The Dr Louise Newson Podcast - 080 - ”How My Work Was Affected by the Menopause” - Kate Halfpenny & Dr Louise Newson

Episode Date: January 4, 2021

In this episode, Dr Louise Newson talks to Kate Halfpenny, who was a celebrity stylist and designer for over 20 years. Kate now has a globally successful, British-made bridal brand, Halfpenny London, which she launched in early 2000. Kate had her first and only child, Sylvester, at 40 and talks to Dr Newson about how her perimenopausal symptoms started a year or two after that. Now 45 and 6 months into her body identical HRT regime from Dr Newson and Newson Health, she has started to feel like the powerhouse she once was, managing to keep a few balls in the air again and not struggling as much to communicate and be the business woman/mother/wife/friend she knew she could be.  Kate Halfpenny's three Take Home Tips and signs that you may have low hormone levels: If you're experiencing unexplained fatigue even after a good night's sleep then it may be down to your hormones. Another sign can be a lack of mental clarity, if you are struggling to multitask or concentrate on more than one thing at once. Loss of libido - this is also a common symptom of the perimenopause and menopause.  

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'm very excited to have with me in my studio, one of my patients, actually, and I don't often bring my patients to my podcast,

but Kate Halfpenny is someone I met a few months go now. And I'm not very good with names. A name doesn't mean anything to me. And I always ask as part of my consultation what my patients do for their living. So I was really intrigued when Kate told me what she did. And it wasn't until after she left and I googled her. I realized quite how inspirational, artistic and incredible she is. So I'm really honoured that she's come to the podcast today. So welcome Kate. Thank you for having me. I'm really flattered that you've asked me to be So can you just tell people who are listening who are as ignorant as me and didn't really know about your work and also how you got into it because I am the least artistic person that you'll meet. I'm very scientific, very black and white. So I have so much awe in people who are artistic. Well, likewise, I am the least academic and scientific person. You might ever meet also. So I have complete awe of anyone that can study medicine and be super clever. I went to art college, became obsessed with fashion. and designing and everything else that encompasses within the arts and just loved it.

And went and studied a degree in fashion and a master's in textiles. And on my degree, I specialised in bridalware. And that's just something that I'd always loved. And I got work experience in London on my year out and worked at Vivian Westwood. Soon realised I didn't want to work for another designer. And met this incredible girl that introduced me to the world of TV commercials and costume designing and styling and that was that, it ignited that fire of kind of, I didn't even know there was a job, I didn't even know I was good at it, pulling outfits together for people and

designing costumes. And I've worked with some of the most incredible, most influential, iconic women in the industry, really, from Rihanna to Kate Moss to Mick Hucknullan, simply read to the Kaiser Chiefs, to all amazing men and women across the world and all the MNS TV commercials and Christmas ads that were used to be so absolutely iconic. I always did my wedding dresses on the side. That was my passion and my love. And I launched in 2005, having done it the actress Amelia Fox's wedding dress. And it's just grown from there, really. And in 2012, I moved the business out of my front room, which was, you know, on the side. My poor husband would get trapped upstairs in his studio on a Saturday because he couldn't get down the stairs

through the living room to the front door because it would be full of brides all day. And we found a shop in Bloomsbury very much encouraged by my husband who was just like, you know, take this leap of faith and do it. You know, you're so busy at home doing this little job that you love and it was pre-social media and it was all word of mouth. And then 2012 found a shop, opened it in 2013 and have never looked back. We have over 40 stockists now and I step back from the styling. I still make dresses for celebrities. I'm working on an amazing one right now for a big TV show for one of our British iconic women. So I still dabble in that but more through my brand and dressing them in my clothes rather than other people. So yeah, that's me in a nutshell.

Amazing. My mother-in-law actually designed and made my wedding dress. And it was just incredible seeing the amount of work that went behind it because you look at the finished product and you have no idea what I didn't because I'm so naive, I suppose. A huge amount of work that goes into any sort of hoikature design and it's incredible. Actually, this is such a piece of art. And weddings have really changed, haven't they with COVID? But actually, a lot of people are telling me that it's still, the bride is the important person, isn't it, for the day? And a lot of people are still really looking at their wedding outfit there, whatever they're wearing, has been really key to remember their day, which has been shrunk by quite a lot. Yeah.

They are. Yeah. Everyone was saying, oh, have you noticed a change in all of your brides that have rushed down the aisle during this time and have they changed their dress? Now, some of my brides have held their big old magical number that they'd already ordered for their big part. that they're going to have next year and have done much small and nuptials and have all said how incredible they've been. But some have really gone out there with these amazing outfits, even for such a tiny little wedding of 15 or just if there's the two of them and some witnesses, people aren't holding back. So that's great that people are able to still celebrate and feel amazing. Because for me, my brand is all about being the very best version of yourself and finding something

that just makes you feel incredible and not kind of adhering to trends or stereotypes. So I just want my brides, if they need to wear my beautiful Neptune blazer with a pair of jeans, then do it. Yeah. Do what you've got to do. And that's so important, isn't it? That I love that, that we've got to be the best version of ourselves. And it's very difficult because we have a lot of obstacles, don't we?

And it can be very difficult, I think. I mean, I've got complete imposter syndrome. So I always think whatever I do isn't enough. however I look isn't good enough, whatever I wear isn't right. It's focusing on the negatives all the time, and I've done that throughout my whole life. I'm never going to change. But actually, there are very little things you can do that do make a huge difference. Having a good haircut, wearing something that makes you feel good, is quite transformational.

And it sounds quite naive and a bit shallow, I suppose. But it's really important, isn't it? For men and for women. Most definitely. And I say, you know, I was on the phone to a friend yesterday, and I was like, get out of those clothes. put something nice on. I know you're not seeing anyone and people are only seeing the breast up these days in all these zooms that we're doing. And the other day I came off and my eyes were just so sore and I'm so sick of looking at the screen. But it is so important to still feel good and to put that lick of mascara on, even if you're just doing the score run. I did a TV show once. It was a restyling show and I took real women and kind of just gave them little things that made them feel empowered and good. And I definitely think I'm so influential. by my environment. I'm also the same as you, imposter syndrome. I think, you know,

I can always do better and don't really look at the empire that I've created. And likewise for you, I mean, look how incredible your menopause doctor and the whole Newsom group is now. It's huge. Well, it's still not enough, though, isn't it? That's why we'll never stop. That's why we will always endeavor to do the best we can and to make people feel, you medically and me sort of more shallow. Absolutely. And while it's not, it is shallow, but it's not shallow, is it? I think, you know, being a doctor is the most privileged job in the world because I see and speak to people I would never access before. And often they tell me very confidential, private information that they might not have shared before. And it might be just as simple as telling someone that they haven't got cancer if they've got a headache and they think they've got a brain tumour. It might be as simple as telling someone that their sore throat is a virus and it will get better. It's not rocky. science, but it just to make people feel different and better about themselves, it's quite

incredible. And then obviously, you know, there are a lot more that I can do as a doctor that really will help treat and manage people and also prevent disease. But it is anything that is going to help because life is very complicated. And even though, you know, when I was at medical school, it was very much about a disease and you have a treatment and here you give the patient the treatment, actually they've got to have belief, they've got to be positive, they've got to live well as well, haven't they? And mentally, I have some training in psychiatry, but not enough, really, because the way you feel about yourself can really affect the way you react with diseases as well, can't it? Yeah, completely. And certainly now with, like you say, Zoom and us in lockdown,

it's very artificial having this 2D image. And like you say, you can keep your pajama bottoms on in your slippers and it doesn't matter. And you can see how people's self-esteem, is really rocketing and, you know, this uncertainty of future. So even if it is put on a lipstick and you feel better, well, what's the harm in it? There is no harm, is there? It's a good thing to do. And it also radiates off to other people. So, you know, if we've both got lipstick on today, but if you came on the Zoom and we both had our pajamas on and hadn't brushed our hair, we might be reacting quite differently. And that would then cascade off to other people who are listening, I think. Yeah, definitely. And I think it is inspiring.

other people to feel good and yeah definitely so this is all very positive conversations and you're looking great and feeling great but you know you came to see me as a patient i said and you're quite happy that i've broken confidentiality in front of you but you came to see me as a patient and so that suggests that you weren't looking good and feeling good and maybe you weren't the best version of yourself so tell me a bit about that if you don't mind i honestly could probably say that i was feeling the worst version of myself and i didn't know how to sort this out and And I read an article that you'd written in a magazine and I'd cut it out and I kept reading it. And it took, I think it's probably taken me a year from reading that article because it was quite a while back, wasn't it?

That picture you did that I found you to get in touch. And I was so broken and I was actually up in the Midlands. It was when lockdown had eased and I was with a girlfriend and I was so emotional. And I just was just like, I don't know whether it's because is it the menopause? Is it the fact that I had a baby at 40 after six years of trying and rounds of IVF and all the hormones from that? Have I done something to myself? Have I damaged myself? Or is it just I'm tired because I have got a three-year-old?

I just didn't know the answers. And fortunately, your officer just had a cancellation and I managed to get an appointment with you weeks later when you were fully booked up until I think actually this month when I called. So, yeah, I was really nervous. As a woman, you often think you're making things up, I think. Totally. And you often think, you know, I must say, I think since I've had a child as well, I've become incredibly neurotic about illness and seeing lots of friends really sick. Not lots of friends, but enough people around me to really start giving me that sort of fear of

mortality that I've never had. I was never scared of dying. And since having a child, you just think. oh god you know children and without their mothers and i suppose just i want to be the best version of myself again for him i don't want to be you know i felt incredibly broken i had no energy no concentration i was really struggling with work and it's my own business and i felt that i was constantly making excuses for myself and i've also got hypothyroidism so that didn't get diagnosed until i was doing fertility which they think i'd always had my grandmother had

my mother had lupus, another autoimmune disease. And I was just so grateful when I spoke to you that you reassured me that I wasn't making all these things up. And when you explained to me that, you know, they wouldn't just leave me with my thyroid disease and not give me thyroxin. It's so important to have these hormones to put this back. And when you explained to me that in every single cell in my body was estrogen, I think you'd said.

Yeah, absolutely. in the muscle, in the eye tissue, in everything that you do from the fact that, you know, my gut had never been so bad and my digestion and I'd always known how to manage it. And, you know, the one thing I now need to really get on is kind of just shifting a bit of weight for my kind of own agility and body. I mean, I've always been a curvy, big girl and I'm, you know, I don't need to be a size 10. It's just not me. It's not in my jeans. But I do want to just get more fit, more active. But that will come because it's still only days, isn't it? So how long did you have been experiencing symptoms for?

You said you had a year of looking at my article. So that suggests that you had quite a long time of having symptoms. I think probably two years before I even knew. I just thought it was having a baby. I just thought it was being tired. You know, I'm sure it was from when Sylvester was one. And I thought, why am I still feeling like this? Because actually he was quite a good sleeper from about seven months.

We got a sleep nanny in. And then that was it. He was pretty brilliant. And of course it's exhausting being. a mother and that's what I worry about in the fact that people don't know the symptoms of perimenopausal when they're masking them with being tired at work, you know, or your children not sleeping or you're not sleeping, but all of those symptoms can be related to it. And it is very hard because it comes on so insidiously for a lot of women. It's easier, for example, if someone

has their ovaries removed because you know the next day you're not going to have hormones, but for most of us, it comes on and like you say, when you're busy, you've got your job, you've got children, you might have other commitments, and it's a gradual, oh, I'm just feeling a bit tired. And I remember I used to, well, I still do, but clean my teeth every evening and my husband coming in a box, oh, you know, awful. Are you right? Thanks a lot, mate. So now, I just feel like I'm in drug. I don't know. I said, I felt better when I was pregnant. I just feel awful. I don't know what's wrong with me. And clearly my hormones were low then, but I didn't think about it. Didn't even cross my mind because why would something happen to

me and I knew about the perimenopause still didn't think it was happening because you always think, oh, well, I'm tired today because I've had, you know, I've seen more patients or I've been writing my website or there's something. So there's always a reason and because a lot of it is the psychological symptoms. So you can't go and have a blood test. It's easier for your hypothyroidism, if you like, because you can do a blood test. But, you know, as you know, you can do a blood test one day and it's completely normal. Yeah. And then I actually saw a patient yesterday in my clinic who had her blood test done. was in her 30s actually, and her FSH, her follicle stimulating hormone blood test was very high. And her consultant powner up said, oh, it's okay, you're through the menopause, you're done now.

You don't need any treatment. It's like, goodness me, no one is through the menopause. Once your hormone levels, the FSH stimulates your ovaries. So if it's very high, it means your ovaries aren't really working. And hers was extremely high. But her consultant has said, oh, well, you're through it. Don't worry. And that's the worrying thing.

That's really scary. I fortunately got a GP at my local practice in Favisham, and they're incredible there, and I've always had amazing care from them. And the female doctor that I got there, she said, you see, the problem that we've got is you need to find it's like a car, I need to test your blood. So you've got an old car. Sometimes you get in that car and it starts and you drive off. Sometimes you get in the car, it splutters a little bit, and then it starts, and you drive off. Some days you get in that car and it doesn't start. and I need to test your blood the day that that car is not wanting to start

because then I'll get the results to sort of suggest it and she didn't give up on me and she kept testing and they sent me for scans and they could see my ovaries and one looked like it had kind of given up and the other one looked like it was doing its final hurrah and it was amazing to have that reassurance from my GP but I worry if I'd have got another doctor that didn't like this chap that told her that she was done like It's all of that bad information and how do, I know you're working tirelessly hard with charities and everything to get this knowledge out there, but it is the re-education of GPs and also the way that women in work are really, like you say, giving up jobs.

Yes. You said to me, don't make any rash business decisions. And I said, oh, funny, you should say that because yesterday I told my team I wanted to step back. That was the day that we spoke. And actually, I'm enjoying the new role that I've kind of carved myself and sort of the autonomy that I've given to my team but now it's making me feel more creative and more inspired and the clarity's coming back and I'm a better mother and I'm better wife for sure and even though the taboo subject of libido and you know I spoke with my mother-in-law and she went how's your libido with it and I said I just

don't have one I'm and it's awful and it's you know you feel half a wife and half a woman to not have that kind of that sexual drive and it's come back oh it's amazing no it isn't Incredible. And I feel really sad because so many women do either give up or change their job. And in fact, someone I saw a few months ago came to see me. And she was in a dreadful state. She'd had symptoms for several years, but she's set up a very successful business in Yorkshire. And she'd actually, through the course of feeling so bad, she'd put on about four stone in weight. And she really struggled to come up the stairs in my clinic. And she had brain fog, memory problems, fatigue. She was just awful. And she'd been diagnosed with depression. And one of my, friends who's male runs a business in Yorkshire and they met at a conference and he just pulled her to one side and said look she's at your menopausal and she went what what are you talking about how rude and then he said look go onto this website and anyway when i saw her the day before she'd closed her business because she could have and i could have wept for her and she's now already lost about two stone and weight she's incredibly different.

Everything has come back and she's now having her husband with his business. And it's really sad because I can see when your brain doesn't work, you can't work safely and you can't see that you're going to improve. And a lot of women are just forced out of work really, but they don't always know it. So if you ask them why they've given up work, they'll say, oh, because maybe my relatives have died or I was just not coping as a mother and working mother. And they just didn't realize. And I think that's happened for generations, actually.

Yeah. And it needs to be addressed. It really does. And I don't know how, you know, it's the whole taboo around women and periods and hormones and pregnancy. That what incredible things that our body can do. We can grow humans. But we're so knocked for that as well. And not being all righteous and feminist and, you know, looking at women as better than men because, you know, I don't.

No, absolutely. And it's not a competition. all, and I'm not really a feminist, but I'm turning into one actually because the stories that I hear that women are refused treatment actually. So there are some women like you and even like me who didn't recognise our symptoms, but there are lots of women who do recognise their symptoms. They go and ask for help and they're told no. And someone on Instagram messaged me a couple of weeks ago and said they felt very empowered by my website, my podcast, they'd learned a lot. They went to go and see their doctor and their doctor said, oh, Dr. Newsom's not a proper doctor. Don't listen to her.

Well, what's that about? I have qualifications. I have certificates. I have postgraduate qualifications. You know, and then other people just get told, no, you can't have HRT, it's going to give you breast cancer. But actually, not taking HRT, might give you osteoporosis, dementia and heart disease. But even if it gave you breast cancer, we are allowed to choose. There's very clear guidance about consent. And even if the risks outweigh the benefits and a woman is aware or a patient's aware of those risks, she can decide if she's a consenting adult. Well, HRT has more benefits and risks. So you can choose how to run your business. I can't tell you as a doctor if something is going to affect your mental health because you're doing too much work or what have you. And we have to just take a step back and think,

we're here for our patients as healthcare professionals, actually. We're here to guide them and help them, but we're not here to refuse them treatment if that's what they want. Yeah, I agree. And I think I emailed you to say, oh my God, I found a lump in my net, which was literally just a swollen gland from having the flu jab, but that whole neurotic thinking I'm constantly dying thing has still not subsides. And I don't know if that is becoming a mother or because of the anxiousness of the menopause. But reading the pamphlets that come with the testosterone cream and the estradiol is literally like you are about to jump and you're not sure if the bungee's going to hold you.

You know, it's like, am I literally playing with fire here by taking these things? and actually you're all at risk of getting breast cancer. There's those chances of everything. And it is, you know, I'm obviously not going to take something that's going to make me not feel amazing and good and going to poison me. So I know that huge amounts of care have been taken, but I look at other pills, family members are on, that they're prescribed a million different drugs,

that are basically sort of masking the problem rather than addressing it and fixing it when it could be choosing a healthier lifestyle or those things. And I don't want to just not feel great. Yeah, and the problem with the inserts that are with the HRT, I've mentioned before, they're incorrect, actually, and they're out of date. And even if you look at the estrogen gel or patches or spray

that goes through the skin into the bloodstream, there's no risk of clot. They will talk about risk of clot. They will talk about risk of breast cancer. Now we know that women who have estrogen on its own have a lower risk of breast cancer by about 25%. So all this is on older studies, but they haven't changed it or updated it. They say there's a risk of heart disease.

Now we know there's a 50% lower risk of heart disease and women who take HRT. So I've already challenged them and they sort of push back and it's all about risks. There should be a leaflet in it telling us all the benefits. And they can carry on with the risks if they think. But a lot of them aren't significant. And we're not stupid as women. We have to be told the right information. And it's really shocking.

And, you know, if I was a surgeon and I had done an operation to remove a man's testes, they wouldn't leave hospital without testosterone. Whereas time and time and time again, we see women who have their ovaries removed. And I saw someone in my clinic last week who'd had hers removed eight years ago. And the consultant just said, oh, see how you get on. If you fall off a cliff, you can take some HRT. And her mother had died from breast cancer and she thought, oh, I don't want to take that. And she'd had a year of numerous scans, numerous tests, given up her job.

job, you know, back to back migraines, muscle aches, dry eyes. She'd had migraines and she'd been on all sorts of heavy-duty anti-epilepsy treatment hadn't really helped. It was all related to our hormones. It's criminal. Yeah, she'd had her womb removed as well. So she only needed estrogen and a bit of testosterone. And I said to having that time of H-LT, you have a lower risk of breast cancer anyway. So there are no risks actually for her. But it is, you're absolutely right, it's criminal, because her life had been really affected. And, you know, we've got to change it, but it's really hard to change. As you know, making any change, especially to people who don't believe in that change or want to change is really difficult. But I think the only way we can do it is women helping each other, actually women are quite vocal and they've got something that they want to share.

But I think we can do a good job of it. Yeah, and that's why I was really pleased when you asked me to come on your podcast because it's hoping that I can reach another audience. You know, I've got such a varied demographic of women, and hopefully they listen to this. And it inspires them just to go on your podcasts or look on your website or follow your Instagram and look at some of the posts that you share that just enlighten us to whether you're in menopause or whether you're perimenopause or whether you're nowhere near there yet. But just to look out for those symptoms. It's really key, isn't it? I mean, that's one of the reasons that we've created this free app balance.

So people, my dream would be for every woman to download it. And then every three months, you get the reminder saying you haven't filled out your questionnaire. You fill out the questionnaire, you know the one that you filled out when you came to the clinic. And you then see, oh gosh, I'm getting some symptoms. Oh, right. Okay. Have my periods changed? All they have.

Right. This is where I need help. I need some information. And, you know, there are women in their teens and their 20s, 30s who are perimenopausal. So we don't have to start down lonely when we're in our 40s because that's going to be too late for a lot of women. And it's having the conversation earlier to normalize it. It's the same way that you can openly tell someone your hypothyroid. You know, you wouldn't tell someone, oh, I'm hypothyroid, but I'm not taking thyroxin.

I'm going to let my body do it naturally without. It just wouldn't happen, would it? So it's exactly the same with a low hormones because of menopause. It's changing the agenda, so it's easy to talk about. And, you know, the conversations, I mean, you must have very sort of almost quite intimate conversations with some of your clients because you get to know them so well. And they probably spend longer with you than they would with any medical healthcare professional. And I'm doing some training actually with my hairdresser.

He's going to train his staff about the menopause because when you're sitting in a hairdressing salon, again, you're opening your heart out and you want someone, you know, it would be great. If my hairdresser had said to me five years ago, oh Louise, your hair's changing in texture, what are your hormones like? What the period's like? I would have probably then got HRT six months earlier. Yeah. You know, he didn't know. Why would he? But now he does. And it's that whole conversation, isn't it, to normalise it. And the more people that tell you how there are choices and what the symptoms are and that there is effective safe treatments, the more people will listen, won't they? They will. And is that just going on to the hair thing? Does that mean then, because I'm on hormone replacement therapy, that my hair has gone considerably thinner than it used to be, are we stopping it from falling out to some.

degree by the therapist. Yeah, and it probably will grow stronger as well. It can take anything you change with hair can take three months to notice a difference just because of the cycle of the hair. So estrogen is very important for helping hair growth and like it's very good for our skin as well. And actually testosterone, a lot of people think testosterone is going to cause baldness because they think about how it affects men. But actually having testosterone in the female range can actually make hair stronger and thicker as well. So a lot of people, notice and their hair but can become less dry as well. So hair changes are very common. And obviously you wouldn't take a systemic treatment just because you want nicer hair. But it's just something else

that happens. And it shows how our hormone, like you say, estrogen affects every area of our body. And that's why it's so important for us to function. You know, our hearts, our brains, our bones, you know, are really important and respond very well to hormones. Yeah. I honestly can't tell you the difference and I feel like I'm only at the very beginning of that journey and that I'm not even quite there yet at the end of this race and I don't know what I do without it now and I've gone on so many kind of fads where I'll take vitamins or supplements or I'll cut things out of my diet and I will not go to bed without spraying my spray on my arm, my cream on my leg, my projection, whatever we do with that. So it's kind of, you know, the testosterone as well is one thing that's

not regulated in this country, I remember you telling me. No, well, we prescribe this regulated product, but it's not licensed for women. And it's not licensed for women anywhere. It's absolutely scandalous. You call it the drug of vitality, right? Yeah, well, it's a lot of people. And certainly look, the guidelines say we can prescribe it if a woman has low sexual desire, so reduced libido despite taking HRT. And a lot of women do have low libido, but you know what? Our libido is not about one single hormone. And testosterone works very well on the brain. So, we're not.

we find it really helps improve mood, energy, concentration, stamina, can help bone strength, muscle strength as well. And if someone's less tired, if they're feeling more emotionally engaged, I've got more motivation, more energy, more that sort of joie de v comes back, then of course the libidic is going to increase. You know, it all, it's a big package and actually testosterone can help build muscle. It can help shift some fat, so it can help people lose weight in a very natural way as well. So it's a really, really key hormone, yet we're not allowed to have it. Like, what is that about? You know, you can buy via Grover the counter with lots of contraindications, but our own natural hormone that we produce as women, we're not allowed to have back because it's not licensed.

And there's lots of things I want the menopause charity to do, but one of them I really want to campaign for testosterone prescribing because it's not right. You know, I saw someone in my clinic it was 24 when she had her ovaries removed. And she had had a cancer before. So she thought, I don't need my ovaries. It doesn't matter. I want to obviously, you know, kill myself of the cancer. She'd been given estrogen, but being told she could not have testosterone.

No one would give it to her. And all her testosterone had gone because her ovaries had gone or most of it had gone. So then to have it replaced, you know, it's made a huge difference to her health. It's wrong that we can't have our own hormone back. And another question that we've touched on before when we've had our consultations is the fact that this is now something that I need to do for the rest of my life. It's not something like that doctor said, you're through it. You know, I need to take these every day for the rest of my life. Absolutely.

And that's really important because it's the same way you're never going to stop your thyroxin. So you might not need it for your symptoms. A lot of people find their symptoms improve at time. But as soon as you stop taking HRT, for example, that's when you're going to, you're going to stop. for example, that's when you've got these health risks. You know, you've got then this increased risk of heart disease, diabetes, dementia. So the guidelines and the evidence are clear that women who take HRT have a lower risk of death from all causes, actually, including cancer, but it's safe to take.

You just make sure the benefits outweigh the risks. And the risks are incredibly low, and the benefits are huge. And we have very good established evidence. It's not a bad. I'm not promoting a vegan diet. And next week it will be a. high fat something else diet this is really very clear evidence that we have and it's just because people have been misinformed is why there's all this uncertainty and angst about HRT well whatever i can

do to help shout from the rooftops about this because i only can see the benefits yeah and the great thing about this is as well you've already sent the prescription onto my GP and then this becomes a prescriptive drug from the GP totally and i think that's really important You know, as you know, and many people who listen know, my clinic's private because I can't get a job in the NHS, doing manifold's work. It's not, I feel very uncomfortable. I have a private clinic. And certainly we're doing a lot of work strategically with the NHS and hopefully next year we'll do even more because, you know, I want to reach as many women as possible. And I really don't want any woman, whatever ethnic minority, whatever socioeconomic background she's from, whatever nationality she's from,

all of us, every single woman deserves to have good menopause, care and education, because it affects all of us, every single woman in the world. So we all are equal in that way. We all deserve to have good quality treatment. So we've got a long way to go, but we'll get there. Yeah. So, well, thank you, Kate. I really, really feel very privileged that you've opened your story up, actually,

because I think people learn so much more from listening to how other people have, you know, being effective but also received help. And now you're on the other side. I'm feeling better. It's really wonderful for me as a clinician to see. So before we end, could I just ask for three take-home tips for people who, how would you say the three best ways of really diagnosing yourself and thinking, actually, come on, I think it is hormones.

What are the three things that you wish you had been told or thought about a year or so ago? Having had a full night's sleep and still waking up absolutely exhausted the next day and my child had slept through and I hadn't had an insanely busy week and I still felt absolutely dreadful and it wasn't normal to feel that drained and exhausted. So that's one kind of if you've got absolute unexplained fatigue, then check it out. But I think the second one would be clarity. I just simply didn't have clarity. I was not able to multitask like I used to. And you couldn't talk to me and get an answer from me if I was doing something else. Like I could only kind of manage to focus on sort of one thing that I was doing.

And yeah, I think that was another kind of sign for me. And the third thing was libido, I think. It was totally unexplained. I adore my husband. I think he's the most handsome man that ever wore the planet. And there's no question about the love I have. for in there and the libido issues, the way that that waned for a while was just also awful and unacceptable. Really interesting. So yeah, tiredness, inability to multitask and low libido are

things that it's very hard to admit actually to yourself sometimes. But I totally agree as women, we have to stay on top of our game because no one else looks after us. It's really important. And forgetfulness, bloody hell, the forgetfulness. Like forgetting to say that I'm forgetful. Yeah. I mean, I'm still having to do. to write stuff down. That hasn't just come back overnight. But yeah, the other thing. But it takes a while. You suffered for a while and it takes a world to improve. But you're on the right road. So, brilliant. So thanks ever so much. It's been great. Thank you, Kate. Oh, thank you for having me. Thanks for thinking of me. For more information about the perimenopause and menopause,

you can go to my website, menopause.doctor.com.uk. Or you can download our free app called balance available through the App Store and Google Play.