The Dr Louise Newson Podcast - 095 - The Lorraine effect: menopause in the public eye. Lorraine Kelly and Dr Louise Newson

Episode Date: April 20, 2021

Lorraine Kelly joins Dr Louise Newson in this podcast episode and they discuss their shared experience of talking about the menopause on that infamous couch!   Lorraine talks openly about her own menopause and how treatment radically changed her work life, relationships, and emotional wellbeing. Every time menopause is discussed on Lorraine's show, they have an overwhelming response from women who are struggling with their symptoms and can't get the help they need.   Dr Newson outlines some of the ways she is trying to counteract the misinformation around HRT and general lack of awareness from the public and healthcare professionals. They discuss how attitudes are slowly changing around menopause and share their frustrations at the uphill battle they face in trying to get more help for more women.   Lorraine's top 3 tips for women who are thinking about getting help: Get all the information you can and read up on everything you might need to know. Don't be fobbed off when you go and try and get help. Remember you're doing it for you, to feel better, but you're also doing it for everyone that loves you. If you're given HRT and you don't think it's working , don't give up, keep trying with it, or discuss changing the dose or type, it might take a while to find what suits you. Just go for it and be empowered. Follow Lorraine on Instagram - @Lorrainekellysmith

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 absolutely thrilled, honoured and delighted to introduce to you a guest who I hope all of you know, just by her first name, actually, but I will use her surname as well. So I have with me, remotely, of course, Lorraine Kelly. So hi, Lorraine. Thanks so much. Hi, Louise. It's so good to talk to you. Do you know, it's really interesting. I have quite ambitious targets, as you probably know. My mission at the moment is to improve the global health of women. So it's quite a big target. But a few years ago, I went to a conference and it was my first Manipals Society conference. And they were full of very learned, very, very clever people, far more clever than me, talking about the menopause, obviously, because it was a menopause

conference, talking about the safety of HRT. And I thought, yeah, this is great, this is what I know, but women aren't getting it. There's only 10% of women in the UK getting it. I thought, what should I do? How can I help? And I thought, right, I'm going to play with the media. And I always have these goals that I think are completely unachievable, but I'll try my best because there's no harm trying. And one of them, I thought, right, wouldn't it be good to sit on Lorraine Kelly's sofa and just talk to people about the menopold. because I think she seems so lovely and so down to her. Her talking about it will be far better than me doing a big research project. And I feel very privileged that I've been on your show not once, but I think four times now. I don't quite know how I manoeuvred myself actually to come to you. I think it worked out really well because, you know, I'd been going through it myself. Anyway, and I'd found that nobody wanted to talk about it. I found it really bizarre. You know, other women in the public eyes.

seem to sort of shy away from it. Some of them who shall remain nameless, I think had this idea that it would make them seem old and over the hill and not in their prime. And actually, of course, if you get the right treatment, if you're lucky enough to find someone like you and you get the right treatment, you really are all of these things.

You feel energized, you feel fantastic. I mean, honestly, I thought I'd lost to myself. I remember sitting talking to you about it and saying, I don't know what's going on here. I don't understand. I don't, there's no reason for me to feel like this. And of course you think about mental health. Of course you do. And I can understand that if I had gone to a GP with the symptoms I was showing, I wouldn't be surprised if they put me on antidepressants. I wouldn't have been surprised by that.

But of course it was totally the wrong thing to do. And as you see, that's happening to far too many women, isn't it? Absolutely. And I think it is really hard because as women, we're not constantly monitoring ourselves and looking at our symptoms and thinking we just get on with stuff. And then other people don't necessarily no and it's quite it's quite hard to say oh actually louise you're looking really awful you're looking really down it's quite difficult and it is easier now to talk about mental health but then i think menopause it's always been hot flushes and sweats and yeah in fact a few years ago for something i was doing with channel four we actually did some filming in birmingham with a placard saying menopause and we stop people to say what do you think of it what is it and all the lot of people

just turned away they didn't want to be engaged which you can understand but But then they all said hot plushy sweats, something that old people get. Because if you Google menopause, it's an old grey-haired woman running down the beach, isn't it? Absolutely, which of course there's nothing like what we are now. I mean, we're all taking better care of ourselves. We're all living longer. And of course, we're going to have a lot more of our lives living with the menopause. But honestly, from my point of view, the HRT that you prescribed to me was an absolute game changer.

I mean, it was quite remarkable how quickly I felt better. And also a lot of people, you know, because people are nice, and they're not going to say to you, oh, you know, you're being a bit grumpy or you're not yourself. But one of my really good colleagues at work who I trust implicitly, she said to me, I'm a little bit worried about you. You're flat. You just said you're flat. It's not like you. You know, normally you're full of curiosity and, you know, full of passion for what you do and all was interesting. And that still was. I think it would have taken somebody that knows me really well to know that. But that was the symptom for me. I just felt really flat. I didn't so much get the hot. flushes, not so much of that, a little bit. For me, it was like not sleeping well and, you know, not being able to concentrate, you know, literally sitting there sometimes live on air and forgetting what I was doing next. Which is when you're on live telly, it's not a good thing, is it? Not a good thing or something. Grasping for words, you know, and all of that. And it was my husband as well, because obviously I fix the men in our life too. And he was really worried about me. And he just said, you're just not yourself. I don't know what's going on here. And

when you did prescribe the HRT and it was absolutely the right sort of balance for me, I always remember he said, I've got you back. Yes. It was like, I've got you back. I mean, you were on HRT already, won't you? Yes, but it wasn't enough. It was, I talked, yeah, I talked about it with Walter, who was brilliant. Absolutely.

I talked about anything. I don't think I could show him everything, so we can talk about it, which is fine. And we talked about it, and I had bought the HRT patch. And that really helped for a little while. But you see, I had this thing that I thought, all right, okay, so I put that on and that's me now. But I had no idea that things can change. And that's exactly right.

And I'm doing some quite high-level work with NHS England at the minute. And someone was saying, well, a lot of people give up HRT because it doesn't work for them or it causes side effects or whatever. And actually it's because it's not the right type or dose for them. And a lot of people think, you know, you take paracetamol for a headache. You take HRT for menopause. But as you know, there are different hormones, but there are different doses, different strengths, different formulations. And you're absolutely right. Some people find that what they're given an issue is brilliant.

And then their body's requirements change. So your body produces some hormones. And then what often happens is any reserve you have in your body just goes because your ovaries run out of hormones because that's what happens as we age. So people can be plattering sometimes for a few years. And then suddenly they go, the HRT is not working. Well, it is working. It's just not working enough. And so that's why it's really important that women have individualised advice. They get reviewed regularly. And if they are having symptoms, then they need to get help again. And it's very difficult, isn't it?

Because then you can think, well, am I depressed? Am I anxious? Is there something else? And I remember you saying to me, but I should be happy, Louise. I've got nothing to be sad for and I feel so joyless. And, you know, I hear that all the time. A lady said to me, it's in my clinic. I just feel dead inside.

Yes, yes. That sums it up really, doesn't it? It really, really does. And do you know it was remarkable, though, when you came on that first time, the reaction we got on the show. And we always get a really good reaction to items that really hit home. But this was overwhelming. And I thought there are so many women out there who are suffering in silence, who are delighted that we're talking about it. You know, that it's so grateful that we were talking about, I mean, I have women to this day that come up to me and say, you know, what I saw. a couple of years ago in your show has absolutely changed my life. And I don't know what I would have done. And you think, for goodness sake, you know, this is ridiculous.

We should have been talking about this years ago. So I remember you did a week with, or there was a few days with Dr. Henry, and it was fantastic. I remember one of my friends text me and said, you need to go on. I was like, how do I do that? Yeah, we did that week. And that was absolutely remarkable because, again, that reaction was quite astonishing.

It got, what was really good was it was sparking, of course, conversations, conversations between, you know, wives and husbands, partners. I had a good conversation with my daughter. I mean, I know she's incredibly young still, but, you know, it will happen and talking about it. I talked to my mum, but we'd never had that conversation me and my mum. We just never talked about it. It just wasn't the kind of thing that you did. I sailed through.

I sailed through it and I said, well, did you? And when she popped back, she went, actually, no, I didn't. It was quite hard. Yeah, you see, it's interesting, is it? So my mother has been on HRT. for 30-odd years. And she was a teacher, but she still works now, but she was incredibly tired. Like you're describing, you know, she just didn't feel right. And this was a long time ago in the 80s. And my father actually died when I was nine. So she was young, left with three children.

She was working trying to get things together and was tired. And everyone said, well, you will be. You know, you've got a lot going on. So she went to a doctor, who she's entirely grateful for to this day, who said, oh, I think you need HRT. She didn't even know what it meant. But then you don't ask your doctor then in the 80s, do you just do what you're told? And she said, within weeks, I just felt back to me again and I could teach. And it was my brain was working and she's never come off. And I've never let her come off. And it's great, but she's fit and strong and she's active.

And, you know, she's very different to some of her friends, sadly, who aren't so, but they're not taking HRT. So I've always come looking at my mother and also my mother-in-law, who also takes HRT, thinking, these are strong women actually and maybe they'll be strong anyway but but I've always thought how wonderful but it wasn't until I started my clinic as you know I have a private clinic because I can't get a job in the NHS doing manifold's work and then I I suddenly saw women from all over the country who hadn't just had a few weeks of symptoms they'd had years of symptoms and they were giving up their jobs the partners had left them some of them suicidal you know every week as extras we see suicidal women I saw one yesterday in my clinic

who had had her ovaries removed and then started to self-harm and tried to kill herself. So she was sectioned to a hospital and told she's mad and she had to increase her antidepressants and she knew it wasn't. And, you know, these stories, I just think this is actually cruel and barbaric that women are being denied an evidence-based treatment. I'm not saying we should give people expensive treatment or treatment that's not got any evidence behind it or any data behind it. We've got really good evidence that it not just improves symptoms, but it improves future health and reduces mortality actually. And we've also

got evidence it reduces death from breast cancer. So what else do they need? What other evidence do they need to show? It's just so frustrating. It's frustrating and it must be so frustrating for you because you have got all of that information at your fingertips. And it's unfortunate, isn't it, that there was this kind of scare story. Absolutely. Because when I say to people who aren't as well informed and who haven't really looked at all the data, because a lot of people don't.

A lot of people, they just don't. And they go, oh, no, no, no. I've heard that that can increase, you know, this and that and the next thing. And you say, well, where did you hear it? And when have you heard it? And when was that? And then that's going back with 20 years, which is just crazy, you know. That's right.

And actually, I just recently recorded a podcast with a professor from America who was one of the investigators from this study that everyone was scared about WHOHI study. And it's quite scandalous what happened because the results were leaked to the press before they were analysed properly. It was a billion dollar, not million, billion dollar study. They weren't getting the results they were hoping.

So they sort of had to make something to almost stop it, I think, to prove, you know, well, actually. So a small group of them went to publish this data to try and show about breast cancer and it went straight to the breast. And that was it, Nair in the coffin. The other investigators tried to stop it, but it would already be printed. And then the evidence has been re, re, re-examined. And they still can't prove there's a statistically significant increase in breast cancer.

But the women who just take estrogen, who've now been followed up for 18 years, have a lower risk of breast cancer. That's incredible, isn't it? We don't see it. Well, we do see it getting shouted by you. That's the thing. But the trouble is, as you well know, oftentimes, particularly when it's stories about health, they'll go for the headline. and actually it's very difficult once that genie's out of the bottle it's very very it's very hard and once people have lost that sort of trust if you like which is why it's so important what you're doing

because it is you know everything i'm sure every single day you have to answer these kinds of questions and that will last quite a long time i think but do you find that women younger women are much more i guess accepting are much more open-minded and you know we make our decision don't you've always said that it's up to you whether you're taking it to do not but make sure you're well informed make sure that you have all of that information because you can only make a decision if you've got all of that I think so I think there is a lot more education and I think people are talking more as you know having daughters they're a lot more open they talk a lot more you know openly with us with their friends with their peers and everything else which is great but they only talk about what

they know and if they don't know then it can be very difficult but I think you know we've got to remember also one in a hundred women under the age of 40 have an early menopause. That's true. And people didn't forget that. They do forget that. Yeah, absolutely. So I see patients, my youngest patient's only 19. And she had a cancer when she was 14.

And that damaged her ovaries. So she was put into the menopause. You know, I see young women who have had cancer treatments, young women who have had their ovaries removed for other causes. So they're still menopausal. But a lot of people think, oh, you're too young to be menopausal. But the young ones are often well informed but they still can't get the right help often

and they would benefit more for their health with HRT. So it's the impact, isn't it on the bigger picture? It's bad enough as a woman, but then for our family, for our partners, for our work is really hard and I know you've got the most adoring and adorable husband. You just didn't know what to do. You know, that was a thing. And he's again, it's never been, you know, he was like,

I think he said, my mum obviously went through that And he said, and I do remember looking back when she was about sort of mid-40s to sort of early 50s, that she was a nightmare before she was an absolute nightmare. And now he said, I understand why, because they don't. And that's the thing. It's all very well for us to be educated, women to be educated. It's so difficult. And also the medical profession, as you said, not always in late in June. And I want to find younger GPs are much better. But they're still, it's almost like we kind of go, oh, yeah, that, but they don't know enough of those. They don't know enough. No, I absolutely agree. And as you know, I've got a not-for-profit company doing research and education and we're doing a lot to really help. And to sort of help, we had a meeting today, actually, about working with a company to give them the guidance. So, because you open that book, you know, that BNF that we all have, the British National Forman. And you look at HIT and I don't even know

what half of them are and they've got all these risks that aren't real on them. So it's really scary for doctors when you're busy. You don't know what to prescribe. So we're, you're trying to make it really, really easy. That's a really good idea because, I mean, some of them just don't know. And it's hard, you know, it's quite difficult to pluck up the courage to go to your GP. And then when you go there and we don't really know what to do with you, and then there's always this thing as well, like so many women, especially the older generation say, oh, well, it's just something you've got to put up with.

And there definitely is that. I mean, I have a message on my Instagram, as you know, I'm quite active on Instagram. And it was a message from a lovely lady, and she said, I've watched you on Lorraine, I've downloaded your podcast, I've watched your videos, I've read your book, I've got your app, I've downloaded everything I could, went to my doctor, and they said perhaps you should buy a relaxation tape on Amazon, this is a natural process you'll just get through. And she said, and I don't know where else to go. I'm in a single-handed practice with one doctor, and that's really difficult actually, really hard for these poor women,

because then they have nowhere else to go. And it is certainly, like you say, it's about choice. choose what we eat, we choose whether we drink alcohol or whether we, and as a doctor, I feel like I'm a patient's ambassador, I can't tell them what to do or not to do, but I can guide them and help them and support them and educate them. And if there's good evidence for something, then obviously we should promote it. If someone wants something that's really risky, but they still want it, we have to talk through and then they can still have a treatment or refuse a treatment if it's going to do more harm as long as they understand. So it is a lot about education, but I think there's a real appetite. So when I lecture doctors and nurses and pharmacists, they really actually

want to know more because it is very transformational medicine. It's very rewarding. I love my clinic because people feel better like you know quite quickly. But you also, I know as a doctor, I'm not just making them feel better and helping them keep their partners and keep their job, but I'm also investing in their future health. So you're also, you know, as you know, you're less likely to get heart disease, osteoporosis, diabetes, dementia, you're less likely to be obese, which is great, because there's no other area in medicine I can give a really cheap treatment and it will tick all those boxes.

So we were talking earlier about how hard it is to talk about it in public. And obviously, you've been fantastic. There's Davina is fantastic. There's Lizzo. There's some really amazing people talking about it. But there's a lot of people that aren't. And it must be very difficult when you're, you're in the spotlight, everyone's looking at you, but actually it does seem mad that it's not

spoken about more, isn't it? Because it, you know, it happens to all women at the end of the day. I know, I know it is strange, but I do think attitudes have changed dramatically and I think you've been really, really helpful to change those attitudes. Because like I say, before we talked about it on the show, there were some pretty high profile women who didn't want to be part of it because, you know, it was like, oh no, that's just something that makes you feel old. You know, was saying it makes me fulfilled, which of course it doesn't. And it should just be treated as the next stage in your life, but at the same time, the next stage in your life that you can do something about, that you don't just have to put up with it, you know, that you can do things, which is why

it is so important to know what's out there. You know, whether if you find out about HRT and then you think it's not for you, that's fine. But for goodness sake, don't just dismiss it out of hand. Make sure that you know as much as you possibly can about it. And that's, you know, that's where you come in. That's why I think the app that you've got is so important because that's something that you can do in your house by yourself, get all that information. And you know what it's like. If you've got information, you do feel far more empowered. You don't feel as if it's all happening to you. You can actually do something about it. And that's really important, as you know, when it comes to your health. But every time we do the menopause, we get the most

extraordinary action. There is nothing like it. It is quite extraordinary. It really is and has been a great thing. It was almost like a community now, you know. And I just wish, though, that there were more facilities like yours because that is a lifesaver. It really is. Well, I mean, it is. And, you know, we had another meeting tonight

because we've got such a long waiting list. And we've now got, you know, 31 doctors with us and more wanting to join. But there's, you know, a lot that can be done with the right training. And especially nurses are really, I think, really key in this because as you know, nurses have run all sorts of clinics, such as asthma clinics and contraception clinics, and they're really well placed to help with menopause as well.

And obviously they're cheaper for the NHS. They have longer appointments. You know, 40% of the NHS workplace are menopause or women. See that, when you say that, extraordinary, isn't it? I'm just going to talk in a few weeks' time to a Facebook group. This is really sad. of 800 doctors who are menopausal. Wow.

So this is somebody set up, someone I know who's a sexual health consultant and also another lady who's an A&E consultant, emergency medicine, and they set it up because there is a BMA, a British Medical Association report, showing that 90% of GPs were having difficulties at work because of their menopause.

Gosh, there is a lot of work to be done then. Isn't what you think about it. They're struggling to get help. I couldn't get HLT from my GP because they think it's too risky. So that's the hardest thing, isn't it? Yeah, but once you get that, I mean, I know sometimes it must feel as if you're banging your head against a brick wall. Yeah, all the time. I'm sure you do.

But the thing is, you are the pioneer. There are going to be people behind you. There's going to be, you know, medics behind you and experts behind you that will carry on your work. You know, it's new territory, isn't it, in many ways? Yeah, and I think, I know the first time I went on your show, I got to, told off by colleagues and I was told off because I don't have media training because I wasn't talking on behalf of a society, a professional organisation, because who do I think I am? I call myself a menopause expert and I'm just a GP. And then I remember after doing something with Liz Earle as

well and I got the same sort of feedback from various colleagues and I said to my husband, do know, I'm going to give this up. I can't do it. I'm not strong enough. And then I'd do my clinic the next day and I'd speak to a woman who had given up her job who was really struggling with life and I thought you know well I can't stop this is awful actually but I can't stop and actually now I'm really lucky because I have got the most fantastic team of people medics as well I've got a lot of respect and one of my mentors said to me just carry on be persistent consistent all you're doing is reporting the evidence I'm not doing anything else I don't as you know I don't do any paid work with any pharmaceutical company. I don't have any, you know, and that's really important for people to

know. So I feel like the tide is shifting, but you're right, it's hard when you're trying to say something that people haven't thought someone said to me, look, what you're trying to do is change people who don't know they need changing and don't particularly want to change. And that's really hard, isn't it? And I think when it's about women's health, and I think as women, we're quite strong and we just get on with things, don't we? So then it's almost like you say, it's a bit of a failure. Oh, you're taking HRT. Oh dear. Well, could you not cope with your symptoms? And it's like, well, I'm taking HRT because I don't want osteoporosis actually. So, you know, I started taking it because my symptoms were so bad I couldn't work as a doctor. But I actually now, even if I stopped, I might,

my symptoms might not be there anymore. I've got no idea. But then I don't want my bone to start crumbling. I really want to keep strong. And that's my fear. Other people might be on it because they've got family history of heart disease and they don't want heart disease. You know, there's all sorts of reasons. But my sort of main narrative with all of this is that women should be allowed a choice. Yes. And we should. Informed choice, that's what it's important thing. And this choice has been taken away from us almost. And that's what I find very difficult. If we were talking like this and there were two people wanting HRT that weren't getting it, I wouldn't worry. But there's not, there's thousands, if not millions of people.

I think it's so untamble to me. I think the trouble is that we don't actually know. I mean, you have the position to know more than anybody else, but you're absolutely right. And it's incredible in a way because it just shows that there are people out there that absolutely need help and what's so frustrating is it can be done. And at the end of the people really want to be so cold and clinical about it, it's actually going to save money.

What it is. Absolutely. That should be your main consideration. You know, if the bean counters and the pen pushers and all the rest of it and the red people, if they just would listen, actually, they would end up saving themselves a fortune and get a promotion. Well, you're actually right. So, I mean, the work I'm doing with NHS, they are looking at cost because that's really important. One of my patients kindly spoke to one of the people team, and this is a lady who'd had symptoms for 10 years.

She'd been told she had fibromyalgia. She worked at quite a high-powered job, and then her brain stopped working. she couldn't focus, she couldn't concentrate. So she worked in a veterinary surgery just as a receptionist. Right. But she couldn't remember her login to her password. She kept having to ask people. So then she decided that she couldn't, this was too embarrassing.

So she decided to become a cleaner. And she's got nothing against being a cleaner, but she's got a degree and she's highly qualified. But then she had such bad muscle stiffness and weakness that she couldn't clean. So she's given up her job. Meanwhile, she's been back and forth to her. her doctor hundreds of times. She's had heart test because she's got palpitations. She's had

brain scan because she's got headaches and migraines. She's had urinary symptoms, so she's had tests for urinary tract infections. She's been to a rheumatologist and being diagnosed with fibromyalgia. She's got a drawer full of antidepressants, a cupboard full of other drugs. So each time she goes to the hospital, Kachin, each time she has a test. And actually, so for her, and she's only in our early 50s. So she's had 10 years of awful time. But I saw her, gave us some dirt cheap HRT. It's four quid a month for the NHS. She's on two products. So okay, that's eight quid a month. Three months later, so that's what, 24 quid later. She's going, I don't think I've ever had Fogromyalgia. She said, I'm, this joy is coming back. She's like, you think, I'm happy. I'm not

irritable. I want to say I think about a job. And I just think, oh, really, this is such a shame. It is and that's changed our life. That's completely changed our life. It really does. I mean, if you get a light diagnosis, which you did for me, it just, honestly, and it happens quickly. That's the thing. It's not like, you know, other medications can take a long, long time to kick in.

But this is, I know it's different, but for me, it was relatively quickly. I would say that it felt like the clouds lifting, the sunshine coming in actually, you know, reasonably fast. And change every day and getting better every day. No, and it is trying to reach, like you say, other countries, even America you think would be better, but it's very hard to get HRT. The type of HRT I'm on would cost about $800 a month, someone to every the other day. I mean, I couldn't afford that. You can't afford that. I don't know. I mean, that's so much money. And it should never be about that. Should it? It should never be about that when you're trying to be the best you have. And I've been mentoring a doctor who works in Dubai because it's actually that's impossible to get HRT because they went. made much money out of it. They've made it almost illegal. We've managed to find a way of them getting it now and she mailed me today. So that's started to become really busy. But she works with

the pelvic floor physiotherapist. And some of the women had pelvic floor physiotherapist. It's so uncomfortable. They can't even use a little pezzary for their vaginal dryness. They can't sit down. Yet they're expected to have sex with their partners. Oh, that's true. It's nice. It really is. It is. It is. So we've got such a long way to go. But we're starting and the conversation's going. The conversations are happening. Yes, we're having conversations.

Our viewers are getting in touch still to this day. Obviously, come on, there's a big spike. But it's always bubbling away. You know, it's always always bubbling away. And I, what really I find very gratifying is when women say, look, I went to my GP and I sat there and I demanded, you know. And I'm like, good on you. Which is perfect.

the way it should be. Yeah, no, it's brilliant. And I'm really grateful for you spending your time, Lorraine. And I think it does have this Lorraine effect, I think, when people have, because it gives them confidence. And I think, as you know, as a perimenopoles and the menopals of women, our confidence goes, our self-esteem goes, our feelings of self-worth go. And if someone says to you, you need an antidepressant, of course, you take it. If someone says to you can't have HRT, you'll say, oh, okay. And, you know, I get scared going to a doctor, because I think I'm wasting their time often. And I, you know, I just think, oh, they're so important. They're so busy. So you can understand. But then if Lorraine Kelly can take HRT, then actually I can too. Thanks very much. Exactly.

And it was good. And I actually found it really, actually very liberating to share that. Because what we did was Dr. Helry sort of interviewed me because, like I said, we can do it. So I said, well, I'll do it. I'll talk about it. I don't mind. And it's good.

And my viewers are fantastic. And they really trust me. And if I'm talking about it, they're kind of like, it just, you know what if it's helped you know if it's helped a handful of women that's great but you have helped so many and of course we'll continue because it's a ripple effect louis of course it is ripple effect and there will be you know young doctors now who want to go into this area for all kinds of questions and you know it's just at the moment i guess you have to be kind of wading through glue to make that path easier you know it's like you're going through the jungle you know your machete but you're making it easier for people that are coming behind you don't know really i hope so yeah Oh, you are.

Oh, well, so before we finish, I always do, I didn't tell you, I didn't want you at the beginning, I always do three take-home tips, really. So three tips for women who have listened to you maybe think, actually, I'm going to try it because Lorraine says it's okay. I'm going to try some HR2. What three things would you say to help them? I would say, yeah, first of all, get all the information you possibly can. I mean, you've got so much information on your website and on the app.

Make sure that you've got that. That's really, really important. And if for any reason it doesn't work, if you go to your GP and it doesn't work, try again. Don't feel cheated and don't be fobbed off. Do not be fob off and certainly don't be fobbed off by a doctor saying to you,

oh, well, you're a bit depressed. You know, because obviously of the world we're living in right now, we're all feeling a bit overwhelmed and getting those anxious feelings at 2 in the morning and all of that. So don't really, really don't be, because you're doing absolutely the right thing, not just for you, but for everybody that loves you and everybody you come into contact with

and it does have a ripple effect. Because if you're miserable, you're going to make your family upset as well and you don't want that. So just really, yeah, go for it. Go for it. Be empowered. Be empowered and go for it.

I like that. Empowerment is really, really important. So thank you. I really appreciate your time, Nore. It's been really great. Thank you. Great to talk to you.

Always be to talk to you the reason we'll have you on very, very soon because it's a joy. Oh, thanks ever so much. For more information about the perimenopause and menopause, you can go to my website, menopause.com, UK, or you can download our free app called Balance, available through the App Store and Google Play.