The Dr Louise Newson Podcast - 006 - Importance of discussing menopause early - Meg Mathews, Athena Lamnisos & Dr Louise Newson

Episode Date: July 16, 2019

Dr Newson talks with Meg Mathews & Athena Lamnisos, CEO of charity Eve Appeal, about best times to discuss menopause with women & children. Menopause being on the curriculum has had a mixed response, but as it can cause many different symptoms, which can go unrecognised for years, it’s essential we start the conversation early so children can recognise potential symptoms in themselves & others & become aware of the health risks of the menopause & optimise health. The Eve Appeal Meg's Menopause

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsom, a GP and menopause specialist, and I run the Newsome Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. So today I'm doing something a bit different. I've got a double podcast here. I've not got one person but two people. So I'm delighted I've got Meg Matthews, who's come up out of London to my clinic in Stratford-upon-Avon.

and I've also got Athena Laminisos, who's the CEO from Eva Peel. So I thought we'll do just something a bit different today. I wanted to really talk about when is the right time to talk about not just the menopause, but the perimenopause as well, which is the time when periods start changing in frequency on nature and people, women experience symptoms. So hi both. Thanks for coming. So Meg, this is quite relevant for you.

We were talking earlier because if you'd been given a bit of a bit of you, we were talking earlier, because if you'd been given a bit of information when you were younger. You might not have had such a dreadful experience, which we've all heard about your mother's too. Yeah, I totally agree with you. When do you think it's a good time? Well, the more I'm thinking about it more and brain now, I think the younger, the better. I think, you know, everything that Diane got with the amazing news about, you know, menopause. Yeah, just to announce that. Education. So Diane Danzabrunk is the most amazing menopause campaigner. She's also a psychotherapist and counsellor. and a great friend of mine. And so we have been liaising with Rachel McLean, who is an MP,

who's also, coincidentally, it's funny, I met her at a NCT class. So when my, now 16 year old was a baby, she ran this group for us. And we'd all have had our babies, didn't know what to do with them. And she has got four children. And we were saying, oh my gosh, who's this, Rachel? How on earth. And she was also always destined to be an MP. She's amazing. She's so organized, so clever, so lovely. And then we then, about 10 years later, we started doing yoga together. So we reconnected. Yeah. And then she was always, often didn't make the classes because she was busy with all her work. And then we sort of loosely stayed in touch. And then she found out about some of the menopause work I did with the police and all the women, as you know, who leave work because of the menopause. And so then I started talking to her about my menopause campaign to improve care worldwide for the menopause.

And so she said, right, there's more we can do. do and then I introduced it to Diane and we've had this focus group in the houses of parliament and on Thursday it was announced so it's one of the three actions that the hashtag make menopause matter campaign that Diane set up is is that menopause is going to be part of the PHSE education for secondary schools so that was announced on Thursday so just a few days ago and it's had a mixed review in the press really yeah but I just but everything always does that's just press for you tabloids. Yeah, I think. You know what? There's always, there's always an editor who's going to want to come from another. Totally. And any, I mean, my children said, would you know what, any news is good news?

Good news, yeah. People are talking about it. And also, all those editors, mostly men, I think, so. Well, actually, but on loose women yesterday, they were talking about it. And three of them were saying, oh, but teenagers have got enough to think about. So why tell them about the menopause? Because it's not going to affect them until they're old. No, no. Well, we know that's not true. Don't we by statistic. Yeah, and there's a lot of, there's a lot of controversy around sex education and health education in schools and this all fits into one curriculum. And there's a huge divide around what, you know, what should be included and what should be included. So I think, going back to your question, Louise, you know, as women, we spend a lot of time in touch with health services and it's not because we're ill, it's because we're female. So coming up to periods, going through puberty, smears, coming up to cervical screening,

HPV vaccinations, trying not to get pregnant, trying to get pregnant, going through IVF, having babies, going through perimenopause. These are all reasons to be in touch with health services and to think about our health, and yet we're not ill, we're just being email. And so thinking about that kind of lifetime approach from girl through to a woman, is the right way to think about it and thinking about the teachable moments in that time. So when is early enough, it's at those teachable moments. We know that things aren't scary if you know about them in advance. I don't agree.

And so then that tells you when you should be learning about things. So you need to learn about puberty, for example, at least two years before it happens. Girls are starting their periods at 8, 9, 10, 11 years old. you know, periods, you know, that is getting younger, so we need to think about it then. If you think about a perfectly normal question for a very young child to ask where the babies come from, we need to be able to answer those questions in helpful ways, not hide behind euphemism, makes up stories. Yeah. It doesn't help in the end.

And so having that menopause conversation at an earlier stage, but also at a teachable moment, and there are many teachable moments, one of them, is when you're trying to get pregnant. That's when you suddenly find that women often become experts on their menstrual health. They haven't known how long their cycle was, let alone when their last period was, until they suddenly often and very sadly can't get pregnant. So thinking about your reproductive health at an early stage, it's really important. I mean, I've got two, as you know, two teenage children as well as an eight-year-old, and my teenagers have been taught all sorts of explicit things,

sex education, which is great and sexually transmitted infections, but not all women, or not all girls are going to have sexually transmitted infections. Not all women will have sex. But actually, every woman, if they live long enough, will go through the menopause. And as ways as talking about it, I'm not saying that they need to have hours and hours of education, but actually a few sentences at key times are really important. Thinking about pregnancy, a lot of women enjoy being pregnant and they bloom and feel wonderful, but very few women realise that's related to their high levels of estrogen that they have. Yeah, they're all glowing and their hair and everything.

Yeah, because my girlfriends do IVF all of a sudden. They're like, wow. They feel amazing. But then, as we've already mentioned earlier today, there's a lot of women have postnatal depression. It's very common. It's often under-recognised. People really struggle to get help because the resources aren't always there. The infrastructure isn't always there.

But we know that women who have post-natal depression, have a higher risk of depression during the perimenopause and menopause. Sorry, ladies out there. Another one for you back news. But what is if, when I see women in my clinic who have had PMS, they've had postnatal depression, I say to them, did you feel good when you were pregnant? Oh my gosh, that was the best time of my life. But now they're coming to see me because they're either menopausal or perimenopausal

and they're low in their mood, their motivations reduced, they don't want to go out, they're withdrawn, their lives have been put on. on hold, then I know that those women are more likely to respond well to hormones because they've already told me they've responded well when they were pregnant. So if when they had postnatal depression or even when they had PMS, someone had talked to them just what hormones are, what they do. And if they've even considered their hormone history, that's what you don't think about. They don't think about their entire hormone history and the impact of contraception, which can be very protective against some cancers.

Yes. It is a protective factor. Yes. It's just not considered. No. It's not considered. All of those things that disrupt our hormones are things that can be, can provide risks and can provide benefits. Yes.

But it's understanding and having even considered it that's what absolutely. Yeah. And I think it's also knowing about different types of hormones, isn't it? Because a lot of girls, women take the contraceptive pill. They don't worry out it, do they? They think fine, great, safe. and we know, as you alluded to, women who have the contraceptive pill have a lower risk of ovarian cancer, for example, which is great. But actually, women don't want to take HRT because they're so scared that it's going to give them breast cancer or whatever.

And as we know, the HRT, certainly the body identical HRT, is very different to synthetic contraceptive pill and has different risks and a lot lower risks. But people don't realize they group hormones altogether. Yeah. So if we're teaching about the contraceptive pill, isn't it worth another sentence talking about? Absolutely. I agree with you. Because all my girlfriends that are like who don't even think about taking the pill, but then they're all of a sudden coming into them, they're all like to me, oh no, I'm all really healthy.

I'm doing bio-identical as Meg. I'm not taking that. And I said, well, were you on the pill? And they go, yeah, of course I was. I was on the pill from I was 15 until I was 35. And I'm going, well, there you go. That's fun. A harmful.

A synthetic. You were taking this with all the side effects. whatever and they all say go oh yeah I never thought of that and they never think about that and then they reconsider and think oh okay then you so eight and I'm like yeah yeah so you're right there because they don't all of a sudden they're like whoa well I think HRT those three letters just mean breast cancer to say yeah I mean it did for me I had a bubble there I mean without just you know in my subconscious when HRT you said to me this bubble came up just said cancer totally and you know And if you think insulin for diabetes is the type of HRT, it's a hormone.

It replaces. Yeah, yeah, yeah, yeah, you're right. You know, thyroid, if you've got an underactive thyroid gland, thyroxin is a type of HRT. So we've got to think about HRT not being just one treatment. So I think the other thing for me is that I'm sure, I don't know really you know, but it was my daughter when she was 11 diagnosed my sort of perimenopause. Yes. I know before.

But, you know, I am a menopause specialist, and I lecture GPs, nurses, healthcare professionals all the time and women to say you've got to think about the other symptoms. And there was me with my back-to-back migraines, my poor sleep, my irritability, low mood, low motivation, joint pain, joint stiffness, just generally fed up. But I was cross and angry. And it was my daughter when she was 11 one day when I was shouting at her. She said, Mommy, you're so irritable. Do you think you need your period? And then I suddenly went, oh my gosh, I haven't had a period for a month. And I was having this conversation with her the other day, actually. And my other daughter, Jessica, said, oh, I remember Sophie saying that. And we were both so scared. But we had to say something, Mummy, because you were vile. You were so horrible to live with. And I said, isn't that interesting?

You picked up that it was a hormone thing. Yeah. But if you'd known about the menopause, do you think you would have said to me, do you think you're menopausal? She said, oh, we got, yeah, but I had no idea. But I just thought it was something because, you know, my friends get irritable before their periods. And as I'm sure you know, the time before periods is classically when your Eastergen levels drop. So it's no different to have a perimenopausal.

So that's why women who have PMS, who's often say the week before their periods, that's when symptoms are worse. They feel very low. It's just that estrogen drop. So it's the same with the perimenopause as well. You want to eat chocolate, don't you? Yeah, totally. You feel, yeah.

And then your period comes a few days later. And you feel fine again. It's weird. The minute that you come on, you feel great again. I've forgotten really about that. Yeah, but you see one of the treatments for PMS that works really well is giving some of the estrogen gel. So we give it and it's very easy. You can regulate the dose. So actually my argument would be that if girls and boys know a little bit, they can actually help with... Yeah.

Because I just for one, so for instance my daughter like with the whole thing about smiths, you know, everything was so scary. Yeah. And then Anais did a campaign for the campaign for. Lady Garden where she did a photo shoot with like a flower here and I thought it was very brave when she was 16 and she went back and she would speak to all her school friends and speak very openly and she just said once you know about it and once you know but this whole fearful thing you say smear every teenage girl it should be something that we're not that's not even frightened about so even before that they you know I even think that should be brawomen because in theirs was very you know she went to so Sarah Matthews in London does this like teenage go

through so you go there and then you're not allowed to go in the room and she takes her in and then she talks about shows in the bed and the stirrups that shows everything and then then I know it all now I've had it it's like it's absolutely fine then she tells her hours of friends now and then she put up on Instagram the other day I saw she just said been for my smear and and she said why wasn't that talked about at school mom because nothing was brought in about smears and then all of a sudden we're told we've got to go and do this evasive thing but it could be saving our lives, you know, and she said even that. So I'm like, well, that should be brought in as well.

It's trying to normalise things, isn't it? And I absolutely, everything's about trying to normalise it. And there are certain, that's what I mean about those teachable moments. So it's going from teaching Key Stage 1 primary school children about their anatomy. This whole kind of, if you go on a parenting website, and there are many, there are yards of conversations which go along the lines of my two-year-old has just started to explore her body, what should we call it? You know, and it's just like, just call it what it is. You know, just use proper words, explain, vagina, vulva, you know, don't give them euphemisms to use.

You know, really, that's very important because that contributes to all of the kind of shame and stigma and surrounds the heart of the body. And I think certainly with my, I've got three girls and they're all been very different in what they've wanted to know at different times. And you just go with them, don't you own? some people I know have said, oh gosh, I'm going to sit my daughter down when the time's right and I'm going to tell her and show her this book I've got and I'm thinking, oh God, we just usually, it's using the car when you're driving and they say, I mean, her baby's born or what's this

hole or what? Yeah, I believe that. You just tell them what they need to know. You don't then sit them down and tell them everything because they would get really freaked out. No, yeah, you know when they're just, when they're just, when they're just, when they're when they're just, you're like an early sort of 12, 13, or you're going to actually tell them. They'd just be like, no. because their hormones are flying high as well at that particular moment.

The other issue is all the good practice and all of the evidence tells us that around health and sex education, what's really important is spiral learning. So learning a little bit of something and then revisiting in a bit more detail a year later, a bit more detail in two years later. We don't teach children at the age of five to do quadratic equations. We teach them number bonds. And it's the same with health and sex education. you're building on knowledge and then it's not frightening and then it's not is something that you're going at all.

I think also if you've got some information then you know where to go and get help. So I mean Meg's done the most amazing work with menopause making it not a taboo, but there's a lot of women out there who don't think they're menopausal. I wouldn't have gone to your website because I had no idea what was happening to me. No, well, not have I. And you wouldn't have gone to your own website. So you wouldn't have actually help yourself. No. So it's, but if you'd had a bit of drip feeding information, even when you were pregnant or, you know,

when you'd had a smear, someone has said to you. Did you know this? Have a look at this. Then you would then go to your website. So if we can give some information, then people can access the information themselves. So it's just giving a small amount, isn't it? So that's why when this thing, this came through with the news of the insect, I thought it was amazing. Yeah. I just thought that's the least it's, you know, because our subconsciously brain,

we probably go, oh, that's for, you know, still go frail old grey, head old ladies, which I would do, you know, the little thing, that's what I think the menopause is, but it's planted the seed, doesn't it? And then it will come up again. So if you're starting feeling a bit off, then you remember at school when they taught that, maybe that's why that is. Well, it is, and it has a big impact. So one of my daughters, one of her friends, has a quite nasty stepmother, and she has to go and see her every other weekend. And then my daughter said to me other day, oh, do you know what? My friend said to thank you. And I said, well, what have I done? I haven't seen her recently. She said, no, well, she said, my,

She went to see her stepmother for the weekend, and she was lovely. She was singing, she was happy, she'd cook really nice food. And this girl said, are you okay? She said, yeah, I've been to see this amazing woman who stepped upon neighbours. I realised that I'm being men of course, and she said that she's incredible. I think she's one of your friends' moms. And can you think her? But we've seen it all the time, haven't we?

Women who have their hormones balance. But I thought, how lovely, that, you know, she could be open about. it and you know um it is important because we want our children to be open we want we don't want to know everything that they do but we want to prepare them don't we so they can make the right choices as well really yeah and i think there's something around what we know about the minipause and how we're learning all the time yes if you think about medicine as a practice well one it's a paternalistic practice you know by definition of how it's developed if you think about you know the ancient greeks for example you know a lot of the

clever ones, Socrates and onwards, had it pretty licked in terms of how the body worked, how anatomy worked. They knew nothing about menopause at that stage. If you think about what age women died, probably an ancient Greek woman was having the maximum of 10 periods in their entire life. They were either pre-puberty, which didn't start until 16, 17, 18, pregnant, or breastfeeding, or dead. In the UK, in 1850, in 1850, the average life expectancy for a woman was 49. Yes, so they didn't reach menopause. So if you think about the amount of years that medicine has taken to look at this

and look at what menopause does, it's still a relatively new thing that we're looking at. So we're all learning, but learning fast. We have to appreciate that. We have a lot more periods, and even someone like me, who's had four children, breastfeed each of them for a year each. I started my periods early. I went through the menopause fairly late. I've had a lot of hormone exposure and I've had a lot of periods.

So I've got very different risks to say my grandmother, who probably had 30 periods across her lifetime. I know I'm a very particular case. My grandmother had 18 pregnancies, 14 children. So, you know, she was pregnant or breastfeeding for a lot of her adult life. but you know that you'd find that your grandmother you know on average would have had far less hormone impact than you will have that yeah wow the other thing's interesting is it so when each my pregnancy is same for you you have a lot of help um we had some NHS run anti-nature classes that you could go to which was brilliant but actually I was only pregnant for nine

months and then obviously had the baby but they prepare for the baby they don't prepare you for having a teenager which is quite different to be having a teenager which is quite different to be But actually, you spend a lot, or women, on average, spend 30 years being menopausal. So the majority of their time is in the menopause and we're not prepared for it as a whole. And yes, symptoms can vary. Sometimes symptoms only last for a few years for the lucky ones. I saw a lady yesterday in my clinic who has symptoms for 27 years. So they can go on and on and on. But even if we don't have symptoms, we have low hormone levels in our body. So we have this increased risk of, as you know, heart disease, osteosal.

deoporosis, diabetes, dementia, arthritis, even early death as well. So we need to get away from the fact that the menopause is this laughable, hormonal crazy woman in the corner, she'll get through it. Actually, if we want to live until our 80s, which is the average life expectancy, it's not just a number, it's about our journey there as well. It's not a moment. It's not a moment. And we all, a lot of us are really trying with our diet, with our exercise, with our sleep to look after ourselves but we can't create the hormones that I've got so but it's the real misopportunity we don't have any education like you say just to help us on our way a little bit to think about the bigger picture to not just think about HRT's going to get rid of your hot flushes

but you might as well man up and get through them yeah no absolutely not like that is it so because I was going to say what I've found finding a lot with women is that they're saying I'm through it now. I'm over the other side. So then they're thinking, I'll stop taking HIT. And I'm like, no, no, no, no, just because you think you're through it and now you're feeling good. You want to carry on your phone. Yeah. But they're like, well, like my mum would have been and what they, you know, only five years and stop whatever. They're starting to now say, well, I feel better now. I don't need to take it anymore. And I'm like, no, no, no. You want to stay younger. And the minute you say stay younger, they're like, oh, what do you mean? Stay younger. I said,

want to look younger? Do you want to, you know, do you want all these things to happen to you? Do you want to get frail? And they're like, no. No, I mean, it is, I mean, hormones are anti-aging. I went to a great lecture last week by a professor in America who looked at people who'd had their ovaries removed early. And these women have accelerated aging. Despite any other health risk, regardless whether they're smoking, exercise, anything else, something about estrogen prevents aging or reduces the aging process. So, you know, forget everything else. Just think about and eating. And we know, certainly for our skin, it helps build collagen, it helps reduce moisture loss. So women often look better when they take HRC. I'm not saying you should take it

just for a cosmetic region. But if you think of the millions of pounds that spent on face creams that don't really work, but we do it because we look better. But actually, if it's helping our collagen and our skin, it's helping our joints. Joint and bones. and our bones and seeing as one in two women who go through the menopause have osteoporosis. Me being one. Yeah. You know, HRT

is the best treatment for osteoporosis and it's the best prevention as well but often that's not thought about. No, not at all so. So it's about, it is about what the word menopause means, isn't it? And what's being taught is key. It's all very well saying, yes, it's great,

we're going to teach it. But it's vitally important that people get the right information and not bombarded and scared away because it shouldn't be scary, should it? Can I ask you a question? Good face. Yeah. Because I wanted to ask a question. Isn't it the NHS had this like, do they call it like a 50 overall or something?

Well, women, took. At 50, don't they? Where they ask you for a mammogram. Because I remember them asking me to go in. Yeah. But I was already getting HGIT because it was my, I was already 50. Yeah. So I remember them going to do my, they were going to do my blood pressure.

Yeah. But there was nothing. They mentioned anything. about the menopause to me. They kept going on about great opportunity. So, and that's where you, they invite every woman to go in and have this and every man, but there was not one mention of the menopause from the NHS. We've talked a lot about it. I've been to some task force meetings at the Department of Health.

And one of the things was adding the question, it would be great to say, when was your last period? That's all. And I think it should be asked at those visits. It should also be asked when people have their smears. Yeah, I think so. I should also, I think be pinned onto the information. I'm nearly 50, so I've just been sent the mammogram screen, you know, the breast c-seeing. If they had a fact sheet, and I've told them, I will happily write it just about menopause, because most women go through the menopause at 51. We know a lot of women go through it younger, one in 100 under the age of 40. But even if we're

capturing those women at 50, you know, you have all this other information. If they could just have, have your periods changed or stopped, read five facts. That's all you need. It would be great. one of the problems is obviously that there's no money in the NHS. But also the real problem is everything's very segmented. So there is a kind of whole approach and we are whole people. Yes, definitely. Yeah, we shouldn't be thinking about just going for one thing. It should be thinking about the other impacts.

That's really important. Yeah, because you get manograms. That's the minding it. It is, definitely. And I think it links in. We're talking about education, but it does link in with a lot of eave appeal. work, the charity that you work with and do tremendous amount of work because it's about education, it's about early diagnosis, you know.

It's about knowing your body. It's totally about knowing your body and knowing about changes. And certainly the work that Meg does and I do is to try and get people so they're not suffering so they can pick up on their symptoms early. And it's the same with some of the cancers we've already talked earlier about, you know, a lot of the gyne cancers are picked up too late because women are often ignoring the symptoms, sometimes because they're worried, but sometimes because they don't know. Often because they don't know.

They just think it's one of those things. Women's trouble. Well, that's right. Les Dawson way. It's not really happening to me, so I'll put it off. But if they had the right information and also we're more in tune with the bodies and how they changed, then that would be really important. Absolutely.

So I think that was great. I think thank you very much for agreeing with me that it was a right thing to introduce Menopause education. I know, really good. Thank you very much. Thank you. For more information about the menopause, please visit our website www. www.combector.com.