22:00

PMDD, perimenopause, menopause are

22:02

just natural hormones.

22:05

They are biochemically exactly the same as

22:07

the hormones we produce, which

22:10

makes them very, very safe, really. Well,

22:14

we really distinguished that on the show last

22:16

time because I think I've brought up around

22:18

HRT, which is slightly different

22:20

to what people will be experiencing if

22:22

they have hormone therapy, which is maybe

22:24

some natural progesterone or testosterone on the

22:26

side a couple of times a month,

22:28

a couple of times before their period.

22:30

But I think that is

22:32

what blew my mind that

22:34

this conversation just

22:36

doesn't happen unless you hit menopause

22:38

or perimenopause. So we kind of

22:41

spend women most of our lives

22:43

unless we're pregnant, not

22:45

really understanding our hormone levels at all.

22:47

And it is a really confusing landscape.

22:50

When I've spoken about it since on my Instagram,

22:52

this is probably the first time I'm speaking publicly

22:54

about it at all. After

22:56

our conversation, I spoke to

22:58

you and I said, you know, I really suffer

23:00

with anxiety just for my period, I really suffer

23:02

with heavy periods, I have bursists, but for my

23:04

entire life, I was put on the progesterone only

23:07

pill. And I felt great. But

23:10

then I started to not feel great again, and I came

23:12

off and then I just didn't know where to turn. And

23:15

you mentioned, you know, come and see me,

23:17

maybe you might be hormone deficient, had never

23:19

entered my brain, ever. And

23:22

I think that's the really interesting thing. We might

23:24

think about going on a pill, like the conventional

23:27

treatment to stop fertility, but we don't think about

23:29

it in terms of how we feel. And

23:31

then we might think about HRT and we meet menopause,

23:33

but then everything in between, we

23:35

just kind of struggle with. So when

23:37

I came to you, it was very symptomatic, it was very

23:40

like talking about how I feel. We

23:42

did do a round of bloods just to check for

23:44

any nutritional deficiencies, which I think was really, really helpful.

23:48

And again, anyone listening to this thinking,

23:50

wow, was somebody in their 30s or

23:52

somebody like Louise's daughter, 21 or 20, taking

23:56

hormone treatment, might feel a

23:58

bit uncomfortable about it. might feel quite shocked

24:01

about it. So I really wanna lay the

24:03

groundwork here and say, do

24:05

we have a need to be frightened about

24:07

this? Or is this totally safe for somebody

24:10

in their 20s and their

24:12

30s to take with the symptoms that they're experiencing?

24:14

Because I think that's probably the biggest

24:16

fear for most people. And I

24:18

can say personally, which is totally anecdotal,

24:21

I've never felt better since taking this

24:23

and I had very low progesterone. And

24:27

I only need it for a few days

24:29

before my period and it's really calmed me,

24:31

my periods aren't heavy anymore. And

24:34

I've never really spoken about myself like this on

24:36

the show, because it's not about me, but

24:39

I do think it's really important to voice

24:41

this for any women who are experiencing these

24:43

symptoms and just think they just need to

24:46

suffer because it's not fair. And

24:48

so the stigma

24:51

of me even taking that first pill, I have to say

24:53

I was terrified. And

24:55

then I felt great and I was like, oh, I

24:57

don't wanna stop taking this. And

25:01

so I think kind of let's, I really wanna

25:03

get into the stigma around taking this if you're

25:05

not perimenopausal because a lot of people will fight

25:07

up that argument. Yeah, and I think the thing

25:09

is, I mean, there's lots of unpicked there, but

25:11

I think the thing is when

25:13

we give hormones, it's often

25:15

called HRT. And

25:17

if you Google HRT, it will say risk

25:20

of breast cancer. And then everyone's

25:22

like, oh my goodness, but I'm not menopausal and oh

25:24

my goodness. And that stemmed, we

25:26

spoke about it in the last podcast of

25:29

evidence from 20 plus years ago using

25:32

synthetic, so chemically altered hormones that

25:34

do have risks, but this risk

25:36

of breast cancer wasn't statistically significant

25:38

anyway, but we don't prescribe that

25:41

now. We just prescribe the same

25:43

natural hormones. So people aren't

25:45

scared taking the contraceptive pill, but it's

25:48

synthetic, but they're suddenly scared when it's

25:50

hormones because of this connotation, this hangover

25:52

effect from this WHI study from years

25:55

ago, thinking about HRT. But

25:58

we're very simplistic when we prescribe hormones.

26:00

hormones now because we can prescribe the

26:02

hormones separately and you've just said you're

26:05

taking some progesterone and you

26:07

might be that if progesterone didn't

26:09

work for you we would then

26:11

consider oestrogen and you might need

26:13

some oestrogen added added in and

26:15

actually the beauty of starting when

26:17

people's got or someone's got PMS

26:19

and PMDD we often can start

26:21

very low dose and we can

26:23

just try and then you sort

26:25

of segue in to having maybe

26:27

a bit more as your own

26:29

hormones decline. So in an

26:31

ideal world you will never

26:34

experience perimenopause and certainly never

26:36

experience menopause because you're just

26:39

topping up what's missing if you see what I

26:41

mean. It's like if someone I

26:44

don't know just thinking how else to

26:46

describe if someone had raised blood pressure

26:48

for example we treat it

26:50

because we want to reduce the future risk

26:52

of a heart attack. Raised blood pressure doesn't

26:55

usually cause problems if it's

26:57

very high blood pressure it can cause

26:59

headaches and people feeling quite tired can

27:01

sometimes affect vision but we

27:03

wouldn't leave someone for their blood pressure to

27:06

be as high high high until it causes

27:08

symptoms that would be noncical and it's a

27:10

bit like this you know because there's been

27:12

so much misinformation about hormones we have sort

27:14

of ignored it and women have them been

27:17

you know I see women in my clinic

27:19

who are really struggling you know they've

27:21

given up their job their partners left them

27:23

they've got so many symptoms their quality of

27:26

life is dreadful but actually

27:28

you know we shouldn't

27:30

be waiting for that long and

27:32

the problem is also I see women who

27:35

are perimenopause and a menopausal but they've got

27:37

a history of PMS and PMDD and

27:39

then when they have the right dose and type of

27:41

hormones they say wow I

27:44

wish I'd taken or started this

27:46

10-20 years ago so

27:48

that's where this awareness is really important

27:50

and a lot of

27:52

people with a history of

27:54

PMS and PMDD then will

27:56

become pregnant and they go wow this

27:59

is incredible because you've got good levels

28:01

of hormones in your body. And that, for

28:03

anyone listening, is a really important sort of

28:05

telltale sign that actually if

28:07

you do feel so much better when

28:10

you're pregnant, obviously there's lots

28:12

of reasons why you can feel better when you're pregnant,

28:14

but it is a soft sign that actually maybe

28:17

you do respond adversely to hormones if you

28:19

feel a lot worse when you don't have

28:21

them at certain times of the cycle. But

28:24

hormones like oestrogen, progesterone,

28:26

testosterone, when we prescribe them, they're

28:29

very short acting. They

28:31

only last the day that you use them. So

28:33

they don't build up in the body. If

28:36

they don't work or someone has an adverse

28:38

effect or a side effect, then

28:41

you can stop it and they'll come out

28:43

of your system. Now I spoke

28:45

to someone today who's got lupus.

28:47

She's had lots of problems. She's had

28:49

some antibiotics. She's had some other medication

28:51

for her lupus. She'd started HRT. She'd

28:54

had these blisters and mouth ulcers.

28:56

She didn't know what was going on. And I don't

28:58

know how much is related to her hormones. So

29:01

she's just stopped everything. And

29:03

then she's going to introduce very

29:05

gradually one hormone at a time

29:07

and see, because it probably wasn't related

29:10

to her hormones. It's probably related to

29:12

some antibiotics she had, but

29:14

you never know in medicine and it's always

29:17

better to do things gradually and patients being

29:19

in control. And I think that

29:21

is the beauty. If someone

29:23

has an implant, for example, once

29:25

it's in, it will last for a few months

29:28

or a few weeks, depending on the type. And then

29:30

you can't take it out. If you have the Depo

29:33

Provera injection of progesterone,

29:35

that's it, it's in for 12 weeks. This

29:38

is very different. Even a tablet, it gets

29:40

metabolized in different ways. We're

29:42

very lucky that we can just give

29:44

these hormones safely and try. And if

29:46

it doesn't work, then you haven't lost

29:48

anything. But if

29:50

it improves, like you've had such an

29:52

amazing response with a very simple progesterone

29:55

and having the natural progesterone, each

29:58

progesterone in the UK. is

30:00

a lot safer than having the

30:03

mini pill that you had when you're younger because

30:05

it's synthetic. So we've got

30:07

to stop this fear and I think you

30:10

often get scared of something when

30:12

you don't understand and that's what's

30:14

happened. We haven't been given the information. And if

30:16

you don't have the information or you have wrong

30:18

information about what hormones are, then

30:21

the first thing you do is get scared. And

30:24

that's where information and education is

30:26

so important. I

30:28

think it's one of these things where people are listening and I

30:30

feel very lucky that my job, I

30:33

managed to meet you and then come and see

30:35

you for a consultation a few weeks later as

30:37

I've got to pick him for an appointment. But

30:39

for anyone who's listening to this and

30:42

they couldn't come and see you, you

30:44

know, they just didn't have the access to you, such

30:47

as the financial access or they

30:49

lived in a different country or whatever that was,

30:51

they don't have and also you only have a

30:54

limited amount of spots. Can't see everyone who's got

30:56

PMS or PMDD. What

30:58

would the reaction be going to see a GP

31:00

and asking for this? Like

31:03

I want to make that kind of statement because

31:05

I'm thinking people are listening to this. Yeah, no,

31:07

you're really important. And one of the reasons, you

31:09

know, we developed balance app is so people can

31:11

have free information. We update the information all the

31:13

time so they can really feel empowered wherever they

31:16

live and whoever they want to access. The

31:18

problem is medical health care education hasn't

31:21

caught up. And we have developed a

31:23

confidence in menopause course which people can

31:25

log on to. It's really

31:28

designed for health care professionals. But there

31:30

is, it's not just menopause. So there's

31:32

sections about perimenopause, but also PMS and

31:34

PMDD. So really important

31:37

that people have this knowledge

31:39

as health care professionals. We've

31:42

also produced some sort of treatment guidelines

31:45

that health care professionals can contact us

31:47

and we can share what we do

31:49

in our clinic. And, you

31:51

know, medicine is a science and an

31:53

art. And

31:55

the art is individualizing care and listening

31:57

to patients. years

32:00

of you know dedication my work

32:02

just to hormones. I've learned so

32:04

much but there's also work

32:06

that's been done in the past that has been ignored

32:09

so many women now who've

32:11

had who have PMS

32:13

PMDD have heard of someone called Dr.

32:15

Catriona Dalton who sadly now died but

32:17

she's written some great books about

32:20

PMS and PMDD and she writes

32:22

very clearly about the effects

32:24

of progesterone and how beneficial they

32:26

were and she like we do

32:28

sometimes use progesterone vaginally because then

32:30

you can get higher levels in

32:32

the body and it's the pure

32:34

progesterone and it can be

32:37

transformational for some women but she wasn't

32:39

believed and she had a really difficult

32:41

time the establishment went against her

32:44

and then no one sort of continued

32:46

her work after she died and we've

32:48

sort of reactivated because she was years

32:50

ahead of her time like a lot

32:52

of pioneers are I suppose and no

32:56

one really it's different

32:58

now because when she was doing it

33:00

in the 60s 70s 80s

33:02

we didn't have social media we didn't have

33:04

the internet but in fact even

33:06

even now actually one of my one of my

33:08

doctors who works with me emailed me today and

33:10

said Louise this amazing lady I met had really

33:13

severe postnatal depression the psychiatrist wanted

33:15

to give her ECD and

33:18

antipsychotics and she got hold of

33:20

Catriona Dalton and she was given

33:22

Cyclogest, Pezzaries and she

33:24

was amazing and she felt so much

33:26

better and then her next pregnancy she

33:29

was given some Cyclogest and

33:31

she just wanted to she wants to come and

33:33

record a podcast with me which is wonderful but

33:36

so people yeah so

33:38

people then found this

33:40

doctor out and people

33:42

do you know women have a way of connecting

33:45

but it's easier now but what isn't

33:47

easier is that sometimes healthcare professionals aren't

33:49

catching up or they're scared because they

33:52

haven't been taught but I

33:54

think you know the good doctors have

33:56

some professional curiosity you know if I

33:58

have a patient asking

34:01

me something, then I would

34:03

always challenge myself and think, well why are they

34:05

asking that? Where have they got that information from?

34:07

Could it make sense? And sometimes

34:09

you know people might come and be

34:11

asking for some obscure tablet that they've

34:14

seen on the Mail on Sunday health

34:16

section that's been trialed on three mice

34:18

or something and of course that wouldn't

34:20

be rational to to worry about that.

34:22

But actually if we're talking about natural

34:24

hormones which are biologically active, you

34:27

know I've spent hours poring over

34:29

basic physiology and texts

34:32

and just looking at how our

34:34

hormones work naturally in our

34:36

body. Because if we know how something

34:38

works when we're healthy and we don't

34:40

have it then it's

34:42

easier to understand how important it is

34:44

and how safe it is to replace

34:47

it. Mm-hmm. So do you think a GP

34:50

now would be more

34:52

considered to prescribe progesterone or estrogen?

34:54

I hope so. I want to

34:56

give the listeners. No it is

34:58

in some of the guidelines and

35:01

I'm hesitating because you know I

35:04

see a sort of skew population because

35:06

in our clinic we see women from

35:08

all social and economic backgrounds from all

35:10

ethnicities who come because the NHS has failed

35:12

them. They don't come because they really

35:14

want to see us, they come because

35:16

they want help. So we

35:19

don't see the people who are having

35:21

a great experience doing really well, everything

35:23

else. So you know when I go

35:25

to conferences in the UK and abroad

35:27

a lot of people say, gosh Louise

35:29

your confidence in the menopause course has

35:31

transformed the way I think. So thank

35:33

you so much. So there is this

35:35

effect that's happening. So

35:37

it's always worth asking at your practice

35:40

is there someone who's got a specific

35:42

interest in female hormones? Is there someone,

35:44

nurse, doctor, pharmacist who might be able

35:46

to help me to give me some

35:48

individualised advice? Or is there

35:50

someone in another practice maybe? Maybe I have

35:52

to change practice? Or is there

35:54

a specialist in the hospital? So you know

35:57

it's it you allowed

36:00

as a patient to have second opinions.

36:02

That's the other thing I think. I

36:05

mean I get quite nervous going to see my doctor

36:07

because I think they're so busy, they're running late, they

36:09

don't really need to see me, there's more sick people

36:11

and then if they say something you sort of

36:13

go, oh yes okay that's fine. But actually you

36:17

you are allowed to have to and even as doctors

36:19

we don't all agree. It doesn't matter

36:21

if we don't all agree it's because there

36:23

isn't really solid science but we haven't got

36:25

solid science that supports us. We don't have

36:27

the evidence because who's looked

36:30

and done proper studies in women with PMS?

36:32

No one. Yeah no

36:35

it's such an underrepresented group which

36:37

is really really sad because actually it can be

36:39

the most debilitating and it happens every

36:42

single month. Well indeed and I've seen

36:44

yeah go and say. I'd

36:47

say I've just seen such a difference and I

36:49

think how they got to my mid-30s and

36:51

now I only feel a sense of relief which is why I

36:54

wanted to do this podcast to help not

36:57

just talk about the symptoms of PMS

36:59

and PMDD but the actual treatment and

37:01

the awareness that you can feel better

37:03

and you haven't got to have night

37:05

sweats or have really heavy periods or

37:07

have really bad migraines or

37:10

really bad GI distress. All of these things

37:12

that come with really bad

37:15

PMS and PMDD there is options

37:17

but I do think we all suffer. One

37:20

of the things that I really wanted to mention which

37:22

is something that was mentioned to me in my consultation

37:24

and luckily I didn't have this

37:26

at all but

37:29

it was mentioned that progesterone could make you feel

37:31

worse and I think it's probably important to raise

37:33

that not just saying that you have the symptoms

37:36

and you take progesterone that you'll be fine. I

37:38

was very lucky that I did

37:41

but I think it's important to say that.

37:43

No it is and thank you for mentioning

37:45

it. So when we say progesterone there are

37:47

different types and different doses so there's a

37:49

lot of women who have PMS and PMDD

37:52

who don't get on with synthetic

37:54

progesterone so this is like the

37:56

progesterone only pill even sometimes the

37:59

marina cord. they can be very

38:01

sensitive to because a small amount may get absorbed

38:03

in the body or other contraceptives

38:05

and then they think that's the

38:07

same for every progesterone. Now

38:09

the progesterone that we prescribe in HRT,

38:12

the euchogestan, the capsule,

38:15

is the natural, it's called micronised progesterone,

38:17

so it's got the natural progesterone in

38:19

it, it's been micronised, so made very

38:21

small and suspended in oil so it

38:23

gets absorbed properly, but

38:26

it still gets digested and metabolised through the

38:28

liver, so it does get broken down into

38:30

other substances so it can get absorbed properly

38:32

in the body. And some

38:35

people find that they can't tolerate

38:37

that, it can cause side effects,

38:39

sometimes people can get skin

38:42

changes, bloating, but commonly low

38:45

mood or sometimes anxiety, and

38:47

then they say well I can't take progesterone,

38:49

but like I've said before we can give

38:52

it vaginally, so it's insert in the vagina

38:54

or actually in the rectum as well, it

38:56

doesn't matter whether it's the up the bottom,

38:58

up the front, it then

39:00

gets absorbed through the mucous membranes

39:03

into the bloodstream as pure progesterone,

39:05

so it doesn't need metabolising, it

39:07

doesn't get broken down at all,

39:10

and so then often people find having

39:12

it as the pure progesterone is

39:15

very different and then there are

39:17

different doses as well and so

39:19

sometimes with the pessaries we can

39:21

advise for them to be cut

39:23

and so people can start with

39:25

a lower dose and then gradually

39:27

increase. Now progesterone is very anti-inflammatory

39:29

and it's very calming on the

39:32

brain and it's very good for

39:34

the brain, it's interesting

39:36

one of the first things that happens

39:38

if we have a head injury or

39:40

a stroke is that the brain produces

39:42

progesterone to help repair it and

39:45

so the other thing is though

39:47

because it helps repair the brain,

39:52

it does have effects on the brain

39:55

tissue and the nervous tissue and the

39:57

way that even our sort of personality

39:59

memory everything else can be affected and

40:02

there is not great evidence but

40:04

more clinical experience and knowledge that

40:06

shows that when some women, not

40:08

every woman, has an effect with

40:11

progesterone, a side effect, it can actually

40:14

sort of reactivate negative things that are

40:16

going on anyway in the body. So

40:18

if someone has had some trauma

40:21

or difficult situation then

40:23

it can catastrophise and make things

40:25

worse as the body's healing themselves.

40:27

It's a bit like if someone

40:29

has some sort of cognitive behavioral

40:31

therapy or other sort of psychotherapy,

40:34

once it's all out on the table you feel worse

40:36

and then you feel better because you've shared it and

40:39

that can sometimes happen with progesterone but

40:41

if people know that it might be

40:43

a short-term pain for longer term gain

40:45

then it's fine. The problem is if

40:48

you have something and it makes you

40:50

feel worse then you can stop

40:52

it straight away going you know I'm not going there

40:54

because that made me feel really sad and really low

40:57

and so knowing that

40:59

actually I think is really interesting because like

41:02

our brain is very plastic

41:05

and they talk about neuroplasticity which

41:07

means the sort of the brain

41:09

can't really regenerate, can't get bigger,

41:11

it's stuck in a skull which

41:13

is a fixed box of course

41:15

but it can change the way

41:17

it works and the pathways can

41:19

change and the way

41:21

it's activated, the way the blood supply

41:24

goes through, the way all our brain

41:26

cells and nerve cells function together can

41:28

change but a lot of this doesn't

41:31

change overnight. Some of the

41:33

processes occur and alter quite

41:35

quickly but others you can have genomics

41:37

or genetic effects that change and that

41:39

could take quite a few weeks or

41:41

months and so with hormones

41:43

you have to be really patient as

41:45

well and most of us myself included

41:48

are not blessed with patients. If we're

41:50

unwell we want to be better now,

41:52

we don't want to wait but if

41:54

we have someone that can explain to

41:56

us that you might

41:58

feel worse before you feel better or we

42:01

can change the dose if it's not right

42:03

for you or we can start

42:05

off very slowly and then increase or there

42:07

are different ways then it's better

42:09

and so you know

42:12

and that's where seeing someone who

42:14

understands it's not a one size

42:16

fits all it's not a you

42:18

know one treatment and then sometimes

42:20

people feel better giving testosterone

42:23

or estrogen first and then adding

42:25

in progesterone because the other thing

42:27

I've seen quite a lot is you

42:30

know women who are still having their

42:32

periods they're still producing hormones of course

42:34

they are so

42:37

if you then give progesterone at a sort

42:39

of standard dose you're actually

42:41

they're having twice the amount of progesterone

42:43

because they've got their own and they've

42:45

got some endogenous progesterone

42:47

and for some women that might

42:49

be too much and so sometimes

42:51

I will give estrogen if they

42:53

need it as well testosterone and

42:56

then monitor periods and then that

42:58

might because they're producing progesterone with

43:00

regular periods they might need a

43:02

little top-up of progesterone or they

43:04

might not need any for a

43:06

few months and then when periods

43:09

start changing we add in progesterone

43:11

because if you have too much of anything

43:13

it can cause problems so that's

43:16

where you know it is a bit

43:18

of a juggling act and it is a bit

43:20

of a fine heart

43:23

but that's where working with patients is really

43:25

important because often once people

43:27

start hormones they they know are they having

43:29

a bit too much is it is it

43:31

one or the other and it's also the

43:34

balance of hormones it's not just having one

43:36

and increasing the dose on its own it's

43:38

looking at how the hormones work with each

43:41

other but also is

43:43

how our external environment

43:45

affects so even this Cattier and

43:47

Adolton who is way ahead of

43:50

her years talks about processed foods

43:52

and talks about restricted time eating

43:54

and she talks about exercise and

43:56

everything else and our

43:58

hormones work better we've been exercising, when

44:01

we're eating properly, she even talked about

44:03

snacking through the day so our sugar

44:05

levels don't drop too quickly and it's

44:07

really hard, a lot of us know

44:10

before our periods we get sugar cravings

44:12

you know you feel this like insatiable

44:14

hunger that is really hard to describe

44:16

to people but that's often the way

44:19

our hormones work but rather than just

44:21

having you know a chocolate

44:23

bar or a packet of crisps it's not

44:25

going to help because you'll get sugar cravings

44:27

and your sugar levels will then go up

44:29

and then plateau and go down and then you'll

44:31

feel worse whereas actually what you

44:33

want to do is have something that's going

44:36

to give you slow energy release and that's

44:39

better for your progesterone receptors as well and

44:41

your hormone receptors in your body but if

44:43

you know you're doing it not just to

44:45

be healthy you're doing it because it will

44:47

help the way your hormones get absorbed then

44:49

it's easier to do as well

44:51

so that's where but it's so much better if

44:54

you've got all this knowledge before your hormones are

44:56

all over the place because otherwise it's quite a

44:58

lot to see on board. No of course not.

45:00

None of us have this knowledge why is this not a class at

45:02

school for women? When I first

45:05

spoke to you that was one thing that I thought why at

45:07

15 was I told to take

45:10

naproxen which for anyone who doesn't know

45:12

that as a huge anti-inflammatory and then

45:14

just go on to the contraceptive pill

45:16

even though I wasn't sexually active so

45:19

you know that was my treatment and that

45:21

had been my treatment for many years and

45:23

coming off it and having constant bursts cysts

45:25

you know the gynecologist was like you better

45:27

get back on the pill so I you

45:29

know I felt this constant cycle of just

45:32

I don't know where to turn to I don't even know who

45:34

to speak to I don't think anyone really knows how to treat

45:36

me so I'm a bit of a lost cause so I'm just

45:38

gonna suffer and I think so many women feel like

45:40

that and I think then when I started

45:43

to have the conversation and went on progesterone I

45:45

can tell you something that really worried

45:47

me and I think this might be a worry for

45:49

many people which I actually haven't spoke to you about

45:52

but I think when you think okay well

45:54

I'm gonna go in hormone therapy okay I'm

45:56

gonna take that immediately my thought

45:59

was Oh my gosh, am I going

46:01

into my perimenopause? Or am I

46:03

not gonna be fertile? Or is there a problem with

46:06

my ovaries? All of these thoughts come into

46:08

your head, which obviously is like a huge fear for women.

46:10

I'm gonna luckily say like I then went off and wanted

46:12

to check that and it was fine. But

46:15

I think that's a really big question that a

46:17

lot of my community have come to

46:19

me since who are in that kind of early 30s

46:21

and maybe have listened to that early menopause episode

46:24

and gone, oh my gosh, am I

46:26

a menopausal? And I think that's a

46:28

really big thing to talk about, just because you get

46:30

these symptoms, does that mean that you are

46:32

at a higher risk of being infertile or

46:34

there's something wrong with your ovaries because you've

46:36

just mentioned it's all in your brain. It's

46:38

really important and I've already said

46:41

one in 30 women will have an early menopause.

46:44

But if you have an early menopause under the age of

46:46

40, it doesn't mean

46:48

you're gonna be infertile, which is really

46:51

important because one of the definitions of

46:53

menopause is loss of fertility, but it's

46:55

not actually for younger people. And we

46:57

know that if women have

46:59

their hormones back, then they're

47:01

more likely to be fertile as well. And

47:04

there's a lot of women I see who have

47:06

been to IVF clinics in the past, might

47:10

or might not have been successful in getting

47:12

pregnant, but they've had a myriad of symptoms

47:15

that have been blamed as, oh, you're anxious

47:17

because you can't get pregnant, you're stressed, you

47:19

know, this, that and the other. But actually

47:21

when you unpick it, it's been related to

47:24

their hormones. But

47:26

actually we know that having

47:28

natural hormones is very safe,

47:31

even if you got pregnant on them, because

47:33

all you're doing is topping up the hormones.

47:36

And increasingly there's a lot

47:38

of people who are progesterone

47:40

deficient and having progesterone can

47:42

help improve the chances of

47:44

becoming pregnant. And once some

47:46

of the treatments, I'm not

47:48

a fertility expert, of course,

47:50

but they often do give

47:52

cyclogesis, pesarees, progesterone, pesarees, I've

47:54

mentioned before, as part of

47:58

IVF treatment for some people. I

50:00

don't think we should normalize heavy periods. I'm

50:02

I get shocked with with stories that people

50:04

tell me they say yeah My peers are

50:06

a bit heavy. Yeah, I just have to

50:08

change my tampon, you know every half an

50:10

hour And I'm always flooding and our beds

50:12

always, you know Have

50:15

you ever seen a doctor and officers our

50:17

conversation? Yeah, and often they say what I

50:19

have seen a doctor they say well heavy

50:21

periods are really common But there's two issues

50:23

here One is I don't feel

50:25

anyone should be having heavy periods because there

50:27

is treatments that will help heavy periods But

50:30

the second thing is heavy periods could be

50:32

a sign of something so it could be

50:34

related to endometriosis For example,

50:36

it could be related to Pecos polycystic

50:39

ovarian syndrome. It could be Related

50:42

to a hormonal imbalance, you know, you've already

50:44

said your periods are lighter because you're having

50:46

progesterone So we

50:48

should be on a bit of a hyper alert

50:50

and seeing I mean it it's

50:52

interesting journey My 13 year

50:55

olds started her periods a year or so ago

50:57

and a few days ago one of

50:59

my other daughter said oh my Was

51:02

just crying in the shower and it's so awful and my mom

51:04

was saying we need to go and talk to her and I

51:07

Anyway, I spoke to a couple of days later to say

51:09

what happened in the shower. She goes. Oh, mommy I just

51:11

had my period the next day. She said it was fine

51:14

But she knew that she would feel like that and

51:16

I'm not gonna rush and give her any hormones. Of

51:18

course not. She's young She's fine.

51:20

She's got insight. I'm keeping an

51:22

eye on things But

51:25

knowledge is power because otherwise I would

51:28

have really worried that my 13 year old

51:30

was crying in the shower She would have

51:32

worried is there something going on or has

51:34

someone been mean at school or she might

51:36

have catastrophized the situation So knowing

51:38

that the hormones can make you feel a certain way

51:41

That's where knowledge is important but

51:44

as she gets older if her periods

51:46

are very heavy then there are options

51:48

and You know just

51:50

to mention really For

51:53

older older children and and adults and

51:55

not my fitting or but and you

51:57

know, there there is the marina coil

51:59

for old disorder

58:00

than it's often related to hormones

58:02

actually. Hormones. Yeah. Isn't

58:04

that so sad that that's how it's

58:06

just placed on women? I'm just thinking

58:08

about all of these kind of stigmatized

58:11

comments that come out and it's all

58:13

with women, with hormones. But

58:15

it's the least supported area and

58:18

also it's probably the most hardest

58:20

one to navigate because it can also feel like

58:22

a bit of a cowboy mark out there and

58:24

very unethical when it comes to this as well

58:27

for some people finding stuff online

58:29

and trying to test the hormones and feeling

58:31

really lost or somebody not listening to them.

58:34

And I think with everything that we spoke

58:36

about, how there isn't this gold standard test,

58:39

how it is about symptoms

58:41

and having a conversation with somebody like

58:43

you, your GP and tracking your symptoms

58:45

is really important. So downloading the Balance

58:47

app, having a period tracker app that

58:49

can be really good so you can kind of

58:51

like see when are your symptoms mostly coming

58:53

up. And I think that really, really helped me as well

58:56

when I was coming to speak to you. But

58:59

I think something that we haven't touched upon and this is again,

59:01

because it stigmatizes, how do you talk

59:04

to this about your partner or the

59:06

relationships around you? Because I think that

59:09

conversation with yourself is difficult to even

59:11

get treatment. Yeah. Even

59:13

recognizing that with people around you can be really difficult.

59:15

Did you have any advice on people who are listening

59:17

to this? And maybe they're feeling within themselves a bit

59:19

of stigma, a bit of shame and, oh gosh, I

59:22

feel like that, which they shouldn't at all. But of

59:24

course it's natural because I

59:26

know I did. How can we then

59:28

go about having these conversations with kind of

59:30

the relationships that are around us? It's

59:33

so important and it's not just your

59:35

partner, it's your family, it's your friends,

59:37

it's your work colleagues. Really

59:39

important. And in my

59:42

book, The Definitive Guide to the Perimenopause and

59:44

Menopause, I do talk about PMS and PMDD.

59:47

And there is a section about

59:49

talking to family and friends in

59:51

there because it's so important because

59:53

otherwise you're just seen as this

59:56

hormonal nightmare to be with. And

59:58

it's really quite eye- isolating when

1:00:01

you're having hormonal changes, you feel

1:00:03

quite vulnerable, you feel quite neglected,

1:00:06

you can't always express

1:00:10

what you're saying because your brain

1:00:12

isn't working properly and you want

1:00:14

someone to understand and you

1:00:17

want someone to recognize actually because sometimes it

1:00:19

might be your partner or your friend or

1:00:21

your work colleague who says Do you know

1:00:23

what Louise? Entiret days of

1:00:25

the month. You're just not quite yourself. Do

1:00:28

you think anything can be related to your hormones? Have

1:00:30

you read this book? Have you downloaded balance? Have you

1:00:32

read this article? Listen to this podcast? Maybe

1:00:35

I could come with you and talk to the doctor

1:00:37

about options Because

1:00:40

when you're with yourself 24-7 you don't always

1:00:42

notice or you blame it on something else

1:00:44

You just think oh, it's because I'm tired

1:00:46

or because this, you know, the Sun is

1:00:48

I'm stressed because whatever. Yeah So

1:00:51

so I think actually Even

1:00:53

if you're listening to this and you don't have

1:00:55

symptoms and you're female you are going to have

1:00:57

some hormonal changes at some stage You

1:01:00

know say to people can you just have a read

1:01:02

of this so that if I do change? You

1:01:04

know what's going on and I think we you

1:01:06

know, we need others to help us actually with

1:01:09

this Mmm, and

1:01:11

you had your own personal story with that didn't

1:01:13

you as well? I mean you really know from

1:01:15

a medical point of view but from a personal

1:01:17

point of view as well Yeah, I mean I

1:01:19

it's awful actually I mean when I was Perry

1:01:21

menopausal and I I don't really think I had

1:01:23

much pain I would have had a bit, you

1:01:25

know day before but my periods were not a

1:01:27

big event They just happened But

1:01:29

I had a few months where my I felt

1:01:31

like my brain had been taken over by this

1:01:34

Demon horrid thing that was just allowing me

1:01:36

to shout to be irritable You know, I

1:01:39

mean the the brain fog and the memory

1:01:41

problems were really awful and scary, but it

1:01:44

it's this sort of Anger

1:01:46

that you know a lot of people describe

1:01:48

as well Which is is really

1:01:50

difficult because normally if you're crossed you can count

1:01:52

to ten and suppress it or just walk out

1:01:54

of the room And you're okay, but

1:01:57

it's like someone gives you permission to be

1:01:59

really horrible And that's

1:02:01

a really awful place to be. And,

1:02:03

you know, I'm fine with, we've

1:02:06

got a very stable family with a lot of

1:02:08

love in our home, but there's lots of homes

1:02:10

there isn't. And it doesn't take much for it

1:02:12

to be really on the edge. And

1:02:14

that's what really worries and scares me

1:02:16

with this, because, you know,

1:02:18

people, if you don't understand, and

1:02:21

I did a podcast with someone about

1:02:23

PMDD, really powerful

1:02:25

story with a lady. And, you

1:02:28

know, her husband's still with her, and

1:02:30

she doesn't know how either, I mean,

1:02:32

what her children were exposed to was

1:02:35

quite extreme and awful, but she knew

1:02:37

it wasn't herself. And this is a

1:02:39

big key. You know, if there

1:02:41

are times in the month that you know,

1:02:43

or your partner knows this isn't the real

1:02:45

you, then I just

1:02:47

think ask the question, could it be related

1:02:50

to your hormones in any way? Exclude

1:02:52

your hormones first, and then work out

1:02:54

what else is going on. If

1:02:58

there's one takeaway that you want the listeners

1:03:00

to leave this episode with,

1:03:03

what would that be surrounding their hormones? Just

1:03:06

knowledge and knowing how they can get

1:03:09

everywhere to every cell in our body,

1:03:11

every organ in our body. The power

1:03:13

of hormones is immense, and it's been

1:03:15

neglected for so long. I

1:03:19

mean, I completely agree, I can't believe, and I

1:03:21

say it because I feel you went through the

1:03:23

same thing that I was in, I've been in

1:03:25

the wellness field while being filled for

1:03:29

over 10 years now, you know, in clinic

1:03:31

and working with patients and running a mental

1:03:33

health organization and doing the show, and still

1:03:36

I was unaware. And so that's why

1:03:38

I think this conversation is so, so

1:03:40

important, because if I'm in the epi

1:03:43

center of it, and I don't even

1:03:45

recognize it, I then think,

1:03:47

you know, how is anyone else gonna recognize it? Because

1:03:49

I talk about this all the time. And

1:03:52

it can be really hard, I think, and that's

1:03:54

why I want anyone listening to this to take

1:03:56

a moment and pause and think, have I related

1:03:58

to anything that's come up in today's episode? episode

1:04:01

because so many times we might listen to it and glance

1:04:03

over it, they are not that bad. No, I don't get

1:04:05

angry. I only cry once a

1:04:07

month. It's fine. But they're never really honest

1:04:09

with themselves. And I think

1:04:11

there's no shame or stigma of knowing that

1:04:13

actually you do feel like this for maybe

1:04:15

a good week or more. You are a

1:04:17

nightmare to be around all of those things.

1:04:20

But that also takes a lot of strength to get

1:04:23

to that place. I think if anyone

1:04:25

does relate to this, there's

1:04:27

power and knowledge knowing that you don't have to

1:04:29

feel in that way, which is great. So

1:04:33

I always leave Louise and I know

1:04:35

I've asked you this before and I'm wondering if you

1:04:37

remember and you might do. But

1:04:40

it's what I leave with all my guests, which

1:04:42

is what does live well be well mean to

1:04:44

you? Do you know, I can't

1:04:46

remember what I said before. But I

1:04:48

think... I know what you said. That's how you after. You

1:04:50

can tell me after. But I think live well, be well

1:04:53

is actually... And

1:04:55

I hesitate here because it's sounding

1:04:57

a bit cheesy, really, but being

1:05:00

surrounded by people you love and

1:05:02

also having that internal love, which I think

1:05:05

is the hardest thing to do. You don't

1:05:07

have to love yourself, but you have to

1:05:09

respect yourself because then you're going

1:05:11

to radiate more love and more positivity to

1:05:13

others. And the more I

1:05:16

lean on like good people,

1:05:18

the happier I feel. And I

1:05:21

think if you're not surrounded by love, then

1:05:23

anything else just falls out. Yes,

1:05:25

we can talk about nutrition and

1:05:27

exercise and everything else. But I

1:05:30

think love and respect for people

1:05:32

is really powerful. Yeah.

1:05:35

Love for other people and love for yourself.

1:05:37

Self compassion. I mean, it's my word that

1:05:40

I use a lot, but yeah, love for yourself. It's

1:05:42

really important. Do you know what you said last time?

1:05:45

No, go on, tell me. It

1:05:47

says, it takes a while to live well, be well.

1:05:50

But when it does, it doesn't need to be 100% of the time. Yeah,

1:05:53

that's true as well. And I liked that. Yeah,

1:05:56

I liked that. I think that, you know, they're very

1:05:59

similar. Didn't It has to be perfect all the time,

1:06:01

but you do have to have respect for yourself, which

1:06:03

is important. Absolutely. Louise,

1:06:06

I know everyone, you've mentioned a couple of

1:06:09

things here, Balance App, your book. Could

1:06:11

you please give all of the information, because

1:06:13

I know that this podcast is not

1:06:15

gonna be enough information. But actually

1:06:18

we tried to get everything in. We didn't even

1:06:20

touch upon diet, but we didn't have time. But

1:06:23

can you give all the resources so people can

1:06:25

go and find you please? Yeah, the easiest thing

1:06:27

actually, is just to go to drlouisenewson.co.uk and

1:06:30

then you can springboard into anything from that

1:06:32

website and see what I'm up to, what

1:06:34

I'm doing. And follow me on Instagram, menopause

1:06:36

underscore doctor. That's where I spend a lot of my

1:06:38

time. Just explaining

1:06:41

where I am, what I'm doing, how I'm

1:06:43

helping. And it's a join up effort. I

1:06:45

don't work on my own. I work with

1:06:47

an amazing team, but there's lots

1:06:49

of women who are working together to

1:06:52

really amplify messages, which is great. Yeah,

1:06:55

women supporting women, it's so important. And honestly, if a

1:06:57

man's got to the end of this episode, well

1:07:00

done. It's a huge accolade for you.

1:07:02

Well done. And I'd say to women, if anyone's

1:07:04

worried, you know, when we were talking about getting

1:07:06

support, send them this podcast. Just

1:07:09

send it and let them listen to it. And let me

1:07:11

realize that, you know, it's not just you that goes through

1:07:14

this. So thank you so much for

1:07:16

coming on. Oh, thank you. Thank

1:07:18

you so much for just changing my life. And

1:07:21

I've never said that before, but it

1:07:23

means a lot. And I really hope that this

1:07:25

touches many women who are listening to this as

1:07:27

well. Thank you.