Just As Well, The Women's Health Podcast - Perimenopause, Menopause and Beyond: Busting Myths and Misinformation

Episode Date: September 17, 2020

It’s Fit At Any Age month on Women’s Health, where we’re celebrating women’s evolving health, fitness and wellness needs. And, of course, arming you with the tools you need to feel, perform and look your best - at every age and stage. This week we’re talking about the menopause and perimenopause - stages of life that have gone unspoken about for too long, and might not be as far away as you’d think. The perimenopause (where hormone levels drop, your periods become inconsistent and you can experience a tonne of undesirable symptoms including fatigue, low mood and forgetfulness) tends to start when women are in their early 40s. And, in the case of WH Editor-in-Chief Claire Sanderson, they appeared in her late 30s. In today’s episode she chats to GP and leading menopause specialist Dr Louise Newson about her disorienting journey into the perimenopause and the key lessons she wants all women on - or approaching - that journey to know. Here, they discuss how to spot the signs that you’ve entered a menopausal or perimenopausal phase, and discuss the actions you can take to get back on your game at what is - personally and professionally - such a key time of life. Follow Dr Louise Newson on Instagram: @menopause_doctor Follow Claire Sanderson on Instagram: @clairesanderson Follow Women’s Health on Instagram: @womenshealthuk Topics:  Spot the signs of the perimenopause Two women share their perimenopause journeys HRT and breast cancer: how robust is the connection? Managing menopause without hormones The mental health impact of nosediving hormones Like what you’re hearing? We'd love if you could rate and leave us a review on Apple Podcasts, as it really helps other people find the show. Also, remember to subscribe wherever you get your podcasts, so you’ll never miss an episode.  Got a goal in mind? Shoot us a message on Instagram putting ‘Going for Goal’ at the start of your message and our experts could be helping you achieve your health goal in an upcoming episode. Or you can send us an email on [e-mail]. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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In this week's show, we're looking at how all women can manage their perimenopausal and menopausal years. Now, if you're listening and thinking, that's ages away. If you're in your 30s or approaching them, it really might not be. So perimenopause, where levels of certain hormones drop and your periods become inconsistent, and you can experience a ton of undesirable symptoms, like you. fatigue, low mood, forgetfulness. So this tends to start when women are in their early 40s. And in a case of women's health editor-in-chief Claire Sanderson, they actually appeared when she was still in her 30s. In today's episode, she chats to GP and leading menopause specialist

Dr. Louise Newsome about this disorienting journey into the perimenopause and the key lesson she wants all women on or approaching that journey to know. Here they discuss how to spot the signs that you've entered a menopausal or a perimenopausal phase and offer advice on what actions you can take to get back on your game at what is professionally and personally, often such a key time in a woman's life. Expect plenty of myth-busting and to come away feeling actually informed about a topic that's not been talked about enough for far too long. Hello everyone. My name is Claire Sanderson and I am the editor-in-chief of Woman's Self. You're listening to our weekly podcast going for goal.

And it is women's health fit at any age month where we are celebrating healthy women, regardless of their age throughout the decades. And my guest today is one of the leading doctors in her chosen field, which is menopause. And she is Dr. Louise Newsom. Hi, Louise, thank you so much for joining me. Hi, Claire, thanks for inviting me today.

So Louise, we're going to talk all things menopause today, but we're actually going to cover off peri menopause as well, which is a phrase that until I started experiencing symptoms myself at the age of 39, I'd never heard of. And it is being talked about more and more. And there are many high-profile women who are proudly owning their perimenopause and menopause. But it's still a subject that shrouded a little bit of embarrassment for some women. So if you can tell me a bit about what you do and how you got into specialising for menopause and how you help women on a daily basis.

Yeah, absolutely. So I think even looking at the word menopause causes a lot of confusion and like you say, sometimes embarrassment. And it shouldn't be embarrassing because we all go through it as women. So all women globally will be affected by the menopause. And you can argue that all men indirectly will be affected because they all know women. But it's a long-term hormone deficiency. So it's not just about symptoms, although symptoms are obviously very important because they usually have a very negative effect on women's lives. But the menopause can't be diagnosed until a woman doesn't have a period for a year,

which is quite a long time when your periods can be irregular. Sometimes the menopause occurs because women have their ovaries removed and obviously then won't have their hormones associated with those ovaries. And often it's a natural decline in our hormone levels. But what happens before, like you quite rightly say, is this peri menopause. And peri is just a medical term for around the time of. So it's around the time of the menopause. Our hormones don't just stop overnight unless we have our ovaries removed, but they gradually decline. But they sometimes decline and then sometimes increase. And they're a bit chaotic. And they can be chaotic with a gradual decline over a decade for some women's lives. So the average age of the menopause is 51, as you know, in the UK, whereas the average age of the perimenopause can be in the early 40s. So a lot of women are still having periods, but their periods may change either in nature or frequency,

and then they get menopausal symptoms. But as you know, the hormones, estrogen and also testosterone in women are very important for every cell function. So it's not just about hot flushes and sweats. A lot of women find they really miss those hormones in their brains. So they experience symptoms such as low mood, anxiety, memory problems, brain fog, fatigue, just. just general apathy, generally not enjoying life like they used to. But because they're still getting periods, they think, well, I can't be my menopause. Clearly it's not because they're still having periods. They might not have heard of the perimenopause, or they might think, well, the menopause

is about hot flashes and that's not me. But because hormone levels are declining, they're causing symptoms. And also, for me, as a physician, I'm very interested in disease prevention. None of us like going to the doctors. None of us want to become ill. So actually, we need hormones to improve our house. And evolutionary, if you like, we're designed to reproduce and expire. So in the Victorian times, we used to die quite soon after our menopause,

whereas now, thankfully often, women live for decades after their menopause, but they have low hormones. So these hormones are really important for our health. And without them, there's an increased risk of disease, such as heart disease, type 2 diabetes, dementia, osteoporosis. So it's really important, even in the peri menopause, when our hormones start to reduce, we're thinking of hormones being reduced, equalling an increased risk of diseases. So it's a real wake-up call that we need to think about it because we're living longer and we all want to be healthy for as long as possible. We don't just want to

exist, we want to live and enjoy our lives. So to answer one of your questions really, I'm a GP, but I've also done a lot of hospital medicine. So I'm quite unusual as a menopause specialist in that I'm not a gynecologist. Traditionally, gynaecologists have looked after women who are menopausal because they've looked after period problems. But it's not a period problem. Actually, it's the best thing about the menopause is not having periods. But for me, as a physician, I'm worried, as I've already said, about the long-term health risks of low hormones. And it's also the effect that it has on women. So I've always helped and manage women during their perimenopause and menopause as a GP. And then we had some guidelines that came out in 2015,

which were produced by NICE, the National Institute of Health and Care Excellence. So their government endorsed guidelines. And they really show that for the majority of women, the benefits of HRT outweigh the risks. And so I thought this is great because actually this is confirming everything that I've read before everything that I know about HRT, yet the minority of women, as you know, Claire, are given HRT. So I wanted to do more work. I got some qualifications, became a menopause specialist, but I couldn't find a job in the NHS because there isn't much provision for menopause, despite it affecting all women. So I set up a private clinic really to help some of my friends who were telling me that they've been given antidepressants, which is not a treatment for the menopause.

So I set up a clinic one day a week and then I decided to launch a website because I was really shocked by how little information there was out there for women. And so I developed this website, menopausedoctor.com.uker. My clinic quickly exploded. But I was hearing stories and I still do every day from women who have been neglected. They've been told they can't have HR2 for the wrong reasons. They have given up their jobs because they can't concentrate. They can't remember things. They're very tired.

They're very anxious. Their health is risk. A lot of them have developed osteoporosis or heart disease because they haven't had hormones for a long time. Some of them have given up their partners because their relationships have changed. Their personalities have changed. Yet they're not given help. And HRT is cheap.

It's cost effective. It has long-term health benefits. So a lot of the work I do in addition to my clinic is about campaigning really and less. and letting women have a voice. And as you know, we've recently developed in a free app called Balance, which is about giving women evidence-based information globally, really. So it's a massive problem. It's much needed.

I'm 42 now. I'm very perimenopausal. But, you know, my symptoms are deteriorating, which is something that I need to talk to you about side of this. But when I first started experiencing these symptoms, I was 39, the editor of the editor of, woman's health so you'd think that I would be informed about such things and I'd never heard the phrase and it was only going out for dinner with a girlfriend of mine who's a doctor and

she said you do realize that you're describing perimenopausal symptoms but I was 39 I thought it was years off absolutely years off and also my reproductive health up until that point in terms of frequency of periods ease of getting pregnant I'm not sure if that is relevant at all to how tough or easier your menopause, but I sort of thought, oh, I'm going to sail through it, because I've been so healthy in that area of my health, but that's not necessarily the case, is it? No, and it really varies. So you don't know what your experience is going to be like until you're in it. And just because your mother had an easy time doesn't mean that you don't have, you know. And it is hard because these symptoms, especially when you're paring menopoles, will come on very gradually.

And I'm sure some of you might have heard, but when I was writing my wife, website. I was working very long hours and as you know I've got three children, life's busy and I was cramming in this work. And I was feeling incredibly tired, incredibly irritable and I kept forgetting things. And even at work, I kept thinking I can't remember the dose of antibiotics that I prescribed for the last 20 years. And I kept looking at my examination couch thinking I just need to have a dose. I'm really, really tired. I was getting back to about migraines. And I just thought it was because I was working too hard. And it wasn't to one of my teenage children told me off for shouting at she thought maybe it would be good idea for me to have a period because she said

some of her friends get very cross before their periods and she said you're behaving the same I think is your period due and I suddenly thought my goodness I haven't had a period for about three or four months I must be perimenopausal so this is me as a menopause specialist writing a menopause website lecturing to healthcare professionals about how we have to pick up other signs of the menopause and other symptoms I hadn't recognised myself and as soon as she said that oh my goodness how obvious And so then I could think about HRT and my life obviously improved. My symptoms improved.

So I'm not surprised that you as an editor of a key magazine didn't recognize because we don't talk about it. You know, at school we talk about sexually transmitted diseases, talk about contraception, talk about drug abuse, you know, not all our children are hopefully going to take drugs, but all our female children, if they live long enough, we'll go through the menopause and the perimenopause. So it's having this conversation really early. So we can also not just pick it up on our own, but we can pick it up with our friends and our relatives and not think of it as a terrible thing that's happening to us.

Actually, if we let it right, the menopause can be a fantastic time to optimise your health because it's an opportunity to think about our bones, our brain, our exercise, our nutrition, our hormones. We can balance it all if we've got the right. information. So let's talk about HRT. You touched upon the reluctance amongst a majority of British women to take HRT. I read a stat. It's alarmingly low, something like 10%. There may be more recent research, but that's what I learned when you and I were part of the government's women's

health task force, which is where we first met. Actually, a very senior doctor I met there said that she feels the misinformation around HRT is one of the biggest injustices for women's health issues of our generation and it's linked to I believe a flawed study which said that they increased the prevalence of breast cancer now there's a lot of breast cancer in my family including my mother who had in my in her 40s and when I went to the doctor in house for HRT I was was asked you know are you aware of the risks and this was a GP saying it to me I know that you've heard that from so many of your patients so can you can you take me through the concerns that you hear about HRT?

Absolutely. And you're so right that it is the biggest travesty to women's health, this misinformation. And it's misinformation to the media, to women, to the public, but also to healthcare professionals, which is really sad. So just before I start talking about this, I am not paid by any HRT company. I don't have a vested interest. And I think it's really important that listeners know that. So HRT is only three letters, hormone replacement therapy. And there are different doses, there are different types, there are different formulations. The most important hormone for women is estrogen and estrogen declines when we go through the menopause because it's produced by our ovaries. Estrogen has a big function on many cells, in fact, all of our

cells throughout our body. And when we replace it the right dose, the symptoms of estrogen deficiency improve, but also our long-term health improves. So you'll be thinking, well, why isn't everyone taking HRT? Well, a lot of people did. And certainly in the 80s and 90s, so I qualified in the 90s, we used to give HRT all the time. It was just given out because we knew women felt better, but there were health benefits from taking it. And then in 2002, a big study came out called the Women's Health Initiative. And this was a massive multi-million dollar study, funded by a pharmaceutical company in America. And they were trying to look at the long-term sort of health benefits of taking HRT. But they chose a really unusual population of

women. They chose women who were in their 60s, who had finished most of their symptoms of the menopause, but a lot of these women were obese and had heart disease, so they had other health risks. They gave them a type of HRT we don't prescribe now, so a tablet type of estrogen and also a synthetic type of progestogen. And these have different risks to the estrogen we now through the skin and the natural progesterone. So they gave these. And then it was a massive study. The results were glanced at, if you like, and then they were given to the media without them being analysed properly. And so as soon as the media had them, they said, goodness, it causes more risk of breast cancer, more risk of heart disease. That's it. Everyone come off HRT. It's astounding.

And actually, what they didn't do is look at the data properly and they since have, and you can imagine and there's lots of people looked at this data. And they've shown some really important things. So firstly, they've shown that women who only take estrogen, so women who have had a hysterectomy, their womb removed, only take estrogen as part of their HRT. They've followed these women up now for 18 years, because it was 18 years ago the study was done,

and shown that these women have a 25% reduction in breast cancer risk and also reduction in breast cancer death from taking estrogen. Now, that's quite a lot to take on board, isn't it? Because everyone thinks estrogen causes cancer because you talk about an estrogen receptor positive cancer. But actually, estrogen is beneficial and it used to be a treatment for breast cancer, in fact. So we've got really good study that show that women who take estrogen, you follow them up and they reduce their risk of getting breast cancer with taking estrogen-only HRT, which most people don't realize it didn't come even to the media when they're going. came out. So then the synthetic progestogens that I said some of them take, the study show there

might be a small increase risk in some women who take this synthetic progestogen. And when you look at the risk, it looks horrendous when you read about it in the media. But actually, if you compare the risk, so there are other reasons why women get breast cancer, like you say, if there's a family history, you might have an increased risk. But also other factors such as drinking alcohol, being overweight, not exercising, these increase a woman's risk of breast cancer. And this big study that has been the nail in the coffin for HRT showed that the risk, even with the worst type, if you like, of HRT, in the highest risk of woman, the risk is less than the risk a woman has if she drinks a couple of glasses of wine a night. So we don't have warnings on wine bottles telling us about

risk of breast cancer because the risk is small. And if you increase, a small risk, you've still got a small risk. So if your risk was low and I doubled that low risk, double sounds really high, doesn't it? But if it's low, it's going to still be a low risk. And this is what we need to think about. And then there's been studies that have been done using these other types of HRT to show actually the risk is probably not even there anyway, because the study wasn't set up to look at breast cancer risk. It was looking at other benefits of HRT. So we've had a lot of other studies showing that women take HRT have a lower risk of death from all causes, including from cancer if they take HRT for 18 years.

They have a lower risk of dementia, a lower risk of osteoporosis, lower risk of heart disease. So it's just sad, actually, that women have been given wrong information, but also healthcare professionals have been fed wrong information actually from the government as well, which is something that is really sad because doctors want to do the best for their patient. All healthcare professionals do. And we want to work based on the evidence. And I have time and dedication to read the journals and the articles properly. But healthcare professionals will just read the take-home message because they're busy,

understandably. So we have some other information that's come out from the MHRA, which is the advisory body, if you like, from the government, who have recently said, oh, HRT causes breast cancer, we have to be really careful. And they've gone on old data, not on new data, and they haven't looked at the benefits. And there's never ever been a study that shows that women who take HRT have a higher risk of death from breast cancer. And that's really important. So it might be for some women who've already maybe got a small breast cancer, it might change the speed of the growth of it.

it might, but it doesn't cause the breast cancer to be worse or the more likely to die from breast cancer. And women are more, there's more to women and women's health than breast cancer. So we need to look at the bigger picture. And we need to share some of this uncertainty with women. You know, I couldn't function without HRT. I would be at home staring at the four walls. I would not be a director of a company trying to help other women because my brain didn't work. So even if the type of HRT I take does give me a small increase risk of breast cancer,

which I might get breast cancer anyway because I'm a woman. But actually I'm prepared to take that risk because I know there are other benefits from taking HRT for my day-to-day functioning, but also I'm not as likely to get heart disease and osteoporosis. And I'm more worried about osteoporosis than I am about breast cancer. But it's my individual choice. So I'm not coming on to here to say everyone has to take HRT. But I am saying that everyone has to know the facts, which is sadly not happening at the moment. So the work that you're doing to educate women, the bigger scale, is so important.

And then women can think, actually, let me rethink what HR2 means. I'm here for Bet Rivers Online Casino and Sportsbook with poker icon Phil Helmew. Thanks to Bet Rivers, I'm also a slots icon. Great. And a same game parley icon. Cool, cool. A blackjack icon, a moneyline icon, a roulette icon. a roulette icon. If you love games,

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although they could look at you on Instagram, which is full of packed with detail and your website. But for women who have to just go to their GP, and they come up a bit of a resistance, what should they say and what type of HRT should they be asking for? So it's really hard, isn't it? I really feel for women,

and I feel for anyone who isn't getting the help that they deserve, because it can be quite hard. I feel quite nervous going to see a GP. I keep thinking, I'm going to waste their time, and certainly the menopause when it's not a disease, a lot of women feel quite nervous, understandably. But actually, we've got guidance, and doctors need to work about,

work towards that guidance. And I'm certainly a lot of doctors are fantastic with the menopause, but those that haven't had the information, we need to try and educate them in different ways. And I have developed a menopause education program with a company called 14 Fish, which is now available remotely for healthcare professionals. So that's going to help a bit. But women need to be empowered with the information. So like you say, there's a lot of free information on my website. there's also an ability that you can record your symptoms. So if you put in questionnaire as in the search function on my website, menopausedoctor.com.com.

UK, you will be able to download a symptom tracker, which is really important. And also, if you put in easy, as a search function, it will come up with an easy HRT prescribing guide that I have written for healthcare professionals, but a lot of women have found that very useful to download and give to their healthcare professional. And it might be a practice nurse rather than a GP, but that will give them a guide to the type of HRT

that has got the best evidence behind using it and the best safety profile. If a person still isn't getting the right help, then they should try and see another doctor or another nurse. And if they still can't get help, then they should really challenge that doctor and say, look, I've read the nice guidance. And again, the nice guidance is available on my doctor. website. I have some information and actually I really want to take HRT and can you tell me why you're

not giving it to me. You know, if someone had an underactive thyroid gland, they wouldn't be denied thyroxin and it has to be looked at in the same way because of the health risks that's available, that are given to, or the health risks for women when they are denied HRT. You know, we see a lot of women who are very young in my clinic who have had their ovaries removed, maybe in their 30s, they've been denied HRT for sometimes 10 years and then they've already got some thinning of their bones. So it's really important if you're listening and you think it's me or my friend or my relative hasn't had HRT and they need it, then they do their homework if you like because that will help direct the consultation and just stick to your guns. It's really

important. And what natural things can women do to help them navigate the perimenopause and the menopause. Yeah, do you know that's very interesting, Claire, that word natural, because actually it's very natural to have hormones. So a lot of people, and certainly when I first opened my clinic, they would come to me, so I don't want HRT, I want something natural. And then when you talk to them about how unnatural it is to not have hormones, they change. And my clinic has changed because I have given a huge amount of free information on my website. And women now are a lot more empowered. They have a lot more knowledge. And so they realize that actually HRTs are missing, heart. But it's not just about HRT. It's very important to look at other ways to improve your

bone, your brain, your heart health. And some women choose not to take HRT. Some women can't have it in the first instance, and that's usually women that have had an estrogen receptor positive cancer, although some of these women will still choose to take HRT for the other benefits that's afforded, but they need to see a menopause specialist. But all women, regardless of whether they take HRT or not, should be looking at ways to improve their brain, their bone, their heart health. So they should look at exercise, especially weight-bearing exercise to improve their bone density. They should look at their diet, make sure they have plenty of calcium for their bones, look at healthy, non-processed diet, reduced sugar, reduced processed food.

And they should be looking at their alcohol smoking if that's pertinent to them. There are a lot of supplements that are labelled for menopause that people can buy. And to be honest, my sort of rule of thumb is if anything is labelled that it's for the menopause or women, you should avoid it because it would have a price tag associated with it. And there are a lot of women desperate for help who will spend a lot of money on these products because they're desperate to feel better. And I always think it's look at what you're taking and why you're taking it. So are you taking a treatment to help your hot flushes? and it might. So some things like Sage might help your hot flushes.

But is that going to help your bone density? Is it going to help reduce your risk of heart disease and dementia? So it's looking at what you're taking. We should all be taking vitamin D. That's government guidelines to help with our bone density. Some women choose to take supplements such as magnesium or a fish oil or a probiotic. But you just need to think about what you're taking and why you're taking it really. Are there any lifestyle changes you can adapt in your 30s that will ultimately help you through the perimenopause and the menopause when it's your time?

No. Because we're all different. So everyone's perimenopause and menopause's journey, if you like, is different. It's very individual and that's why every woman deserves to have individualised to help and advice. But it changes. So some people find that initially they might be. be getting night sweats and that can be really affecting them. And then they might get flushes, but then they might improve, but then they might find they get overwhelming anxiety,

or they might get very low thoughts, or they might get muscle and joint pains, or they might get urinary symptoms. So symptoms can change and evolve. I think it's a bit like before someone's pregnant, you're much better off being really healthy before you get pregnant because once you're pregnant, you're a few weeks pregnant when you find out. It's a bit late. then to suddenly change your lifestyle. And I think it's a bit like this with the perimenopause and menopause. If we can be really healthy when we go into it, it's then a lot easier because I know when I had symptoms, I just couldn't be bothered to cook. My yoga practice was hard because my joints were stiff and sore. I had no energy. I could not be bothered to do anything. So actually

then to make changes to my lifestyle would be really hard. But I wanted to keep my original lifestyle. So I had more motivation. And certainly once my hormones were balanced with taking HRT, it was a lot easier to go back to yoga and eating healthily and not drinking alcohol or not smoking. But if you're coming from a place where you've been, you're overweight and you haven't got the best lifestyle, you add in the menopause or the perimenopause to that mix. It really flaws women. And then they feel failures because they can't improve.

So there's nothing worse than trying to tell a menopause of women that they have to get our, early and go for a brisk walk before breakfast and to eat the most healthiest homemade granola because they're going to not do it because they'll feel awful. Not all of them, but a lot of them will and it won't help their symptoms. You can't replace estrogen naturally. People will talk about having flax seeds or some phytoestrogens. You'll increase a little bit but not enough to really help and not enough to reduce future disease as well. So everything you described there it will impact a woman's mental health as well. So you have the physical effect on the mental health,

which for my symptoms of perimenopause is fluctuating mood, but I have a history of depression, so I know I'm more prone to that and breast pain. But it's my mental health that I'm more concerned about. And I've read a lot of women talking about how their relationships have collapsed or on the verge of collapse because they haven't been able to communicate with their partners exactly why they're feeling so low,

why they've lost the libido. Also, women have taken a step back from their careers because they've lost their motivation to thrive in work because the brain fog has got too much. So how do you support women in your clinic with the mental side effects of menopause and perimenopause? It's really hard. And actually, one of the big things that we do is listen to women

and actually help them to understand that what they've been experienced isn't their first. fault, making them understand also that hormones are really important in our brains. And I didn't realise quite how important they were until I've seen the volume of women that I have because I know it's related because they feel better when you replace their hormones correctly. But a lot of women find that all these symptoms that you're saying, this low mood, the loss of interest in things, relationship problems, problems at work. They play the way. themselves and actually just to know that it can be related to their hormones is a huge step

in the right direction. And then often balancing hormones can make a huge difference because you're treating the underlying cause. And then we work with other practitioners. So, you know, psychologists, some people find CBT can be very helpful. Some people find that, like you say, changing their diet, we have a great nutritionist Emma Ellis Flint who works with us who looks very closely at improving gut health because we know if your gut health is good, it improves your serotonin, it helps you feel better. And we look at sleep as well because so many women don't sleep well during the perimenopause and menopause. And that can improve with hormones, but also it's looking at any ways of improving sleep hygiene is really important.

So the most important thing for me is a doctor is looking at the whole person. It's not just about you've got a hormone deficiency, let's give you hormones. It's looking at the type of exercise. You know, a lot of people are doing very high impact exercise, which is increasing their cortisol, making them more stressed. So I know I'm a great advocate of yoga, but it helps me calm my brain and help makes me strong physically, but mentally as well. But it's not for everyone, but it's finding out what works for each person and then building on their strengths. because, you know, at the moment there's so much going on in everyone's brains, even more now with COVID, you feel like you're just going to explode sometimes. And adding hormones to the mix is just so hard for so many women.

And the most important thing is women should not feel alone in their journey. They don't all have to talk to a healthcare professional at every stage of this journey, but they need somebody or group of body to talk to. and we're actually in the process of setting up a charity called the Menopause charity. And one of the first things we'll do when we have some money is set up a helpline so women can be given the right advice and be guided in the right direction. Because there's so many women out there that are lost and it really saddens me. Well, they don't call the 40s the battleground years for nothing, do they?

Because, you know, we've got these fluctuating hormones. Many of us will have young children. and then when we get to our 50s, when we may be going into the full menopause, we have elderly parents and teenagers. There's so many avenues that women are trying to go down just to thrive. And, yeah, it's incredibly hard for us. And I find, well, I've heard friends describe a sense of invisibility that they feel when they get into their 40s, which is really sad.

And I spoke to Davina McCall quite recently, and she's a very outspoken advocate of taking HRT, and she's on the cover of woman's health at the moment. And she truly says that she feels the best she's ever felt, the most confident, and she credits a lot of that down to HRT. Is there a time limit that women can take it for? Absolutely not. So in the same way that when you, if someone has an underactive thyroid gland,

you give them thyroxin, you'd give it for life. If someone was diabetic and needed insulin, you would give it for life. So this is exactly the same. And some people think they're only taking HRT, to help their symptoms. But actually, even those women without symptoms, you still have health benefits from taking HRT. So I've already said I take HRT.

If I stop taking it tomorrow, I might have had all my symptoms. I might have worked myself through my symptoms and feel fine. But actually, as soon as I stop it, then I'll have this increased bone turnover. I'll have this increase inflammation in my body, more likely to have heart disease,

diabetes, dementia. And I've already said I'm very scared of osteoporosis. It affects one in two postmenopause or women. One in three women will have hip fractures. It causes a lot of mortality, but morbidity as well. You know, I want to be a fit, healthy 70-year-old if I reach that long. I don't want to have trouble using a zimaphrane getting out of the bath, for example. So I'm taking it for the health benefits because there are health risks without it. And that's the same. So the guidance is very clear, women can take it as long as the benefits outweigh the risks. We just need to be reviewed every year. But most women, those benefits continue.

And even a very low dose of estrogen can still improve women's bone strength, which is really important to know. Well, Louise, thank you so much for joining us today. I'm going to finish by asking you one question. This podcast is called Going for Goal. So what is your goal at the moment? My goal is for all women to globally, all women to receive good quality information about the menopause so they can make their own choice based on that. Brilliant.

Well, Dr Louise Newsom, thank you so much for joining us today. And you've been listening to Go on for Gold. Thank you. Thanks, Claire. I very much hope you enjoyed listening to that episode. As ever, we welcome all your comments, reviews and questions. So get in touch with us. Our Instagram handle and email are both.

in the show notes. And if you have a health goal that you'd like us to tackle in an upcoming episode, you can drop us an email or a DM about that too. We'll be back next week with more inspiration and know-how for working towards your health, fitness and wellness goals. Until then, take care of yourselves. Bye.