The Dr Louise Newson Podcast - 083 - The Importance of Lifestyle During the Menopause - Amanda Thebe & Dr Louise Newson

Episode Date: January 25, 2021

Amanda Thebe is a personal trainer and nutrition coach, with nearly 3 decades in the health and wellness industry. She is the author of 'Menopocalypse: How I Learned To Thrive During Menopause and How You Can Too!' Dr Newson actually helped Amanda with the HRT chapter in the book. Amanda (who is British) joins Dr Newson from her home in Texas, USA.  In this episode, Dr Newson and Amanda discuss how menopause awareness differs across the Atlantic, yet despite our different medical organizations, women still are not being helped through menopause. Women are still being dismissed by doctors or misdiagnosed, so there is still much work to do. As well as a discussion about the role of HRT in menopause management, they discuss the importance of lifestyle changes that are integral to supporting menopause and bulletproofing women into aging against the major diseases like diabetes, CVD, osteoporosis and Alzheimers.  They also discuss:  Living a movement based life vs a sedentary life.  Knowing there is an entry point into exercise for everybody.  Making small changes that develop into lifelong habits.  Simplifying nutrition to support your body.  Cutting through misformation in the health and wellness world  Adding things of benefit rather than deprivation and restriction.  Amanda Thebe's Three Reasons to Buy Her Book: It's giving you knowledge and knowledge is power! There is a 12 week strength training programme in the book - it's great for during lockdown. The book contains advice on how to age resiliently. This is about how to live your life based on your strengths! Buy Amanda's book 'Menopocalypse' here: www.fitnchips.com/books/ Find Amanda on Instagram: @amanda.thebe

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 and delighted to introduce you someone who's not in the UK, actually, someone who's across the waters in America. So I'm really pleased to introduce to you, Amanda Thib, who has been connected to me quite while ago, I think, and then we actually met in real life and days that we could go out.

And she's recently authored a really amazing book called Manapocalypse. So welcome, Amanda. Thanks for joining me today. Thank you. And thank you for being part of the book as well. I know when I was writing the hormone, there's a section just on treatment options, and I ran it by both you and also a not.

American Menopause Society doctor over here. And it was just really great that you spent the time helping me out and just making sure that I was given valid information because I'm very clear about staying in my lane as a non-medical person trying to educate on menopause. Yeah, well, it was a real honour that you asked me to look. And as you know, in the menopause, there's so much misinformation out there. And women are desperate for the right information. And I've noticed more and more how much bad information is coming out. But every word counts when it comes to the menopause. And when you start talking about HRT, absolutely has to be 100% evidence-based. And so it was great that you reached out and I could help you. So no, that's brilliant. But those of you that

listening will be wondering why I'm talking to someone in America who hasn't got an American accent. So do you mind before we start talking about your book, who, where you've come, obviously, not from America, but what you're doing and how you've ended up doing what you're doing? Who knows if there's Amanda Thief and what you're doing yet. So obviously I'm English. I'm from the northeast of England. I'm from Billingham, which is in Teaside near Middlesbrough, and I left 20 years ago to come to the US. My husband went to Boston to school. And so we packed up all our bags in the UK and we just headed overseas and we haven't come home, basically. So we were in Boston for two years and then we moved to Canada for 15 years. And I'm actually Canadian. So I got my Canadian citizenship.

And now we're in Texas. And I know. I don't sound very Texas, but I do say y'all all the time because I love it. And so, yeah, so we're here for maybe another two or three years and then who knows where. But I'm with my husband's job, which is okay for me because being in the fitness and wellness industry, that's quite portable. You know, I can do that anywhere. And I am a personal trainer and a nutritionist, and I've been doing it for, I keep saying 20 years, but actually if I really count up, it's maybe 30 years. because I'm older than I actually think I am, yeah. So have you always been into nutrition and exercise?

I have, yes. I started out as like an active kid doing karate. I was a black belt in karate in the UK. And then I went to Luftwere University to do personal training and nutrition when I was like 20, 21. Excellent. So do you spend a lot of time doing one-to-ones or groups or how does your personal training work? I actually never really did it as a job. It's interesting because I worked.

for IBM. I was a business analyst for them. It was always just a passion project, if you were. And then when I was in Canada, I started doing it as like a real job when I'd had my kids and I started training the moms from the local school. And then when I moved to Houston, I did like some online training, but mostly now I just do writing. I write quite a lot of articles. I wrote the book as well. And I'm now actually spending a lot of my time doing educational courses on nutrition. on menopause, menopause in the workplace, all of the sort of things that you do as well, you know, like it really is now,

I've been quite flexible and organic in my approach to where this has taken me. And I think I've just realized that over here, we're not doing quite a good of job as you guys are in the UK at like amplifying the message. So I just want to be one of those voices of reason and sanity in the world of menopause and exercise and nutrition. Like you said,

misinformation is just, it drives me nuts as well. Yeah, because it's very interesting. So you're saying we're doing better in the UK and I spend every night when I go to bed, frustrated, sad, disillusioned, upset that we're not doing enough. And I think it is getting better over here, but we've got such a long way to go. But there are other countries you think America would be better

because there are so many things that Americans are probably better than us. But this is terrible, isn't it? I mean, it's a global health crisis. actually, how poor menopause care is. And I can't, I don't think we can even pretend that it's better in America and I certainly think it's worse, isn't it, than it is over here. Yeah, and I'll give you some sort of comparisons. I mean, I know we all get the menopause fatigue.

I mean, it hits us all. It's like, why am I bothering? This is exhausting. I'm like a broken record. But, you know, when I look at the UK and I see like Diane's campaign and your work and And like if I personally go back eight years ago when I realized I was in perimenopause, there was no conversation. I didn't hear the word anywhere.

And since that time, you've now got it in the school curriculum. You've now got prescribing guidelines that help GPs to help women. And I know there's still resistance to sort of like hormone therapy. And I know it's still not a very easy topic to talk about. But at least you'll get a national coverage. So when my book came out in the U.S. and the U.K. at the same time, I had national press coverage in the U.K. and I didn't get anything in the U.S. I got coverage in Canada. I did go on one TV show in the U.S., but it was slim pickings. It's just not a big topic of conversation. And the hard thing about the U.S. is the healthcare system because it's privatized. And so they will never be prescribing guidelines at all. then all of the other medical societies are not in line with the hormone therapy message that the North American Menopause Society are actively saying they're saying it's first-line

treatment. Every doctor should consider a woman for that if she approaches you and she wants help. And it still happens that women get turned away, dismissed. It's the same old story. But, you know, I do believe in the ripple effect of these multiple conversations and communities, right? once a woman talks to one other woman, it opens her mind to possibilities and choices.

And so, yeah, I feel like I'm banging my head against a wall too, but I do think we're making a difference. Yeah, and I think one of the ways I've tried to work really hard is to try and empower women because if there's resistance from the healthcare professionals, is it because the women don't want it or is it because women can't get it? And I think in the past, women haven't known that there are choices, whereas now they do. So I think the more we can empower women, the better.

But when you look at the management of the menopause, HRT is not just the only treatment that should be given to women. We have to look at lifestyle. We have to look at diet. We have to look at exercise. And we did a study of around 3,000 women, and we found that only 24% of women had been asked anything about lifestyle in their menopause consultation.

And I find that really sad. So the majority of women are not being asked. We know the majority of women don't get HRT, but this is different to HRT. If a woman takes HRT or if a woman does not take HRT, she has to still have lifestyle advice from her healthcare professional. I strongly feel that because women who are menopause have an increased risk of heart disease, osteoporosis, dementia and so forth.

And we know that a good diet exercise will help reduce those things. And, you know, we want to try and prevent disease. So I wasn't actually shocked when I saw that, but I was really sad because it actually takes me one minute as a doctor to say, do you do any regular exercise? Do you smoke? How much do you drink? And what's your sleep like, actually, I usually ask as well. So it doesn't take very long. And actually some women have said to me, do you know, that question you asked when I first met you and I said, I don't do any exercise. Just that question made me feel really uncomfortable answering.

I don't do any exercise. And that was enough to just get me out and do, you know, some running or couch to 5K or whatever. So I think actually as a doctor, we've got a very privileged position that people often do listen to us. And it's very sad actually because lifestyle is huge, isn't it? Well, you're speaking my speak of course now because this is like my boat. It's literally all I talk about. So in the book I talk about, you know, the what, like what menopause is and what the treatments are. But then women want solutions, right? They want information so they can make good choices. And the lifestyle side of it is something they actually can take control of. And so one of my big message is whilst you actually can't really control what's happening in menopause, you can control

what you do every single day. And these things can help support not just what happens through menopause, but then when you're menopausal. And it really frustrates me that there's a lack of awareness about the post-manipausal state of women when we really are at a higher risk of these diseases, the end of killing us. So for me, like if you have a sensible approach to exercise, nutrition, stress management and then even the conversation that you have with yourself about what menopause and aging look like in a more positive resilient way. These are really amazing tools that you can harness. And I used to bulletproof yourself through menopause. And so the fact that you even ask those questions is so great. I know over here I spoke to somebody recently and their doctor said to

them, I can't remember exactly why she was at the doctor, but the doctor said, I hope you're not lifting weights because that's really bad for you. And I'm like, one, like the doctor, if he has no training in that, shouldn't be given that advice. So like, it's like what can they say and what can't they say? But I know that this doctor is hugely influential in this woman's life and he's actually limiting what she's going to do. And so my message is always, what can you add to your life that's going to be beneficial? Not what can you take away. What can you do and add today that's going to make you feel better about your life and just in general the things that you can take control of. And we know that things that a woman can control to some extent are insulin

and cortisol, like they're within our wheelhouse to control. And they're like easy to manage when it comes to like movement. So that's a great one. Do you move every day? And women are like, I don't have the time to exercise every day. And I'm like, you do, right? Because I'm asking you just to live a movement-based life and not a sedentary-filled life. Go and walk to Starbucks. Get off the bus. Remember when we used to take the bus? Get off the bus and just walk. Like, walking is a really great entry point to any exercise program. Like, start walking every day. Like, it's the most studied exercise on the planet, one of the most beneficial ones. And so that's an easy thing you can do. And those lifestyle things are really helpful for controlling like cortisol and insulin.

And we also know that through menopause that women can become insulin resistant, right? It's just intrinsically linked with our falling estrogen. So what are you going to do? Move every day. That's an easy place to start, right? And I think it can be quite scary so people could look at you with your amazing fitness and stamina and all your lovely photos of you. And you think, oh my goodness, I'm never going to be like Amanda.

crazy. Yeah, but you do, totally. But you think, well, there's no point doing it because I'll never get to Amanda's level. But actually, I think, and I hope you agree, that there are so many different types of exercise, but it's doing what's right for you as an individual is really key and not a feel that we have to do a certain style of yoga or a certain type of running or a certain type of hip class. It has to be what works for that person, doesn't it? So I believe that exercise as an entry point for every single person.

person, you've just told people I've been doing this all my life. Like, but literally I started my first karate class when I was 10 years old and I've never not exercised, right? So I don't expect comparison and it's really not what we're about as women were better than that, right? And so I believe if you've never, ever exercised before, you can still start today, tomorrow if you want to. I'll let you off.

And so that's why I think there's an entry point for everyone. And usually the barrier that stops women exercising is fear, fear that they're not going to be very good and lack of belief in their abilities, their athletic abilities. And so that's why I think walking is a really great place to start. And so what usually happens is when you start moving and feeling better and your endorphins start flowing and your health markets start changing, it builds up curiosity. And when curiosity starts, women will go, oh, well, I wonder what it would be like to do like an online dance class. Or I wonder what it would be like to do yoga three times a week.

Or I wonder what it would be like just to do some squats while I'm making the curry tonight. You know, like it sort of opens those pathways for women to start doing choices. And you know, what's so great during this pandemic if we're looking for silver lineings here is that all of these fitness coaches have pivoted online. and they're doing all of these free classes. And it's sort of accessible in everybody's home now. And so, I mean, I obviously give guidance what I think would be like a gold standard for exercise if I could give a prescription.

But I would never ever say to a woman, don't do Zumba, that's a pack of crap. You don't want to be doing that for your body. I'm like, does it make you happy? Do you feel good afterwards? You know, and if the answer is yes, then, well, why would I ever say stop doing it? Like, why?

right there are certain types of exercises that do provide better benefits than zumba and i'm not going to lie about that but i'm like certainly not going to ever say to women don't do it and one of the reasons is is because we're largely a sedentary nation you know there's more people don't exercise than do and so if i could just get every woman to move every day it's just a great way to just take control of your health yeah and i think it's making it's making making it so that it's part of your routine, isn't it? You know, I am quite busy, but on a Wednesday morning, I've always done yoga. And I do a stang yoga, so it takes about an hour and a half to do a primary series.

So I have someone that comes to the clinic, and everyone knows that that's it. I'm just at 10 o'clock, I do yoga. But obviously, we're locked down, or the second lockdown. And so at the moment, I can't have my yoga teacher coming. And so this morning, because it's Wednesday to date, I just did it on my own. And everyone was saying, well, what are you doing there? Are you doing Eager? Because I said, yeah, no, it's fine.

James isn't coming. I'll just do it on my own. But it's like, no, if I don't do it, it's very easy to then fill up that hour. And then it's that slippery slope, isn't this? And I think for a week or two, you can carry yourself through without exercise. And then I find my mind goes, actually. I find it very difficult to concentrate. And I find that I'm not sleeping as well.

Right. That's really a great point, Louise. There's a knock-on effect of, like, exercise. So the benefits. aren't just about the exercise. It's like the knock on effect. And when you stop doing them, it really does impact you. And especially in this really stressful time, it's just such a great way to manage stress.

I have a funny Ashdanga story because I did yoga for a lot of years, like 10 years, and I studied Ashtanga. And I even went to my soul. I even went to the home of. And I went to study with Batabejo, who at the time was like the guru there. and I went every day to the class and I even climbed a hill and had tea with a sadu in a cave and I went to the temple and I did the puja and it was all of these like wonderful things and at the end of it I was like, you know, I'm not very spiritual at all.

I actually just like the physical side of it. So it was really funny. This 10 year journey made me realize that I don't have a spiritual bone in my body. But it made me also realize that, you know, you don't have to. You don't have to buy into what yoga does at a spiritual level to get the benefits from it. And as far as menopause is concerned, it's a super great addition, a super great addition to your life. And so how to motivate yourself to do it when you don't feel motivated is like the golden question, right? So planning is one strategy.

So carving out the time to say, I am going to put aside 20 minutes, 30 minutes, an hour, whatever, three times a week. be accountable to somebody. So if you don't have the resources financially to get a coach, make sure that your best mayor is going to go on to Zoom with you at the exact same time and you can't let her down, right? Like say yourself some targets that are achievable like 5,000, 7,000 steps. Get outside as much as possible. And then I also think that doing something is better than nothing.

So I am a big fan of fitness snacking, I call it. and I had to do this myself when I was recovering from COVID and I didn't have the energy to do anything. I would be like, I'm going to do 10 minutes of two exercises and my two exercises might be kettlebell squats and push-ups. And I would just do them for 10 minutes and I didn't care how many I did. I just did it.

And it felt so good just to have achieved a little something rather than like nothing at all. So that's another good approach. Yeah, I mean my daughter, my oldest daughter is a trombonist actually and she's been just doing a five-minute upper-body workout most days because her upper body needs to be strong for her trombone. And some of them, you just sit off five minutes, it's not. And by the four and a half minutes, oh my goodness, your arms are,

or my arms are really aching and I am quite strong. But I said to her, goodness me, if I said to you right, you've only got five minutes to go on your phone, you'd go, well, that's not long enough. You know, I need to spend longer than five minutes going through my whatever. But actually five minutes of exercise every day or most days is actually, you know, if it's a new exercise, it can really do things for you. Exactly.

I mean, don't diminish anything like that. I understand the principles of overload and progression and stimulus in the body, but that doesn't matter to someone who's never exercised before. What matters is how they start. And it's like the psychological hurdles, they have to jump to get there. And so if your exercise workout looks like five minutes, then it's five minutes more than you did yesterday. So give yourself a break and just try something, right?

And I mean on my Instagram, I do give ideas of things you can do. And I know that when I post things like I did a 10 minute core exercise the other day and people are like, oh yeah, I'll give that a go. That looks fine because I know I make things look easy. But that's my job. But it wasn't. And I had all of these messages later going, why did you do that? So, you know, there are ways to make it fit into our lifestyle.

And I think once you get over the hurdle and then you, you reap the benefits to your mental and emotional health as well as your physical health. You can't beat it really. Yeah, absolutely. But also, you've already mentioned that diet, nutrition is really important, isn't it? And there's so many confusing messages, aren't there? You know, certainly we know that women put on weight through the perimenopause and menopause because of you already said the metabolic changes that occur with low estrogen levels.

And a lot of women do comfort eat because they feel rubbish. They have sugar cravings. They don't sleep well. And so their diet changes, they often reduce exercise. But even those women whose lifestyle stays exactly the same, they put on weight. And they often get told, oh, well, just eat less. But it's not always the right thing to do to eat less, is it? And I think that a woman's knee jerk reaction is, I put weight on, eat less, exercise more.

That's where our mind goes. We think back to when we were 20, we were like, oh, we're going to Lanzarotti in six weeks, I better like eat 1,000 calories a day and only have salads. I mean, that's all what we all did. I don't care. Don't deny it. We all did it. And then if you were to do that to your body right now,

it's adding another stress to an already stressed about body. And I think that that's the message that I, like, so I've studied nutrition. I do believe I can have a really good debate and conversation on this. And there's so much information out there that a lot of women don't have the ability. to be able to question it because it's so confusing. So one of the things I really like to try and do is simplify nutrition because in fairness, the laws of thermodynamics, which govern nutrition science, haven't changed.

But what has changed is our understanding of the physiological changes that happen to a woman through menopause. And so we know that estrogen impacts our ability to build and maintain lean muscle, which impacts our metabolic rate, our fat deposits change. We start holding fat around our belly area, which leads to health issues if we gain too much. So there's all of these ripple effects of things that happen that make the hurdles of losing weight in menopause so much harder.

But the actual methodology to do it is still the same. Like the energy laws don't change. And so essentially for a woman to lose weight, she needs to be in a calorie deficit. it. The amount of energy that she expends has to be more than what she consumes, but what women tend to do is do this in an extreme manner. And so the amount of messages I see where women are, like, I'm going to go on a detox or a cleanse or I'm going to just drink green juices, and they're literally reducing their calorie intake down to the baseful metabolic rate, like the rate

that your body needs just to function if it was like a sleep or in a coma. And that's, so much stress on the body that the body then will go into a retreat and go, well, I better start storing now because you're going to die and I want you to survive. And that's obviously an oversimplification of what happens. But what women really need to do through menopause, if weight management is their goal as well, is to understand that the body still needs nutrients. Nutrients help support your body. They can help manage stresses as well. But you don't want to do anything in an extreme way. And so one of the things that I've already said is I like to give women things that they can add and not take away. So like the messages I hear in my world, like the

wellness world and the fitness world is cut out sugar, cut out gluten, cut out dairy. And it's all like you have to restrict in order to achieve what sinness or something, right? And so what I would say to women is instead of that is how about you think about adage? how about you focus on increasing your protein intake? I've already told you that lean muscle mass is harder to maintain and store, so what you can do to support that, along with exercise, is build muscle, like with protein. So focus on eating enough protein throughout the day. And the knock on effect of doing that is it keeps you fuller, longer.

It helps stop those blood sugar dips. And so you won't be reaching for the hobnobs whenever you get hungry. And so it's just a really easy thing to like introduce. Like increase your fiber intake. Most women don't eat enough fiber. And it's the brilliant feed into the gut microbiome, right? Lots of water and fiber. Another really easy thing that women can add.

And it also helps what keep you fuller as well. Like so there's small things that women can do. Another thing that they can add is more vegetables. We need to increase our vegetables, our plant-based eating. it's so important, right? One of the benefits of including more vegetables and leafy greens and stuff is that they don't have a huge calorie intake. So, you know, you're getting all of the benefits and the nutrients, but you're not piling on all of these extra calories. And so that's the sort of like message I try and steer women towards rather than say, go keto, go intimate and fasting.

It's not necessary. Do them if you want, but why? Yeah, and I think, you know, food needs to be pleasurable, doesn't it? You know, we have to, we all have to eat. We don't have to smoke. We don't have to drink alcohol. But we have to eat. We have to eat to keep going.

And it's real torture if you say to someone to reduce, reduce, reduce, because that's all they do then is think about food. And as you said, if you don't have enough to eat, your body goes into shutdown. And I think that's really important because a lot of people do starve themselves because they think that's the only way they can lose weight. And the whole thing about the stress hormone, your cortisol, your adrenaline, that will change the way you utilize food when you do then eat, which makes it worse, isn't it? Yeah, and then just think about already you're struggling with symptoms. You've got

menopausal symptoms that are causing a stress on the body. You're not sleeping. And when we don't sleep, we know how that increases our stress response. And then maybe you've decided you're going to do intermittent fasting while restricting your food intake in a time to manner like that is another stress on the body. And so I'm just like, well, if you know that you can manage your stress through lifestyle factors like exercising, meditation, yoga, breathing. Why would you do all of those positive things but then restrict yourself in your nutrition when that can actually help support that journey as well? And so really it's just about just telling women to simplify the way that they look at everything

to remove any sort of moral barriers around food, you know, that this is bad, this is good, or I've been a good girl, so therefore I'm allowed a treat. And it's just there's guilt and it's confusing and it's not necessary. No, it's totally right. And I think food has changed so much when, you know, I certainly grew up in the 70s and we just had, you know, what was it growing in the season? We had, you know, meat from the butcher. It was nothing fancy.

My grandfather, always used to say this foreign fancy food, I would never change. I look back and I think, well, actually, it's not about foreign, but he was talking more, you know, because pasta was. wasn't really a thing when I was growing up. We had more just vegetables and, you know, I thought of buying a pizza, I don't think you could even do when I was little. So these were the foods that even he was saying. You know, we had Finder's deep pan out.

You know, those frozen people? Yes. It was a treat, though, probably to have that. You probably have that once in a blue moon. It wasn't a sort of thing. We didn't just go to the deep freeze and get whatever. It wasn't easy then. But then no one was overweight.

We were looking at some videos recently of my husband when he was growing up. And my children actually said, mommy, on the beach, no one is overweight. And it's like, no, they weren't. But they all weren't fixated in the same way. And I think it is also, if there's something you're not sure about food, if you're not sure about the labelling, just don't have it. Have something that you do know what it is. And I love the idea of adding, because if you add more fresh fruit and vegetables,

then you're automatically going to be less inclined to eat some of the other things. But it can take a while. You know, I still got a bit of a sweet tooth, but. If someone offered me a donut now, I actually wouldn't want it. And I'm not just saying that to feel all virtuous. I know it would give me a headache. It would make me feel awful. I probably would stop me sleeping tonight and I really need to sleep

because I haven't had anything like that for such a long time. And your body just adapts, doesn't this? And I think also if you feel better, it's easier to do it, isn't it? I mean, I'm quite extreme. I don't drink alcohol and I know if I suddenly did, I would feel awful. So it's easy to say no. Yeah. But it's easier to say no because it's.

makes you feel bad. Actually, I didn't look at glass when I think, well, I really want it. I think, don't miss it. It doesn't, doesn't there anything for me because my lifestyle's changed. And if your lifestyle changes and it's working for you and it means that you know you can sleep or you know you can think more rationally. But it just takes a bit of adjusting, doesn't it? It does. And that's why I'm all about these baby steps because it's like these habitual changes, these small baby steps are things that have like long lasting like impacts, right? I was speaking to somebody on a podcast earlier, and she was saying, I've got into the habit of having an apple at four o'clock every day. And it was like a virtuous move for her. It was almost like saying, look at me.

She said, now I just grab the apple and eat it and I don't even think about it. And it's because she's done it continually over time, it's second nature. And you sort of want your food associations to be second nature as well. You want to just be able to prepare your food and just say, look, I've got adequate protein there. I have a plate full of vegetables. this is just perfect for me and it's like a no-brainer but instead we've got all of these confusing messages that are just saying well don't eat potatoes because that literally turns to sugar and it's going to ruin your life and it's terribly confusing and so there's something like if a woman

wants to make like a positive change I'm just like saying pick one thing and just do it for four or five weeks and just see how it feels and see if you see some positive results from it instead of doing this massive overhaul I mean we're right in the midst aren't we? like the resolution phase. And most resolutions are over and done by second week in February, right? Because we can't maintain these massive overhauls. And people are doing detoxes. And I'm like, well, what do you think is going to happen at the end of your seven-day shake thing? Like, what are you going to just go back to your old habits? You've got to address those. Yes. Yeah. And I think certainly, you know, your book goes through so much in so much detail.

and it's making it accessible for people as well. We're not talking about doing expensive things or things that are only certain people can do or certain classes that people can access or certain food groups that people can choose. And it's about individualising it, isn't it? I think that's what's most important is, you know, how you choose to live your life

and how I choose to be mine are different. Of course they're different. We're different. We look different. We have different lives. But that's fine. There's no right or wrong. And I think women shouldn't be judging themselves. or comparing themselves.

I think that's really important. So, well, we could talk for hours and I'm conscious of the time, but it's been really, really useful to just get a bit of insight as to what you do and how much more we all need to do by working together. But before we go, Amanda, I always give three take-home tips, but I would actually like to ask you three reasons why people should buy your book, actually, because I've got, I know, you weren't expecting that way, you expecting something about lifestyle or nutrition, but you've been really eloquent explaining that.

So I just would like three quick reasons to buy your book. There you go. Okay, I've got them already. I'm full of self-promotion, so it's fine. I'm just joking. First of all, buy it because it's giving you knowledge, right? And knowledge is power. So that's the first thing. Like, if you have information, you can make choices to support yourself. And that literally is the only reason I wrote the book. So that's the first reason. second reason is there's a 12-week strength training program in there. It's perfectly great for the pandemic because it's based on a set of dumbbells or you can do it with your body weight only and it's progressive over 12 weeks.

So if you wanted to start doing something and you weren't sure, there you go, you can start there. And then the last thing is by because I talk about how to age resiliently. and this is a psychological tool that I personally gained from learning. And what it does is it encourages you to live your life based on your strengths. And as women, we're so hard on ourselves all the time. We're really good at focusing on all of the crappy stuff and all of the negative stuff. And it's the last chapter in the book and it just focuses you on the right path.

And it just gives you reason for like getting up and doing what you do every day. So that's my three reasons. Perfect. I think those are very legitimate reasons and I think it's, I mean, I loved it. I think it's such a brilliant book and I'm not just saying that because I helped you with a little bit because my bit was so small, but it is very empowering and it is about being positive. You know, life's hard for so many of us, for so many reasons. And one of the wonderful things about being as a doctor is you listen to things that maybe other people would never hear. And every woman has a story, every man has a story. Most of us have something that we've had that's been really awful. in our lives. But we can't dwell on it. We have to move on. So being positive and keeping positive is so important. So yeah, that last chapter in your book really, everyone should read. Yeah. And then supporting one another on that journey. Yeah, definitely. Thank you, Louise. So thank you very much, Manda. Thank you so much for your time. I really appreciate it. Yes. Thank you so much for having me on.

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