Content advisory: this episode includes themes of mental health and suicide

In this episode, Dr Louise Newson speaks with Rachel Birch, a doctor who shares her personal journey of menopause, mental health and alcohol addiction. Rachel discusses the lack of training on menopause in medical education, her experiences with anxiety and depression, how she found herself using alcohol as a coping mechanism and how she is navigating her recovery. Rachel emphasises the importance of self-advocacy, community support, and self-love in recovery. The conversation also highlights the need for better awareness and understanding of menopause and its impact on mental health.

Rachel also shares the following advice if you find yourself struggling with addiction:

• Listen to your body and trust your instinct
• Be your own advocate – you know your body best
• Prevention is better than cure: be alert to drinking habits
• Don’t suffer alone, reach out for help.

Click here to find out more about Newson Health

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

Transcript

Dr Louise Newson: [00:00:00] 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. So today on the podcast, I’m very excited actually. I’ve got someone who I’ve known for a little while now, and unlike many of my guests I met in real life when I was on my tour. So she is a doctor called Rachel Birch, and she’s got a very interesting, quite emotional story that she’s happy to share about. And it does have a happy ending, I just hasten to add. So welcome, Rachel. Thanks so much for joining me today. [00:01:12][72.1]

Dr Rachel Birch: [00:01:13] Thank you very much. I’m really excited to be here, actually. And I think I think the work you’re doing is great. I love these podcasts. I’m, I’m an avid listener and hopefully, you know, what I’m going to talk about today will, will help others. That’s the aim. [00:01:26][12.8]

Dr Louise Newson: [00:01:27] Yeah. Well, I mean, I set up the podcast because it’s just another forum, isn’t it? And I feel it’s such a privilege actually, because my diary, as you know, is really busy. So to have time with people understanding more, not just from people who are experts, leaders in their field, but also real people with real stories. Because as you know, Rachel, in medicine, you learn a lot from the from the data, from the studies, from the trials, from the academic papers. But actually, the icing on the cake, which really changes our clinical practice is, is clinical experience listening and learning from patients and people. And that’s the most privileged part of being a doctor, isn’t it, is being allowed to listen to these stories? [00:02:11][44.0]

Dr Rachel Birch: [00:02:12] Well, absolutely, yeah. I mean, I think almost everything that I learnt really has come from from patients, from listening to people. You know, you can learn, of course, you know, what books saying what the papers say, but, you know, how it translates to people’s real lives. It’s, you know, that’s that’s the important bit. [00:02:27][15.3]

Dr Louise Newson: [00:02:29] Absolutely. And I’m very fortunate at the clinic that we have we have a lot of time. And the time is something that has gone so much actually over the last 25, 30 years of me being a doctor is that people are so rushed and then you don’t get the bigger picture. So, so tell me a bit about you, if you don’t mind. [00:02:47][17.9]

Dr Rachel Birch: [00:02:48] Yeah. So, So, yeah, a little bit about me. Wow. What to say? I’m 53. I’m a mum. I’ve got two children who are now 21 and 23. I am a doctor. I trained as a GP and worked as a GP happily for many, many years. Now I work for an organisation that actually supports doctors, which is equally rewarding as being a GP actually in in different ways. Hobby wise, I love cold water swimming, I love Pilates. I’ve got two dogs that are very active and keep me out in nature. I practice Pilates. Yeah, photography. Got a lot of interests, but one of my passions is, is menopause as well. And even within my workplace, I’m part of menopause support network. You know, I’m, I’m passionate about mental health and I’m passionate about, you know, women’s health. So, yeah, they’re big interests of mine. [00:03:39][51.0]

Dr Louise Newson: [00:03:41] Really? And probably like me, you didn’t have much training about menopause and certainly menopause and mental health when you were an undergraduate student? [00:03:49][7.5]

Dr Rachel Birch: [00:03:50] Goodness no, no. As an undergraduate, honestly, the message was, you know, when women become menopausal, their periods stop. Like that was it, back in those days, I think we’re the same age. I qualified in ’94. I think maybe you did, too? [00:04:00][10.4]

Dr Louise Newson: [00:04:01] Yes, I did. Exactly the same. [00:04:02][0.6]

Dr Rachel Birch: [00:04:02] Say, well, yeah, we probably had very similar training then, you know? I mean, I think they didn’t know as much. It’s not that we weren’t necessarily it wasn’t hidden from us. But, you know, I really think that, you know, we knew about hot flushes and night sweats. We knew that the periods could become erratic, could become more frequent, could become less frequent, you know, but ultimately would stop. And that was it. You know, a woman was menopausal. They called it post-menopause back in the day. Yeah. Yeah. Mental health as well. You know, I mean, I did have quite a lot of psychiatry training as an undergraduate. And and, you know, there was really no mention of hormones and their relationship with mental health. So that wasn’t really an issue I kind of really got until I became a GP and started seeing for myself, you know, that actually, you know, they were very closely linked hormonal health and mental health, you know, listening to people, listening to patients. [00:04:55][52.6]

Dr Louise Newson: [00:04:57] Yeah. And I didn’t realise either. Like, you know, I’ve done a lot of psychiatry, I’ve done a lot of general medicine, a lot of general practice, but I didn’t put the two together. And it’s only the myriad of people we see who have actually come from psychiatrists and they, they’ve treated as much as they can about their mental health, but they’re still having symptoms as well as physical symptoms of menopause or hormonal changes. And then when we give them the right dose and type of hormones, everything fits into place. And then going back and reading papers, reading how these hormones work in our brain, reading how they affect the levels of, you know, serotonin, dopamine our happy hormone, our reward hormone, you know, it’s all there. But we just don’t, if we don’t teach it, you don’t know. So tell me a bit about your story. We said at the beginning that you had an interesting but not unique story. And actually, I think it’s more common than people were led to believe. So So tell me a bit about what happened with you Rachel, if you don’t mind. [00:05:51][53.8]

Dr Rachel Birch: [00:05:52] My story is not unique, actually. And and also, you know, what I’d like to say is that, you know, when I was working as a GP, I probably heard this story fairly frequently, you know, and perhaps didn’t really quite realise the implication of the story. So, you know, I think this story is a good one to share for, for, for women so that they appreciate, you know, what I went through and you know, for GPs as well, just, you know, to give another, another lived experience, you know, and put that out there. I think I was about 44, I was working as a busy GP, I had teenage children, I’m a single mum. I became really anxious and it was almost overnight, you know, I mean I’ve been quite stable, quite sane. Suddenly I just became really anxious. I couldn’t really put my finger on it. I just felt really on, you know, on edge, ill at ease. I was getting really horrible mood swings. They started to appear. They would occur over minutes. And again, mood swings is something I’d never really experienced before. So, you know, one minute I could be absolutely fine. The next bit I’d be snapping at the kids, you know, really losing the plot. I wasn’t really doing this at work because I think you can maintain a kind of professional persona, can’t you? And you perhaps don’t don’t give into your your personal sort of feelings just quite so much. But at home, I think I was a horror. You know, I was snapping at the kids. I felt really down. The kids started calling me volcano mom, you know, And that was appalling. I couldn’t believe that. Yeah, Yeah. I felt for the kids because, you know, I, I, I realised, you know, I was doing it, you know, it would come from nowhere. I didn’t really have any control. I was forgetting things. I couldn’t think, you know? I just felt like I was losing my mind. I felt quite down. That came later, really. I think, you know, the mood swings and the anxiety were all there, and I just felt helpless. And I thought, what is happening with me? I thought, I have I got dementia? You know, I’m forgetting. [00:07:55][123.6]

Dr Louise Newson: [00:07:56] It’s very scary isn’t it? [00:07:56][0.0]

Dr Rachel Birch: [00:07:57] It was terrifying, actually. It was terrifying. And I talked to friends about it and nobody at the time had really sort of experienced something similar. So I just thought, gosh, that’s me. You know, What, what’s happening? [00:08:09][12.4]

Dr Louise Newson: [00:08:10] That’s, do you know. Yeah. And that happens so much, actually, Rachel, that people blame themselves because if you don’t understand what’s happening, you know, you’ve already said you’re single mum, anyone knows bringing up children can be very hard. Bringing them up on your own can be difficult too. And then having a job. You know, it’s so easy to internalise and say, well, it’s probably because I’m not coping with my situation. And that happens so much, doesn’t it? [00:08:38][28.1]

Dr Rachel Birch: [00:08:38] Totally. I beat myself up. I thought it’s you. You’re not coping with with having a job and bringing up children. You know, this is a defect in you. This is your problem. None of your friends are having this, you know, totally,, I’m a perfectionist. I think many doctors are anyway, it goes with the territory. And and I did. I just I had a history of mental health, you know, issues. So I just thought, it’s it’s it’s you not coping Rachel. You know, it’s it’s really sad. [00:09:07][29.0]

Dr Louise Newson: [00:09:09] So what did you do? How did you get help Rachel? [00:09:09][0.1]

Dr Rachel Birch: [00:09:11] So I went to my GP and and, you know, explained what was happening. I mean I guess I probably you know, again, I’m not the best person at actually asking for help. And I thought, it’s me, It’s a phase, you know, I think I waited, I had a holiday. I waited to see if it improved when I’d had the rest and relaxation because again, you know, sometimes you’re overworked and perhaps you do need a holiday but, didn’t settle. So I went to my GP and she was lovely, you know, but she said, well, you know, you’ve got recurrent depression. This is another episode. And I said, Well, you know I don’t know if it is. And she said, you know, if you’ve got teenage kids now, this is kind of par for the course. You know, she had kids of a similar age. And, you know, I get that teenage children are challenging. You know, mine were challenging in wonderful ways if you’re listening kids. But you know and again, you know, I don’t blame her. I think, you know, it was it was a fair, it was a fair thought. You know, is is it recurrent depression? I had had three episodes of depression in the past. One was post-natal. You know, I think we all can realise now that that was probably hormonal. You know, the other two were in the sort of ten years before, you know, this episode and, and it could well have been hormonal too. But you know, I kind of, I suppose I’d been labelled and perhaps labelled myself as having recurrent depression, you know, almost like it’s a vulnerability in me. And therefore, of course that’s what it was. Yeah. So, you know, she increased. [00:10:34][83.0]

Dr Louise Newson: [00:10:35] So then what happened? [00:10:35][0.4]

Dr Rachel Birch: [00:10:36] She increased the dose of my medication, which, you know, I was happy to try, but it didn’t help. I just felt worse because I got sort of side effects from a higher dose. I kind of went back to her a few times. So, you know, I, you know, we talked, you know, she said, well, you know, let’s give it a bit more time. You know, do you want to change antidepressants? I wasn’t really keen on that. I went to see a psychiatrist myself privately. I thought, look, I’ll get some some input there. And he suggested changing the antidepressant, you know, which he did. So nobody really thought about hormones. And actually I didn’t think about hormones. So there’s no blame here because, you know, I’m a doctor, my GP’s a doctor, my psychiatrist is a doctor. I do think that we kind of fell into the trap of, it must be depression, you know, and it took four years before I really just suddenly thought. [00:11:24][48.5]

Dr Louise Newson: [00:11:25] Four years? [00:11:25][0.0]

Dr Rachel Birch: [00:11:26] Yeah. I mean, that’s shocking, isn’t it? Suddenly, you know, I just thought, Gosh, you’re 48 now. Hello. You’re perimenopausal age, you know, and I could have kicked myself. You know, I went to my GP and she immediately said, gosh, yeah, you’re right. And we tried HRT. [00:11:43][17.1]

Dr Louise Newson: [00:11:44] And is that because you you went to your, so you went to your GP saying, I think it’s my hormones? [00:11:48][4.3]

Dr Rachel Birch: [00:11:49] Yeah, I did. And she immediately said, No, I think you’re right. You know, I can see you’ve been struggling on, you know, it’s clear it isn’t just depression. You know, I think there’s always this suspicion, isn’t there, that that I that I could have two things going on and maybe I did. But the antidepressant medication and, you know, seeing a psychiatrist and trying, you know, counselling and self-help hadn’t been enough. So she was very open, you know, immediately. You know, she, she she is of a similar age to me, you know, possibly, you know, she she was on her own journey, you know, I don’t know. But she was very open straight away. So HRT that day, you know. And then… [00:12:27][38.4]

Dr Louise Newson: [00:12:28] And then what happened? [00:12:30][1.4]

Dr Rachel Birch: [00:12:30] Gradually, gradually, everything improved. It takes a time. I had a Merina coil, which I think clouded the issue because I haven’t had periods for 20 years because I’ve been one of the lucky ones to be amenorrhoeaic, no periods on the Merina coil. So since my son had been born, you know, so, so there was never that clue. You know, and again, you know, maybe if my periods had stopped I would have thought, or got erratic, we would have all put it together more quickly. But, you know, that clouded the issue. So, so I started on patches gradually increasing the dose and it just gradually got better and better. And, you know, I’m on the three hormones now, actually, I’m on testosterone as well. And and I feel absolutely great. You know, so it’s clear because none of the stresses have changed, really. You know, I still have a really heavy job, a really important job. I work full time, still got children who still need me, you know, got two dogs who need me, the crazy cat, you know, all the same things that possibly could have contributed to, you know, the worry pot in my mind, you know, they’re all there. So. So, you know, the only thing that’s changed is that, you know, I’ve I’ve, you know, I’ve got recognition from myself, from others. And also, you know, I’m on the treatment, which is really helping. Really helping. So. [00:13:49][79.2]

Dr Louise Newson: [00:13:52] But you had a few years of struggling on your own. Which is so hard. [00:13:55][3.6]

Dr Rachel Birch: [00:13:55] Yes. And I have to say, during those years, it was awful and I couldn’t do anything to get relief. And so the only thing that gave me relief was red wine. You know, at the end of the day, when everyone went to bed, I would have a glass of red wine. You know, I self-medicated. You know, it’s clear now to see that I couldn’t get rid of that horrible feeling of snapping. I also had, towards the the latter two years, I started getting quite horrific suicidal thoughts and urges as well. And and they came from nowhere. And again, you know, everything was getting worse rather than better. My confidence was going, I started not believing in myself. I actually changed jobs. You know, that’s when I stopped being a GP. I, I wondered, you know, maybe it was my job, you know, which was a really drastic step, but one I felt that I had no choice to make. You know, I started drinking a glass of wine a night, and it became two glasses of wine a night. Before I knew it, you know, actually, it was nearly a bottle a night, you know, which is a hell of a lot of, you know, if you add that up, you know, I was on 60 or 70 units plus a week, which is which is so damaging. I would wait till the kids went to bed usually. I mean, I have to confess, sometimes I didn’t and I would have a couple of glasses and that didn’t help my memory. That didn’t help my night sweats. That didn’t help the itch. That didn’t help my buoyancy and my mood. I felt more depressed. You know, the suicidal thoughts got worse. But the only thing that would just make everything stop was just obliterating it really, and just numbing everything. And I think that’s quite common. I’ve been reading a lot. I’ve listened to some podcasts, you know, of your on the subject. And I think I think it’s a trap that we can fall into because. [00:15:46][110.8]

Dr Louise Newson: [00:15:47] It’s very common. Yeah. And it’s very common. And I hadn’t realised how common it was until, like you say, before you said at the beginning, you learn from patients. And of course part of the history taking you ask people about alcohol and, and smoking and lifestyle and you can always tell when people are lying as well. And, you know, the beauty of our consultations is they’re confidential so that people then open up in a way that they often haven’t opened up even to themselves before. And so I do have a sort of maybe I’m a bit witch like, but I do have a way of getting things out of people. And when they do tell you and it’s not just often one bottle, it could be two or three, but it’s not just the bottles of of alcohol. People have told me about their drug addictions as well or their gambling addictions. Anything that’s, you know, escaping from reality, actually. And they know it’s not healthy behaviour, but they don’t know how to get out of it because they feel so awful. And actually, it might be a short term escapism, but it’s the reality still there that they’re feeling dreadful. And when I first started to hear these stories, I just thought, goodness, this is a bigger problem. This is a far bigger problem than perhaps people are realising. And last year, as you probably know, we did a questionnaire about addiction and there were free text answers as well. And you know, I still feel very sad when I read those free texts about people that have turned to Class A drugs in their late 40s because they need to escape from what was going on and they knew it wasn’t right. Now, these are highly addictive illegal drugs that women are turning to. And I’m not saying there’s, it’s very common, but it’s still there. But actually, what is very common, like you say, is alcohol, because it’s so readily available, it’s socially acceptable. People laugh about their wine o’clock. You know, children, a lot going on. Yeah. And that’s okay as a glass, but not when you’re using it as a tool. And as many of you know, I don’t drink alcohol at all. And it’s not because I’ve ever had a drink problem. It was because of my migraines. And if you, I, I know that if I had a drink, I’d have a migraine. So it’s easy for me not to drink, but so many times when I’ve been under stressful or difficult situations, either at home or at work, I can see why people go, oh I’ll just have a glass of wine. But I can’t. So I meditate. I do yoga and that’s good and probably a lot healthier, but it’s so easy to do it and it’s I think there’s many reasons. One of them is because people are feeling low and flat, they want to escape. But the other thing is the addiction side because like we said at the beginning, these hormones affect dopamine levels. Now dopamine is our reward, you know, that pleasure that you get opening the curtains, the sun’s shining. Oh lovely day. Now, if you don’t have dopamine, and often when your oestradiol, progesterone, testosterone are low, then you have a negative feedback. So you have low dopamine as well. So when you open the curtains and it’s sunny and you’re like, What the hell, it’s another day. I just don’t want to, I’m just existing, not living. Of course, then you’re going to need that bit more to actually just feel a bit of pleasure from something as well. [00:19:08][201.3]

Dr Rachel Birch: [00:19:09] Yeah, I think you’re right. I mean, yes, the pleasure would be short lived, you know, with that first couple of sips. But but, you know, it was there and I think it probably did give me a temporary dopamine hit. And the more I learn about, you know, chemicals, you know, brain chemicals, the more I realised that that that’s what happened. I mean, I, I, I, then COVID happened to me then while I was, you know, and obviously that, that caused so many challenges to people, I suspect that COVID and menopause and drinking was probably the perfect, you know, bomb but it wasn’t it? It got a bit worse, you know, three years and and two months and a couple of days ago, I. I just actually saw the light and thought, right, you’ve got to stop because I realised I was addicted. So, you know, I think some people don’t become addicted, but many people do. And I did become addicted. I became addicted to alcohol and I realised that I was at the stage where I couldn’t get through an evening without it. And that’s terrifying. There’s a lot of shame. A lot of shame. You know, I thought I should have known better because again, I’m a doctor, you know, forgetting that I’m actually a human and a woman, you know? And that’s okay. There was a lot of shame, and I had to accept it and I had to admit it. And again, that’s a really difficult step sometimes, but. But admit it I did. And then I hit it with everything I had. I told my GP, I went to Alcoholics Anonymous, I got lots of books and downloads, and I had started practising mindfulness by then and meditation. So I did lots of that. I just did everything that I could. I got an app on my phone, which was really helpful. That tells me how many days I’ve been sober. All of this, like I just used every tool because I didn’t want to fail. I wanted it to be the the only attempt. And it was really hard. I have to say, I did not know how hard it would be. I, I did have quite a lot of physical symptoms. I had crazy psychological symptoms where I just felt I really need to drink, kind of peaked around day 18, 19, 20. It was, it was it was unexpected. But Alcoholics Anonymous got me through that. I mean, I’m really grateful to all my all my colleagues and friends and pals there because, you know, they were really helpful and I managed to do it first time, you know. But, but I’m mindful that, you know, it’s it’s day by day. In the early weeks and months, I replaced my alcohol drinking with eating chocolate. Okay. So I couldn’t have a drink and I just needed something to get through those evenings so I would eat chocolate. And that definitely helped my dopamine levels, but gradually I weaned myself off that. And now, you know, hopefully the levels are a little bit better. I’m going out in nature loads more and cold water swimming even more than ever. Mindfulness, I think really does help with the whole dopamine thing as well. Some practices of self-love, self-compassion, you know, just giving myself love, give myself a hug. It all helps, actually. [00:22:09][180.4]

Dr Louise Newson: [00:22:10] I think that’s really important. And I think it’s something, this is a generalisation of course, I think it’s something generally people, especially women, don’t do. And, you know, the last few months have been quite difficult for me for various reasons, and I’m trying to teach myself some more self-love. And it sounds really cheesy when people talk about self-love because I don’t look at myself and think I’m the most amazing person or the most beautiful or the most lucky or the most whatever, or talented. But actually, deep down, there’s something inside everybody where there’s a bit of something that needs loving. And whether it’s related to past trauma, whether it’s related to a poor relationship, whether it’s related to just how you’re feeling. But it’s that deep down self-love. It’s not that, I’ve got a new dress on. Don’t I look lovely? That’s too superficial for me. It’s more something within, isn’t it, that I think even more when you’re on your own, even more when you’ve got lots of stresses. It’s actually two things really, taking time for yourself, but also acknowledging that a bit of you somewhere needs a bit of a cuddle and warmth and you’re not going to get that by drinking or talking or offloading to someone else. You’ve got to do it from within. And that’s quite a hard thing to do I think. [00:23:26][76.3]

Dr Rachel Birch: [00:23:27] It’s really hard and it’s taken me a while. I have been practising mindfulness. I’m studying it as well and I’ve been practising it for about two and a half years. And I can say actually on camera now that I do have self-love, I can say I love myself, which, you know, honestly, two years ago, there’s no way I would have dared say that. But, you know, and I do give myself hugs and I do gratitude journals and put myself in the journal. You know, I think it does make a difference. It does sound cheesy, but but it does help if you keep going and you get used to doing it. We are great, women are great [00:24:03][35.9]

Dr Rachel Birch: [00:24:05] I think you’re absolutely right… yeah we are and we shouldn’t be we shouldn’t be stripped down and we shouldn’t be gaslit and we shouldn’t be accepting something that isn’t right. But we have, it’s society. It’s history, but we shouldn’t. But one of the things I noticed when I was on the tour and you came to watch, you were with a group of other people. And there was a lot of, you give so much positive energy. And I wonder whether it’s come, I have didn’t meet you before all of this, but I wonder whether it’s come because you are in a better place physically, mentally, spiritually, that you are able to give others even more. You’ve probably always been that sort of person, but you’re just there’s something that’s coming out of you that I think is incredible. And it could feel other people picking up on that, too. [00:24:50][45.0]

Dr Rachel Birch: [00:24:51] That’s a lovely thing to say. Thank you. And I think you’re right. I think you’re right. That’s a really lovely thing to say. And I believe you’re right. I do think that if you exhibit positivity, you know that there is research that has been done. I mean, we have these things called mirror neurones in our in our brains. And and you tend to mirror other people’s sort of behaviour and, and, and, and affect, you know, mood. And so I think that has an effect. But also I think in a greater than that, I think, you know, I think we are all interconnected, you know, we are all human, we do have common humanity here. And I think positivity has a ripple effect. You know, my my, my Pilates class, I will shout out to them, Bev, Diane, Kirsty and Viv. Hello. They are brilliant and they have helped me as much as I have helped them because we are a small group that meet every week and we talk about the menopause, we talk about our mood, we talk about how we’re feeling. I think we all buoy each other up. So I think once one person is positive, the next person, you know, perhaps becomes more positive. And again, that ripple effect happens. So, you know, I do think being positive about the menopause as much as we can and being positive about our mental health and just thinking, look, let’s do our best, let’s let’s not shy away from talking about it. Let’s, let’s, let’s, you know, not embrace it because, you know, but but go with it. [00:26:12][80.7]

Dr Louise Newson: [00:26:12] But it’s so, it’s so important because I think so often people have, this conversation’s been normalised about menopause. Oh you will feel like that. You will feel that or you won’t feel like that and we’re all different. But also there’s this big conversation as you either take HRT and you feel wonderful or you don’t take HRT and you’ve got to try all these other things. But actually in my mind, whether you take HRT or not, you’ve still got to be thinking about ways to improve your mental and physical health. And that’s so important. You can’t just use HRT as something that’s going to turn you into this amazing person because you’re still going to have challenges in your day, whether it’s work or home, or you’re still going to be making food choices. You know, you’re still going to be making choices about doing exercise. You know, this morning I woke up and I’m really tired, but I still got up to do 20 minutes of yoga before I got in the shower. And I feel better for it. You know, it’s only 20 minutes, but actually it would have been really easy to have just set my alarm 20 minutes later. But, you know, I feel better. I ended in a headstand. I did some meditation and and I’m like I can fight this day, but that’s not HRT. HRT is good, but it’s not everything. But on the flip side, there’s so many women who aren’t able to access HRT who, like you were, thinking, this is just my lot. And this is nothing to do with my hormones. And this is also, and it’s sad because you were blaming yourself. But actually you saw different doctors. So how we do this joined up process where we can empower women, but also we can educate healthcare professionals from every speciality. Just to think, could any of Rachel’s problems been related to her hormones? And even if it was only 5 or 10%, treating your hormones might have been enough to stop you becoming, you know, having problems with alcohol. [00:28:01][109.0]

Dr Rachel Birch: [00:28:02] Yeah. [00:28:02][0.0]

Dr Louise Newson: [00:28:03] Or just having a better time with your children or just not giving up or changing your job. There’s lots of little things. And I think as doctors, we need to tease out every single bit. We’re not just blaming one part, but if we don’t have the whole 360 approach, like, you not having the hormones was definitely a bit of the puzzle that was missing. [00:28:22][19.6]

Dr Rachel Birch: [00:28:23] You know, it was. And I think once I got the hormones, I was able to see the bigger picture. You know, I think I think I think my mental health was I guess so impacted by this by the time, you know, I became 48 and I, I had my light bulb moment. I thank goodness for the light bulb moment. But, you know, I had started to make all those wrong choices with diet and with exercise as well. You know. You know, I think, I think, I think HRT just just just improved my my mental health to the, I mean, it improved hugely. But in the early days it improved enough for me to actually then tackle the alcohol. I mean because I am an alcoholic, it’s you know, it’s it’s that that’s what I am. I’m addicted to alcohol. And again, I have no shame in saying that, you know, probably a couple of years ago I might have done. But, you know, it happens. It happens. It’s just something that happens. We’re humans, you know, what can I say? You know, it’s there’s no shame. I, I really want to break down the stigma as you do. I really want to get conversations opened. I think it’s really great work that you’re doing and back at you with the positivity. I mean, your positivity has a massive ripple effect, too. And I think, you know, talking about this has a massive ripple effect. And we have to keep spreading the word because people, you know, women and doctors can be educated. I mean, me, my GP, the psychiatrist back in the day, none of us thought menopause. I would like to think that if the same person had the same symptoms as I had now, you know, nine years on, I would really like to think that maybe it would be different. But I guess it’s only from talking it through more and more that we can get it out there to every doctor and every woman. [00:30:05][102.1]

Dr Louise Newson: [00:30:07] Yeah. Well, it’s been amazing, Rachel, and I’m. I feel very honoured and privileged that you’ve shared your story as well, because I know it’s going to help people, either people directly who’ve been listening or people indirectly who will know, you know, people will know others that they might be able to reach out to and just start that conversation and try and help. So I’m very grateful. So before I end, I always ask for three take home tips. And you’re no exception. You’re not escaping from that. So three things I think that you would either say to your former self or to others that were maybe just realising that they’re on that slippery slope and addicted to, it doesn’t matter what, to anything. What would you say to those people? [00:30:49][41.5]

Dr Rachel Birch: [00:30:49] Yeah. Okay. The first message I think in many ways is the most important message. And I would say, listen to your body and trust your instinct because you know your self best and you know you live with yourself 24/7. Your mind and your body are one. So your body, when it’s telling you things, is as valuable as your mind. And just look at the whole picture. Listen to yourself, notice and and, you know, don’t put them down to anything. Just think. Look, my body’s trying to talk to me and I’ll listen. And what’s it trying to say? And that leads on to number two, because then I think number two is be your own advocate because you’re the one that knows your body most, best. It can be particularly challenging for for people like me who had pre-existing history of mental illness. I had a history of episodes of depression. But if you think this is different, if your body’s telling you this is different, tell your GP and don’t be afraid. As I say, to advocate for yourself and say, Look, I know you think this is depression, but you know, could this be the perimenopause? I’ve done a bit of reading. I’ve listened, I’ve watched podcasts. My body is telling me that that something is different because for me, my mood swings and the suicidal thoughts and all the crazy sort of up and down-ness, that that was new, you know, so new things. I think listen. The third thing relates to alcohol addiction really. Prevention is better than cure. Okay? I wouldn’t really want anyone to get to where I was because it was pretty horrible and a little bit lonely until I accepted it. So be alert to the fact, notice if your drinking is creeping up and tell people, you know, tell people, don’t suffer alone like I did, you know, because there’s help out there. If you want to prevent problems as well as you know, if you find you are addicted and you are drinking too much, there’s help there at that stage too. Hit it with everything. Alcoholics Anonymous, you know, friends, GPs, family, you know, tell as many people as you can to get the help. Don’t suffer alone because, you know, there’s loads of help out there and you know this this can all be better. So that’s what I would tell myself. That’s what I tell myself but she didn’t listen. [00:33:02][132.8]

Dr Louise Newson: [00:33:06] Well, hopefully others will say, thank you so much for your time. I really appreciate it, Rachel. You can find out more about Newson Health Group by visiting www.newson health.co.uk and you can download the free balance app on the App Store. [00:33:23][17.4]

ENDS

The post Alcohol addiction and menopause: Rachel’s story appeared first on Balance Menopause & Hormones.

Joining Dr Louise on this week’s podcast is Alex Newman, a substance misuse therapist with a special interest in the menopause.

Alex’s passion is supporting women who are self-medicating menopausal symptoms with alcohol and drugs – a recent survey by Newson Health of nearly 1,200 women found some were spending nearly £3,000 a year on alcohol and over-the-counter medication in a bid to cope with menopause-related symptoms.

The pair discuss the relationship between substance misuse and menopause, and crucially, strategies on how to get help for yourself or a loved one.

Follow Alex on Instagram @alexnewmantherapy or email alexnewman.therapy@gmail.com.

Click here to find out more about Newson Health

Transcript

Dr Louise Newson: [00:00:11] 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. Today on the podcast, I’m going to introduce to you Alex Newman, who’s a substance misuse therapist. And the more I do in the menopause, perimenopause, PMS, PMDD space, the more I speak to women who actually are addicted to all sorts of things. Not just drugs, but alcohol, food, various things that they know aren’t right. But it’s to get comfort, actually, for sometimes symptoms that are really affecting them. And they don’t always join the dots and realise that their hormones can cause the symptoms that are leading to their addictions. And I’ve spoken to a lot of people whose addictions have come back, actually, when they’ve become perimenopausal. So Alex reached out to me for a while ago, so I’m super excited about listening to her today. So welcome to the podcast, Alex. [00:01:49][98.5]

Alex Newman: [00:01:50] Thank you very much. [00:01:50][0.4]

Dr Louise Newson: [00:01:50] So tell me a bit more about you, if you don’t mind, and how you developed your skills to become a substance misuse therapist. [00:01:57][6.5]

Alex Newman: [00:01:58] Well, I started my counselling training over 25 years ago. My first placement was in a drug and alcohol setting. So yeah, and I became really interested in the whole subject of addiction. My first job actually was as an alcohol crime and education worker. So, that was quite interesting. And yeah, so throughout my career then I went from being a counsellor support person to team leader, manager and then got involved in service development and training consultancy. So I did all of that for a very long time, up until three years ago when my own perimenopause hit and I fell off what I call the hormonal cliff, really, and realised that the corporate job that I was doing, I just couldn’t cope with anymore. And I wanted to go back to doing what I really enjoyed, which was working on a 1-1 basis, and especially working with women around not only their alcohol abuse but their anxiety and, you know, all of the symptoms and issues that come with women dealing with midlife. And yet that’s become my passion really now. [00:03:04][65.6]

Dr Louise Newson: [00:03:05] And so did the perimenopause affect you in ways that you were expecting, or was it different to what you were thinking or had, you no expectations? [00:03:13][8.1]

Alex Newman: [00:03:14] Well, I’ll be totally honest with you. I had no idea what was happening to me. I left my job and moved to New Zealand, strangely, because my husband got a job there and then I just wanted to leave a very, very stressful management job behind. And when I got there, my doctor advised me to come off the Pill, she told me I was too old to be on the Pill at 46, and I came off the Pill and all I can say is all hell broke loose. Really, every aspect of my physical, mental health and I really, really had no idea what was going on. To the point of where I begged my new GP to give me benzodiazepines, because they were the only thing that were helping me relax and sleep and get rid of the anxiety. And I am not normally an anxious person. I’m a fairly confident person, but I had no idea what was happening to me and doctors gave me hundreds, it felt like, of blood tests. They thought I had diabetes, they had thought I had all kinds of things. And in the whole three years that I was going backwards and forwards to the doctors with all of these issues, not one person ever mentioned it was to do with my hormones, and it was only through my own research did I actually figure out what it was, and then ended up going to see an endocrine doctor who in the end helped me get onto some HRT and to sort out my hormones. So I have a very big passion for helping women, because I was so in the dark myself, and I was using alcohol and over-the-counter medication, painkillers, anything I could really to be able to get through anything at the time. [00:04:54][99.9]

Dr Louise Newson: [00:04:54] It’s very frightening, isn’t it? And it can be very isolating as well, especially when you’re not expecting the symptoms to come on. And I hear this a lot from people who have developed some mental health symptoms because of their changing or reducing hormone levels. And they say, I know I’m not depressed, I know I’m not anxious, I there’s no other reason. And I spoke to someone yesterday actually, and she said to me, my doctor said it must be because you’re not getting on with your husband, or it must be because of your job. You’re feeling like this. And she said, no, I know it’s not. I know it’s absolutely not. And she was only 38 and she said it took three years. [00:05:27][33.3]

Alex Newman: [00:05:28] I think women need to listen to their own intuition. We know ourselves better than anybody else. I knew that there was something wrong. I knew it wasn’t all of the things that the doctors were telling me it was. I knew something bigger than that, but I really couldn’t put my finger on what it was. And the only reason that I figured out what it was, was that I went back to my GP and I said, this all started when you took me off the Pill. And as soon as I realised that being on the Pill was probably what was just actually keeping me going, really, with that, those moments in my body that as soon as I stopped taking that and I had literally every symptom on the list. I mean, I had a really, really horrendous time. And yeah, it took me a long time to educate myself and get the help and get back onto a level playing field, really with with everything. And I don’t want any other women to have to go through what I went through, I really don’t. [00:06:19][51.2]

Dr Louise Newson: [00:06:20] Oh, no. And so for many years I’ve heard women say they drink more alcohol often to numb their symptoms and think wrongly, often, that it will help them sleep or help lift them. And we know that alcohol can be quite a depressant, actually, and it can affect sleep patterns. So it’s not always the best thing to do. But they’ve sort of got into this slippery slope, and I completely understand it, that they think they’ll feel better. But it’s not just alcohol actually. And we did an addiction survey actually in October last year asking people questions. And we had a huge response. And people wrote quotes as well. And one has really stuck with me about a lady who is 51. Well, she still is 51. And she said that she started to experience symptoms. She was in this very dark hole. She didn’t know how to get out, so she started using class A drugs. She’d never used Class-A drugs before, but she said it was the best thing to lift me from this deep, dark abyss that I thought I could never get out of. And then after a few months, I realised this was not the best way to help, and I knew I had to get other help. And I’m so ashamed that I did this. But actually it was wonderful when I was doing it. And I thought, isn’t this really sad that we’ve got evidence-based treatment that’s recommended in the guidelines as first line treatment for the majority of women, as in replacing the missing hormones that are causing a lot of these symptoms. Yet women can’t get help. And this woman had been offered antidepressants by her GP and knew she wasn’t depressed, but she had taken to abusing drugs. And there were lots of other stories of people, not just class A drugs, but smoking a lot more cannabis…and it was all about their mental health. They were doing it to try and relax and calm themselves, reduce their anxiety and get out of this hellhole that they’re in. And I’m not saying that everybody who’s perimenopausal will feel this bad, but there are a significant number of women out there who are turning to recreational drugs or over-the-counter drugs or even prescription medication, and they are addictive as well. And I really worry that we’re giving someone something that’s addictive, that’s actually not beneficial as well in the long term. [00:08:31][131.0]

Alex Newman: [00:08:31] Absolutely. I mean, most of the women that come to me initially come to me because they’ve worried about their substance misuse. I have a lady who I met fairly recently. She came to me because she was suffering huge anxiety with intrusive thoughts of past trauma. Within five minutes of me talking to her, I could tell that she was actually perimenopausal. So we had the session and at the end of the session I said, look, I just would like to offer you something. And I actually gave her a copy of your book and I said, would you just go away and read this book and let me know if anything in this book resonates with you, and I’ll see you next week. Within two hours, she had screenshotted lots of paragraphs from your book saying oh my God, this is me. Oh my God, this is me. Oh my God, this is me, you know? And I said, I think that this is really where we need to start. You know, I’m not saying that all these other things are not going on for you. But one of the reasons why she’d come, because she was really worried about her drinking. Her drinking had increased, and she was worried that she was drinking so much that was she sober enough to even drive her child to school in the morning. She was fearful of driving lots and lots of issues from her past come up. And this is another thing that I’m recognising with women is that if there is any unresolved issues, trauma, relationship problems, it all seems to really rise up to the forefront where drinking alcohol and taking drugs again is the only thing that they think that they’ve got as a crutch to help them through all of these difficult situations. And it really is becoming a huge problem and has become worse since COVID. And this is another thing is to recognise how many people,their substance misuse has increased so much more since COVID, and a lot of people haven’t actually stopped or been able to stop because they’ve actually become addicts. [00:10:14][103.1]

Dr Louise Newson: [00:10:15] Yes, absolutely. And it is a real issue. And it’s also people see it is a real shame that they can’t talk about it. And it’s socially obviously a lot more acceptable to drink wine than it is to abuse drugs. But actually the addictive properties vary between people. But it’s also looking at the reasons behind and it’s so multifactorial with addiction. I don’t need to tell you that as a therapist, but it’s sometimes one small thing that can tip that balance as well. And we know, and I’ve mentioned it many times before, that all three hormones, actually oestrogen, progesterone and testosterone work in our brain. But they also affect the dopamine levels, which are our reward levels. And we all know that, don’t we if we, do some exercise or we have a good laugh with some friends or we eat some chocolate. You get this hit where you feel great. And that’s often with addictions, isn’t it? People want to get that sort of endorphin, that sort of hit. And if we’re not getting enough dopamine naturally because our hormones oestrogen, progesterone, testosterone have lowered or are fluctuating and causing chaos in our brains, you’re not going to get the same hit with just having a belly laugh or watching a good film. You’re going to want something a bit more and a bit more, and it’s that slippery slope. And then if you’re not recognising which often a lot of people don’t, because we’ve all been told the menopause and perimenopause is some hot flushes and sweats that may or may not last for a few years, some vaginal dryness and that’s all is related. Then women aren’t going to be thinking, oh, it’s my hormones. And then I don’t think I’m different to many other women, but I internalise a lot and blame myself for the way I feel. So I then think, oh gosh, that’s because I’m no good. I’m a failure, I’m really anxious. And then you’ve got this downward spiral. And often in the perimenopause and menopause, people do ruminate a lot and they catastrophise. So what would have been a trivial worry when their hormones were balanced becomes out of proportion. So they’re worrying, you know, not just, can I take my child to school, but what if I have a car crash? And what if this happens… like things that you wouldn’t naturally normally worry about. And we see that a lot. And if you’ve got that sort of addictive personality or you just don’t know how to get help. You’re spiraling down and down. So you need these crutches sometimes. But they’re not right are they? [00:12:41][146.2]

Alex Newman: [00:12:42] Exactly. And a lot of people hide it as well, you know, I mean, I know I know lots of people who their substance misuse is incredibly problematic, but they’re hiding it from their partners, from their children, from their families, from their work. You know, I mean, I know people come and tell me that they’re taking vodka into work with them to have at lunchtime, or they’re smoking cannabis before they go to work, lunchtime, after work, just to be able to be able to relax, you know, I mean, people are doing things that they wouldn’t ordinarily do because of the shame of that, I think. And and I’m talking about people with quite high brow jobs sometimes as well. [00:13:20][38.3]

Dr Louise Newson: [00:13:21] Absolutely no, from all socioeconomic backgrounds. And, you know, when I was the medical student, obviously people, so in the 80s, 90s, people used to describe a lot of benzodiazepines. We didn’t know the addictive nature of them. We’d prescribe a lot more codeine based preparations as well. And then obviously we realise addictive properties. And then WHI study came out scaring people away from HRT. Around the same time, when I was a GP, there was a real move to stop benzodiazepine prescribing, which was the right thing, obviously. And looking back, I had so many women, female patients who were in their 50s, 60, some in their 70s, who’d been given benzodiazepines, often started when they were in their 40s. And then my job was to try and get them off, but I had nothing else to give them, so I would lower and lower it and talk to them till I was blue in the face. But it was impossible, often because of their crippling anxiety. And I’m so embarrassed and ashamed because never once did I think, oh, what about their hormones? What if I replaced their hormones? Their anxiety might reduce because no one taught me then that anxiety, low mood, depression, rumination, low self-esteem, reduced self-worth could be symptoms related to the perimenopause or menopause. [00:14:38][77.7]

Alex Newman: [00:14:39] I felt the same, Louise, because I used to run women’s groups for addicts, and there were lots and lots of middle aged women in those groups who were either addicted to alcohol, addicted to benzodiazepines, heroin addicts, crack addicts, you know? And I had no idea. And I just think to myself, if only I had known that these women were in perimenopause, I could have done so much more to help them. But I had no idea. [00:15:02][23.2]

Dr Louise Newson: [00:15:03] No. And we only need to look back in history, don’t we? And see like, you know, in the sort of 50, 60s,70s, women were given Mothers Little Helpers, so they were given amphetamine based medication, they were given benzodiazepines, anything to calm us so we weren’t a nuisance so we could stay at home and clean for our husband and warm his slippers by the fire and make sure everything…because if you look back in history, that’s just fact what happened and pharma then decided to do that. And even now there’s still a huge amount of antidepressant prescribing. And that’s another conversation. But these drugs can be addictive, but they can also have long term harms as well. We know long term antidepressant use is related to osteoporosis. We know menopause increases risk of osteoporosis. So even if you just look at that one problem then that’s something we need to consider. But it’s such a shame we haven’t done a study, and I’d love to know how many women who take the right dose and type of HRT are abusing drugs, alcohol compared to those that are not taking HRT. And certainly the women that I see are the women who haven’t been taking it, that are the ones that are having problems and often when they’re on the right dose and type, especially often with testosterone as well, it can be very calming on the brain. They can still function, but they get enjoyment. They get pleasure from things that they didn’t used to. You know, just looking at the sun shining, they’re happy, whereas without hormones the sun so what. [00:16:32][88.8]

Alex Newman: [00:16:32] Well, everything’s just flat. Everything just gives you no joy. I certainly felt like that for a long time when I was in that space. And even with drinking or taking drugs, you know, you have to take more and more and more to get the same effects, you know, and that’s where the problems then arise, because before you know it, you’re having not just a glass of wine every night, you’re having half a bottle and then a bottle, and then maybe even two bottles of wine a night. And and it just creeps up for people because their tolerance levels just increase and increase and increase without them even realising it. And then where do they go to try to stop? And we all know that the NHS is crippled at the moment with the mental health issues and addiction issues, and there’s less and less funding to go around. So the average person that just needs probably some education and some counselling, for instance, that doesn’t need full on treatment but just really does need some help and support guidance, maybe a group or something like that. That just isn’t enough help to go round really. So women I think are struggling and don’t really know where to go to be able to get the real general advice, really, how to sort of reduce their substance misuse gradually and easily over time and try to replace it with other things. Obviously, if they go onto HRT than that, it’s fantastic, you know, because you can try to kind of reduce one and increase the other if you like. And that’s definitely something I try to do with my clients. And it works. It really does work. I mean, the women come back to me and say, oh, you know, I feel like a new woman really. And they don’t want to drink anymore. They don’t want to smoke cannabis. They don’t even want to go out that much anymore because they’re so much happier and relaxed, either at home or doing the things they love. [00:18:13][100.7]

Dr Louise Newson: [00:18:13] Absolutely. And it is really important. And I remember giving a talk to some health care professionals about eight years ago now, and it was just a ten tips about HRT because this was many years ago now and people were a lot more scared about prescribing it. So it was things about there isn’t a clot risk with oestrogen through the skin that it can reduce risk of cardiovascular disease. It can reduce risk of oesteoporosis. And then my number ten tip was women can take it forever. Just be reviewed every year, as long as the benefits outweigh any risks. And for the body identical hormones they usually do. And a gynaecologist then stood up at the end of the lecture said, I really disagree with your number ten, she said. I get everybody age 70 to come off. They don’t like it. They’re all addicted to hormones because they are steroids after all, so they just get addicted to them. So I just say they should all stop, they don’t like it. But actually I’m not going to prescribe to any woman over the age of 70. And I was really quite surprised with this very black and white, because nothing in medicine, in my mind, it is an art as well as a science. And for me, the patient is central to everything I do. And actually, physiologically, what’s the difference between a 70 year old and a 71 year old? I don’t quite understand that either. But actually, for most women, there aren’t any increased risks the longer people take. This has come from unfounded fears from the older types of hormones and the breast cancer risk. But that risk was never statistically significant. But then we have to choose, don’t we? But this whole thing about something being addictive, I really reflected on afterwards because I thought in my mind, the problem with addictions is it’s when you’re addicted to something that is not good for you in the long term. Whereas for most people HRT, just giving hormones back is good in the long term. So to be addicted to something that’s beneficial, surely that’s different to being addicted to something that isn’t good for you in the long term. [00:20:04][110.4]

Alex Newman: [00:20:05] Exactly. And I think just that word addiction, you know, it conjures up real negative connotations, really. You know, you know, we all joke about being addicted to things we like sometimes like exercise or chocolate or whatever. And people laugh at that, but it’s just like, I don’t know, I think it’s if you mention the word addiction, it’s almost like it’s something that has to be controlled. And how do we do that? But it’s all down to the individual, you know. And obviously as you know, it’s all about being holistic and everything needs to be balanced. So I mean, yeah, I would hope that I’m going to be on HRT until, you know, I pass over to the other side and the thought of coming off, it actually terrifies me now because I’m like a new woman, you know? [00:20:48][43.6]

Dr Louise Newson: [00:20:48] But yeah, but it did make me really reflect about the word addiction because it is associated with negative things, which is absolutely right when we’re thinking about, you know, drugs and alcohol and things and other substances. But. To be addicted to being happy, or being addicted to being with friends or being addicted to good food actually isn’t a crime. It’s not a bad thing. And that’s the same with when we talk about some medication. But this isn’t really medication, it’s just natural hormones. And you know, you could say people are addicted to thyroxine because without it they feel slow and sluggish and they’ve got an underactive thyroid gland that’s not really the same as a proper addiction. So I think we have to be really careful on the words that we use and the connotations that they have. And certainly as a doctor, I’ve learned very early on never to judge my patients. You know, I’ve seen and spoken to and managed a lot of people who have taken all sorts of medication. But actually, when you get under the layers of complexity, there’s usually a very sad person in the middle who really wants help. I’ve never met someone who doesn’t do it with any other trouble in their mind, and for us, well for me, as a healthcare professional, you as a therapist, it’s finding out all those layers is really important because actually, if you don’t address them all, you’re just doing that person a disservice, really. It’s not going to help. [00:22:14][85.5]

Alex Newman: [00:22:14] Yeah. I mean, I always say that I work with the person and not the problem, not the issue. You know, you need to look at the person as a whole, look at every aspect of their life, what’s actually going on for them. But also a lot of people use substances because they have unresolved trauma of something’s happened in their life, whether they’ve dealt with it or not, you know, and quite often, as I said previously, women, once they start to experience the perimenopause, I think that those things come back, you know, and especially if there’s anything from childhood or things might get triggered, if you like, with their own children or with relationship breakdowns or, you know, anything could happen like that and it can trigger off a series of events, then, which women just don’t seem to be able to handle in the same way when they are in perimenopause, unless they are stable on the hormones, you know, it’s and they make some very strange and weird sort of decisions sometimes about leaving marriages or, you know, leaving jobs that they really don’t want to or shouldn’t because they just literally cannot cope with how much they have to deal with. [00:23:15][61.1]

Dr Louise Newson: [00:23:16] Yeah. And I think the other thing to just highlight actually, is that addiction of certain drugs can actually lead to an earlier menopause. So I spoke to a lady recently who’s 30 and she’s a heroin addict and she’s now on methadone, and she said, oh my goodness, I’ve got all these symptoms. I thought they were due to me being on methadone rather than heroin, and actually I haven’t had a period for two years. And I said yes, but actually our bodies protect ourselves. We don’t want to get pregnant when you’re abusing your body. So actually it’s great that the body does that, but actually it means that you’re not having your natural hormones in your body. So you abusing drugs. But also there’s a lot of people that I’ve spoken to who don’t eat properly. They, very chaotic lifestyles, but also domestic abuse, whether it’s physical or sexual or both or psychological, it doesn’t really matter. Any abuse can lead to an earlier menopause as well. And actually there’s somewhat that it can lead to more severe symptoms. But again, if someone’s been abused, people will be thinking of the effects of the abuse, but not the effects of hormones on that person as well. And so it’s really important we’re not waiting for people to be in their 40s and 50s and thinking about hormones then. And the other thing is, there’s a lot of women who have PMS or PMDD, so it might just be a few days before each period that they’re using or abusing drugs, alcohol, whatever, more than other times. And that’s really important for people to listening to, to think, is there a variation at all? Could any of this be related to hormones? And of course, I’m not saying all addictions are due to hormones, but actually it’s another layer that we I think there’s been really spoken about much before. And once you see it like you have Alex, you can’t really unsee it. And and that’s what’s so important for all of us to be aware of, isn’t it? [00:25:12][116.4]

Alex Newman: [00:25:12] Exactly. And also, I think that the symptoms of drug and alcohol abuse exacerbate the symptoms of perimenopause. And this is the problem, even though in the short term they might help for a short while, you know, with the relaxation, with the feelings of wellbeing, you know, the next day, unless you’ve got your drinking or using that drug again, you know, you’re going to feel worse. You’re going to have all… And if you look at the list of symptoms of a hangover and the list of the symptoms of the perimenopause, quite a lot of them are very similar. You know, the dehydration, headaches and you know that that type of thing, anxiety, for instance. I mean, the amount of women that I know still drink, even though they experience massive anxiety the next day. And it’s like your body’s trying to tell you that it just cannot tolerate alcohol anymore, you know? Are you going to, when are you going to start listening? And eventually they say, oh, actually, I had three nights now without having a drink and I feel so much better. And I’m like, okay, you know, when we get to the age where perimenopause is starting to happen, our body physiologically cannot tolerate especially alcohol and other drugs in the same way as when we were younger. Just how it is. Yeah. It’s just fact. [00:26:23][70.6]

Dr Louise Newson: [00:26:24] It’s just facts isn’t it. But it is difficult. And just finally the other thing that many people are addicted to actually is processed foods. It’s a different conversation. I’ve done podcasts about this before, but we need to be thinking what we’re putting into our bodies as well. And you know, this isn’t a lecture, but it is really difficult to once you start to sort of stop. But making small changes is really important. And for those of you that are listening, there are things that can be done and you’re not alone. That’s the other thing. As you’ve already said, Alex, there are lots of people that aren’t talking or aren’t admitting that there is a problem. So working out within yourself is really important. So I’m really grateful for you being so open, also about your own personal experience as well. Before we finish, I always ask for three tips, and I feel like we’re opening a bit of a sort of can of worms, really. I think people will be thinking mmm. yes, maybe that is me. I know someone that might be struggling. And it might just be they’re just getting home after the school run and having that glass of wine a bit earlier than they would have done before or like you say, waking and having a pick me up or taking something to work. Or it could be something that’s more addictive or drugs or whatever. But if people are thinking, oh gosh, who do I admit to? Who do I talk to? What’s the best way of getting help? What are the three tips that you would give either to that person personally with, or for them to give to someone who they think might be struggling? [00:27:50][86.6]

Alex Newman: [00:27:51] Well, the first thing is a very practical thing. I’ll just ask anyone that thinks that they might have an issue just to do a drinks diary. I think it’s very important just to be able to write down exactly what you’re using on a daily basis and try to correlate it with your symptoms as well. If you are kind of looking at what you’re drinking and what your symptoms are, if you could see a correlation with how you feel the next day as to whether you’ve been drinking a lot or not or taking drugs, whichever you do. And then you can just really see in black and white what you’re dealing with. Because I think when you see it, when it’s actually written down, it’s much easier to be able to see what, you know, which of the days or the problems, or you know, what situations might arise that make you want to drink more. Is it on a Friday night or is it on a Monday morning, for instance? You know, those types of things and also try to record your drinks in units. If people can learn about units, which is very simple to learn, you can find it anywhere because people think, oh, a glass of wine. Some people’s glass of wine is one unit, some people’s are two. Some people will pour themselves a three unit glass of wine and think oh I’ve only had one drink, but that’s actually three units in a glass. If you have three of those and you’ve already almost hit your healthy units for the week, and also, again, it makes it a lot clearer to yourself about how much you’re actually drinking. And the third thing I would just say is get help, talk to people, talk to your friends, get some support, do your own research. There’s so much out there now on the internet. I mean, there’s no way that you can’t find what you need where you are, you know, and it might be difficult to actually find a counsellor or that type of thing, but, you know, there will be other areas that you can discuss your alcohol use with. Even if you just start with your GP, you know, or just go online to find a local support group or AA or any of those things. Really. I just say to everyone, talk and try to do things that don’t involve drinking with your friends, like go for a walk instead of the glass of wine or the wine o’clock on a Friday. You know, just try to do different things and try to cut your drinking down that way. [00:29:50][119.1]

Dr Louise Newson: [00:29:51] Really great advice. So important thing to acknowledge if there’s a problem and do something proactively and so, I’m really grateful for your time. It’s been really interesting and revealing and thank you very much. [00:30:04][12.9]

Alex Newman: [00:30:04] Pleasure. Thank you very much. [00:30:05][0.9]

Dr Louise Newson: [00:30:10] 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. [00:30:10][0.0]

ENDS

The post Addiction and menopause appeared first on Balance Menopause & Hormones.

1. Manage expectations

Christmas is steeped in tradition and with that comes expectations – if the whole family usually descend on you each year, there’s probably an assumption that’s going to happen again this year. Or maybe you always wrap your presents with a flourish or are known for your delicious Christmas cake. That doesn’t mean you have to continue to do these things if you don’t want to.

Relate advises that you talk with your family and friends in advance about everyone’s expectations of Christmas. Make them aware if there are any changes you want to make (they might have some of their own, too). It’s not easy to keep everyone happy, and that’s not a role you have to fulfil, so the sooner conversations are had, the easier it will be to find compromises.

2. Organise your meds

Avoid any panic over running out of your HRT or other medications by making sure you have enough. Newson Health pharmacist Hayley Berry recommends re-ordering when you get down to about one month’s supply.

Over Christmas and New Year, pharmacies and general practices will be closed on some days and may be open different, shorter, hours on others, so it can take longer to renew prescriptions. Getting a prescription from your GP then getting it filled at a pharmacy can take between seven and 10 days during busy periods so bear this is mind when placing your repeat prescription order, Hayley advises.

‘Get your prescription in with plenty of time so that if there is any issue, it can be sorted out, and you can have the peace of mind of knowing you won’t run low of HRT over Christmas. HRT can have a significant impact on your wellbeing, so while we often put everyone else first at Christmas, don’t forget the importance of your medication,’ says Hayley.

If you are away from home and forget your HRT, don’t feel you have to go without. Go online at NHS 111 and follow the link for emergency prescriptions, which will link you with a local, open pharmacy.

3. Budget ahead

Money worries can have a huge impact on your mental wellbeing, so Citizen’s Advice suggests to be realistic about what you can afford, and budget accordingly. Work out how much are you going to spend on each person and stick it to avoid a January debt hangover. If you have a large family, consider doing a Secret Santa with a price cap so you each only buy for one person.

The Money Saving Expert website has lots of great advice on saving money this Christmas.

4. Talk about your symptoms

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

If you don’t feel comfortable talking with your family, make sure you have one person you can contact during the festive period if you need to let off steam – or create a Whatsapp group with friends purely for that purpose as you’ll not be alone!

RELATED:  how to talk to your children about the menopause

5. Delegate jobs

Christmas is full-on at the best of times but it’s common to experience feelings of overwhelm when you are perimenopausal or menopausal. Some women don’t delegate as they prefer to stay in control but asking others for help makes them feel more included and fosters an “all in it together” spirit.

There are no medals awarded for taking everything on yourself so delegate, even if it’s just little jobs – children can lay the table, parents can peel spuds, etc. ‘After all, it is your Christmas as well and you should be able to enjoy it,’ says Dr Lewis.

6. Get outside

Whether you have a house full, or you’re visiting family and tempers are starting to fray, suggest leaving the house for a walk to break things up a little. When everyone is cooped up indoors, it’s natural for tensions or pressure to build up. Going for a walk will give everyone the chance to chat to someone different, and grab some mind-clearing fresh air.

RELATED: 5 reasons to walk more during the menopause

7. Think: good enough!

The notion that Christmas has to be perfect means you can heap extra pressure upon yourself. ‘We can often feel overloaded by this pursuit of Christmas having to be incredible,’ says Dr Lewis. Instead, adopt a new motto “good enough”. So what if your roast potatoes aren’t as crispy as usual – if they’re cooked and edible, count it as a win. It also helps to adopt a sense of humour when things do go wrong – if you can laugh, the whole family will take their cue from you.

8. Consider your diet

If food and alcohol trigger or affect your menopausal symptoms, try to limit these. Aim to be sensible when it comes to alcohol, as Dr Lewis advises: ‘Alcohol often increases tiredness by disrupting sleep, can make hot flushes worse, increase our anxiety and lower mood.’ But if you do have a drink or two, there’s no need to feel guilty or beat yourself up about it.

There is also some evidence that spicy foods and caffeine can exacerbate hot flushes, which is worth bearing in mind if this affects you. Try to strike the right balance at Christmas between having a well-rounded diet with the odd treat thrown in.  

RELATED: alcohol and the menopause

9. Stick to your sleep schedule

Sleep boosts your brain power, immunity, heart health and curbs hunger hormones, all of which can help keep you healthy over Christmas. But declining levels of hormones due to the perimenopause or menopause can impact your sleep. Keep to your regular evening routine, even during Christmas, by going to bed and getting up at the same time. Your body will thank you for it.

10. Take me-time

Yes, Christmas is a time for thinking of others but there are 24 hours in a day and you deserve at least 30 minutes during each to do something for yourself that makes you happy. It might be finding a quiet spot in the house to read a book or do something creative, practicing yoga or mindfulness or taking the dog for a walk.

Whatever you choose, spend some of the time thinking about your breathing to help you relax – find breathing exercises in the mental health symptoms section of the balance app.

11. Enjoy safe sex

Perimenopause and menopause can be a time of sexual liberation – if you have children, they may be growing up fast or have flown the nest altogether, so you have more time, or you may have started a new relationship or are enjoying dating.

Sex has many benefits for your physical and mental health and Christmas provides more opportunity to enjoy it. Just remember, it’s still really important to think about safe sex and using contraception to safeguard against sexually transmitted infections (STIs).

RELATED: contraception during the menopause and perimenopause

12. Know there’s support if you need it

Some of us know that Christmas will be a challenging time – in that case, ensure you have some understanding friends or family on stand-by should you need them. But you may be surprised to find yourself struggling or feel you don’t want to burden others at this time.

You’re not going through this alone, help is available. Reach out for support by contacting:

• Samaritans: call 116 123 or email jo@samaritans.org
• SHOUT: text on 85258
• National Suicide Prevention Helpline UK: call 0800 689 5652
• Campaign Against Living Miserably (CALM): call 0800 58 58 58

Or if you’d like support about perimenopausal and menopausal health, try the balance app where you can read expert articles, track your symptoms and talk to a like-minded community.

The post 12 (menopausal) tips for Christmas appeared first on Balance Menopause & Hormones.

Women are spending nearly £3,000 on alcohol and over-the-counter (OTC) medication in a year, in a bid to cope with menopause-related symptoms, a survey by Newson Health reveals.

With the yearly UK grocery spend for an average adult woman now reaching just over £1600*, women are spending over £1,000 more on self-medicating than on day-to-day food costs.

Key findings

The survey, conducted by Newson Health Group, also revealed that one in three (33%) respondents said they drink more since becoming perimenopausal or menopausal, while one in eight women regularly consume more alcohol than the recommended intake of 14 units a week to alleviate their menopause symptoms.

Over the counter medicines and herbal remedies

Similarly, over half of respondents (55%) had increased the amount of prescription painkillers and over-the-counter medication they take to try to manage their menopause-related symptoms. Nearly a quarter (22%) said they spend up to £50 a year on OTC remedies, while one in eight (15%) were spending in excess of £100 a year on pain relief, eye drops and herbal remedies.

The news comes against the backdrop of issues with access to treatment, misinformation and medical gaslighting in an area of women’s health that is undervalued, under resourced and underfunded.

What respondents told our survey

The survey of almost 1,200 perimenopausal and menopausal women, conducted by Newson Health Group in recognition of World Menopause Day, goes on to show that one in four women are spending up to £50 a week on alcohol.

Managing menopause symptoms and a lack of access to menopause treatments were the main reasons driving women to drink more according to the online responses. Some 70% of the women surveyed cited anxiety, stress or depression as the reason for doing so, with several women describing alcohol as ‘an escape’.

Gambling

Gambling and OTC medication consumption are also coping mechanisms for many women. Some 5% of respondents said they gambled more during the perimenopause/menopause, with four in ten (40%) respondents saying they have been prescribed more prescription medication since the start of perimenopause/menopause (excluding HRT).

The lack of education amongst health practitioners seems to be a widespread problem with over three in ten women stating that they were wrongly prescribed antidepressants. 
Not being able to access to the right treatment seems to be a key factor driving women to take things into their own hands. Over half (55%) of menopausal women questioned admit to using more over-the-counter medication since been going through the perimenopause and menopause despite there being no evidence to suggest that this work.

When diving into what they are actually spending their money on, 36% of women admitted to buying over-the-counter painkillers to ease crippling pain with a further 15% hoping that herbal medicines would ease the symptoms of a health condition that affects over half of the population.

Lack of awareness and access to treatment

Whilst the menopause taboo in the UK is slowly lifting, these stark figures reinforce that due the lack of awareness and access to treatment, more needs to be done as many women are suffering unnecessarily.

Dr Louise Newson, GP, Menopause Specialist and founder of the balance menopause app, said: ‘It deeply upsets me to see that women are suffering unnecessarily, but sadly I’m not surprised by our survey findings. I speak to many of my women who are struggling with issues around alcohol and other addictions.

‘The changes experienced in the perimenopause and menopause can cause women a lot of discomfort and stress. As a result, they may turn to painkillers or alcohol to relieve these symptoms or, as our study shows, be more susceptible to substance abuse.

‘For people already addicted to substances, addictive behaviours can increase during the perimenopause and menopause, likely because of the loss of sex hormones in the brain. The sad truth is that these women would find greater relief for menopause symptoms and less disruption to their lives were they to have access to appropriate education and treatment, including HRT. We must do more to make menopause treatment more broadly accessible and to stop women turning to unhelpful and harmful substances in desperation,’ concluded Dr Newson. 

More discussion and awareness needed

Consultant Psychiatrist Dr Judith Mohring said: ‘A lot of women find themselves depressed, anxious, and with variable symptoms that are often misdiagnosed as anything other than menopause.

‘Coupled with the demands of mid-life, numerous women I see end up turning to alcohol as a way of coping. Many find that they might be less tolerant to drink than they used to be, and it worsens their symptoms – but it can also be a way of managing what otherwise feels unmanageable. For women with stimulant abuse issues, there’s a complex interplay between symptoms and drug use, meaning they can easily slip in their recovery.

‘Much like mental health and addiction, the menopause wasn’t publicly discussed until recently. The shame around talking about it has led to a lack of research and a significant impact on the real lives of women. What we need is public discussion, more awareness in the profession and a reduction of shame. When women are being cut down in the prime of their lives, due to simple a lack of information about what to expect, how to manage and effective treatments, it affects everyone – couples, families, businesses, and society.’

The post UK women spending more on alcohol a week than on their grocery shop to cope with menopause symptoms appeared first on Balance Menopause & Hormones.

Hot summer days can mean long, warm nights that make sleep difficult, particularly if you are already coping with menopausal symptoms such as hot night sweats and fatigue.

Here, balance takes you through some top tips on keeping cool when the mercury rises.

Why do I find it hard to sleep during the perimenopause and menopause?

Sleep issues can be common during the menopause due to hormone changes. The hormones oestrogen and testosterone both have important effects on your brain, including helping with the quality and duration of sleep. Low oestrogen levels can also lead to fatigue, difficulty concentrating, headaches, weight gain, and mood changes, all symptoms that can be exacerbated by a lack of sleep.

RELATED: How to cope with hot flushes in warm weather

The hormones progesterone is also beneficial for sleep: it increases the production of GABA (gamma aminobutyric acid), a chemical in your brain that works to help sleep. Progesterone can also improve relaxation and mood, and a drop in progesterone levels can lead to symptoms such as anxiety, restlessness and trouble sleeping, including a tendency to wake up frequently.

Add to that you may be getting up in the night to use the toilet, and the fact disturbed sleep pushes up production of the hormone cortisol, which can make you feel anxious and on edge and increase the number of hot flushes.

A bad night’s sleep can also disrupt the production of the hormone melatonin, which is believed to have a role in regulating the body’s temperature and may impact the number of hot flushes you have.

How can I keep cool on a hot night?

It’s much easier to get to sleep and stay asleep if you are on the cool side of comfortable rather than warm, especially if you have hot flushes and night sweats. However that can be easier said than done on a sticky summer’s evening.

Try having a fan on a low setting to help cool your room without being noisy enough to keep you awake.

You could also try bed coverings made from natural fabrics will help wick away any sweat. And while stripping off when you are feeling hot might sound appealing, if you are having night sweats the sweat will remain on your skin and take you longer to cool down.

And some people also swear by a lukewarm rather than cold shower shortly before bed.

Why you need to practice good sleep hygiene

Sleep hygiene refers to the routines and practices that promote good sleep. It’s about getting your mind and body into a favourable state for sleep, and making your bedroom the best possible environment to fall asleep in.

This includes:

• Avoid alcohol and caffeine close to bedtime. Both are stimulants that can disrupt your sleep cycle, so if you have menopause-related sleep issues this could exacerbate them. The evidence on whether caffeinated or alcoholic drinks contribute to hot flushes is mixed, anecdotally many women will say they find these beverages to be triggers [1,2]
• Try and curb time spent on mobiles and tablets at the end of the day. Blue light in the evening disrupts your brain’s natural sleep­wake cycles. There are several ways to block blue light in the evening, including dimming or turning off the lights in your home and amber tinted reading glasses
• Keep your room as dark as possible as it helps your body’s natural sleep rhythms. Try blackout blinds or curtains.

RELATED: Alcohol and the menopause: why cutting down can improve your menopause and overall health

Speak to a healthcare professional about treatment

While it won’t be able to do anything about the temperature outside, HRT replaces hormones and eases symptoms such as hot flushes, night sweats and urinary symptoms that can contribute to keeping you awake a night. Speak to a healthcare professional for an individualised conversation.

And remember to keep hydrated

If the weather is hot, and you are having regular night sweats and hot flushes, you are going to be losing water through sweat.

This leaves you at higher risk of dehydration, which is particularly important when you are menopausal as it can lead to a surge of adrenaline.

Adrenaline, the so-called fight-or-flight hormone, further pushes up the number and intensity of your hot flushes.

So drink plenty of cool water to keep yourself hydrated and ward off spikes of adrenaline. You can use the balance menopause support app to track water and food intake.

References

1. Sievert, L. L., Obermeyer, C. M., Price, K. (2006). ‘Determinants of hot flashes and night sweats’, Annals of Human Biology, 33(1), pp.4–16. doi.org/10.1080/03014460500421338
2. Schilling C., Gallicchio L., Miller S.R., Langenberg P., Zacur H., Flaws J.A. (2007), ‘Current alcohol use, hormone levels, and hot flashes in midlife women’, Fertility and Sterility, 87 (6), pp.1483-6. doi: 10.1016/j.fertnstert.2006.11.033

The post How to sleep in hot weather when you’re menopausal appeared first on Balance Menopause & Hormones.

If you’ve just had another night covered in sweat and too hot to sleep, or spent a sunny day in the grip of hot flushes, then read on.

About eight out of 10 women in perimenopause and menopause are affected by hot flushes and night sweats, which are called vasomotor symptoms, and around one in four report that it affects their quality of life [1].

Body temperature is controlled by an area of the brain called the hypothalamus and when your oestrogen levels start to fall it causes disruption in this area, says Dr Penny Ward, GP and menopause specialist at Newson Health.

‘This leads to your hot flushes and night sweats,’ says Dr Ward. ‘Then when the weather is hot, this causes further glitches in the hypothalamus, which means you are likely to have more night sweats and hot flushes – just when you least want them.’

Here are balance’s six top tips on surviving hot flushes and night sweats when combined with hot summer weather.

Avoid the peak of the heat

While we are used to being advised to avoid the hottest parts of the day to protect our skin from sun damage, another benefit is to reduce your hot flushes.

As body temperature rises, this leads to more glitches in the hypothalamus, that can increase the number of hot flushes and night sweats.

RELATED: 7 common sun protection mistakes – and how to avoid them

Keep your bedroom cool

Try keeping the window open, having minimal coverings from natural fabrics and even, some claim, cooling your sheets in the fridge. Whatever works for you, do it to keep things cool as you sleep.

Disturbed sleep pushes up production of the hormone cortisol, which can make you feel anxious and on edge, and can also increase the number of hot flushes.

A bad night’s sleep can also disrupt the production of the hormone melatonin, which is believed to have a role in regulating the body’s temperature and may have an impact on your number of hot flushes.

RELATED: Sleep and hormones

Keep hydrated

If the weather is hot, and you are having regular night sweats and hot flushes, you are going to be losing water through sweat.

This leaves you at higher risk of dehydration, which is particularly important when you are menopausal as it can lead to a surge of adrenaline.

Adrenaline, the so-called fight-or-flight hormone, further pushes up the number and intensity of your hot flushes.

So drink plenty of cool water to keep yourself hydrated and ward off spikes of adrenaline.

…and consider cutting down on caffeine and alcohol

The evidence on whether caffeinated or alcoholic drinks contribute to hot flushes is mixed, anecdotally many women will say they find these beverages to be triggers [2,3].

‘A lot of women will say that they stop drinking in the perimenopause as it gives them hot flushes,’ says Dr Ward. ‘Robust research hasn’t been done, but it may be something that you want to try to see if it helps.’

RELATED: Alcohol and the menopause: why cutting down can improve your menopause and overall health

Speak to a healthcare professional about HRT

If your hot flushes and night sweats are bothering you, consider speak to a healthcare professional. They should be able to talk about the benefits and risks of taking HRT to replace your own declining hormones, which are triggering these challenging symptoms.

HRT is the first line treatment for the perimenopause and menopause symptoms [4].

And this is not just to help you through uncomfortable, humid nights, Dr Ward says.

‘There is some evidence that hot flushes and night sweats are linked to your future risk of heart disease [5]. So lowering the incidence of these symptoms may have a long term benefit as well as easing discomfort in the short term.’

RELATED: Taking your HRT abroad: everything you need to know

Wear loose, cool clothing

Items made from light-weight natural fabric can help keep your temperature low and prevent your hypothalamus going into over-drive. Wearing lighter colours should help reflect, rather than absorbing, heat, Dr Ward says.

‘Some women find fans, ice packs and flannels really helpful, and these can be simple and affordable ways of keeping cool,’ says Dr Ward.

References

1. Hickey M., Szabo R.A., Hunter M.S. (2017), ‘Non-hormonal treatments for menopausal symptoms’, BMJ, 359 :j5101 doi:10.1136/bmj.j5101

2. Sievert, L. L., Obermeyer, C. M., Price, K. (2006). ‘Determinants of hot flashes and night sweats’, Annals of Human Biology, 33(1), pp.4–16. doi.org/10.1080/03014460500421338

3. Schilling C., Gallicchio L., Miller S.R., Langenberg P., Zacur H., Flaws J.A. (2007), ‘Current alcohol use, hormone levels, and hot flashes in midlife women’, Fertility and Sterility, 87 (6), pp.1483-6. doi: 10.1016/j.fertnstert.2006.11.033

4. National Institute for Health and Care Excellence (NICE) (2015), ‘Menopause: diagnosis and management’, www.nice.org.uk/guidance/ng23

5. Thurston, R.C. et al. (2021), ‘Menopausal vasomotor symptoms and risk of incident cardiovascular disease events in SWAN’, Journal of the American HeartAssociation, 10 (3), e017416. doi:10.1161/JAHA.120.017416

The post How to cope with hot flushes in warm weather appeared first on Balance Menopause & Hormones.

Many of us reach for a glass of wine in the evening after a busy day. But what should you do if you are starting to worry about your drinking?

Being addicted to or dependent on alcohol can have a major impact on your life, but the impact of the menopause on these behaviours remains poorly researched and understood.

However, healthcare professionals working with women who are perimenopausal and menopausal regularly see that managing addictive behaviour can become more challenging at this time.

‘We see a lot of women in our clinics struggling with issues around alcohol and other addictions,’ says GP and Menopause Specialist Claire Phipps.

‘While there isn’t a lot of evidence – because the research simply hasn’t been done – we do know that alcohol consumption often goes up during significant life changes, such as the menopause. It’s an area where women can need help.’

RELATED: My story: menopause in recovery

When is alcohol a problem?

Alcohol misuse is when you drink in a way that’s harmful, or when you’re dependent on alcohol, according to the NHS.

There is no safe level, according to the NHS, but to keep health risks from alcohol at a low level, both men and women are advised not to regularly drink more than 14 units a week.

The number of units varies on the size and strength of a drink. A bottle of wine with a 13.5% alcohol by volume contains 10 units, a single shot of 40% spirit has one unit, a bottle of 5% beer or lager has 1.7 units.

Higher risk drinking for women is defined as drinking more than 35 units per week.

You can calculate your weekly intake using Alcohol Change UK’s online calculator.

Does alcohol affect women differently?

Men and women’s bodies respond to alcohol differently. Although men are more likely to drink alcohol and consume larger amounts, biological differences mean women absorb more alcohol and take longer to break it down [1].

After drinking the same amount of alcohol, women tend to have higher levels of alcohol in their blood than men, and the immediate effects of alcohol usually occur more quickly and last longer in women.

These differences mean women are at higher risk of the long-term negative health effects of alcohol compared with men.

RELATED: Alcohol and the menopause

Health impact of alcohol

You are at higher risk of alcohol-related liver disease and cirrhosis than men, and alcohol-related cognitive decline and brain shrinkage occurs more quickly.

Women are at an increased risk for damage to the heart muscle at lower levels of drinking and over fewer years of drinking than men.

According to the NHS, there are many long-term health risks associated with alcohol misuse, including increasing the risk of several types of cancer, including liver cancer, mouth cancer, head and neck cancer, breast and bowel cancer.

Other risks associated with alcohol

Excessive alcohol use, particularly binge drinking, is a contributing factor to sexual violence [1]. As well as increasing the risk of serious health problems, long-term alcohol misuse can lead to social problems for some people, such as unemployment, divorce, domestic abuse and homelessness, according to the NHS.

How does the perimenopause and menopause affect drinking habits?

Like much of women’s experience of the menopause, this remains a significantly under-researched area.

But Dr Phipps says that drinking can increase during life changes such as the perimenopause.

‘The perimenopause can have a massive impact on women – it can make you feel anxious, have that sense of overwhelm and maybe lead to you having an extra glass of wine as you feel you aren’t coping’ she says. ‘That can escalate into drinking more and more. It so common to hear women say I am drinking more than I used to, I’m becoming reliant on alcohol and I’m at a tough stage.’

The causes are of increased drinking are often multifactorial, Dr Phipps says. The perimenopause could provide the tipping point on top of other sources of stress from busy family and work life commitments.

She has seen women relapse with problems they have had in the past, such as drinking to excess or eating disorders.

‘During perimenopause, hormonal fluctuations mess with your brain, particularly with the neurotransmitters, which are the chemicals which carry messages between brain cells, and that can mean you are more at risk of looking for coping strategies,’ she says.

Figures show that women are most likely to exceed recommended drinking limits during the age of 45 to 64, with almost one in five (19%) women drinking more than 14 units of alcohol in a week in England [3].

A Yale University study of more than 3,000 women suggested that those who don’t drink much could change to excessive drinkers during the early perimenopause onwards, while women who were excessive drinkers before the menopause, appeared to moderate their drinking during that phase [4]. Researchers from said it was clear that menopause marked a period of ‘instability’ in drinking habits.

Another review found that stress and depression related to menopause may trigger the onset of alcohol abuse or worsen established alcohol misuse [5].

Researchers pointed out that due to social stigmas, women tend to have more difficulty gaining access to treatment and recovering from alcohol dependence than do men.

Some women find that alcohol, particularly red wine, triggers hot flushes and night sweats, though the evidence is mixed in this regard [6,7].

What impact does alcohol have on mood?

You may find you turn to alcohol when feeling stressed or anxious, as when you have a drink your brain produces more of the happy hormone dopamine.

The charity Alcohol Change UK says that these changes in the brain initially make you feel good and also make want you to drink more.

It can lead to loss of inhibition and slows the parts of the brain that makes decisions.

Alcohol can also affect mood. In the short term a hangover, a combination of dehydration, low blood sugar and the by-products of alcohol can be a miserable experience.

And in the longer term, your body gets used to the dopamine boosts and starts to make less, which can lead to low mood and anxiety.

Alcohol can also impact your general mental health, with research showing links between excessive drinking is linked with depression, self-harm and suicide [8].

How does alcohol affect my hormones?

One study suggests that heavy drinking could lead to an earlier menopause [9].

There is some evidence that the perimenopause can reduce your body’s ability to metabolise alcohol, Dr Phipps says.

Where should I turn for help?

If you are concerned about your drinking, then make an appointment with your GP.

‘This is the best first step, but often women in this situation don’t want to talk about it. There is a big stigma or taboo against asking for help, which is the single most important thing we can do,’ Dr Phipps says. ‘But take heart that there is a lot of good support out there for women with addictions.’

Accessing therapy is often part of this, she says.

‘Really thinking about what your trigger may be and how you can address that. It is a very personal journey, working on that source and behaviour change.’

Looking after yourself, by eating well and taking regular exercise, can also be an important part of recovering.

‘For some women, taking HRT may be part of the solution that will help them look after their wellbeing and restore some balance,’ says Dr Phipps.

‘This can be part of a holistic approach to looking after your health, which should include making time for the things you enjoy.’

References

1. Centers for Disease Control and Prevention (2022), ‘Excessive alcohol use is a risk to women’s health’

2. NHS.uk (2022), ‘Risks: alcohol misuse’

3. House of Commons Library (2021), ‘Alcohol statistics: England’

4. Peltier, M.R., et. al (2020), ‘Changes in excessive alcohol use among older women across the menopausal transition: a longitudinal analysis of the Study of Women’s Health Across the Nation’, Biology of Sex Differences, 11(1), 37. doi.org/10.1186/s13293-020-00314-7

5. Milic J., Glisic M., Voortman T., et al. (2018), ‘Menopause, ageing, and alcohol use disorders in women’, Maturitas, 111:100-109. doi:10.1016/j.maturitas.2018.03.006

6. Sievert, L. L., Obermeyer, C. M., Price, K. (2006). ‘Determinants of hot flashes and night sweats’, Annals of Human Biology, 33(1), pp.4–16. doi.org/10.1080/03014460500421338

7. Schilling C., Gallicchio L., Miller S.R., Langenberg P., Zacur H., Flaws J.A. (2007), ‘Current alcohol use, hormone levels, and hot flashes in midlife women’, Fertility and Sterility, 87 (6), pp.1483-6. doi: 10.1016/j.fertnstert.2006.11.033

8. NHS.uk (2022), ‘The risks of drinking too much’

9. Gill J. (2022), ‘The effects of moderate alcohol consumption on female hormone levels and reproductive function’, Alcohol and Alcoholism, 35(5):417-23. doi:10.1093/alcalc/35.5.417

The post Menopause and alcohol addiction: what you need to know appeared first on Balance Menopause & Hormones.

‘From the age of 13, I struggled with the usual awkwardness that comes with being a teenager, but it was also accompanied by troubling moods, feelings of isolation and anxiety, particularly around the time of my period.

‘I started drinking and partying in my teens which helped to create an illusion of self-confidence and ease – a welcome anaesthetic for all the angst and discomfort I felt.

‘But over time, my reliance on alcohol started to negatively impact my relationships, family and college studies, particularly my emotional and mental health. Instead of the numbing effect I originally sought, my escalating drinking caused my anxiety to worsen, spiralling into panic attacks and the need for more alcohol.

RELATED: Alcohol and the menopause

‘Simultaneously, my periods worsened with intense migraines, acne and extreme mood swings – and I continued to find solace in alcohol.

‘I spent many years chasing the elusive effect alcohol had first given me and then a good few more trying to control the amount I drank, finally realising I wasn’t able to stop using my own will.

The turning point

‘Fortunately, I followed a suggestion from a like-minded soul entered into a 12-step programme. In that wonderful welcoming place, I was able to find, not only, a way to stop drinking but a connection to a group of people who showed me a new way to live.

‘That was 23 years ago, and I am still sober today. Throughout my early sobriety my hormones and menstrual cycle were still causing severe mood swings around ovulation and debilitating migraines before and after my periods.

‘At 35, with five years sobriety, happy and married, I had my first child but immediately after the birth I developed severe anxiety and depression.

‘Consumed by the irrational fear that my baby would be taken from me, I didn’t tell a soul; not my friends, my husband, the doctor or health visitor, pushing through each day without help. I was still in a 12-step programme but I began to isolate, justifying to myself and those around me that I had a new baby who needed me at all times.

How hormonal changes affected my life

‘I threw myself into motherhood and work, putting everything else before my programme, causing my mental, emotional and physical health to deteriorate further.

RELATED: Living well through your perimenopause and menopause booklet

‘I was still sober but I was stuck in a cycle of anxiety, low mood, fatigue, regular migraines and irritability lasting for the next decade. In 2016, and at 16 years sober, my wonderful grandmother died and within two days of her passing I developed a deafening ringing in my ears.

‘The next few nights I sat up, wide awake in bed, stricken with intense anxiety, unable to close my eyes, concentrating on the noise ringing in my ears.

‘I was 46 years old, and I was terrified. I sank into a depression I’d never experienced before: unable to get out of bed or move my body, I was paralysed by desperate repetitive thoughts. I couldn’t look after my children or communicate with my family.

‘I had isolated myself from my friends, and my family were worried. I began to think everyone would be better off without me. Then something magical happened which I will always be grateful for: a 12-step friend called and offered her help.

‘Again, I followed the suggestion and reconnected with my programme and I began to change. I started to get better. I was functioning again.

The start of my perimenopause

‘I was able to look after my family, help others and be part of the world, but I was still struggling with terrible migraines, tinnitus, fatigue, crippling body aches, irregular heavy periods, acne, itchy skin, sinusitis, skin allergies, digestive problems and most worryingly, the anxiety and repetitive negative thoughts were increasing again.

RELATED: Heavy periods during the perimenopause: what you need to know

‘I was confused because I had worked really hard on my 12-step programme, I couldn’t understand why I felt so unwell.

Listening to me, a friend simply replied: “It’s perimenopause!”

‘No, I thought to myself, menopausal symptoms started in your 50s.

‘I had been totally misinformed. It all started to make sense. That was seven years ago when there wasn’t good information about menopause in the public domain.

‘I unfortunately didn’t find the help I needed at my GP surgery, so I searched out a menopause specialist and was diagnosed with perimenopause and, something I’d never heard of, premenstrual dysphoric disorder (PMDD) a very severe form of premenstrual syndrome.

RELATED: Premenstrual syndrome and menopause

PMDD diagnosis

‘Everything fell into place. I’d been at the mercy of hormone fluctuations for 40 years creating monthly bodily and mental upheavals – and by adding alcohol into the mix during my younger years, I had created a toxic cocktail.

‘I chose to go on HRT at 48 years old. After some tweaking of the dosages and introducing some lifestyle changes including yoga, exercise, nutrition, therapy and plugging right back into my 12 step programme, my symptoms subsided and are now mostly in remission – those that remain are very mild.

During the 1980s when I’d first been to my GP, I was told my mood swings and headaches were normal and would improve once I had children.

Post-menopause: a more positive future

‘Sadly that wasn’t the case and luckily today there is more accessible information about hormone health out there. I am now 54, post-menopausal and the healthiest I’ve probably ever been. I have the gift of stable hormones, peace of mind and contentment (most of the time!).

‘Most importantly, I had to reconnect with my 12-step programme and seek out the help I needed.

By not asking for help earlier, I created fertile soil for my illness to grow. Thankfully I didn’t pick up a drink. I would never have got well without the people who took the time to support me, therefore I now spend a good deal of time sharing my story with women, particularly those recovering from addiction.

If you are struggling, ask for help. Share your experience. Talk about it. Please don’t suffer in silence.

‘There is help – there is always a solution.’

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

The post My story: menopause in recovery appeared first on Balance Menopause & Hormones.

Many people choose to take stop drinking alcohol, most commonly in January, but at other times of the year too.

For some, it’s a chance to give your body a break after and save some money in the process.

For others, it goes further and forms the start of a significant shift in their relationship with alcohol, its impact on their life and loved ones.

How do you feel about your current alcohol intake? And how does how much you drink impact your perimenopause ad menopause?

Here, we take a look at the issues.

What is Dry January?

Started by the charity Alcohol Change UK, the idea behind Dry January is to abstain from drinking alcohol for a month to improve your general health and wellbeing including improved sleep, energy, mental health and concentration – all very attractive propositions if you’re also affected by symptoms of the perimenopause and menopause.

RELATED: Living well through your perimenopause and menopause

What are the current alcohol guidelines?

Current UK guidelines state that to minimise health risks, you shouldn’t drink health more than 14 units per week. If you drink near this amount, it’s best to spread it evenly over three or more days.

But what is a unit and how will you know how many units you drink a week? It all depends on the strength of the drink and volume in your glass.

Source: UK Government (2016)

This above from the UK government image shows the varying units of wine and beer according to the size and strength of drink [1].

You can calculate your weekly intake using Alcohol Change UK’s online calculator.

RELATED: The Dr Louise Newson Podcast: gut health and addiction – Lindsey Beveridge and Dr Louise Newson

How can alcohol affect my perimenopause or menopause?

As you age, you become more sensitive to alcohol and your body holds less water so any alcohol you consume is less diluted – and perhaps goes some way to explaining hangovers are worse the older you get.

Some women find that alcohol, particularly red wine, triggers hot flushes and night sweats, though the evidence is mixed in this regard [2,3].

Alcohol can also impact your general mental health, with research showing links between excessive drinking is linked with depression, self-harm and suicide [4].

In addition, alcohol disrupts your sleep cycle, so if you are suffering with menopause-related sleep issues this could exacerbate them [5].

RELATED: Sleep and hormones factsheet

Long term consequences of excessive drinking

The risk of many conditions and diseases increase substantially after a decade or more of regularly drinking more than 14 units per week, osteoporosis and bone fractures, breast cancer, heart disease and a deterioration in mental health including depression, as well as an increased risk of many other cancers, stroke, and damage to the liver and nervous system.

Finding support

Higher risk drinking for women is defined as drinking more than 35 units per week.

There are lots of ways to find support if drinking has become a problem for you. Firstly see your GP and try and have an honest discussion. You can search for local sources of support here and there are apps and other online tools that can help you cut down.

Tips for cutting down

Get ready: Set yourself a reduced drink limit and start counting your weekly units. Reduce the amount of alcohol you keep in the house and plan your alcohol budget for the week. Buy smaller glasses to drink your alcohol from and buy low-alcohol or alcohol-free versions of your usual drinks. Check out this article on goal setting for a deeper dive into how to change behaviours.

Menopause wellbeing: how to set goals to boost your health and happiness

Make a plan: Have a few drink-free days every week and plan them in advance. Think of something else to do on those evenings, such as a walk, long bath, baking or a TV catch up. On days when you are going to drink, delaying the first glass by a couple of hours can reduce the overall amount consumed in an evening.

Enjoy alternatives: Get to know the no and low alcohol options and keep a supply of ones you like in the house. Supermarkets now have a wide choice and if you’re out in a pub or restaurant, ask what no and low options they have.

Stay hydrated: Don’t let yourself get dehydrated or drink on an empty stomach. If you are going out, eat beforehand, avoid doing rounds, or offer to be the designated driver. At home, you could stick to drinking only at dinner time.

Think about family and friends: If telling family and friends is difficult, practice some set phrases in advance such as ‘I’m pacing myself’, ‘I’m on a health kick’, ‘I’m trying to cut back’, and find a no/low alcohol drinking buddy for support. Telling supportive friends and family will help keep you accountable.

For broader information on making healthy lifestyle changes see our Living Well booklet.

References

1. UK Departments of Health (20126): UK chief medical officers’ low risk drinking guidelines (accessed December 2022)
2. Sievert, L. L., Obermeyer, C. M., Price, K. (2006). ‘Determinants of hot flashes and night sweats’, Annals of Human Biology, 33(1), pp.4–16. doi.org/10.1080/03014460500421338
3. Schilling C., Gallicchio L., Miller S.R., Langenberg P., Zacur H., Flaws J.A. (2007), ‘Current alcohol use, hormone levels, and hot flashes in midlife women’, Fertility and Sterility, 87 (6), pp.1483-6. doi: 10.1016/j.fertnstert.2006.11.033
4. NHS.uk (2022): ‘The risks of drinking too much’ (accessed December 2022)
5. Jehan, S. (2015), ‘Sleep disorders in postmenopausal women’, Journal of Sleep Disorders and Therapy, 4 (5) 212.

The post Alcohol and the menopause: why cutting down can improve your menopause and overall health appeared first on Balance Menopause & Hormones.

The post Living well through your perimenopause and menopause Booklet appeared first on Balance Menopause & Hormones.