Just As Well, The Women's Health Podcast - Why Women Are Running On Empty | Dr Zoe Williams on Stress, Burnout & Mental Load

Episode Date: June 30, 2026

Why do so many women feel exhausted, overwhelmed and unable to switch off — even when life looks “good” on paper? In this episode of Just As Well, Gemma Atkinson and Claire Sanderson sit down with Dr Zoe Williams for an honest conversation about chronic stress, burnout, cortisol and the invisible mental load women carry every day. From 3am wake-ups and brain fog to chest pain, anxiety and feeling constantly “wired but tired”, Dr Zoe explains how stress shows up in the body — and why so many women ignore the warning signs until they physically can’t anymore. The conversation also covers: The difference between normal stress and chronic stress Why women struggle to say no How stress affects sleep, hormones, fertility and libido The pressure of balancing work, motherhood and home life Burnout, boundaries and the importance of recovery Simple techniques to calm your nervous system A relatable, funny and eye-opening episode for any woman who feels like she’s juggling too much. 🎧 Follow Just As Well for more conversations on women’s health, wellbeing and modern life. Want more from Women’s Health? Join the Women’s Health COLLECTIVE for workouts, exclusive events and expert advice to unlock your fittest self - Train smarter. Live better. Visit www.womenshealthmag.com/uk/wh-podcast Learn more about your ad choices. Visit megaphone.fm/adchoices

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That was easy. This episode is brought to you by Activia. You might already be eating yogurt, but not all yogurts are created equal. Activia contains over one billion probiotics per serving to survive and reach the gut alive. When it comes to gut health, Activia is the number one family doctor-recommended probiotic yogurt brand. Choose Activia. Feel good from the inside out. Visitactivia.ca for more details. Hi, I'm Gemma Akin-Sern.

And I'm Clay Sanderson. We've just had a lovely chat with the wonderful Dr Zoe Williams on our podcast just as well. Thank you for tuning in. Zoe's actually been on the pod before and her episode did so well we had to get her back. You might know her as being the residential doctor on this morning. If you're my age, you'll know her from the gladiators. She's an actual gladiator. But she's just brilliant, isn't she?

Because she's a doctor with so much knowledge, but she's somehow so relatable in terms of being a moment. being a friend, being a woman, she's very easy to chat to. Yeah. So in this episode, we tackle stress and chronic stress. Which would establish you have. We have established, I have it.

It was a checklist of symptoms. And so he has actually encouraged me to go to a doctor when I shared some of the physical symptoms that I've been experiencing, which I'm sure are linked to stress. And I am not alone. They are women like us who are juggling life and children and jobs and homes and all the responsibilities life throws at us.

And as women, we take on more, more and more and we don't say no. And she and you spoke about the power of saying no. The power of saying no, yeah. Sometimes you've got to tell people no or say it with two words, one beginning with F. That's my motto. But yeah, she gave us techniques to help manage stress, conditions and symptoms to look out for and yeah, just ways to kind of chill out

because it has such a detrimental impact on your health. So as always, please do like and share and subscribe and enjoy this episode of Just as Well. So Dr Zoe, welcome back to Just as Well. Thank you so much for joining us. Let's start with the big question, stress. when it comes to stress. We hear the words stress,

we hear the words cortisol, juggling plates. What is stress? What is cortisol? And why are women wearing it as a badge of honour? Well, I think the first thing to say about stress and cortisol is that they're not the enemy. I think we often use them as negative descriptors. But stress, without stress, without cortisol,

quite frankly, we wouldn't be here. We wouldn't have survived to now as a human race. So stress is. is when your body goes into fight or flight. So, you know, many, many years ago it would have been when you're faced with a predator or there's, you know, severe weather or a famine or something like that. So it's a stress, the stress response enables you to survive whatever danger is imminent in that moment. So you shift into your sympathetic nervous system, have a fight or flight, a load of physical things happen in your body that enable you to fight that bear, survive that.

crazy weather, swim out of that very cold hole that you're falling into or whatever. But then we shouldn't be spending too much time in that state. It should be an occasional burst here and there. As part of that stress response, we have a rise in cortisol. There are many reasons we have rises in cortisol. And throughout the day, actually, we have different fluctuations that are normal. But also with a stress response you get, is followed by a rising cortisol, which prolongs your ability to be able to deal with that

threat. But we should be spending the majority of our time, not in the stress response, in the parasympathetic nervous system, sometimes called the rest and digest. But what's sort of happening in modern lives, and I think why we're so stressed, what we mean by that, is that we're not fully recovering. We're spending too much time somewhere between the two. And cortisol levels are not having, we're not having a little burst when something severe happens like we're faced with a predator. We're responding to emails and deadlines and children whilst also managing work and, you know, internet and not getting enough likes on your social media post

and watching the news and seeing what's happening around the world because our nervous system is actually very primitive, doesn't understand that we live in a world now with technology. So we can experience suffering of many different people around the world. Our nervous system perceives that as you're witnessing suffering right in front of you in your own tribe. So I think there's a real mismatch between what our nervous system understands and the world that we actually live in.

And therefore there are so many reasons that we're stimulating that stress response inappropriately. Most of the listeners to this podcast, I'm going to assume while female. Women's health, yeah. Women's health, as a clue. It's a feeling the name. Yes, I'm assuming apart from maybe my husband, Gorka and your husband listening to this episode, it's almost exclusively female.

How does stress manifest for our skills? that may be different to men, or is it similar? Well, I think stress can manifest for all of us, irrespective of gender, but lives, we are different as women. We are built differently. And, you know, as much as some men may deny it, we tend to be better at multitasking, which is a great skill to have.

And if you think back again, a lot of this is thinking back to our ancestors and you think about a woman's role back then, you would be the homemaker, you'd be juggling lots of things, whilst the man would need to be singularly focused and not distracted on hunting or, you know, providing. So it makes sense why we can multitask. But I think that's a big downside for us.

I often kind of like give this example of a typical day working from home. So you say to a woman, oh, tomorrow you're working from home, straight away she's thinking, oh, I can get the washing done, I can do that, I can empty that cupboard, I can rearrange the Tupperware or whatever. Yes. A man doesn't think like that. So if a woman's working from home, I always think, right, start answering this very important email. And after five minute, phone goes ping and it's school.

Like, oh yeah, do you want to order your tea towels that the children made this designed this year? And I might as well just do it now. Then it's done because I've got a list this long and it'll take them two minutes. So you get distracted doing that. You come back to your email. Something else goes off. You know, your partner says, oh, I'm going to the supermarket tonight. Do you need anything?

So you go and have a quick look around the cupboards. and you respond. You need a wee. You go for a wee. The dishwasher pings on the way back. You enter the dishwasher. I might as well make a cup of tea whilst I'm here. Before you know it, you've got all these things going on,

whereas a man will sit at that computer. If the school email goes off, you'll just sort of triage it. Think, that doesn't need to be dealt with right now. You message him going to the supermarket. I'll check that at lunchtime. Need a wee. Goes for a wee. Come straight back.

Probably doesn't wash his hands. So, you know, already that load in the brain, the tabs open, the tabs open, the kind of what we're not designed for as humans for our attention to be spread across so many things I think that's one of the reasons why we are different as women because we have the ability to do that we do take on more of the load as well the load in the home I think

not because men will do it if we ask them but because they are it is more difficult for them to be juggling lots of things so we do tend to take on that load a lot more I think and it's a mental load as well it's like when my kids aren't with me I'm always thinking, have they had the lunch? Are they okay?

Have they washed their hands after the toilet? You know, as she managed to open a water bottle when I'm not there. So it's mentally as well. This episode is sponsored by Femfresh, an intimate skincare brand that specialises in products made for the vulva. Its washes and wipes are designed to slot into your daily routine and are clinically tested for compatibility with the intimate skin's natural pH range.

All the products in the range are formulated to bring special special. specialist care to your intermaterial and often overlooked part of skin care. What's the difference between regular day-to-day stresses in terms of, you know, missing the bus or something, as opposed to the term chronic stress? You're suffering from chronic stress and chronic fatigue. So normal stress should be short-lived, it's short-term. And it's in response to a specific thing. So it is because you miss the bus. So normal stress would be. you miss the bus. Actually, you know, it's not life-ending, is it?

It's not the end of the world, really, but we will have a stress response, but as soon as you get on the next bus, it should recover within minutes. Similarly, you know, your child knocks something over, knocks over the milk or whatever. You'll have a stress response, but it should recover. That's normal stress that recovers.

Chronic stress is when you don't have the recovery. So these little things are happening. You're having a stress response, but you're never properly recovering. And that's this chronic stress that's always there sort of grumbling in the background. The cortisol is sort of, you're not having that normal rise in the morning

and then it going down as you go through the day in a dip at night time, you've got it sort of grumbling along all day. And that's when you start to run into illness, disease, mental and physical illness. And that's when you get to that point where you feel like you can't really cope and your resilience.

And stress is a bit like a snowball effect as well. So if you have occasional, stress is it's a bit like in the gym. If you go to the gym and work your muscles to the point of which you cannot lift it anymore and then you have a period of rest and recovery, those muscles will get stronger for next time. And it's the same with stress. If you have a stressful event that happens, but then you have time to process and recover, the next time you're faced with a stressful event like that, you'll be more resilient. But if you don't have that recovery in between, it's a bit like when in the gym. If you don't recover and you don't rest, eventually your muscles get more tired and less able

and you're more likely to get injured, it's quite a good analogy between, I think, the body and stress. And as women, you know, working women, we all work here, we've got kids. When do we have time to recover? I don't have time to recover from the stresses of work. I try to go to the gym,

I try to lift heavy weight, but that's a stress on my body, as you just said. So that's raising my cortisol. So my cortisol is already elevated. And then I'm piling all the other... pressures of life on top of that. For instance, yesterday, in my house, I got home from work about earlier the normal, 6.30, because I've been away on business abroad, there was loads of washing an iron in.

9.30 still doing the iron in. The kids had chucked all their clothes everywhere. You know, my son had just literally taken his uniform off and left it in the bathroom, had a bath and not emptied the bath. My husband had hidden my work bag. and I genuinely felt like a tightness in my chest and that's a physical manifestation of stress. At least you detected that.

Yeah. That's a good sign that you were able to at least detect it and see it for what it was. But I felt like I'm going to have a panic attack. I was getting so wound up by the environment and the situation and my perceived lack of support from my family, which I know this is a tale as old as time for us working mothers. But why is it positive that I think?

detected that then. So I mean, I think if we take a step back and think about your life is very busy, Claire, we're all very busy and we put this almost stamp of approval on business, don't we? You know, we meet with friends and off a sin, you've been so busy. Like, that's a good thing. And business in and of itself isn't a bad thing. But I think stress can then get lost within that busyness. Because when we're busy, we're focusing on what we're doing, the task, the, you know, doing this podcast and then doing that bit of work and then get home, you've got the washing. So it's good that you did identify that your mind and your body are connected enough, but you're observing those sensations.

I think a lot of people, we get warning signs in the body when we're stressed, but a lot of people don't hone in and notice them. And that can be quite dangerous because that's when things can get worse and worse and worse. First thing I would say, I know how hard you work, Claire. I don't think you should be doing your own ironing. I'm going to give you that tip. I think, you know, it might not be the reality for everybody, but I don't think you should be doing your own ironing.

So I'll leave that one there. But, you know, we have these stresses in our life. And there may be some of them that we can alter. Like you could just not do ironing anymore. But a lot of the time, we can't alter the stresses in our external environment that impact us. But we can learn techniques and, you know, little switches that we can make that mean that that external stress doesn't have as much of an impact on the stress in our bodies.

So stress is a physical thing. It's in our bodies. You know, we have that shift in our autonomic nervous system. And there are lots of different things we can do. We'll probably come on to it a bit later. But things like simple breathing techniques, having, you know, three words of gratitude when you get out of bed in the morning,

exposing your cell to daylight. I know everyone's talking about that at the moment, aren't they? but we can talk a little bit about actually within that first hour being awake, if you can expose yourself to natural daylight, that can have an impact on your cortisol levels. And not does your cortisol levels, your melatonin at nighttime, the sleep hormone, your serotonin levels, your happy hormone later on in the day. You've sort of got this one hour of a golden window

to expose yourself to natural UV light. And it has this positive impact on your hormones throughout the day. This morning in my hotel, my window in the hospital, my window in the hotel opens about four inches. I opened it and I was just squeezing my face, literally, like, getting as much as I could. And look at the sky. Yeah. If it's cloudy, like if it's, look at the sun.

But if it's cloudy, look at the brightest bit of the sky and just try and get that. And I know it's difficult. Like the mornings are off in chaos when you've got a family. So the way the switch I've made is that my kitchen opens out into, we've got a back door attached to the kitchen. So my rule now, first thing in the morning is sometimes I'll even put on. on a jumper or a jacket, open the door. And then just nip outside when I can. Whilst the kettle's boiling, spend 30 seconds just outside.

Because it doesn't need to be a lot. It's whatever you can get. Whilst Lisbon's eating his breakfast, go for a few minutes outside whilst I'm checking my emails or whatever. Just try and get a little bit. This time of year, you know, it's accessible. More tricky in winter. There's a list here, some of the symptoms of stress.

And some of them, it's obviously poor sleep, waking in the night, brain fog, anxiety, sugar cravings, fatigue that rest doesn't fix and feeling wired but tired. Yeah. So those things as well, women must, you know, I'm going down on that list. I have brain fog daily, but I'm not stressed, so I probably think, oh, it's not that. Or, you know, the sugar cravings, when I'm on my period, I have that. So it's hard to match each craving with a specific stress, isn't it?

Yeah, definitely. I think they're all, you know, our hormones all interact with each other and they're all linked. So a lot of those symptoms that you've read out as well, people who are perimenopausal will recognise those symptoms, people at certain phases of their menstrual cycle, possibly even in pregnancy or breastfeeding or people who don't sleep very well will recognise a lot of them as well. So I think when it comes to symptoms of chronic stress, there can be many, many symptoms. I think waking up in the middle of the night, that's sort of the 3 a.m. wake up is an important one. That feeling wired but tired, that's quite a key one that links to stress. Yeah, no, it's just describing me. So you're exhausted, but you could spread in your like, your brain's still going. You just can't calm it down.

I think that's, but I think, you know, I think it's kind of getting to the stage where you feel like, you can't cope with life or you're not enjoying life. You know, everything's great because stress isn't always negative as well. Stress, you know, things like financial insecurity, obviously things like that are stressful. But it can be that your life is everything you ever wanted to be. You've got an amazing career. You've got kids that you wanted and they're doing great. You know, you're planning a big event.

And all these things are wonderful things that you want in your life. But they're stressful. You know, like going on a roller coaster is a really good example of, normal stress. So you plug yourself in and you start to feel that excitement building. You flip into that final flight response. You know, your mouth gets dry. You get tunnel vision. Yeah. Heart's going faster. You get a bit sweaty. And you're chug, chug, chug, up to the top. And then you have the roller coaster and you're fully, you know, cortisol. You're fully riding that wave of cortisol. But then as you get to the end and it goes, you decelerate,

you just feel everything coming back down. And by the time you get back to the end of the cue to queue up again, you're completely back down to baseline. That's sort of normal stress. But when you're on that roller coaster all day long and you can't get off and it comes to time to go to sleep and you're still going around that roller coaster, it's chronic stress. So I think a lot of those symptoms are quite vague. But I think it's more about asking yourself the questions. Can you relax when you want to? Can you sleep? Can you switch off and do you feel? like you're coping. And if you're not saying yes, then it could be that chronic stress is a problem. Because it's a vicious circle, isn't it? Because you are describing me, go, this is so

enlightening this conversation. But I look at everything and go, I should be ecstatic by my life. You know, most people would look at my life and go, she's cracked it. So then comparison syndrome comes in. Guilt. And then you're even more stressed. Exactly. What are you feel guilt? Like what, I'm frustrated. Why am I not able to enjoy this? scenario, this once in a lifetime scenario that I found myself in. Well, I find myself resenting opportunities that other would jump at, you know, amazing opportunities to travel aboard for work. And I'm thinking, I just want a day at home.

I just want to be at home doing the ironing, you know. Not the ironing, Claire. I thought we solved that one. Do you actually find that relaxing, though? No, I do, yeah. No, I do. The ironing with a documentary, generally about serial killers. which might not be, you know, the most relaxing thing to watch on TV.

Legends on Netflix and watching at the moment. That's a top tip. But, yeah, so then it's this vicious circle that you become more cross with yourself and frustrated that you can't enjoy all the things that you've worked so hard to achieve. And as you say, having the great job, having the children, having the nice house and stuff. He said, well, why am I not able to be happy in this moment? But it's chronic stress, isn't it? Because you're not having the recovery.

Yeah. You're not having the recovery that you need. And, you know, and you're working out and you're training your body hard as well. And actually that's really good for you. But as you mentioned before, that can release cortisol as well, especially if you're doing something like hit or you're doing long endurance exercise. So, you know, it is probably sometimes thinking, well, throughout my week and the more stressful parts of my week, that's when it's a good time for me to do the slower workouts, the more restorative,

workouts and you know the weightlifting is not too bad actually but it's more the hit or the endurance training is is the worst when it comes to stress on the body and it but it's taking breaks sometimes sometimes listening to your body and thinking do you know what today I'm not going to do anything I'm just going to sit in the jacuzzi it's giving yourself grace you've got I mean I've had a kind of mental switch like so me and my best mate laura we we said at new year this is the year of the no and I'm 42 this year she's 43 this year and what we've mean mean by that is by if anyone asks us to do something that we don't actually want to do, I'm not asked if they think I'm rude or this.

I'm trying to say, do you know what? Thanks so much. But no, I'm not going to, I'm not going to bother. And in the past, I would have gone, oh, I'll try and make it. Yeah. I'll keep you posted. And the event's getting closer. And I'm thinking, oh, my God, I don't want to go, but I don't let them down.

And then you go and you have a crap time and you come home and you think I could have been doing something I wanted. So we both said at New Year, this is the year of no. and the amount of times I've said to people, thanks for the invite, but do you know what? I'm just going to stay at home. Yeah. And it feels so amazing.

People get it. Yeah, it feels brilliant. I think people get it. I've got a few instances of that where friends have said, I'd love to come, but actually I just want to stay at home and spend time with my children. Yeah. And that's okay to do that.

And things like that will alleviate stress, but it's hard to do that in the workplace. You know, if it's your boss who's saying there's this. event it's 11 o'clock, four hours from your home, you have to be there. That is different. But if it's like your weekend where it is time to rest and reset and recharge, and the option is doing that at home in the garden with the kids, or even with your partner or even by yourself, I mean, that would be bliss.

Or going to the market stall. The market stalls in town. So let's go and queue up and get our coffees and go on the fairground. You know, sometimes just the art of saying, no, it's such a big thing. I think saying no to your children as well. You know, Saturday morning, what are we doing? What are we doing today? We're doing nothing.

Yeah. You've got all your toys, you know, we'll do some painting together or we'll make something or, you know, something that involves being in the moment because mindfulness is something that brings you out of chronic stress. So, you know, not always being in the past or in the future. But yeah, I think sometimes saying to your kids as well, we're doing nothing. And we need to rest. We tend to put ourselves last as women, don't we?

Yeah. We prioritise our kids. I've got a teenager and, you know, on Friday night. Yeah, so-and-so has invited me to their house and it's 40 minutes drive away. And I said, well, no, because I'm working in London on Friday. And so is daddy. We're not then driving 40 minutes on Friday night and picking you up. I said, if you can find a lift there and back, you can go. But afterwards, I thought, I might be a mean saying that.

But you do have to create boundaries for yourself. Well, you do. And I know it's easy to say this. it's much harder to live out in practice. But actually what our families, our loved ones need more than anything, is for us to be okay. And, you know,

putting extra pressure on yourself, doing that, you know, a two-hour round trip so that they have a social life and not having time for yourself. In the long run, in the future, if it gets to a point where you are burnt out

and, you know, you're just not able to function, they would retrospectively have given up that time with our friend for you. And I think sometimes we just have to be honest with everyone around us and say, actually, this is what I need today, or I need this weekend or I need this week, or even to some extent with our bosses, you know, being, not being afraid to share with our boss or with our team. Actually, I'm struggling a bit at the moment. I'm just struggling a bit. I'm feeling like I'm quite stressed. And these are some things that

you could help me with to help me through this period. I'm sure I'll be back to normal soon. but I am struggling a little bit. I don't want to end up having time off because I'm not coping at all. So I've put together a few things that would help me and it's not going to that event actually and it's coming in a little bit, not getting on that if you're really struggling

or you're in a moment of crisis for some people, it can be getting on that tube in a morning at the same time as everybody else is just too much. So I know as a GP, often what people call the sick note, it's not called a sick note anymore, a fit note, often people come in asking for time off work because they're not coping because of work-related stress. And they don't need time off. What they need is for amendments to be made. What they need is to start work at 10 o'clock instead of 9 o'clock so they can miss rush hour

traffic or what they need is to be able to work from home one day a week so that they can, you know, have their session with their therapist or they need amended hours or duties. And I think bosses actually would rather have that heads up that we just need to amend things for a couple of months and that's going to save you completely having a meltdown and not being able to be here at all. There's in a selfish way

that benefits them anyway if you're at your peak. It benefits everyone if you as the woman as the head of the household are at your peak. So sometimes saying no for self-preservation is doing them a favour anyway. You need to make it the year of the no.

Join me. The year of the no. It's hard, but it's hard. But I think we just, it's the norm, isn't it, as women, that people are used to us always saying yes. I have my year of the no. A couple of years ago, I had two years of it because we were mostly living abroad.

So I was forced to say no and I had the perfect excuse. And it's that sense of relief when you say no. Yeah. That's one thing gone. You don't have to worry about it. We had the managing director of YouTube on this podcast and she said to us that she is very protective over her weekends. She has to have the weekends to recharge, get herself back to a state

where she can then cope with the pressures. She has no emails, nothing over the week. Everything's completely detached. Because I admitted that I'm someone who's stood watching my son play rugby while looking at work emails. And she said that that might work for me, which it does actually work for me, because I like to be on top of things.

And if I go on holidays and come back to two weeks worth of emails, That's literally enough to give me a panic attack. But the way that she copes is she has to completely detach from work over the weekend. There could be a happy medium for you perhaps, couldn't there? Where instead of being on always at the weekend you have, because it doesn't matter whether you respond to that email at 8am or 8pm on a weekend, does it? Because nobody else is working. So where you schedule it, you schedule in an hour maybe each day on the weekend.

At least it means that you're fully present and mindful. and in the moment when you are watching your son play rugby or at the dinner table and your brain can just have because we do need we need a break i i do that at the weekend i don't engage in work except well i do sunday night i normally i have i have my clinic on a monday so i normally start having a look at a bit of the admin just to ease the load on a monday because otherwise i don't leave the surgery until 7 p.m on a monday um but the rest of the weekend yeah i do switch off when did you last do something? something just for yourself?

Well, I go to the gym, really, which is just for myself. I hear you were going to say that. I've even started taking my daughter to the gym now, which is wonderful and a great example for her. But it gets in a way of your work now. Yeah, it does get in the way of my work out because I'm then sort of managing a 10-year-old in the gym when... So something that doesn't raise your cortisol levels that the gym does.

When was the last time you did it? I don't. And there'll be so many people watching this who are the same. I've booked, I'm 48 in June and I have booked the day before my birthday off to go to a spa or something for that day. That's what I've decided I'm going to do. I shouldn't take that. So you should, you need to book the Friday and the Monday off of your birthday week and have a long weekend. Finish on Thursday and no, I'm not doing anything until Tuesday morning.

I get grief at work just in a funny way from my colleagues because I book literally, if it's my birthday on a Wednesday, I'm off that Monday, Tuesday, Wednesday. I literally, I'm at another year around the sun, another year on the planet, being privileged to age, I celebrate it, sometimes by doing nothing, sometimes by going for drinks with the girls, nice walk, but my boss will say you off again. It's my birthday. I ain't coming in on my birthday. It's about me today, not you. When it comes to our skincare,

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Are there any other lifestyle aggravators that increase stress? So, coffee, UPFs, out-processed foods, alcohol. Is coffee making us? We love coffee. We do love coffee. Well, this is the thing. It depends on what state your nervous system is in. So if you've got a really well-regulated nervous system, you can get away with so much more. You know, so for yourself, Gemma, you're telling me you're not stressed.

You think your nervous system's well-regulated. If you do have a stressful event, you can recover from it really well, and you drink coffee and it doesn't affect your sleep and it doesn't make it feel ill-ditorious, fine, fine. But if somebody is not sleeping well, their nervous systems dysregulated, they're having palpitations, you know, they're tired and wired, then it becomes quite obvious that caffeine isn't going to help. Isn't going to help. But that's when they really feel like they need the caffeine because they wake up in the morning. They're exhausted. They feel like they need the caffeine.

So it's, again, it's that vicious cycle. Similarly with, you know, ultra-processed, highly palatable foods, if your cortisol levels are chronically raised and you haven't slept well, then your own biology is going to make you crave those foods. So that's when that becomes more of a problem. What else did we talk about? Alcohol. Again, you know, cortisol can interrupt all of your sex hormones. Your sex hormones can interrupt your cortisol. And alcohol, you know, plate leans into that and disrupts and makes everything worse.

So I'm then thinking about these modern trends like ice baths and intermittent fasting and all of these things, which again, if your nervous system is really well regulated, then potentially there are some benefits. to them for the right people if you want to do that you know it's a personal choice thing but if your nervous system is you know in fight or flight your body doesn't feel safe then if you start having prolonged fasts your nervous system thinks it's a famine and it's going to say right I'm going to cling on to every ounce of calorie that I can and store it as fat when I have the opportunity your metabolism's going to slow down that's going to lean into me feel more tired more exhausted um you And if you get in an ice bath, well, that's going to raise your cortisol. And you're not going to recover because you haven't got that resilience to recover.

So I think, you know, what we all need to focus on when it comes to chronic stress is identifying if we are somebody who's suffering from chronic stress and starting to take steps gradually to make the body, make the nervous system feel safe again. And then that can look like having like regularity. So same bedtime and wait time, even off. the weekends. Routine. Eating three round meals a day that contain complex carbohydrates. Again, I'm not in any way against a ketogenic diet, but switching to a ketogenic diet when your body's already stressed might not be the best thing to do. So, you know, having breakfast at the same time every day within an hour of waking and exposing yourself to sunlight, these are all things that make your body feel safe and eventually over time you can start to unpick that chronic

stress and that's when you can then think about calorie deficit intimate fasting ice baths hit training all of these things caffeine drinking i stress my mom and gawker out for being too laid back i'm their cause of stress literally my mom's always saying to me you are horizontal shape yourself come on but because my dad died of a heart attack then they said it was likely stress i'm like no nothing's worth my health. And it's not just like there's loads of big wellness trends at the minute, but it's also about, I think, like you said, understanding your body better and understanding how it works,

how it ticks, how it, you know, what makes you feel a good baseline and what makes you feel. And if you don't want to be in them situations or circumstances, you can just say, I'm not going to eat that, or I'm not going to have that drink tonight, or I'm going to remove myself from that circle of friends. And that's okay as well, isn't it? Yeah, absolutely.

And I think, you know, what you've demonstrated, I mean, you choose to not be stressed. To some extent, you know, probably a number of factors mean that you're just not a stressed out person anyway. But it's interesting that you say that. It's that you've sort of made a pledge almost decided that you can't afford to be stressed. I've seen the impact it can have on someone

in terms of them passing away. So I'm like, no, it doesn't matter if I'm like, it doesn't matter if I don't show up. It's the least of my worries. I've become more aware of stress in my body since I, a couple of years ago, I don't know if you know about this, but I had a really weird thing happen with my heart. I had to have a procedure. So I was in Barcelona with some girlfriends.

We went for a swim in the sea. And my heart went into an abnormal rhythm called at atrial flutter. So it was beating at 300 beats a minute. Oh my gosh. For about 5 or 10 minutes. And then it went back to 150 beats. So I stayed on the beach and waited for it to recover. and ended up.

So I ended up in A&E in Spain, attached to, like, monitors with 20 people in the room, they were about to cardiovert me, whilst the anisitis was about to put drugs in to sedate me, and they were going to put the paddles on and try and shut my heart back into a normal rhythm. It was all pretty dramatic, and in the end, they didn't have to do that,

but I had to have a procedure to burn a scar into my heart so that this can't happen again. What caused that? Well, this, so at the time, I thought, right, I'm giving up caffeine, I'm giving up alcohol and I'm giving up stress. So I've seen, I've seen the cardiologist and, and he's explained, look, we see this is a random thing. We see a handful of young, healthy, fit people, usually fitter than average people, often footballers and rugby players who get this for no apparent reason. There's no cause. You know, it's not linked to people who say, is it because you have COVID or vaccine?

and said, no, numbers haven't changed in recent years. It's just a handful of people. And there's no cause of it. So it's probably got nothing to do with anything. So the caffeine and the alcohol crept back in. But I kind of made a pledge, a bit like you at that point, kind of reflected on my life. And a lot of it was good stress.

I can't afford to be getting stressed like that. So now, if, I don't know, my child's trying to argue with me or whatever, I feel it. Then you're saying the pain in your chest, I was never aware of it before. But I described it like it's a bit of bubbling. up, I feel the stress coming, I feel my body trying to go into fight or fly. And I just block it and just say, no.

So I always do something called a physiological sigh, which is you take a deep breath in through your nose and then a second sharp deep breath in through your nose, then out through the mouth. So you got this. I do that and that's sort of my physical reminder and I tell my body, this one's not worth it. Some things are worth getting stressed about. This one's not worth it.

Because I've been having episodes. where it's happened three times and this pain, and I'm not doing anything strenuous, does not happen in the gym or anything like that. I've literally just been stood in the bedroom one time, in the car, another time, just, you know, very innocuous lifetime activities. And this pain starts in my chest,

and then it radiates around my back and go round my body, this pain. And the pain is so severe. I have to like breathe through it. I've tried doing the cat cow and moving my body. Nothing, nothing works. So it's not because if it's, I thought if this is muscular,

I should be able to release it. And it's truly, truly agony, breathing through it. Went on to AI. Gemma knows this story. Went on to AI. AI told me get to the hospital. I ignored AI. And then it happened three times.

And AI was then really trying to persuade me to go to the hospital telling me I was having a heart attack. I disagreed with it. Price spoke to a GP friend of mine at my daughter's football and she said it sounds like esophical spasms caused either by bad diet that won't be me or stress. I went, yeah, it's probably stress there, isn't it? You have had an ECG though, haven't you?

No, I didn't go, no. I said I'd have gone. It's worth checking it out, Dustin, because we know that angina or heart attacks do present very differently in women. And I agree, it doesn't sound, I don't think it's likely as your heart, but it's always worth

ruling it out. I used to get a softchial spasins. That's how mine used to present. I used to have to take medication for it. I've had all types of tests and invests. It's horrible. Mine used to wake me up in the middle of the night. It's like this tightening

and it just like shoots up to your head. You've got pain in your head. And I had to undo my bra and then it almost feel the pain radiating around my back and then it'd come back and it'd around a round of a back. And it goes on for about half an hour. Oh my gosh.

And then suddenly just slowly, suddenly like slowly dissipates. And I literally, like an indigestion. Well, I don't know whether it's indigestion because it's a pain here. Yeah, and it is, it's just bosoms. It is a cramp kind of almost. But it's in the chest.

So it feels like a heart attack. Yeah, it feels like, I thought I was on a heart attack. And, you know, I was at home and my kids were trying to talk to me and I was like, everyone just needs to leave me. And I was just having to breathe slowly,

trying to get through. I initially thought I was starting to have a panic attack because I used to have them when I was doing my ale. you know, back long, long time ago, 30 years ago. But yes, it's just, and it's just this pain that sort of grips your chest and goes around and grips this whole, but it starts where your heart is. So you can imagine I initially thought, ooh, what's this?

But yeah, chat, my friend chat, told me to go to the hospital, which I didn't. I still agree that your friend chat should, is being sensible in, say, it's best to just to rule it out. B. C.G. won't hurt, will it? So what I have said, if it happens again, I will, I will go to the hospital then and say, let's just have a quick check. Yeah. But I think it's stress. I think this has proved to me.

I think I am chronically stressed. Even though Satier now, you probably think, oh, you don't look at it. I agree. It's funny because I used to have this quite frequent esophage. And it was when I was going through a particularly stressful time in my life. Same as you, never got it if I was in the gym working out. I used to cycle everywhere back then.

Never got it when I was cycling. but it would wake me up at rest in the middle of the night from bed. And I actually, and what didn't make sense is the doctors tried all different types of medication to manage it. The only thing that worked for me, because mine wouldn't ease off, it would go on all night if I didn't treat it. The only thing that worked for me was diazepam. Now, diazepam is a muscle relaxant, but it's a relaxant of skeletal muscle, not smooth muscle, which is in your esophagus. kind of didn't make sense because it shouldn't be relaxing, but it makes sense now because it alleviated the stress

that was causing the esophageal spasm. But I'm going back years before I really understood this stuff before we really talked about stress in the way that we do now. So yeah, I mean, that's what a warning sign. Your body is literally flashing the red light, the fire along is going, yet we just carry on. And you're stood ironing. She's stood ironing having a heart attack.

But that's the thing, right? This is, I'm not even. joking, like the, when we talk about the difference between men and women having a heart attack, the sort of stereotype of a man is usually an overweight man clutch in his chest falling to the floor in agony. The stereotype of a woman having a heart attack is doing the eye and going, oh gosh, having a bit of discomfort here, just pause for a minute, all right, I'll carry on. That's the reality.

You treat it like a contraction as if it'll just come and go and it'll be fine. And imagine a man sat there telling this story saying, yeah, I get central crushing pains in my chest and chat GPT tells me to get to A&E but no, no, what a load of nonsense. Well, they wouldn't do it. They wouldn't do it. We're just wide differently and it, you know, it's risky for us.

Would stress affect to females like fertility and sex life, you know, and stuff? Yeah, definitely, definitely. Because what we're talking about in this state of chronic stress is your nervous system feels unsafe. and when it comes to getting pregnant, your body doesn't really want to get pregnant in the middle of war or a famine. You know, it's not the best time.

So cortisol feeds back to the part of the brain, the hypothalamus, which is also involved in releasing sex hormones, you know, therefore involved in ovulation, involved in libido, and has a knock-on effect. So I think it is definitely fair to say that if you're chronically stress, that can negatively impact fertility and, you know, your sex life as well. And if you're not falling pregnant, you'll get even more stressed about not falling pregnant. So many vicious cycles, yeah.

So why do you think intimate health is such a taboo topic for women and something that is shrouded in also a sense of embarrassment maybe? Oh, gosh, it is kind of like the big last taboo, isn't it, talking about intimate health, talking about sex, talking about our sexual organs, like, you know, at the moment lots of people on Instagram professionals saying that they can't use words like vulva and vagina or else their content gets blocked and why not they're just words they are just words that describe our body parts yet they're seen as in some way offensive and that's wrong and we need to change that in order to change this idea that you know we're not allowed to talk about intimacy and our bodies you just said then vulva or vagina yeah I just assumed it was the but clearly they're not.

And this is exactly the issue, isn't it? Like, you know, because we're... I did, but I run on myself. Because we're, we kind of can't use these words freely. So the differences, so the vagina is the internal part, so the tunnel. Right. That goes from the outside up to your cervix. That's the vagina.

The vulva is everything on the outside. So the labia minor, the labia majora, the clitoral head, all of that is the vulva. So everything you can see is the vulva and then everything, the internal tunnel is the vagina. As if I just thought all this time, the vulva was the posher word for the vagina. I just thought. You're not on your own.

No. And I think a lot of people say vagina to describe the outer genitalia. Yeah. Yeah, that's right. To be honest, even though I'm joking, oh, I run one myself, I know I didn't, because I thought the vulva was the sort of mound area

outside the canal. The vagina. Yeah, the vulva is everything you see on the outside from where the pubic hair is, which is called the Mons pubis, all the way to your anus really, all of that that that you could see. So if you imagine, like, now in a textbook, like people like to have images now, or just imagine somebody with their legs spread apart. Everything you can see is the vulva and the vagina is the internal bit, which we use, you know, as a speculum.

We use a speculum to open the vagina to get to the cervix. Isn't it shocking that two women in their forefirm. 40s. Who've had kids. Who have had kids who are both really engaged in wellness content. I do it for a bloody living. And I was confused about that. And so were you.

One of my colleagues, Dr. Aziza, C-say she's called, you should have her wrong because she's got this big campaign. And she has that, she'll bring all their props. She has that little knitted vulvers. But she does this campaign called They're Not Bad Words, where she's trying to encourage everybody to use these words. normally because yeah she still gets censored on social media for saying the word vagina or vulva which you know if that's happening no wonder we don't know a friend of mine she works um she's in like

CPS she looks you know helps children and stuff and she was saying they're trying to encourage them to use them words in school she says because it helps us determine what is going on yeah she said if some you know if a little girl was to say yes to see my flower yeah he's their way of around it is well we were in a park. I meant the flower in the grass. She said if the girl says they asked to see my vagina, we know straight away that kid's telling the truth. Yeah. Well, Lisbon, my little boy, he will say, Mummy, is that your vulva? He knows and he's five. And he knows what a tampon is and he knows where it goes and he's seen it. And yeah, I think we don't need to, we don't need to hide these things because these are our bodies. And the same as you're going

to put a cotton bud in your ear. Don't do that, by the way. we put a tampon in our vagina and why should my son not see that happening? You know, I don't go out of my way to bring him in to show him but if we're in the bathroom together, like we often are. We're always naked in front of him in our house

and the first time Tiago saw mine pubes, he went, what's that? I was like, pointing. But Mia knows about him. Did you say it was pubic, did you say it was hairs on your vagina? I said it's mummy's hair on her vulva. I didn't imagine I'm good, I will do.

But Mia knows about periods. and stuff. Like I told her this morning I started my period and she went oh gosh she said have you got your big knickers? I said yeah, don't worry I've got them

because the amount of times we've been out shopping and I've come on my period and I've had a thong on so it's come through and I've had to say we need to go and I've just explained to her you know what it is

and this and that. I can say with things like doing your breast checks once a month you know if you have daughters the best thing you know you wouldn't you wouldn't put usher them out of the room to brush your teeth

which is self-care if you can do your break because often people say to me at what age should people start doing a self-check? Well, children don't need to do a self-check, but the best way for them to learn is to see you doing it regularly. Like, it's not a big deal. It's just a normal part of self-care.

So when they start to get a little bit older and first get changes, first get their breast buds, then they'll just see that as something that they should be doing as well. Shameless plug for my book, by the way, you grow girl. So it's all in there. So I think it's designed for nine plus. But yeah, everything in that, I even say in there, go and ask your mum

what difference is between a four for and a vagina because she might not know and you can teach her and, you know, a lot of things to prompt conversations with parents. From the fragrance-free, sensitive wash to the 99% national origin ingredients wipes range, Femfresh's products are dermatologists tested to help confirm they are gentle and suitable for intimate skin. Whether it's a wash using your daily shower

or a wipe kept in your bag for on-the-go fresh. the focus on bringing specialist care to the vulva's skin remains the same. Before we let you go and we do our quick-fire questions, which you will have done before actually because you've been on here, but we're going to do them again. One final question for you, Zoe. What does looking after yourself genuinely mean to you now? I think, you know, since for me personally, since I had that episode with my heart, it's a bit like what Gemma's said. It's a bit about do I really want to do this? Am I saying yes to be a good girl? Am I saying yes to people please?

Am I taking on all the burden? Because it's kind of got me questioning a lot of what are my actual responsibilities and beyond those responsibilities that I definitely see as mine that I identify as having responsibility for, the rest of it's a choice. So understanding that all those things in life That potentially could cause you additional stress

Which ones do you have to do? And which ones are a choice? And if it's a choice, it is a choice. Ironing is a choice. Ironing is a choice. I will take that advice forward. Right, should we do all quickfire question? Yes.

So we're coming around for dinner again, the second time. Yeah. What are you going to cook us? Ooh, I can't remember what I said last time. I'm going to cook you. Well, Stuart's going to cook you. We do it as a double act. You're going to have dirt chicken,

rice and peas, cauliflower cheese, and roast up Mediterranean vegetables with gravy because I'm northern. Oh, nice. I love collie cheese. Lovely. What one thing you were to take to a desert island?

You said your little boy last time. That was my first go-to with my little boy. No, I'm not going to take him. I'm going to take Netflix. Yeah. Netflix. Not just necessarily Netflix, but, you know, podcast either.

What do you call them? Box sets. Box sets. You can only drink for the rest of your life, either coffee or wine. Coffee. Yeah, I mean. What's the last thing that made your belly laugh?

I mean, this is lame, but it was something I saw on Instagram. And I'm trying to remember. Oh, yes. They've drawn mustaches. You know, you get sort of, what do you call it, a medley of different videos put together. And it was all moms who'd drawn mustaches on their baby. and it was the dad's reactions and it was hilarious.

What's one thing that someone can do today to make themselves feel better? Breathe. I think breathing, I think that is the number one ignored, accessible, free gift that we all have is learn a breathing technique, doesn't matter which one. So physiological sigh I did earlier. Box breathing is one I use between patients, if I'm feeling like, I need to bring myself out of stressed mode with patients or even just the prolonged exhale,

so in for four, out for six. Making that just, I think, recognising when you're stressed and having a breathing technique, get used to it. It's hard at first, but train it like you would train anything else because it's, yeah, it's the quickest way to bring yourself out of that fight-flight mode. And I shall do that then as well. So, Zoe, thank you so much for coming to see us for day.

Thank you, Zoe. You know,