know, the important thing for people to understand is, of course, there are other issues for mental health and other issues around mental health. And it might be that there are other factors coming into things and at play. And, you know, hormones aren’t the panacea and the be all and end all. But in my particular case, and why I felt quite strongly about talking about it is that, you know, I was at a certain age, so it’s obvious that something was happening hormonally. I was too blind to see it because I’d got myself into such a state so quickly. And, you know, it really, really did work in my case. And obviously it’s not going to work in everyone’s case, but it couldn’t do any harm. [00:16:39][40.8]

Dr Louise Newson: [00:16:40] Well, this is the thing, I tend totally agree. And you can have more than one diagnosis in medicine. So you’re you know, there are some people that do have a psychiatric illness. They do have clinical depression or schizophrenia or bipolar, but there’ll also be menopause and perimenopausal. So there’s no way that I’m saying it’s all related to hormones and will be fine if everyone just has their hormones. But we need to co-prescribe, we need to work together. And the same way that if someone had an abdominal operation and also a migraine, you would give treatment for the migraine and you would do that surgery as well. That’s fine. But I think what’s happened for many years, decades, centuries is that our humans have been forgotten. And then you can never completely help that person to be completely well because you’re not treating the underlying cause. [00:17:26][45.6]

Louise Mulley: [00:17:27] Yeah, I think the other thing, too, I wanted to say, I suppose, is that you talk to so many different people about their experiences with menopause. Some people have 10 or 12 different things happening to them. Some people say they’ve had nothing happened to them. In my case, it was well, I will say say I was a bit of weight gain, but I don’t think that’s because of menopause. I just think that’s my age, sadly. But in my case, I really just had one big thing happen to me. I have no brain fog. I don’t forget things. I sleep extremely well. You know, this thing just went for this. Like I got one big thing happen to me. And so, again, I think, you know, women need to know that menopause isn’t one of these things necessarily causes brain fog or heart palpitations or lack of sleep. It could be just one other thing. And if you are suffering from anxiety, you are feeling stressed and anxious. Maybe go and do something about it from a hormonal point of view. [00:18:22][55.6]

Dr Louise Newson: [00:18:23] Yeah, and that is really important because actually some of the menopause guidelines will still talk about hot flushes, sweats, low mood and vaginal dryness. They don’t talk about any of the other symptoms at all. And lots of people think you have to have a certain number of symptoms or a certain duration for those symptoms or certain sequence of events. And some menopause conferences I’ve been to, they say all women have flushes and sweats and then they have some low mood and then they’ll get vaginal dryness and it’s like, hang on. No. I’ve seen women that I’ve only had tinnitus or they’ve only had dry skin or they’ve only had vaginal dryness and cystitis when they’re young and no other symptoms. So we can’t put people in a box and say, No, you’ve not had X, Y, Z symptom, therefore you can’t be perimenopausal or menopausal. And that’s a danger, I think, in medicine because we don’t have a diagnostic test. You know, I can’t send you for a blood test to go. Yes, actually, you are definitely menopausal. But even if you had a blood test, of course, age 54, you know, you’re menopause will be low because that’s what happens as we age. But having low hormone levels doesn’t mean it’s the cause of your anxiety. You know, you could have had something else going on. And so that’s why in medicine, it’s really important that we keep our minds open to all sorts of reasons for a possible diagnosis. And also think about a differential diagnosis as well, because sometimes what happens is and I’ve seen it a lot, people maybe give an example, someone with tinnitus, the ringing in the ears. I saw a lady recently and she had been seen by the maxfax team. She’d been by ENT, so she’d had brain scans, she’d had inner ear balance tests. Everything was normal. They said, Well, it’s fine, you’re normal. She’s like, no I’m waking up with tinnitus. It’s driving me to distraction. I really can’t cope. I can’t work, I can’t function, it is awful. And she was 54, so I said, Well, you’re menopausal because of your age. I know there are more benefits and risks for you for HRT. I have no idea if it’s going to help your tinnitus, but we know tinnitus is a symptom and that’s saying how you get home. And then when she came back three months later, it cured me. This is incredible. So the proof is in the pudding. Sometimes as long as we’re giving safe treatment to see if it helps. And if it doesn’t help, then I can think of something else, you know? And that’s what we often do in medicine. But you you know, your story was very clear that you had this catastrophic, it really was catastrophic, anxiety. [00:20:52][149.2]

Louise Mulley: [00:20:53] Oh it was awful and just so fast, but fixed so quickly, too. That’s the unusual thing. The other thing I also wanted to say is I have told a lot of my friends about it because I just you know, I think it’s important for people to not be afraid to talk about these things. But there are few women that I knew who sort of said to me, I haven’t needed any HRT. I’ve been fine. I have no menopausal symptoms, almost sort of showing off if that makes sense and well, good luck to them. But the problem is that makes all the women feel bad. And I don’t want other women to feel bad about taking HRT. It’s not a secret. I think that. Why wouldn’t you and I want anybody out there who might possibly feel even the tiniest bit anxious or low to go and get their hormones checked and to continually check their hormones and realise that maybe it’s not them, it’s their hormones. [00:21:47][53.8]

Dr Louise Newson: [00:21:48] Yeah. And that’s why doing even a symptom checker, like on the balance app is really useful because you can see if you have any change in symptoms. Now, having hormone levels checks can sometimes be confusing, but thinking about hormones is the most important thing. But also allowing others to know the importance of hormones so they can maybe witness it in you and, you know, maybe ask, could this be related to hormones? Because I’ve read that anxiety could be a symptom when your hormone levels change, because that’s really useful as well, like your friend did for you. But you’re right, and I’ve seen quite a few patients over the years who’ve felt so much better on hormones, but they say, I am not telling my friends. It’s like it’s it’s just a badge of shame for taking hormones. And that’s hanging over from the WHI study, from people thinking hormones are bad. And actually, I keep saying to people, you don’t get a medal for suffering. No one says, well done Louise. You’ve had menopausal symptoms for three years and you’ve done nothing about it. But also, I think we need to turn away a bit from thinking even about symptoms because we need to think about the health risks of not having hormones. So we know that there are health risks. The longer we are without our hormones, so i.e. Being menopausal? And these risks include heart disease, dementia, osteoarthritis, osteoporosis, clinical depression, type two diabetes, neurodegenerative disorders. I mean, that’s just we know that that’s fact. Doesn’t mean everyone’s going to get these conditions. It’s like saying to you, if you never exercise again, you will have an increased risk of all the same conditions, actually. Or if you eat fast food every day, or if you smoke or drink, it’s your choice. But you need to know that. So these people that are saying, I don’t have symptoms, fine. But actually they’ve still got these health risks. And you obviously can reduce risk by nutrition, exercise, but you’re not going to replace those missing hormones that are biologically active. And it’s really important because we’re living so much longer. In the Victorian times, the average age of the menopause was around 57 and the average age of death for women was around 59, and evolutionary we’re designed to reproduce aren’t we, we’re designed to be pregnant most of our lives with very high levels of hormones. Actually, when we’re pregnant, we’re not really designed to have 30 or 40 years without our hormones. [00:24:07][139.4]

Louise Mulley: [00:24:08] Funnily enough, my mum, who is 76, had a late onset epilepsy condition, mainly because she had a brain tumour when she was 50 and went into menopause as a result of that surgery and everything was fine. But then the scarring, it was a bit more rudimentary in those days, the scarring of the brain caused to have late onset epilepsy. She’s got this lovely old doctor who’s about 90. I mean, he said, Get back on HRT and obviously she’s on anti epilepsy medication. But she said the HRT has made an enormous difference and she said, I will be on it till I die. [00:24:40][32.5]

Dr Louise Newson: [00:24:42] And that’s really interesting, actually, when you look at the effects on the brain, I’m very interested in neurophysiology. So how our brain actually works and how it responds to hormones and our brains produce hormones. And one of the first things our brain does, if we have a head injury or a stroke, the same with your mother. The scarring on the brain is that your brain cells will produce some progesterone, which is very anti-inflammatory by healing, if you like, on on tissues. But if you are older and you’re not producing the same amount of hormones, of course you won’t have that there. And so it can not just stabilise conditions, it can improve conditions. And over the years people have said, we can’t start HRT in older people because there are risks, know there are risks with older types of hormones, but not the natural ones. And I’ve got a patient who’s got dementia and is quite mild, but it’s come on over the last couple of years and she started HRT and it’s absolutely stabilised her dementia and she had a fall recently, quite a nasty fall, but she didn’t break her hip. And when she went to hospital they were shocked that she hadn’t break. So she’s still independent. She has carers, but she’s at home and it definitely has made a difference to her muscle strength, obviously her bone strength, but cognitively she was declining quite a fair amount. And if she’d carried on, she’s only 76. If she’s alive for another ten years or so, she’d definitely be heading towards a nursing home and it’s been stabilised and who knows whether it’s hormones or not. But certainly her son really doesn’t want them stopping because he noticed a really big difference. [00:26:15][93.6]

Louise Mulley: [00:26:16] And it’s very interesting. Well, all I can say is, you know what? I’m very grateful to you. I’m extremely grateful to my friend. I mean, she’s a very good friend indeed. And I think all of us are very lucky with the friends we have in our lives. And we need to share with them, because if I hadn’t shared with her, I don’t know where I’d be now. [00:26:36][19.4]

Dr Louise Newson: [00:26:36] Yeah, and that’s such an important way to end, actually, is, you know, look out for each other, sharing information, sharing how you feel. Because so many times people feel embarassed, especially when it’s mental health. It’s so much easier. If I had a rash on my arm to show you and you would give me sympathy. But when we’re feeling vulnerable, when we’re feeling low or anxious, it’s a really crucially important time that we share with people because those people might help us get the right help, support and treatment. So I’m very grateful for you being so open about your story. Before we end, I always ask for three take home tips. So you’re not going to run away without me asking those. So three tips, I’m going to spin it a bit. Three things that if you were a friend, an acquaintance, a loved one, a work colleague, and you saw that person slipping mentally. What are the three things that you think would be really useful for them to do? [00:27:31][54.7]

Louise Mulley: [00:27:32] Well, if I saw it, I would firstly approach them and say, Would you like to talk to me about it? And if not me, somebody else? Would you like to talk about it, with no judgement. And of course I’m not going to talk to anyone else about it, in a very confidential way so that they felt they could sort of unburden themselves. And then I guess I’d if I hadn’t told them already, I would share my story. That would be my second thing, because often if people realise it’s not just them they feel more comfortable in sharing what’s going on. And the third thing I suppose is I would always tell anybody to just keep an open mind because obviously if you are feeling very low, you should certainly not turn away from antidepressants or other sort of psychological aids or talking therapies or any other sorts of therapies or medications, because your experience might be individual to you. But if you do the maths and you’re a woman between 45 and 60, there’s a very high chance your hormones are playing an integral role in this scenario. So keep an open mind and perhaps consider that it might, as I said, not be you. It might be your hormones. [00:28:55][82.8]

Dr Louise Newson: [00:28:56] Absolutely. Really important and great advice, and I’m very grateful. So thanks so much for your time today, Louise. [00:29:02][6.6]

Louise Mulley: [00:29:03] It’s been great. Thank you for your time because you helped me a lot. Thank you. [00:29:07][4.3]

Dr Louise Newson: [00:29:12] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk. And you can download the free balance app on the App Store or Google Play. [00:29:12][0.0]

ENDS

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