The Dr Louise Newson Podcast - 082 - The Personal & Professional Costs of the Menopause - Chris Oglesby & Dr Louise Newson

Episode Date: January 18, 2021

Chris Oglesby is the chief executive of Bruntwood, which remains a family-owned and run company founded on a belief that its success comes from the success of its colleagues, customers and the communities in which it operates. He works tirelessly helping cities such as Manchester to thrive in many ways including by improving health inequalities, funding research and by supporting cultural and community initiatives.   Chris talks to Dr Newson about how his wife, Jane, really struggled during her perimenopause and menopause and how difficult it was for him to watch her experience various symptoms. He also speaks openly about his sister, who also found it difficult to receive adequate help and treatment for her menopause.  Dr Newson and Chris explore ways in which menopause in the workplace can be addressed to improve organisations and also about how poor menopause care is a global health problem which urgently needs to be addressed.  Chris Oglesby's Three Take Home Tips for employers: Start with your own awareness, do your research and learn more about how the menopause may affect your staff.  Then you can roll out a programme of awareness within your business to benefit all colleagues, both male and female. Look at pathways into providing your female staff with high quality treatment and menopause advice.

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. This week I'm really delighted to introduce to you, Chris Oglesby, who is the second husband of a person who I've already interviewed before. So it's a bit of a theme going on, but it's a different theme. So I'll explain more in a minute. So welcome, Chris.

Thanks for joining me today. Great to be here, Louise. So Jane, I have known for several years and for some of you who listen to the podcast frequently will have heard. We talk to her. Jane is someone I went to medical school with, actually. So we do go back a long time. And she's been working very closely with me for the last 18 months or so,

developing our free app, balance, which has been already downloaded by more than half the countries worldwide, which we're very proud of. So Chris has known Jane for a long time. You've probably known Jane almost as long as I've known my husband. And I met my husband in Freshers Week, so 31 years ago. So it's a long time, isn't it, that you've known Jane? It's a very long time, yes. So what, 27 years now. And certainly when we were all young, we weren't thinking about hormones or menopause or anything like that. And despite being a medical student, I was never taught anything about the menopause either. So I'm sure it probably wasn't on your radar, was it, many years ago? So the menopause

wasn't, but actually hormones have been for a little while. Again, very lucky to have met Jane, who's an incredible wife and sort of life companion on the journey that we've gone on trying to sort of make sense of the world. And there have been various stages where particularly for her, hormones have had a big impact. So she was somebody that suffered quite badly with sort of premenstrual hormones as well. And that got us both sort of reading up about hormones a lot more. So I read quite a lot about their power early. I'm a big hugger, so I love oxytocin as a for instance. And I'm an absolute believer in the power of that as well. But all of that was at a sort of earlier stage of our lives. And we hadn't really got our heads up about the menopause and about just the

sheer impact that it could have on James and therefore our lives. Yes, yeah. PMS, as some of you listening know, we've spoken about it quite a lot before and I did a podcast with Dr. Hannah Short specifically about it, but it is when estrogen levels are at their lowest just before periods, classically, when people really experience symptoms. And again, I was taught at medical school to give people antidepressants for these times. And how wrong is that? It's so easy just to replace their missing hormones on those times.

So, and then Jane reconnected with me. It must have been about three years ago. I just got an email and she said, you may remember me from medical school. And of course, her surname is different now. She's married to you. And I googled her, as you always do, don't you if you're not sure who someone is, and immediately recognised who she was. And then she came down to my clinic, but she wasn't the Jane that I remembered.

And she was really struggling, wasn't she? She was, yes, yeah. And it's such a shame because it was at such a period of her life, where she should have been absolutely flourishing as well as the kids were getting older. And she was starting to really sort of connect with a number of things that she was passionate about, but she was really struggling to get passionate about them. And, you know, as she started to look at life away from the routine that she'd had, where the family had been such a focus, she was just facing so much self-doubt about her ability to do that.

And it's so common. And even though she's got a medical background, she was still quite scared about HRT and scared sometimes about having the right dose or type. And she had quite crippling anxiety, which she has spoken quite openly about. I don't want anyone to think we're talking out of term about her. But for you as a partner, it's very frightening, isn't it, when someone you love and adore is changing and you don't know how to help? It is, and the reality is that manifests itself in lots of different ways. So it manifests itself in you seeing them struggling, but it also manifests itself often I believe in their behaving differently

in the relationship as well. And so you start to question actually whether they do love you as well and whether actually at such an important part at a time in your life together when your relationship almost changes and you start to focus on a different agenda together, it seriously started to bring into question whether we had got a life together as well. So we never got to that place at all or had those conversations, but that's the way that it starts to play out. And I can see why it could be catalytic for the breakdown in so many relationships. And indeed it is. As you know, lots of women I see and speak to have given up their

partners and not because they've always wanted to. You know, lots of women say to me, I still love my partner, but not in the same way. And I'm no good for them. And there's a lot of people that go through relate or marriage counselling and really trying to keep their relationship together. But no one's really acknowledging or really understanding that it's related to the hormones because why would they if they'd never realised how important hormones are for our brain function as well? And women often feel really such different. People just say, I just don't feel myself.

I feel very different. I'm not motivated. I'm not interested. And I'm also incredibly tired. And so for men to then go home and if they've been working, or just to connect with their partner who isn't the partner that they knew that time ago is very unsettling, isn't it? It is hugely and it just seems so crazy because it doesn't have to be.

No. I know my whole work is full of frustrations. I mean, there's so many things in this world that we can't control that are making life really, really tough for people, that when you have something like this that is so easy to control. And as you say, the trouble is, for me, the idea that HRT was the answer, given what I'd read about HRT seemed in the nash, and was a huge risk, whereas, of course, as we've got into it and looked at the statistics that sit behind this, you look at cause and effect and the basic analysis of specifics, and you can

see that quite clearly there's correlation, but not causation. Absolutely. And I think that's so important, isn't it? So along with, thankfully, myself, helping Jane to certainly be really much better and she has really quite transformed as a person for when I saw in my clinic the first time. You've sort of become more engaged and I know I'm quite a pestering person, but you kindly invited me to come out. I remember probably about 18 months, two years ago now, to give a presentation to you about the menopause. And I came up with Marcus Daly, who's our non-executive director for my company and a really good friend as well. And he was very kindly, came with me. And can you remember that presentation that he gave you?

I can very much so because it's very rare that you get presentations like that in a business environment where everything about businesses that you have to find a need in society and then you find a way of satisfying it and if you satisfy it well you get paid for it because it's got a value to people and in the world today there are so many things that we do where we almost create a feeling of a need in people where there isn't really one because our needs are so satiated whereas here you have something where there's just such an obvious need that isn't being dealt. with. And, you know, everybody says there's no such thing as a silver bullet, but if ever there was a silver bullet for so many things, this is it. The whole medical world doesn't spend enough time

looking upstream as you talk about it to find what the root cause is of what manifests itself then so often in people in so many different ways. And as you explained this to me and I started to look more into the statistics and then it became in a topic of conversation over the dinner table with Jane at home, the more that I've dug into it, the more it just seemed such an obvious thing for both the state and for businesses to be supporting for businesses because, and you haven't mentioned, my sister Kate, but my sister Kate also is a patient and a hugely impressive lady in her prime who found that, again, she'd lost a sense of her focus and her effectiveness directly as a result of the menopause. And I look at, we've got a number of very

highly performing women in our organisation. We've got a very low gender pay gap and in fact, probably a good 50% if not more of our senior leadership team are female. And it takes quite a lot of nurturing to get females through the sort of childbirth and that early stage within a workplace and we've spent so much time thinking about that. But just as you get them to the place where they're going to really be able to, in many cases, to absolutely fly again. They get taken away at the knees by this. Yes. And Kate had really tried hard to get help locally to where she was living and had gone to various private people and hadn't received adequate help at all.

But just to put it in the context, I probably should have introduced you better at the beginning. Can you just explain, well, you and Kate working together what you do in Manchester? Yeah. So we've got quite a, we would, I suppose, introduce it, a property company, but it's been a number of years since it really was just a property company. Our businesses has a purpose to create thriving cities and everything that we do, every day that we get up is looking at the multifaceted ways in which we can help our cities and the citizens to thrive. And with a view that as a long-term investor in place, as owners of property in that place, if the place is healthy, then your business will be healthy.

If the place isn't healthy, it doesn't matter how good you are as a long-term investor. or eventually the investments will fall in value and the property will become worth less. And so when we look at what it is that helps a city to thrive, some of the biggest single areas are, think that we're working on the moment of things like health inequalities and ensuring that a healthy population is so correlated with a economically active population as well. Our business is owned 25% by charitable trust that puts back into those economies in which we invest. And so our charitable trust works a lot on health inequalities already, and so we're particularly

interested in that. And then from a purely commercial perspective, one of the big areas that we're investing in at the moment are creating innovation districts around universities based on the growing life science and technology sectors. So on the one hand, on a commercial point of view, we're looking at helping businesses that are coming to sort of solve those problems. And then on the other hand, we're investing in the place, both philanthropically and as sort of social investors in how we deal with the challenges in place as well. So when you came and saw me with Marcus and started talking about the menopause, they immediately sort of seemed to tick so many of those boxes and you could see how economically we were shooting ourselves in the foot by

not dealing with something that just is so easy to deal with. Yeah. And I think that's exactly right, isn't it, whichever aspect of your company or business, there are women there who are struggling, who often don't even realise they're struggling because of the menopause. And we know around one in five women actually give up work as a result of their menopause, which is a huge amount. But when I did some work with West Midlands Police, we found that nearly 80% of these women didn't know their symptoms related to their hormones. So they would be signed off with stress, depression, they'd be tired, they wouldn't be able to cope with their job or they'd have migraines. and no one would actually then ask them.

They'd go to their doctor who's saying they felt low or stressed. No one would ask about their hormones. So it wasn't being acknowledged or recognised. But companies are hemorrhaging money, aren't they, by not recognising this. And then looking at their health inequalities, it's huge when it comes to menopause care. And often women from lower socioeconomic backgrounds,

as you know, are more at risk of type two diabetes, obesity and cardiovascular disease, heart disease. Yet these women are less likely to receive HRT. We've shown that, or there was a study that one of my colleagues did, were at university showing that women from low socioeconomic classes are around 20% less likely to receive HRT. And when they did, it was the higher risk oral, which has got a risk of clot.

And these women are more likely to have a risk of clot because they're more likely to be obese as well. So that's shocking. And I know when Jane, your wife, spoke to some doctors who work in some of the deprived areas in Manchester, they said, oh, Jane, these women have got more to think about than their menopause, actually. But actually, isn't that wrong? It's the first thing they should be thinking of. Yeah, exactly, because almost certainly high up on the list of the reasons why they're obese, etc.,

is because of the fact that they're suffering with the menopause and therefore they're not inclined to exercise or to eat well or anything else because it has such a damaging impact. So whether are these things that are so obvious that can be dealt with upstream. Yeah, no, it's very interesting. And certainly one of the police principals that I was working with is now doing a lot of work with domestic abuse.

And there's no doubt, I'm sure, there's no research been done in it because hardly any research has ever done in the menopause, but I'm sure there is an increase of domestic abuse during the menopause because a lot of these women during the menopause feel worthless. They feel that they're no good. Obviously, a lot of them don't have libido.

And so the men become very frustrated, and this whole victim role that happens is often made worse when people feel worse about themselves anyway, and they almost feel they deserve to have this abuse because of the way they are. And so you can see how these cycles just go on and on and on, and the women have no way out. And as you know, at the moment, my clinic's very busy,

and in those weeks I'm seeing extra women who are suicide, and there's a direct response of them having no hormone levels. Yet for every woman I see in the clinic, there will be thousands, if not millions worldwide the same. And we know the peak suicide rate is in the early 50s, the same age as the menopause. So the physical symptoms are almost, doesn't matter anymore. It's the psychological symptoms, but also the health risks as well, because we're living so much longer, aren't we, as women?

So, you know, the health economy is huge for menopause. looking after women with dementia and osteoporosis is not insignificant. No, no. And certainly one of the bigger impacts along with all the psychological impacts on Jane was sleep. And, you know, there is nothing that you could do to her to torture her more and disrupt her sleep to the extent that it was being disrupted. It's one thing when it's a newborn baby that's doing it, that gives you something back. This was far from it.

Yes. And it is a form of torture, isn't it? Yeah, absolutely. It's not sleeping. And it is one of the first things people usually think before in the clinic because their sleep comes back. Yet, again, there's a lot of research about sleep. We know about the health risks of not sleeping, but no one thinks about the hormones. And it just seems crazy, really, because hormones in our brains are so important.

Yeah, exactly. So as an organisation, what do you feel like a priority should be for workplace to try and address it? Like you're saying, the way workplace is quite right, have done for pregnant. But they've also in the last 20 years done a lot for mental health, haven't they? It's almost, well, it is easier, isn't it, going into workplace to say that you have depression or anxiety, which you could never have done 20, 30 years ago. But it's still, how do we do that with the menopause? It's quite hard, I think.

I don't think it's going to be. It might have been, but if we look at priorities around diversity and inclusion at the moment for all the right reasons, and whilst I talked about our organisation, organization as being fairly progressive in terms of gender diversity, I think we've still got more to do on the inclusivity piece. So we've managed to allow them to progress in the organisation, but looking at those other factors that then mean that the workplace is as recognising of their challenges as it is of everybody else's. And this is one thing that just, once you become aware of it, and I do think it appeals to chief execs and senior people in business, because when you're wired this

way and you know that the world really does have very, very few silver bullets in it. When you do find one that can have such a big impact, then it does grab your attention. And particularly at the moment, given that diversity and inclusivity is such a priority, typically, but there's two reasons. Firstly, because actually we've all woken up to the fact that a diverse workplace is a more effective workplace because the challenges that we're facing today are far more complex and therefore or need all sorts of different types of thinking in order to cure them. But secondly, because it's just not fair otherwise, and actually this deals with both of those two things.

One, it sort of deals with an unfairness that this happens to women, which does seem incredibly unfair that it does. But secondly, it also makes those women more effective in the workplace, which allows them then to be sort of a contributor to that diverse thinking that's going to drive business performance as well. So it works on both those two things. And it's why it's, it really, then is it just a case of how do businesses then engage with you and, for want to a better word,

the menopause industry effectively in order to be able to treat women? And that's a big stumbling block quiz, isn't it? Because there are quite a few companies and organisations that will go into different businesses and talk about acknowledging the menopause, maybe changing work patterns, trying to introduce flexible working or reduced hours. But actually, for most women, they don't want that. They want to carry on working. They want to be promoted. I mean, it's amazing hearing about your proportion of men and women at senior levels, because that's very unusual. And as the menopause isn't covered by private health insurance, because most GPs have no training in the menopause, women really struggle. And this is my

sort of big, I've got lots of frustrations, but this is one of them because we really need to be able to find ways of having some in-house clinics, actually, I think, or access to remote clinics now that is almost organized by the organisation, which you could argue, don't do that for other medical conditions, but there's no other condition that's so poorly managed. We know that only the minority of women receive a treatment that the majority of women would benefit from. And globally, that's just a disaster. It's an absolute disaster, and it wasn't a disaster 100 years ago because we didn't live so long. So we would be wiped out in our 50s, so it wouldn't matter. But retirement age is increasing.

post-COVID, we're all going to have to carry on working probably even older to try and pay off everything. And the companies, you want to carry on with the staff that you have. I mean, we have a really quite robust menopause policy, as I hope you could predict in my clinic. And, you know, when we have any staff that are struggling, they come in, they get a free consultation. And they think it's wonderful. But my hidden agenda is I want to get the best out of my staff. I want them to focus and be sharp and to be on the ball and not make mistakes. Whereas patients tell me they can't remember their login details.

They can't remember which meeting they've been to the day before because their brain's gone without their hormones. I don't want my staff to be like that. But I want to nip it in the bud early. And that's a big problem as well because women are just being sort of fobbed off. And if they're told, oh, well, you can reduce your hours at a reduced pay, they don't want that either. It's really hard, isn't it?

It is. And our whole colleague proposition is, we define it to shape your world. And what we look to do is to give people what we believe are the three motivators for them, autonomy, progression and a sense of purpose. A sense of purpose comes from the creating thriving cities. The progression is just continuing to move forward. And the autonomy piece is where I think this is particularly important because women lose that sense of autonomy when they, an autonomy is that sense of control over yourself and when the menopause is hugely disabled. in terms of your autonomy. So anything that we can do. And within that, we then do look at the sort of broader well-being agenda in which that would form part. So not all businesses like the fact that the state is increasingly pushing the responsibility onto companies for these things. But actually, I think it presents a great opportunity for the world.

Because effectively, we're all in a race for talent. We want the best people. we want the best people working in the most effective way. So the company and the workplace is a good place to address. Yeah, and I think it's a sort of joined up way of thinking, isn't it? It's not saying that companies should have full responsibility because obviously women have to have responsibility and also healthcare professionals,

but it's trying to do it so it all works together. And certainly, as you know, I know you've been involved with the app that we've produced. And, you know, my vision is that all women can download it, create a health report that will then, go to their doctors and it gives you the diagnosis because we did a study of 5,000 women and it took 9% of those 5,000 women, 10 GP consultations just to get the diagnosis of the perimenopause or menopause, which I could do in two minutes, but with downloading the app doing a questionnaire,

you'll diagnose it yourself. So actually, not just for the NHS spending all that money on 10 consultations, if I was working for one of your companies and I had 10 GP appointments, that's quite a lot of time. would just lose, just trying to make a diagnosis. That's before getting any help. So it would work both ways, wouldn't it? So if everyone worked together on this. Absolutely. Yeah, completely.

And what's been interesting is just the level of education that's required within healthcare professionals as well. And how this is something that when you and Jane were at medical school, it just didn't get taught as having the impact that it does. No, and sadly it still isn't. And, you know, it's traditionally been a gynecological. problem, but actually, as you know, it's when periods stop. So most of us don't need to go and see a gynecologist for our menopause. And I'm not a gynaecologist. I'm a physician. But any person

that sees an adult should know about the menopause, whether it's a nurse, a pharmacist, a physiotherapist, a surgeon, you know, they still see menoples or women. And there certainly needs to be a massive change in the way that education is given to students, undergraduates, postgraduates, because that's a real sticking point, which I can't think of any other aspect of medicine where people are refused to treatment that has more benefits than risks. Yeah, no, I can't either. And it's certainly one of the priorities now that, as you know, we're looking at through the health deprivation work that we're doing in,

particularly in Greater Manchester, through these focus care workers that work in the GP surgeries that actually go and talk to people about what the underlying problems are that sit behind what they present with, and the more that we can get that message out through that network as well. Because that makes a huge difference. You know, a lot of women, even before thinking about treatment, will just be so relieved to know that they haven't got dementia

or that their crippling anxiety is not because they've had an abusive relationship. It's because of the way the hormones are affecting them. And that can make such a difference. And then they know how to get help rather than trying to think, well, have I got a mental health? house disorder? Is it right that I'm on another antidepressant or should I be drinking this much wine to try and numb my symptoms? And when it's pieced together, you know, before treatment, they're already feeling better because they know and understand what's going on. Oh, yes, exactly.

And it gives, I mean, we all need something to provide the hope thing and you can hang your strategy off if you're not fond of the better word. And I've seen it, you can rebuild your life. Suddenly all of those other things that are causing you a problem because you're able to thought that out, gives me then the confidence to sort out your physical health and your weight and your diet. Yeah, because it's very easy, isn't it? Especially now we were talking earlier, about COVID, and a lot of people's lifestyles really changed and taking a nose dive. And it's very easy to think, well, we should have better lifestyles.

We should eat better. We should drink less. We should smoke less. We should exercise more. But actually, for a lot of people, when they don't have their hormones, the last thing they feel like doing is that. And they often comfort eat, drink more, sleep less, as we've already, said and their lifestyle worsens and you can't then you can do all the well-being you like in the

workplace but it's so difficult if you haven't treated the underlying cause first yeah but if what you're doing is you're giving somebody that ladder out and that ladder is the metapause treatment then and you know this is a conversation that you and i've had a number of times but i i do see then that what you're doing and whether that be the balance app or whatever being that ladder off which then you can help them with these other health challenges and other sort of life challenges that they've got because you're giving them that thing that they can cling on to, which is the cause of this whole mess that I've got myself into is this thing that actually isn't my fault at all. It's happened to me. In fact, I'm not being my fault. I've been wronged because

I've not been treated for this and therefore now's the time for me to roll my sleeves up because I can deal with everything else because now I've got me. Absolutely. And you know, women can be quite determined, as I'm sure you know at times. And once they've decided something, we're try and get it. And you only have to look at some of the comments that I receive on my Instagram every day from women who are frustrated. But a lot of women have, it's lovely actually, have increasingly saying I've read information on your website, I've listened to podcasts, I've downloaded some videos, and more recently I've used the app, and I have gone back to my doctor, and I have demanded HRT, and my life has been transformed. And, you know, for me, that's amazing.

I never know these women. I've never treated them, and they, but it's absolutely. Absolutely lovely. And the more we can do that, the better it's got to be. It's got to be for better future health for women, which is so important. Yeah. And if you think I look forward to, I've just turned 50, well, I say just turned, sorry, I'm a central time. I turned 53 years ago. And I look at what I call the second half of my life. And I look at the second half of my life with just as much excitement, if not more than the first half. How wonderful would it be if, you know, if every woman turning 50, who's at whatever stage they are with the menopause, was looking at life in exactly the same way, having got their energy and their mojo back, and feeling like they've got so much to contribute to the world and so much to live for. And it's not overstating it to say that it is, in my mind, you know, the single biggest factor that for so many women that puts them back on that positive path. I certainly, Kate and Jane. Jane, I mean, Jane, my wife's ready to take over the world again, which is great.

Fantastic. Absolutely. And it's also knowing that her future house, you know, her risk of heart disease, diabetes, osteoporosis dementia has reduced. So it's so many things. There's no other medicine that can do so much, so easily and so cost-effectively as well. Yeah, it's amazing. You mentioned earlier about health anxiety, and you would think that somebody that suffers health anxiety

would therefore be permanently anxious about having breast cancer as a sort of HRT. Quite the contrary. I mean, Jane has barely had an episode of health anxiety in the last few years because of the fact that her mind has been significantly improved as a result of the OQRP. So for women that are feeling, you know, that maybe they can't deal with that sort of anxiety of the perceived risk, I would say, you know,

go for it and you'll find that it's... Absolutely. You're absolutely right. And a lot of women, in fact, I spoke to on this morning has taken me in a year to get her to start HRT because she has so much health anxiety. So I told her this morning, it's my best Christmas present, actually, knowing that she'd started it.

But I know in three months time, her brain will be better. She'll have less anxiety. all the information that we know about estrogen being associated with a lower risk of breast cancer, she'll take on board, but she can't because she's so anxious at the minute. And this is very, very common that we see that. So, yeah, there's a huge amount of work that needs to be done. But I'm very grateful to you, Chris, for spending your time today to go through with your

perspective. So, but before I finish, I'm going to put you on this spot because I always do this at the end of a podcast and just ask for three take-home tips. So what would you say to people who are employers of menopals or women and have never thought about the menopause affecting any of their female staff? What would be three easy wins would you say or things for them to think about? I think like with anything, you would start with awareness. So start by understanding it yourself and then rolling out a program of awareness in a business. and then the third would be, which we haven't done yet, as you know.

And part of it actually is a bit about the demographic of the women in our business. So a lot of the female leaders we've got are in there, 30s and 40s. So we know we've got a ticking time bomb there. But we do have women that are older as well. So we really, having done that, it's how do we create the signpost? We've done it to balance and the app. And then I think the final thing, which we've done, as you know, after that meeting with Marcus was to get involved

and to put some financial support behind you and balance as well, which is something which I believe is going to have a huge impact. But if I'm taking that back to advising a business at this stage, it would be the practical thing would then be to look at pathways into providing women with access to high-quality treatment, such as that that you provide. But the trouble is that that last piece is the piece that we're working on together, isn't it?

Absolutely. Because that's difficult because there aren't many high-quality solutions available. But it's going to change, I think. We've got lots of plans and lots of determination as well. You certainly do. But it can be done with teamwork. And, you know, I'd like to sort of publicly thank you for all your support and belief because that's the only way I can keep working is by having light-minded people

who really believe for women and for the future of women. So I'm really grateful, Chris. Thanks so much for your time today. Well, there aren't many things we come across that provide us with such a sense of belief. So it wasn't a difficult one to support. Oh, thank you. For more information about the perimenopause and menopause, you can go to my website, menopausedoctor.com.uk,

or you can download our free app called Balance, available through the App Store and Google Play.