The Dr Louise Newson Podcast - 073 - Menopause in the Media - Kaye Adams & Dr Louise Newson

Episode Date: November 10, 2020

In this podcast, Dr Louise Newson is joined by Kaye Adams, a radio and television presenter and regular panellist on ITV's Loose Women. Kaye has recently co-authored the book called Still Hot in which 42 women have written about their own menopause experiences.  Kaye and Dr Newson talk about the ways journalists and the media obtain their information and how, for many years, any information they have obtained about the menopause has been incorrect. They also discuss how the incorrect prescribing of antidepressants is so common for menopausal women and how this can be reduced in the future.  Kaye talks openly about her own menopause experience and the reservations she had. She talks about how she came to consider HRT because she's the type of person who needs to read and ascertain the research, which she found to be so different from what she, like many women, had wrongly been told in the past.  Kaye's Three Take Home Tips: Don't feel like you have to keep your head down and soldier on.  Stand back and take the time to really assess how you are feeling and what you need to feel better. Prioritise yourself and don't feel selfish for taking that time for you! Follow Kaye on Instagram: @kayeadamsofficial Twitter: @kayeadams Facebook: @kayeadamsprogramme

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsome, a GP and menopause specialist, and I'm also the founder of the Menopause charity. In addition, I run the Newsome Health Menopause and Well-Being Clinic here in Stratford-upon-Avon. So today I have with me in the studio, Kay Adams, who is a radio and television presenter, and she is also a regular panelist on. loose women that I'm sure many of you have watched and enjoyed. She's also brought out her a really lovely book called Still Hot. So thanks Kay for joining me today. Well, it's my pleasure. And also can I say thank you for contributing to Still Hot because I think it's lovely, obviously, as a medical professional, you know, you give your thoughts on menopause, but it was really good of you to share your own personal experience. And I think it's good for us all to remember that, you know, doctors are also human beings.

Yeah, thank you. And in fact, it was really exciting when it came out because I remember giving the story quite a long time ago now and then seeing it in black and white and I have shared it to all sorts of people and all sorts of platforms. And in fact, some of my colleagues have thought it's quite wrong, but I've done that. And I think people actually sometimes relate to it well. Like you say, we are just human beings. We all make mistakes and I made a big mistake missing my own perimenopause. So if people can learn from it, then that's fine. So some of your colleagues thought it was wrong? Yeah, I'm very open that I take HRT. I'm very open that I have symptoms that affected me in the workplace. And I think we're more open as a society than we used to be, aren't we? Sort of 20, 30 years ago, we didn't even talk about cancer. It was a C word. We didn't talk about mental illness.

And whether it's because it was the menopause or whether it was because it was my personal journey, I'm not sure, but I think some of it was the whole menopause. And there's still so much stigma, isn't there? I don't know. I mean, you've done so much amazing work in journalism, in the media, but you were saying the menopause is something that's not really being talked about very much until now, is it? Well, I would say it's probably the last three or four years, and this has kind of jogged my memory. So if we go back to 2016, Kirsty Wark, who's somebody that people are probably familiar with, and I know very well, she did a documentary for the BBC.

So four short years ago. And actually I do a radio program for BBC Radio Scotland, and she asked if she could come in and do some filming and, you know, whether we would have a phone in about menopause. So given that Kirsty is virtually royalty in Scotland, we said, of course, Kirsty. And so she came in to do it. And we just really didn't know what to expect. And we were absolutely overwhelmed by the volume of calls that we got from women in their 70s and 80s, which was really interesting. who were kind of reflecting back and some of them still experiencing symptoms

as well as women going through it. And it is only four short years ago, but I remember at the time thinking, ooh, this is interesting, Kirsty doing this. But since then, you know, we have heard these conversations in many, many different forums and it's really starting to build up. And so it's been interesting to kind of chart that

and see that happening. It is interesting, isn't it? I remember going on to the radio with Vanessa Felt, It's about similar time, maybe three and a half years ago. And I just started doing a bit of media work because, as you know, I sort of use and abuse the media to give out messages. And she got a bit crossed because I started talking about brain fog and fatigue and not just about hot flushes. And she said, Louise, if you talk like this, no one will do the phone in afterwards.

And I said, well, let's just see how it goes, shall we? And then after half an hour, they asked me to stay on the program even longer because they had so many questions. And they were surprised. I wasn't surprised at all because people are really desperate for good quality information and that's what's been lacking. We've not been talking about menopause, but then we've not been giving people or giving journalists even good quality information. Well, it's interesting, isn't it? Because we live in the information age and obviously we have access digitally to more information than we will ever, ever be able to consume. But I think people have found in all sorts of different areas, it's actually quite difficult.

to sift through the amount of information to find what's credible and what's authentic and to really get to the nub of it. And it's really been through the process of putting together this book along with Vicki Allen, that it's become so clear to me that, you know, we're not getting good quality information. It's very difficult to try and decipher what is reliable information, what is information that has been checked and counter-checked, and what is just gossip and scaremongering and hearsay. And this is very important. This is our health. This is an extended part of our lives as women. And I mean, just in terms of the terminology, we talk about the menopause. And I know I'm preaching to the converted here, but I'm admitting to my own

failings. I suppose there is a tendency to see it as the menopause when your period stop. And that's a relatively short and finite period of time. But what I've learned through the process of doing this and these conversations is that actually this can be five, ten, fifteen years of women's lives, you know, the perimenopause, going through the sort of heat of the menopause and thereafter. And it's about our health. It's about our well-being. It's how we function. It's about our relationships. About our job opportunities.

You know, it matters, you know. Absolutely. And as you know, once we go through the menopause, it's here forever. It's not just about our symptoms. It's our low hormones that last forever. And so as a journalist, where would you go for information? Well, it's funny. And I mean, I'm not going to enter into the big old HRT debate,

which is the big one, isn't it, around it? Because I don't have that scientific background to be able to tell anyone anything. I mean, that's your job. But it has intrigued me, actually, you know, the more I've heard. and when I read the stories of these 42 women in here, and you could multiply that by however many. And so, you know, I just sit on the computer, and I went through Google,

and it is really difficult to get information. And the information you are most likely to get is about the potential harms of HRT. And so I think it would be natural for a lot of women who were thinking, what shall I do, I don't feel very good, my doctor's not very sympathetic, oh maybe HRT, let me look on the computer. Oh, no. Oh, God, I'm not going there.

And that would be the end of the conversation. I'll just soldier on. And if I'm honest, that's probably what I did. And even as a journalist, I thought, right, no, I'm going to spend a bit longer on this. I'm really going to start digging here. It's virtually impossible to really know with some confidence what is right and what is wrong, which is terrible.

Yeah. I think it still is. I, as you know, set up my website about four years ago because I was shocked with how little good quality information there was and I'm not funded by a pharmaceutical company or I'm not sponsored by anyone. But I don't have a big financial backing so I don't have a huge voice. But I see increasingly there are a lot of companies that do have a big backing and they do have bigger voices and they're often pushing treatments that are not evidence-based. There was one recently that was a supplement. and the journalist I spoke to her about it because she wanted a quote from me, said, oh, it's been backed by some really good science.

I said, really, where is it? Can you show me? Oh, this person tested it on 40 women and they said they felt better. And I said, you know what, I would feel better. Someone gave me a beautifully packaged supplement and just gave me a bit of information about my perimenopause and made me feel special. So a trial of 40 is not enough.

But this person's got a big voice. There's been a lot of noise about it in the media. already and you know that's really wrong and it's quite misleading isn't it well it isn't i mean that's sort of purporting to have a scientific backing but there's a whole load of products out there you know whether it's sort of ice-cold pearls that you put round your neck in order to you know try and calm the hot flushes or a cold pillow or a this or that you know and if it helps you crack on i mean i'm not saying that you shouldn't but we are kind of corks bobbing about in the ocean aren't we and it is bringing it back to this is about our health. I mean, if you want to buy a fancy new pair of shoes

or you want to buy, you know, something for your kitchen, some coffee machine for 500 quid and it's rubbish in the end, well, we're adults, we make choices. But this is about our health. Yeah. And that's, to me, as a doctor, that's what's so important. And, you know, if I was writing a media report and I said, we've got this new drug, which is very cheap, we've got good evidence for it. And the Evidence has shown that this transforms women's lives. It helps them get back to work, helps them function better. It also reduces their risk of heart disease more than taking a blood pressure treatment, more than taking a cholesterol lowering drug. As well as that, it reduces this woman's risk of developing osteoporosis, diabetes, depression, obesity and dementia.

As a journalist, you would go, come on, give me this now. Come on, let's put it on the front page in the papers. Well, but it's funny you say that, but I'm going to be in touch. honest with you, as a journalist right now, okay, so you're telling me all this, that because of everything that I have absorbed over the last, well, let's say, probably 20 years, I wasn't that interested in the menopause 20 years ago, to be perfectly honest, but over the last five or 10 years, everything I've absorbed is counter to that. And so when you say that, it makes my head spin. Because I think, how can this be? How can this be?

If this is really so blooming wonderful, how do we not know? about it. And again, being really honest, that's where I'm stuck right then, because it seems to me incredible. Yeah, and you're not alone. And the problem is, is that I've worked out more and more, one of the barriers is the press releases that come with medical articles. And so when a medical article is written, there's often a press release behind it if it's done by a savvy team of people. And so this is a real example, which I'll give you because it puts it into context. So just over a year ago last September, there was a big article in The Lancet, which is, as you know, is a very well-respected journal. And they had a press release associated with it. So this article was

looking at published and unpublished data, looking at the risks of breast cancer with HRT, which is what everyone worries about with HRT. And it analyzed data that we know already. It also analysed data that hadn't been published because the way the studies had been developed were not good quality. Anyway, they'd grouped all this evidence together and they They said the risk of breast cancer is higher than we thought. And they wrote this press release with it saying, new study shows increased risk of breast cancer worse than before. Even in young women, women taking various types of HRT.

So women should now take HRT for lowest dose, shortest length of time. And that went to the papers. It went to lots of journalists. It was in many newspapers. I was on the radio, I think 12 times that day talking about it. The week after, there was another study in exactly the same journal of The Lancet, and it was looking at young women with early menopause, and one in a hundred women have an early menopause who are under the age of 40.

And we know from evidence from before this paper that women have to have hormones to replace their missing hormones because of their health risks to their heart, their brain, their bones. And this study confirmed that women with early menopause should definitely have HRT because of the risk of heart disease really increases. so much with these young women. There wasn't a press release with that. That never went anywhere, didn't go anywhere at all. But this Lancet paper has gone to healthcare professionals. It's gone to women taking HRT. What it didn't tell you in this Lancet paper was that the HRT they're talking about was not the type of HRT we even prescribe anymore. It was about old types of HRT.

What they also didn't tell you in the paper was that there's never been a study, including these unpublished study, that show that women taking HRT have an incredible. risk of death from breast cancer. And also, more shockingly, it didn't talk about any of the benefits of HRT. It didn't talk about the benefits for your heart, bail and brain. And it also didn't talk about patient choice. It was all about, like almost a woman is about breast cancer. And we have, you know, we're more likely to die from heart disease and breast cancer. We have a drug that reduces our risk of heart disease by 50%. So why can't we be given balanced information, and you know, you buy your coffee machine,

you want to know what's the good reviews, but if you're like me, you'll always go to the one-star reviews and see what's wrong. And you buy a car, not on evidence base, but you buy it because you like it. You've heard from your friends, it's good, you've read something in a magazine,

but you've weighed up whether you can afford it, whether you like the seats, whether you like the colour, you know, all sorts of things. But it's a bit like this with HRT. We have to know the risks of not taking it, and then we can make a decision, because almost as women, we've been made to feel failures for taking HRT.

It's like it's a last resort treatment. Yeah. And you wouldn't do that. If you had an underactive thyroid gland, you wouldn't try everything else and then take thyroxin. Yeah, it's interesting, actually, because if I'm being honest, in the back of my head, that probably is the way that I have seen it. I mean, as I confess in the book that I have been a menopause denier, and so it's quite hilarious that I'm, you know, connected with anything to do with the menopause

because I just didn't want to associate myself with it because I held negative connotations, you know, and I put my hand up to that. I'm not particularly proud of that, but that's the truth. And so wrapped up in that, there probably, excuse me, was a sense within me that I'm going to get through it on my own. You know, I am going to tough it out or whatever it requires.

You know, I'm not going to be one of those middle class, you know, sort of well-heeled women who, you know, gets my hair done every week and, you know, wears a certain handbag, has the HRT, and drinks, Prosecco and Cupcakes. That's the image that I had in my head. And do you know, it's really wrong because a lot of people think, oh, they take it because they want nice hair, they want nice skin, and they don't look at it as a long-term health problem, having no hormones. And it's very easy to think it's a middle-class drug.

And, you know, I'm doing some work at the moment with COVID. and estrogen, as you know, because women taking HRT are less likely to die from COVID. And also, women who are from low socioeconomic classes are 29% less likely to get HRT than women from other backgrounds. And when I talk to some of the doctors who work in these deprived areas, they say, well, Louise, these patients have got far more to think about than the menopause. Well, really, these women are more likely to have heart disease. They're more likely to have mental health issues. they're more likely to be obese, they're more likely to be depressed. So they're more likely to benefit from taking HRT.

And it's just this whole perception. Like you say, it's a sort of middle-class meditation. And it is an indulgence. And it's not at all. You know, a lot of women are given antidepressants because they have such low mood, they have anxiety, and they're being misdiagnosed with depression because they don't almost, no one thinks about HRT because they think it's just a sort of lifestyle reason for taking it.

And it's not, it shouldn't be seen like that. It's really interesting, actually, the whole antidepressants thing. I know in certain instances it can be a very appropriate treatment for someone going through the menopause. So I'm not in any way dismissing it. But given the level of angst surrounding HRT and the prescription, there's no angst around prescribing women antidepressants, is there? I mean, when I went to my GP to say that I just wasn't feeling right, I wasn't feeling myself, I just, you know, just things weren't good for me.

That's about as far as I could define it because I didn't have any obvious physical symptoms. I mean, I wasn't running with sweat. I didn't have insomnia, but I just didn't feel good. And literally within 90 seconds, she said, I can give you antidepressants. And I was so shocked by it. that because there wasn't even a okay tell me about it how are you what's happening in your life none of them just i can give you antidepressants i thought wow there's a massive overuse of antidepressant prescribing and don't get me wrong i've been a GP for many years and i have

prescribed antidepressants to people men and women with clinical depression and it can work incredibly well so there's a real need for them but we have no evidence that antidepressants help with a low mood associated with the menopause and perimenopause. And about three years ago, I gave a lecture to the Royal College of General Practitioners about the menopause. And there was a very esteemed chairman there who has been a GP for many years. And I was talking about myths of HRT. So obviously one of the myths is that antidepressants work as well as HRT. So at the end of my presentation, he said to me, Louise, I feel really bad for the last 30 years as the GP. I've just given out antidepressants because I thought it would help their mood, it might help their hot flushes,

which it can do for some people. And then I thought, I don't have to have that whole HRT conversation. They can leave my room a lot quicker. And he said, I'm going to change my practice now, which was lovely to hear. And it was also really humbling that he was so honest at, in fact, in front of an audience of about 100 GPs. But then I reflected afterwards and I thought, isn't that interesting? It's so much easier to prescribe an antidepressant because as a a GP prescribing HRT, you have to talk about the benefits. You have to talk about the potential risks. You have to balance it. And women are no different to you, no disrespect. Hey, they're worried about HRT because they've been told all this information. So when they go in with a low mood,

they might not even be thinking about their hormones. So for me as a GP to say, well, when was your last period? So many women have said to me, Dr. Newsom, I'm not talking about my periods. I'm talking about the way I feel. It's really affecting my work. And I say, no, no, hang on a minute, just hear me out. But to hear me out in 10 minute consultation, either I have to be talking very, very quickly, or I have to know my patient very well. And in my old practice, I worked there for 15 years. And I knew the women very well. So they knew where I was coming from. They had hopefully some respect for me. They would listen to me. Whereas now, GPC, different patients every day, a lot of it's now remote consulting, to suddenly change the

shift of the dynamic, the consultation to someone who's feeling low, possibly, they're depressed can be quite hard. It's funny actually. I was with a friend just yesterday having a coffee and she works in the entertainment business and we were, you know, chatting away and she was saying that this year she'd gone through quite not related to COVID,

a really difficult time that she said I had a complete lack of creativity. I just wasn't having ideas anymore and this is a very kind of dynamic sort of person. I just felt flat. I felt very low, very low in mood, bleaker than I have ever it felt in my life. My brain just wasn't firing and it was scaring her actually because she was

somebody who writes and things and just does stuff all the time and she said it was just gone. And I happened to say, how old are you now? And she said, 49. Why? And I didn't, you know, I'm not going to do you about. I thought, gosh, I said, I don't know. I mean, I'm not going to diagnose her. I'm not a doctor. But I could imagine she hadn't thought of it. No. Yeah. And from what she told me about speaking to health professionals, nobody else talked about it. And so the obvious route for her with, you know, medical practitioners would be antidepressants. Which would make her brain function even worse, actually. And I see a lot of women, I've seen people who bake cakes and ice cakes for living who have had to stop, artists who've had to stop, dress designers who have

had to stop because they're creative part of their brain and stop working because estrogen and also testosterone, which is what we produce more than estrogen actually from our ovaries, is very important for our brain function. So it's just trying to, it's like that feeling of trying to work when you haven't eaten for a while. You know, you're just tired. It's very, very difficult and brain function is really important. Yeah, I mean, people are leaving work left, right and centre because of their symptoms, but they often don't realize they're related to their home lines. Yeah.

It's fascinating. It's funny because saying earlier that it was Kirsty's documentary four years ago that kind of made me start thinking and now we've got many more people talking about it in a public forum. Davina McCall, I know,

was working on something just now, Mariela Frostrop, Kirstie, Andrew McLean on this woman. So it's really, really good to see that. But I have to say, it wasn't until I actually saw this book put together and I read the 42 stories that the whole thing moved on for me

because as a journalist you tend to sort of call right, okay, I'm going to interview Davina. So I'll interview DeVina about the menopause or I'll interview this person about the tabinols and you sort of see it within an asylum. But actually, when you see a whole bundle of experiences coming together at the same time and you see the threads,

although everyone's in a different place, they all come from different backgrounds, they've got different family circumstances, you know, there's a whole lot of things that are different. But that thing that kept coming back, I didn't feel myself. I thought there was something wrong with me. I didn't know what it is. I didn't know who to speak to. When I saw that all, you know, that jigsaw put together, that is when I thought,

all right, this is just not good. You know, this is really not good. These aren't isolated instances. This is a thing. and it's unacceptable. It's unacceptable for women who have achieved so much in their lives. And that doesn't matter whether you are a mum of five

who's never worked in the workplace before. It doesn't matter what your circumstances are. You get to the stage of life. You've got a lot of notches on your belt, haven't you? And to get to that stage and think there's something wrong with me, it's a travesty. Absolutely.

And certainly, you know, we see a lot of women in the clinic who think they've got dementia or they've been misdiagnosed, with fibromyalgia, chronic fatigue, depression, anxiety. A lot of women we see, I see every week I see as extra cases in my clinic who are suicidal. And we know it's related to their hormones because it's come on since their periods have stopped or they've had an operation to remove their ovaries.

But, you know, all the women in your book are all educated in different ways, aren't they? Yeah, absolutely. And a lot of them didn't know about the different symptoms that can occur. And just talk through, just very briefly about your book, because although it's a group of experiences, you've split them up, haven't you, into different areas? Yeah, well, I have to say that was Vicki's bright idea, Vicki Allen, who is my co-author on this.

So full credit to Vicky on that, and I thought it was a great idea. So the different sort of categories, if you like, rage, fog, grief, low, stronger, spark, desire, wisdom, freedom. So it's not all negative by any stretch of the imagination. So women have been kind of broadly put into a category. They're not mutually exclusive, but, you know, there's a kind of major theme. And I thought that was a lovely way to do it because, again, it gives the sense of the breadth

and the diversity of experiences that women have. And, you know, we deliberately didn't take a highly medicalized approach to it. It's a much more experiential book as how people were feeling, what impact it had on them, what impact it had on their relationships, how they felt about themselves, what decisions that they took, whether or not they did decide on HRT or they decided to do ultramarathons or like Louise Mention, the BBC newsreader who started to do triathlons. You know, people have different responses to these things. But it's really lovely to see it laid out like that. Yeah, it's such a great idea. And like you say, I think there's something for everyone there

as well. And some of the stories start off at more negative and then they, you know, end, like you say, same ways that they've helped. And, you know, the menopause is a stage in our lives for many women. It lasts for decades. And it should be positive. And we should feel happy with whatever decision we've made. And, you know, the more I sort of think more philosophically about life, the more I think, well, actually every day is a new day and we have to make the most of it. And you can't be defined by our hormones. It's about what you choose to do. And we all have made mistakes. We all wish we could do a bit more exercise or a bit more this or a bit more that. But actually there is a lot we can control.

It's our bodies and we have to look after our bodies because we own them, don't we? Yeah. Well, there is this terrible kind of modern phrase which kind of makes me heave ever so slightly. You know, living my best life is a very kind of Instagram kind of mantra. But to take it at face value, whatever stage of life you are at, you want to live for your best life, don't you? I mean, that's a very good aspiration. So you don't want a whole section of society

trying to live their best life with one arm tucked up behind their back, you know? Yeah, absolutely. And I think this is the problem, the stories that I hear all the time are for women that want to, they're desperate to have their lives back almost, and they feel their lives have vanished or they've gone or they're something different

and they don't know how to get them back. And it's only with talking and sharing experiences and looking at the evidence is the only way really that a lot of women are going to feel better. I mean, I think at the very least what I would like to see, because I'm certainly not in a position to be prescribing HRT or anything else to anybody, but that there should be within the NHS freely accessible to all women, a space where they can easily get information about their menopause, about what it might entail for them,

and for them to be able to have time to do that and share experiences with other women and get informed, get properly informed with reliable information that they can then make their own decisions. And that is the baseline for me as to what we should be looking for. I totally agree, and that's certainly I had a meeting this morning actually with some of the people who are helping me with the Menopause charity and it's one of our big aims is to give out information

as many times as possible in the right way. So every time a woman has a smear, for example, a woman told me this morning in my clinic, she missed her last smear because the penultimate smear was so uncomfortable and painful that she decided not to go back for another one. And the nurse said, yeah, it can often be like this when her menopause on. No one gave her any information, any treatment, nothing. So, you know, for a smear test, mammography, I've just turned 40, I've sent some information about mammograms telling me all about risks, all about problems. But why didn't they have a sheet telling me about my menopause? I'm going to be menopausal by the time I'm in my early 50s. So I would like to know about it. When I was pregnant, each of my three children, I had so much information about whether to breastfeed, not breastfeed, whether to put my baby on my back, do all this. And that was only nine months.

And, you know, my children have grown up. But actually, menopause is with us for so long. We have to know information about it. But also that information that you were given at these various stages in your life, you trust it. You know, and I mean, you're right to talk about having babies, You know, for women who've had babies, there was a big discussion. Obviously, we have about breastfeeding, about weaning, about how our babies sleep,

more and more about post-natal depression, thankfully. And we trust that information, you know, because our health organisations, they agree on it. You know, it's got the stamp of approval. There's everything for us to believe that this is authenticated. Yes. Whereas with the menopause, we're wading through, you know, a whole whole. load of stuff. It's like a swamp. Oh, I like HRT. No, I don't like HRT. Oh, HRT will do it this. You know, oh, no, we'll do this to you. And you're sort of like, what? We're like rabbits

in the headlights. Exactly. Yeah. And yeah, totally. We're not prepared for it at all. And, you know, a lot of my children's friends, mothers, you know, my children are, I think she's, I think your mum's menopausal because, you know, they're saying, oh, my mother's been shouting at me, she's been tearful, she's been forgetting things. She's been so awful to live with. And my daughter said, oh no, they won't talk about that. Oh, no, no, no. And really, it's just changing the whole perception, isn't it, to something that we shouldn't feel ashamed.

It's a natural process, you know, it happens. We all talk about our hair going grey or we all talk about, you know, various changes that happen to our skin. We'll go to a department store and ask about different face cream, but we won't talk about the menopause, and it just seems wrong somehow, doesn't it? Yeah, I think there are just too many negative connotations. Now, who is it in the book? I think it's Helen Fitzgerald who said that she saw an association between conversations about the menopause and mother-in-law jokes, which I thought was very

perceptive, actually, because we have all of those gags, don't we, about the big battle axe, who's getting a few hairs in her chin, that no one would want to go near sexually, who's got a foul temper. And it's kind of that is like the menopausal woman, isn't it? I mean, that is the sort of It's always a bus of jokes. Yeah, yeah. And so it's no wonder that we're kind of loath to say, well, yeah, that's me. So, I mean, it's woven through our sort of narrative in a really kind of uncomfortable way. Yeah, so we need to change it.

We need to change it, and you're the woman to do it, and I'm right behind you. Good. So on that note, I'd just like to end, obviously by saying thank you for giving up your time, but two, I always do a three take-home tips actually. So, putting you on the spot now, I'd love to hear your three tips for women who are maybe struggling, don't know how to get proper information, and maybe have been offered antidepressants. What would be your tip to those people who, you know, had been offered antidepressants but thought, that's probably not for me?

Oh, God. I suppose, well, don't do what I did. That's probably my first bit of advice, which is keep my head down and soldier on and just sort of firefight the whole time. Unfortunately, it's a period in a lot of women's lives that they are firefighting on lots of fronts, you know, perhaps with elderly parents and kids and stuff. But I think it has to be you've got to stand back and take that time for yourself to really assess this situation. And whatever time it takes, take it. because we can too easily allow ourselves to be swamped and, you know, it goes way down the

priority list and you've got a million things to do. But this really can affect the way the next few years of your life and beyond pan out for you. And that goes into all of your different relationships. So take that time, stand back and look around and try and information and speak to people. But it's more about taking that time for you because I don't think women are largely very good at that and be quite selfish about taking that time to find out what you need to find out in order to be confident to move forward. Don't just brush it aside, put your head down and Sally forth. Yeah, great tips, really useful. And, you know, also I think the only other thing to add really is that no decision anyone makes is irreversible. So a lot of people feel they've

left it too late or they should have decided earlier or they should have changed what they did. nothing's too late for any of us. So we can always change or make changes or change our decision about whether we take HRT or not, for example. There's always choices. They'll never feel bad that you've decided one thing and you want to change your mind. Well, I think that's a good lesson throughout life. Indeed. Yes. I keep telling my children anyway. Yeah, absolutely. Yes. Well, thanks ever so much giving up your time today, Kay. Okay. It's been lovely to speak to you. And for anyone who's listening, your book is available from Amazon, I presume.

It is, isn't it? And Waterstones. And Waterstones. Still hot. Still hot. Well worth a read. And it's got a lovely vibrant cover. So thanks ever so much for today, Kay. Thank you, Louise. Thank you.

For more information about the perimenopause and menopause, you can go to my website, menopausedoctor.com. Or you can download our free app called Balance, available through the App Store and Google Play.