The Dr Louise Newson Podcast - 028 - Menopause and Friendship - Kate Parr & Dr Louise Newson

Episode Date: December 17, 2019

In this week's podcast, Dr Louise Newson is talking with one of her closest friends, Kate Parr, about her reasons for setting up Newson Health Menopause and Wellbeing Centre. Kate encouraged Dr Newson to start educating women about the perimenopause and menopause by hosting a lunch in her house a few years ago, to which many of their friends were invited. Both ladies were really surprised with how eager women were to learn about menopause and how little they knew about something that they will all experience. This inspired Louise to continue to educate and empower women with the right knowledge, so that they can make evidence-based decisions regarding their future health during their menopause. In this episode, Louise and Kate also discuss why talking about menopause to our friends and families is so important.  Kate Parr's Three Take Home Tips: Be informed! Find out everything you can about the menopause, from reliable sources. Talk to your girlfriends and support each other. Mothers - talk to your sons and daughters about how you are feeling. Educate them so that, in the future, they know what to expect and know that it's okay to talk about it.

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsome, a GP and menopause specialist, and I run the Newston Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. So today I've managed to drag one of my really good friends here into my clinic, just to talk really about how much ear-bashing she's had from me over the last few years. years about the menopause. So Kate, welcome. Thank you for coming. I hope it will be a pleasure, Louise. So obviously we've known each other for quite a while and when I first met you, I wasn't really talking very much about the menopause and now all I do is talk to you about the menopause, I think.

Yeah, taking me back to the good old days, Louise, when we used to have other conversations about other things. Not anymore. So when did I first lure you into this whole menopause conversation? Well, I can remember coming around one day just before. your youngest daughter was about to start full-time school and you were sitting wondering what you were going to do with all this extra time that you had available and you said to me do you think women would be interested in finding out a bit more about the menopause because at the time you were seeing a lot of ladies who were struggling at your practice in Shirley yeah and I said well we could give it a go and we all going to do you remember the lunch we all

yeah absolutely because I think that was just after the nice guidelines came out, weren't they? So the Nice, the National Institute of Health and Care Excellence, menopause guidelines were published in November 2015. And like you rightly say, my general practice, I have for years and years seen menopoles or women and helped them, and it's been very rewarding. But when the guidelines came out,

it really gave a passport for healthcare professionals as myself to really think properly about individualised care, getting it right, giving the evidence right, and really considering HRT if it's appropriate. They came out in November, so I think you're right. Lucy had started full-time school in the September. I was working. I've always worked one day a week as a GP

and then sort of filled my time with lots of writing commitments. But I had this feeling I wanted a bit more around the menopause. So, yeah. Well, I'm about five years older than you, and I think you targeted me. Maybe. I think you had me in your sights. And I think we thought it would be a bit of,

of a giggle to start with. A helpful giggle, but a bit of a giggle. And so I sent an email out. I remember I addressed it to all my hot lady friends. Because in those days, that's what the menopause was. It was just about hot flushes. And we had a really good response, didn't we? And we did a, I think, a vegan, healthy lunch, which we could. Otelengi-style salads we decided to make. We did. We got all our earthy bowls out and all our good bits of basket wear. And And we set my sitting room up with every single chair I could find. Yes. All the outdoor chairs.

My husband, Paul, helped and then legged it. Yes, because we had, we decided a bit of a goodie bag as well, didn't we? And I remember you wanted an evaluation sheet, which is very important because you're very structured and I'm very chaotic to find out what people thought about the event that we were organising. But then we also put some vaginal moisturiser and lubricant samples on the chairs. And I think that was the time. that your husband legged it out of the house, isn't it?

Yes, he saw all these little packets of yes and just thought it was going to be too scary. He couldn't cope with the atmosphere. Anyway, everybody turned up, pretty much everybody we invited came and those that couldn't make it asked

if we were going to do another event. And it was like the house was full of birds. Everybody was just chattering and chattering and chattering because we had the lunch after your talk. Oh, that's right, yeah. It was your first talk. To women, yes. I mean, so I've spoken to healthcare professionals lectured before, but we rigged up the screen, didn't we, in your sitting room. And I decided to do some very simple

slides and decided to do a presentation talking about what the menopause is, what the perimenopause is, the time before a woman's period stops when she starts getting symptoms. And probably more importantly, talk about the health risks of having low hormone levels. Because like you rightly said, a lot of women still perceive, and men actually, the menopause to be, let's give them a fan, be a few years of hot flashes, and then they'll be fine. What women and men aren't realising necessarily is that once we have our menopause, so our ovaries run out of producing hormones or they're removed from a surgery, then we can't replace those hormones.

And if we live for decades, often, without the hormones, we can't replace them. So we have this increased risk of heart disease, osteoporosis, obesity, type two diabetes, depression, dementia. And that's really what I wanted to come across. So we talked about that. We talked about obviously symptoms such as low libido, vaginal dryness. And also the mood changes, anxiety, memory problems, fatigue. And then I talked a lot, didn't I, about HRT, because that's what struck me actually is that when you started talking about your experience and some of your friend's experience, you kept saying that they've been given antidepressants. And I thought,

what? I've never given antidepressants in my life for someone with menopause. And it was quite a recurring theme, wasn't it? It was. But the other thing that you did quite a lot of dispelling of myths. And I think one of the key things that I took on board from that talk, and I think, you know, my lady friends did as well, is that products you can buy, you know, in chemists and supermarkets, a lot of so-called natural products, may treat some symptoms, but A, they're not tested and B, do they deal with the other issues that arise out of menopause? And I think that was really enlightening for a lot of the women there. I think because it's a massive market. It's a huge industry. And as you know, I quite often get asked if I can put a quote behind

some of these products that are coming out now. But there's very little evidence that they work. And even the nice guidelines are very clear that if a woman is taking something, they need look for the THR logo, the traditional herbal logo, to see that it is regulated. But there's so much about natural, but actually dejoxin of Foxglove is natural. Yeah, exactly. But actually it will kill us if we eat it. So you have to be really careful what that means. And like you say, there are some products.

There's even a magnet that you can pop into your pants. I told you about that. I know. I think you nearly fell on the floor. I did. And then I found out my sister-in-law had tried it. And she said it actually got stuck to her pants as she was pushing the Tesco trolley. So it's not without risk.

But like you say, that might help her symptoms, but it's not going to help her bones get strong, her heart to remain healthy, her brain to function. So that's what we need to be thinking of. So I think the women were a bit shocked, weren't they initially? I think they were surprised. But I think more than that, I think they were just so relieved. to be able to be talking about it, not only to you, Louise, but also to each other. And it's this whole sort of, I know it sounds a bit funny, but it's the whole sisterhood thing.

And it's the fact that you and I talk about it all the time, obviously. But no one else does. But nobody else does. No, and it's starting the conversation. I think we felt we started that conversation at that point. And then do you remember after lunch, when we eventually got rid of everybody and there was not a scrap of food left? We walked into the sitting room and looked at all the chairs

and there must have been 30 or 40 people there. We looked to all the chairs and every little sachet of yes had gone. And we just looked at each other and went, what? That tells us something. It did. And yeah, I mean, 80% of women, we think, from some studies, have shown that 80% of women have vaginal dryness. And that's a huge amount of women.

Yet we also know for studies that only about 8% to 10% of women received treatment. So there's a lot of women out there that have pain and discomfort during intercourse, but also others that find it hard even to sit down or to wear underclothes, but they won't talk about it. And, you know, the menopause happens to all of us, doesn't it, if we live long enough? And Diane Danzabrunke, who's a great friend and campaigner often says, if you know a woman, love a woman, or work with a woman, you need to know about the menopause. So it's really key, isn't it? That we do talk about it, but it's, I don't know why people can't. You know, there's so much more that we talk about than we used to in the past, you know, 40 years ago, we weren't talking about

cancer. We didn't even mention that word, did we, or it might say the big C. And then probably 10, 15 years ago, we wouldn't talk about depression because that would be a failure. And now we can talk about depression even in the workplace and wellbeing, which is really important. But somehow, menopause is still a bit uncomfortable, isn't it? It is. It's associated with, you know, such a difficult time of our lives as well, where our, you know, life and our lifestyles are changing our children are growing up, our parents are getting old. And so really, it just couldn't arrive at a worse time. Yes, definitely.

And, you know, we've got children, well, they've just turned 17, haven't they, my oldest daughter and your daughter, and never going soon. And, you know, and that's a really difficult time of adjustment. And then our hormones are changing. So it's a double whammy, isn't it? And also, I mean, you're lucky with your mother. You've got a very close relationship with her. But many of us don't know how our mother's experience.

the menopause. So we're not getting any information passed down from our own parents. So we have to look to each other to provide that support. And I think that is really key. I mean, I, as you know, you know, my mother well, she's taken HRT for decades. And she's a, you know, massive role model to me because she still works. She's incredibly independent, having been widowed for 40 years. But she wouldn't be like that without HRT. So actually she's really speared me on to thinking, actually, we shouldn't be stopping HRT on women. There's lots of women get told when they're 60 or when they've been on it for a certain length of time,

but they need to come off it. Yet that's against the current guidelines. And the evidence is very clear that even women who take low doses of estrogen still have protection for their bones. And in fact, at that lunch, I had a little heel scanner, didn't I remember? That's right, the dexas scanning.

Yeah. A little bigger. Yeah, we had a little giggle because I hate feet. It's just something about feet. I could examine any. part of anybody's anatomy without being embarrassed, but I just don't like feet. But this was a little ultrasound scanner that I'd borrowed. You can't use them to diagnose osteoporosis or osteoprenia, so it shouldn't be used as that. But I'd borrowed it really just to make people think about their

bones. So these women were taking off their tights and their socks. And queuing. And they were queuing all down your horn and I had to touch their horrible feet. They weren't horrible. They were my friends. They were beautiful feet. All of them like nice feet. And we had these little printings. out and it just made them think about it. And I think they hadn't thought about their bones, had they? Well, I don't think any of us really knew. And I honestly, and still come across people that think that menopause is all to do with periods stopping or becoming infrequent and then stopping or changing and then stopping and just getting terribly hot. And it's so much more than that. And that's what I've learnt from you, obviously talking to you about it, endless hours.

But you do find you talk a lot more, don't you, about it to various people when you're dog walking or when you're out in court or whether you're... Yes, unfortunately, Louise, I've become quite evangelical about it. I've spent way too much time with you. And I'm doing a course in counselling at the moment. And as part of the course, we have to do a presentation. So I did mine on menopause, obviously, and how it might present in a counselling situation. So thinking about women who in their late 40s, early 50s have got everything else going on, job, work, family, marriages that are getting on and struggling a little bit sometimes,

and how that might present in a counselling situation that the counsellors that I'm training with are now aware of the menopause and the symptoms that can present. And, well, it just, it was an amazing evening actually. How long was your presentation? Well, my presentation was supposed to be, I think, eight or ten minutes. And I think we spent an hour and a half talking about it. And that's nine people in the room, including a man. And did they know you were going to talk about that?

They did know I was going to talk about that. And I don't think they thought it was going to be anything more than talking about hot flushes. But I was, oh, well, I had a great time, actually. And they really enjoyed it. And I'm not sure I enjoy is the word. I think they felt really informed for themselves and if they ever become counsellors for their clients and for their mothers and their daughters and their friends.

And what about the man? They took a man. What was his reaction to it? Well, actually, he's pretty cool. And he was really interested. And I think he made some comment about, you know, feeling much more. He works in a very male environment. So I think for him it was in relation to his friends and family.

and I think he feels much more enlightened and able to talk about it and obviously in a counselling situation it is the sort of thing that you might want to discuss with your client have you thought about it from this angle you know I'm happy to offer you the you know therapy space but there may be some other things that you can do that might improve your well-being brain fog loss of libido the effect that menopausal symptoms can have on relationships and on your own sense of self.

And those are all things that could bring somebody into a counselling situation. Yeah, I see a lot of women. We all do it in my clinic who have been seen by counselling, often marriage guidance, but also just counselling on themselves. And because, like you say, you have all these symptoms and reduced self-esteem is a really common symptom of the menopause because the hormones, estrogen and also testosterone are very important in our brains. So without them, these symptoms can occur.

But if you don't know that they're related, that's when you think, am I going mad? Have I lost? So sometimes actually people just come to my clinic and feel happier, just knowing that it's related to their hormones. This is despite them having any treatment, just knowing what's going on. And I think it's really hard for partners, isn't it? Because they marry someone maybe 20, 30 years before and then they're changing. And then they're thinking, is this me or is it them or what's going on? And then these women are feeling really low, really bad about themselves.

And this sort of spiral goes on, doesn't it? So I think even if and when, hopefully, they have the right treatment for the menopause, they still often need some counselling or talking treatment, don't they, to really help? Yes, talking therapies. You know, and I think those two things combined, but most of all, and at the end of my talk or my little counselling school, it's just that people need to know and we just don't know about it. And that's changed enormously in the last five years. You know, if you watch TV or tune in on the radio or read the papers, there will often be

something about the menopause, quite often with a Lewis news and by life, we hope. Yeah. And it's about dispelling the myths. It's about informing people and it's about encouraging people to go and find out themselves. Yes, absolutely. At least the information's out there now. And it's about making a choice. H.R.T. in my opinion, you know, has been great for me, but it's possibly not for everybody, but find out about it. And, you know, what I say to some of my friends is you can start taking it and see how you go. Yeah, absolutely. And I think for people just to know there are different doses, there are different types, it's not a one-size-fits-all. And actually, HRT isn't the only treatment for

the menopause. You know, you've just said, you take it, I clearly take it. But actually, there's other things that you have to do as well. We do our yoga together every week. Lovely James Critchlow, who is... I'd just like to point out, Louise, is so much better than me. Well, no. But James is the most wonderful yoga teacher. He teaches us this Stanga Yoga, but he is very calm, isn't he? You go into our yoga studio, we're very lucky we have a yoga studio in my clinic, and he comes to that every Wednesday morning and teaches us. But just seeing James makes us feel very calm. and together and, you know, that's part of my menopause treatments. And then obviously looking at diet or other exercise or general well-being,

but sort of mentally as well, you have to be in a good space, don't you? I think I see a lot of women who are thinking all their symptoms, all their life worries are due to the menopause. And I don't know whether they are or not. But every bad day that I have, I don't think it's the menopause. I think it's because of life stresses. Life, yeah. So there's a bit of a bend diagram, isn't it?

There's a lot of overlap. But I think we need to be able to have the right mechanisms and support that if things do become overwhelming mentally, then we need to know how to get help, don't we? My view, I've got one daughter. I'm very lucky we have a bit of a patchwork family. So there are children around and now a grandchild as well, which is very exciting. But it's made me realise that you need to try and keep yourself as well as you can be for as long as you can be well. in my in-laws are aged and needing help and care. Yeah.

And old age comes to us all and you've just got to try and be and remain in the best position you can be in. It's totally true, isn't it? Because we all know how precious and valuable our lives are. And we also know how hard the NHS work. And you've kindly taken me to a hospital on a few occasions when I haven't been well and saying, are you sure this right going to this big, busy hospital? run by the NHS and I'm saying absolutely because you get the best care when you're ill

under the NHS especially in an acute situation but we don't want to be a drain on the NHS and certainly a survey I recently did of 5,000 women showed that about 30% of women are taking at least four years to have the diagnosis of the menopause even made so these women are going back and forth to GPs they're often referred to cardiologists for their palpitations to neurologists for their migraines, to urologists for their bladder symptoms. And these are costing women a lot of money, taking time off work often, just taking time out of life to go to visit various doctors, then worrying that they might have dementia or they might have a brain tumour or whatever.

So we really need to obviously educate healthcare professionals, but like you say with giving that first lunch, really empowering women so that they know, they can take the lead for their health. You could almost see at that lunch when you started talking about the other symptoms, and brain fog is the one that I always nod massively about. You could just see the penny dropping for so many people and the relief. Yes.

Thinking, I'm not going mad. I've not got early onset Alzheimer's. Other people are feeling like me and this is what it is and I can do something about it. Yeah. And that was really, I mean, you must have a lovely time in your clinic where you see that every day. I do. I'm so privileged and I'm so lucky because, you know, I can really help people, or mostly, obviously some people can't or don't respond in the same way that you'd hope. But the majority of women, they come back and they're different and they say, thank you. I've got my life back. I've got my brain back. My husband, my family, I'm smiling again. I've got joy back in my life. And, you know, my husband, as you know, is a surgeon, but he's quite jealous of my job because he said, how do you do it? You know, you can make all these people better. And actually sometimes or often, I don't actually see these women. So as you know, I know you stalked me a bit on Instagram. I every day have messages for women saying, because of you, I've become empowered. I've asked

for this type of HRT and wow, my life's better thank you. And so for me, that's lovely. You know, it's not great business model for me running a business, but actually it's great that women can really seek help. And I also get a lot of emails practically every day from different doctors asking me advice. And I have freely given. And then they often reply, I say, thank you, that's really helped. And now I can help with other women. So it has this real ripple effect, which is good. I know that given the choice, you would not have set up your own private clinic, I don't think.

No, not all. You would much rather have done it through the NHS. No, because when we had that lunch, there was no way. I hadn't even thought about doing private medicine. I wanted to set up an NHS menopause clinic. And as you know, I went to different health authorities to see, and there's no money for menopause care. And I've done a lot of, I still do a lot of campaigning. And one of the meetings I've had in the Department of Health, they said, well, there's no money for menopause care.

But we need to think about saving money in the future. And I'm hoping with some of the research that I'm doing, people might start to think differently. But yeah, we've got 16 GPs working with me who are all NHS GPs, but they do some work in my clinic. And initially, when they come, most of them say, well, why are you doing this privately? Because this is what we do day and day out in our GP practice. and they're all great GPs with a special interest in the menopause. But sadly, there are a lot of doctors and nurses and other healthcare professionals who have had no training in the menopause.

And we know from studies that around 70% of women are inappropriately offered or given antidepressants. And so these are the women we're seeing who just aren't getting help. You know, it's a great shame. Shouldn't be happening? No, I mean, I look back at my mother and, you know, at that age, she was in a really bad way in her mid-50s. The doctor was prescribing diazepam and all sorts of, I don't know what, I mean, the drugs in those days were pretty hefty as well, were they. Yeah, I mean, I've still got a lot of patients who I had in general practice who were in their 70s, 80s on diazepam,

and it's really hard to get women off when they've been on it for 30, 40 years. And when you say to them, well, when did you start, we're in the 50s? And now, I mean, it's in the paper most days, isn't it about over-prescribing of antidepressants? And when you look at the demographics of people taking antidepressants, it's more common in middle, age women. Yeah. But no one's really thinking about why is it. Yeah. It's, you know, trying something else before we... Yeah, and these women don't want to be on antidepressants. We know from the evidence that there's no good evidence to show that giving antidepressants improves the low mood associated with menopause. We know that women going through the menopause

have at least a three to four times increased risk of developing depression. And having estrogen can actually reduce this risk. So it's really important. We're, about to start some really exciting research looking into this in more detail. But I think the message for women is if they are offered antidepressants, they need to really think, am I really clinically depressed? Do I need the, because no one wants to take inappropriate medication. No. And also you're missing the medication that might benefit you in so many other ways. Yes. What do antidepressants do for your osteoporosis, for your heart, for your, I mean, I'm not a doctor. Make it worse. What do antidepressants do you think of them? Well, they can actually make it

worse. And I think it's really important. When we think about the benefits versus risks of HRT, everyone worries about breast cancer, yet the majority of women in the UK die from cardiovascular disease, so heart disease strokes. And we know that taking HRT reduces the risk of heart disease by about 50%. It's a huge amount. So it's more effective than blood pressure treatment or giving cholesterol lowering treatment, taking HRT. Yet no one thinks about it. We know that one in two women over the age of 50 have osteoporosis. Yeah. And taking HRT increases our bone density, reduces our risk of osteoporosis.

Yet people don't think about that. No, the slide that particularly stuck in my mind and that I used in my counselling session was the slide about the average age of menopause a hundred years ago. Yes. Being 52 and the average life expectancy was 54 or... Well, it was 57 and 59. It depends on what you read. But essentially, in the Victorian times, we used to die quite soon.

And Victorian women did get locked up in asylums. You know, hysterectomy, hysteria is where the word comes from. There's no coincidence there. But they didn't have these long-term health effects. They didn't have dementia. People weren't in nursing homes in the 70s and 80s. Whereas now, you say the average age is slightly younger, but then the average age of death is about 82 in women.

So we live a long time post-menopausal. And we're not designed. If you look, there's a couple of mammals. There's a certain type of whale that has a menopause. Yes. But most mammals don't have a menopause. So it's not a problem because I think evolutionary we're here to reproduce really, aren't we? And then we die.

And then we die. It's good. Jolly note. But I think, you know, it's important to think about. And it's important for our future generation to think about as well. because I know your daughter and my children aren't taught anything about the menopoles at school other than when it's when their period stop. If only it was so easy.

That is the best part about it. There's no doubt about it. But it's really important that information is drip fed at the right time and the right place. Not sure flooding in a lunchtime when, you know, you think these women got to the ages of 40s, 50s, some of them, without even thinking about the menopause. And I've certainly got friends. I know you have who are well into their 50s and say, no, I don't experience any symptoms. Yes.

And we know that they do. Yes. But they think it's a failure almost, don't they? Oh, yes. I have a friend who said, don't tell my husband. Yeah. Don't want him to know. It's hysterical, isn't it?

Why is that? Yeah, so we need to change. And I think because of your friendship and belief in what I do, I've managed to carry on. And I'm very grateful, but I do feel sorry for your ears. because I, as you know, there are lots of times where I feel very frustrated and I feel very sad for women the way that they're treated. And there are a lot of times when I am absolutely exhausted and say to you, I think I've done enough, I can't. And you keep saying, no, you have to keep going. And it's really important for women. You know, you say this whole sisterhood at the

beginning and women need other women. And I was in the middle of reading Melissa Gates' book. And she talks a lot about empowering women and if you want to make a change you involve women and I am learning that and the more women that can help me on my crusade to educate women not just in the UK but globally then I think the more productive that we can hopefully be so thank you very much this has been really good and making me feel that I've still got a good friend just about before we finish in use your style, do you mind just giving three sort of take-home tips, maybe for women who are in denial about the menopause or what you think they should do? I think it's really important to A, be informed, inform yourself, find out what you can. I think you need to talk to your girlfriends,

talk to each other, talk to your GP, and take a view on what's best for you, and don't discount anything until you have really thought about it and tried it. And I think most importantly, for mothers out there, talk to your sons and daughters about it. So that, you know, in 20 or 30 years' time when they're reaching this phase in their lives, it's perfectly normal, happy to talk about it and nothing comes as a surprise. Absolutely. Thank you. Thank you ever so much for coming. I'll see you soon. Bye. Bye-bye. For more information about the menopause, please visit our website www.companthroposdoctor.com.