The Dr Louise Newson Podcast - 099 - Kate Muir: I cannot let this happen to other people

Episode Date: May 18, 2021

Journalist and menopause activist, Kate Muir joins Dr Louise Newson in this podcast episode to discuss Kate's experience of her own menopause journey and what propelled her to make the Channel 4 documentary, Sex, Myths and Menopause.   Kate shares how she struggled to find the right information about her symptoms and HRT, and after an unsuccessful spell taking compounded bioidentical hormones, she was shocked to realise how little advice was out there and how limited healthcare professionals' knowledge is of up-to-date treatments. Kate thought if she, as an educated woman with an enquiring mind was fumbling in the dark, how much harder is it for other women from all walks of life to get the right menopause care and treatment?   Kate's 3 messages for listeners: Body identical HRT saves your life, it saves your work, it saves your relationships, it makes your body work. It's fantastic. The research on the long-term benefits of HRT is fascinating. If you're in a family with a history of osteoporosis, heart disease, or dementia, I would be paying very close attention to the evidence on the benefits of taking body identical HRT for your future health. Tell your story. Every woman has a unique story to tell of their perimenopause or menopause. We need to talk about it more and more.

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsome, a GP and menopause specialist, and I'm also the founder of the Menopause charity. In addition, I run the Newsome Health Menopause and Well-Being Clinic here in Stratford-upon-Avon. So today I have with me someone who I've admired for quite a long time, actually, and this is a story that I'm going to share because my husband is a surgeon, as many of you know, but he really would like to have been a film critic because he loves watching films. So for the last however many years, I've had this name of Kate Muir branded in front of me with film reviews. And then not that long ago, probably about 80 months ago, I had somebody who came to sit in my clinic who also had the name, Kate Muir, but I'm a bit dyslexic almost with names. So names don't mean anything. And as part of my history taking, I said to this lady, what's your job? And she said, oh, I write a bit. And I'm a bit. And I'm a bit.

I review films. I went, oh, great. And we carried on and we had a conversation about her hormones and her menopause. And then she left and I suddenly thought, oh my goodness, that is the Kate year. And because of confidentiality, I couldn't tell anyone, not even my husband. So it was really lovely that I've managed to now become very good friends with Kate and I can now, in fact, my husband's met her as well. So welcome Kate. Thanks ever so much for coming today. Thank you for having me on, Louise. And I just want to say you have you. changed my life in all sorts of unexpected ways. Yeah, so let's talk about when we first met, and it was quite good actually, so I wasn't starstruck with you because I didn't realize who you

were. So you came to my clinic, didn't you? And just if you wouldn't mind sharing about your journey up until coming to the clinic. Sure. Well, I had a terrible perimenopause. And as I sort of went into menopause, I thought, I wouldn't touch that nasty HRT stuff. And eventually I went to a private clinic and got compounded HRT, which was in retrospect a terrible mistake. And I was on it for a year. My symptoms went away. I felt much, much better. And I'd had a really, really hard time with heart palpitations and hot flushes and anxiety. I'd been miserable. So this saved me. A year in, I got my little package of compounded hormones from unlicensed pharmacy. And this is one of the more famous clinics in London. So it's happening to a lot of people. And it's a lot of people. And it's

tasted different. They tasted different from the previous year. And it was the same compound. It's had the same numbers of each hormone on it. It had progesterone, testosterone, testosterone and estrogen. And about two weeks later, I started getting terrible vaginal bleeding. And it went on for about a month. I went back to the clinic and I said, this has gone wrong. They gave me another expensive prescription. And then the bleeding came back. I went to the NHS. I said, something was wrong. and they said, we're going to put you on the cancer test fast track for uterine and cervical cancer. And I thought, oh God, this is absolutely awful. So I went and had all these tests.

I had biopsies. I had every examination you could possibly have. Each time I met a consultant, I showed them this little packet of hormones from this clinic, these little packet of lozenges, and said, this is what I'm taking. Should I keep on taking this? Is it affecting what's going on with my body? And everybody said, oh, I think that's all right. don't worry, no, I don't think. It's as if I brought them sweeties. And then I met Kirstie Lang,

who is, as you know, is a friend of yours, Louise, and had been to Louise herself. And she said to me, do not touch those hormones, throw them away, go and see Louise Newsom. She'll give you the safer, regulated stuff. So I chaps away the hormones, and I got on the train to Stratford-Naven, and I met Louise. And she gave me, immediately, the body identical, regular. hormones, which were the gel and the micronized progesterone, and everything returned to normal, the bleeding disappeared, and then a few months later, they checked me out, and that was absolutely fine. So basically, I realized I, as a grown-up journalist, had utterly failed to ask the right questions the whole way along from my GP to the clinic, to the gynecologists, to all

these experts who had not spotted any of this happening. And I know that's a long story, but that's when I thought, I cannot let this happen to other people. And I'm an investigative journalist. Why didn't I find out? Why couldn't I Google this? Why didn't I? Yes. And it's very shocking, isn't it?

Because you had lots of opportunity, actually, for people to say. And I remember when Kirsty phoned me up and said, oh, I've got this friend who I've been speaking to, and she's in a real mess, but I don't think she'll want to come to your clinic. And I said, well, I'm happy to see her, obviously. But it's a big marketing. with some of these compounded bioidentical hormones. And actually, when you're menopausal or perimenopausal, many of us find that we're so desperate to feel better that we actually don't

care what we take. We just want to feel better. So if we can't get right help, then we would go anywhere to help. And some of these compounded hormones, they do contain hormones and they will make people feel a bit better, but it's the longer term danger, as you know. But it's more worrying that you say that you couldn't access the right information and it wasn't that long ago was it it was probably what 13 months or so ago and i mean things have changed as then but what i didn't know was i needed more progesterone to balance out you know to look after my womb lining and that sort of simple thing i should have known you know but what it's just not common knowledge in the way that periods are common knowledge that everything else you know we have no idea what our hormones do but anyway

I remember coming to you that day and you sorted me out and I was like, oh, it's all great. And I'm on the train on the phone to Kirsty and going back from Strathland. And I said, Kirsty, we've got to make a documentary about this because Louise has told me story of one of her patients who agreed to have her story told, who ended up having electroshock treatment for depression in perimenopause because her depression was completely misdiagnos. She came and got hormones seven years later and she'd been in the house for seven years. And about four or five days after she got the hormone, she went out and went for a dog for the first time. And that story made me want to cry.

And I just thought, this is sort of medieval, the lack of recognition of what's going on. And I have that journalist thing in me that just gets something and gets, I get my teeth into something. And I can't help it. And I just knew I could smell it. I knew it was a horrible story. And it wasn't just me.

I wasn't some odd person. It was lots and lots of millions of women, millions and women. Absolutely. And since that time, you've spent a long time, obviously, talking to me, reading the evidence, but not just listening to me, but listening to other experts. And I've obviously introduced you to all sorts of people in the UK,

but worldwide. And then you've gone off and done your own journalism investigative work, which I really, really respect you for. And the more that you have found out, I think the worse it's been almost and the more it's encouraged you to do more, isn't it? I mean, what astonished me, there are two things that astonished me about this story. And I've interviewed people from Yale and the Mayo Clinic in America and, you know, the head of the International Menopause Society in Australia. I've interviewed people in Switzerland. You know, I've got a sort of worldwide picture.

And what is happening is that we all know there are these fantastic. plant-based regulated hormones, which I am taking, and you are taking the leaves, and they are got a really, really, really safe breast cancer profile. And they are very good for you. And there are these French studies of 80,000 women over five years using micronized progesterone and estrogen gel or patches, and they show no signs of breast cancer. And what I did not realize was all those old studies that we talk about and we scrolls, scream about in the newspaper headlines are about an entire different product. It's synthetic

progestins and often estrogen made out of horse urine. Ask a 12 year old, would you rather have your mom take HLT made out of plants that are yams that match her own hormones exactly? Or would you rather your mom took horse urine and some synthetic chemical? 12 year old would be able to tell you what to do. That's what I don't understand do is. Explain to me why the entire medical establishment cannot see that when the really intelligent people at the top do, the people at Yale, the people at mayor, the people in all the big NHS menopause clinics are prescribing what we're on. Why aren't ordinary women getting it and why they're getting the crap? That's mad. It's absolutely, yeah, you're absolutely right because it doesn't make sense. And as you know,

I still do sometimes go to bed and say to my husband, I think I'm deluded. I think there's things that I know and understand that must be different to the rest of the world because it just doesn't make sense. You know, there has never been an area of medicine that has so much controversy. There's so much resistance to prescribe. You know, there's a lot more dangerous drugs that we prescribe. And for example, if you look at statins that everyone knows you give for raise cholesterol, they are frequently given and in fact GPs are often paid to lower people's cholesterol

but there isn't nearly as much evidence to how safe they are compared to HRT and there is some evidence that taking statins can increase cancer risk there's other evidence to say they lower cancer risk so most people think well it probably isn't much and that's exactly the same with HRT that this evidence is not good evidence as you know and it's not even the right type of HRT. But there is overwhelming evidence that women who take HRT have a lower risk of heart disease more so than if they took a statin, more so than if they took a blood pressure treatment.

But actually, statin is not going to lower risk of osteoporosis diabetes, heart disease and death, actually, because as you know, less likely to die if you take HRT. So I think it's barbaric and scandalous, actually, that women are denied a real. good cost effective, but also evidence-based treatment. And so many people just think, well, the menopause is natural, but actually aging is natural and raised blood pressure is natural and having some heart disease is natural if you look at it in that way. So there's a huge amount that you've learned and you've already mentioned the documentary and we're recording this before it goes out, but we're going to put it out just after because you have written

and produced their most amazing documentary on Channel 4. So tell us about it. Well, it's got Davina McCall presenting it, and you could probably watch it on repeat, I think, as well. But she is fantastic. And we took this script to her saying, you know, we've got all this women, we've got the story,

we've got the complete neglect of the menopause, and we've got this story of kind of medical sexism, and just these women being left behind. And she took one look at it, and she said, oh, my God, that's me. I was 44, I was in perimenopause, I thought I was going crazy and she says all this in the documentary and she was sitting in the makeup chair in the middle of some shoot

and she asked the makeup lady if the chair was heated because she was having her first hot flushes and she couldn't sleep and she had real trouble remembering things and reading it or to cue and she was told not to say anything about it at work and to keep quiet about it. And eventually she too thought, oh, I'll do the natural thing. And then eventually she realized the natural thing was to get her own hormones back. And so she too is on HRT.

And I think one of the most important moments in the documentary, which I carefully wrote in, was to get Davina to walk her, to walks on the front at Hastings, and she sticks a little Easterden patch, a little C-through one on her hands. She said, you can put it on any colour of skin, which is sticks on this little sticking plaster of estrogen, basically. And you think, ah, that's how people will see HRT now. That is the visual image. Really, really matters.

It's not old ladies popping pills, you know, not be witches. It's people like Davina full of energy who need this to look after their health. So she was terrific. But the documentary was a nightmare because, of course, we started it. And we wrote the script and got through it. We had original director. And then, of course, COVID landed. in March and the documentary was shut down and Channel 4 shut down all its productions and shut down

all the budgets. We were dead. And at that point I thought, oh God, you know, I've got to do this somehow, so I started writing a book about the menopause. But in the meantime, back in the end of summer, it opened up again and Channel 4 started taking people. So we had to reapply to make the documentary. And it was a very different documentary by then because a lot of things have happened. Things like the Black Wives Matter movement had happened and there's this fantastic woman who set up menopause whilst black Instagram who's called Karen Arthur who's in the film and talked about black women's experience of the menopause

which I found it really hard to find out about and she would be Googling at 3 in the morning with strange symptoms and everything she saw was white women with grey hair and she couldn't see herself. So all sorts of people like that, in that period of time it was almost destiny during that lockdown, there was this time for this deep research and meeting more people and talking to them on Zoom. And so by the time we got to make the documentary

second time around, sort of November, December, January, it was much better documentary. And, you know, I wouldn't normally say this, but I'm really proud of it. You absolutely should be. I've got these sweats of blood. You know, we wrote the script 25 times. And, you know, it was really, really hard filming in lockdown

and wearing masks and not travelling together in fans. and it was really complicated, but somehow, and it was an all-woman team, apart from the cameramen who were fantastic, but it was an all-woman team, and three of them were on HLT, and some of them changed their HLT while they were making the program to the better HLT,

but I realised that, you know, there were these menopausal women making this film about menopausal women, and we were not going to be stops. And I think there is something about the movement, and you should talk Louise at this point, I should turn the tables and say, at what point did you get really radical about this?

Because when I first met you, you were very keen to get the information out there. But then you started appearing on Lorraine, on TV. And every time someone put out a statement, you were sort of the rapid rebuttal unit saying, wait a minute, here's the truth about HRT and breast cancer. So tell us a little bit about your, because you've got going, you know. Well, I think, I mean, even my stuff, the first menopause conference I went to around the time of the nice guidance that came out,

I sat there and I thought, you know what, I don't run a big research unit. I can't even get a job in the NHS as a menopause specialist because they don't exist near where I live. What can I do? How can I help? And you know you always, I don't know whether you do. I pressurize myself a lot and I always have fairly unrealistic goals, but I've always tried through life to aim really high. And it's ridiculous because then I get disappointed if I don't achieve everything. But then I sat there and thought, right, I'm going to play with the media because the media have got it wrong. And it's not their false. It's because they've been given wrong information. So I had this little pipe dream that I would sit on Lorraine Kelly's sofa one day.

And I don't even know why. I don't even watch Lorraine. Sorry, Lorraine, if you're listening. Well, I don't because I'm always working on Tobit. I just thought she is a really inspirational woman and I bet she takes HRT. And then she did this menopause M word or whatever. There was a week with, and she and Hillary, Dr. Henry, change seats. They interviewed each other. And she talked about HRT. And one of my friends text me and said, Louise, you've got to get on this program.

And I was like, wow, how do that? And I didn't quite remember how I managed to do it. And then I just thought, actually, these people are really powerful. And I was already doing some work with Lizelle, who, as you know, is very inspirational. And I thought, actually, if Liz or Lorraine say they take HRT, that's far more than anything I can do. And I also, as you know, it all sounds very lovely the work I do, but it's really hard and I get a lot of backstabbing from other healthcare professionals, but also sometimes women as well. And there are lots of times that I have really wanted to give up, but as my clinics got bigger, I've had more doctors working with me.

And the doctors are then saying, gosh, Louise, this is a real problem. I had no idea these women were struggling because in my surgery, I'd never let them struggle. And the more you realize that what you're doing is right. And I think it's really helped actually having you, Kate, that you've come for as a complete outsider, if you like, with no really real preformed ideas about HRT or about the menopause or about the health risks. And you keep texting or emailing me to say, oh my goodness, I've just read this paper or that paper. And it's actually confirmed and thought, no, actually, I am going to hold my head up and I'm going to ignore the haters and just going to keep going. with evidence-based medicine. And I sort of think if you're persistent and consistent,

then people will start to listen. Whether they like it or not is another matter. But actually, I'm only saying fact, I'm not trying to sell snake oil. And I think when there's more people working together, creating a noise, then you feel, actually, no, this is right. And the days that I feel like I're giving up, are followed by another day where I see women,

in my clinic who is either suicidal or given up her job or just really struggling. And I think, well, if I can't help them, then where else have they turned to? Because these women are at the end of their tether. So it's an insurmountable job to improve menopause care. And I could never do it. I can't do it on my own. But I don't need to because there's other people working. And I think this documentary will just reach the hearts of so many women but people as well and you know it is all about women but it's not just about women is it i think it reaches everybody and i think that's what's so important isn't it well there's everybody and everybody's partners and you know male or female or whatever it's so important because all those marriages break up in those years between

45 and 50, my own marriage broke up during the time. And I don't know whether it was, you know, emotional or perimenopausal, but the whole lot comes together. And it's a really, really dangerous time. I mean, for me, my mum was dying of Alzheimer's. I had three kids. I had a full-time job at the times. And I was wildly perimenopausal. It was all sorts of really interesting, you know, heart palpitations that I got sent for, you know, electric cardiograms for them. And I mean, it was like, you know, I was possessed by something. And I just didn't, you know, I'd always been in control of my life. I'd always worked hard. Always been able to sort things out. I could fix my mom. I could fix the kids. Suddenly I couldn't fix anything because these hormones came in from above.

And it really was very humbling to realize that I am no longer in control. And at that point, I also began to understand, you know, all the people that, you know, are having a terrible time of depression or struggling. And when you yourself are aware that something else is controlling you. It's a real revelation, you know, and for a lot of women, particularly working women with kids, this moment when they've just kept juggling everything brilliantly, just brilliantly, and suddenly someone takes away the ball. But it's very scary, isn't it? Because I think lots of us have bad days. Lots of us think, oh, I can't hope. But you know tomorrow will be okay, or you'll have a sleep, or you'll go out with a friend, or you'll do something to feel better.

but actually it's constant and you can't control it. You know, I think that's what's really hard. I found I couldn't control my emotions. I couldn't control my mood. And it's really hard when you're used to being in control. You're used to just doing things and it's effortless. And suddenly you can't even remember where you put your car keys or you can't remember what you're supposed to be doing.

It's really horrid. And it is this psychological impact that is huge. And the program does mention that as well, doesn't it? And it's very sad how neglected women are, actually. I can't think of any area of medicine that people struggle as much to get evidence-based help. But I'll tell you what is the most exciting thing about this. And it's turned out to be such a positive experience. And I think it's what keeps propelling us forward is the long-term health effects of HRT,

the good HRT. And it's like someone has just opened this sort of wonderful toy box, and you're going in and you're going, oh, my God. So, you know, it's going to help heart disease. I've got really stiff joints. Oh, my joints work because the estrogen is oiling my joints, you know. And you suddenly realize, particularly on osteoporosis, you know, that, you know, you know, you and I love a statistic.

Don't really stop exchange them all the time. But, you know, in that year between 50 and 60, lots of women lose about 20% of their bone density and don't notice until they fall over. And that estrogen, if you've taken it from you were 50 to 60, keeps your bone density at the same level. And that to me is this huge gift that we can give the world, that we're not allowed to give the world, that doctors don't know about,

that the Royal osteoporosis society should be waving banners from planes saying HART helps you with osteoporosis. You know, and it is extraordinary that we're not seeing that conversation. And I think it's a deep, deep ingrained. We don't care about older women. I don't know people are even thinking that. It just is the way. You've got to go through menopause,

and it's awfully sad if you break a bone. And no one is thinking around this in an intelligent way. No, you're absolutely right. And I think what's really hard in medicine, you're a bit like you're in a hamster wheel. You're just in this conveyor belt, really. And it's absolutely difficult to think of anything because you're busy, busy, busy.

And as a GP, you're seeing so many patients you get home. And then it's another day and another day. And it's not until you can have a bit of time. I had the luxury of working part-time because I had a portfolio career. So when I was preparing writing an article, I would have to sit down and research it. As you know, you can't just write. You have to know what you're writing about. So there are times when I was writing about osteoporosis, for example, and I thought, right, what's the etiology?

What are the risk factors? Oh, early menopause. Why is it early menopause? Well, what's eustrogen got to do? And then it's this light bulb moment that you think, oh my goodness, estrogen is saying, well, where else does estrogen work? Oh, it works on every single cell. Well, let's think about immune function. Let's think about brain function. Let's think about bladder function. And then you just, it's this whole, like you say, this box that has been

closed in the back of a wardrobe that you suddenly realize. And certainly when I lecture quite a few healthcare professionals, they say, gosh, it's quite an epiphany lecture because you're telling me things I had no idea about. And we learn from our peers. We learned from, what we used to learned from textbooks, but even online. And it's so confusing. And it's even the osteoporosis guidelines, as you know, don't really mention HLT, even though it's licensed as a treatment for osteoporosis. And a lot of osteoporosis specialists I talk to just say, well, I don't know how to prescribe HLT, I would never give it for osteoporosis. And why? That's completely wrong. Yeah. And the other thing, particularly for me, because my mum had a long struggle with Alzheimer's

and died of it in 2015. And obviously, when you get that brain fog of perimenopause, and I was particularly disturbed by it because, you know, I was a film critic. So I was remembering 350 films I saw per year. I was remembering the names of all the directors, all the actors, and I had to often do it on stage in a cinema. So I had to have this really fresh memory.

But I was writing a shopping list, and I was writing the word down for something to shave my legs, and I wrote, shaver. And I couldn't write Rosa. and I lost that noun and I thought my memory was a bit odd but I you know it wasn't like forgetting a director's name I couldn't remember an ordinary

noun I thought something is terribly wrong and I've got Alzheimer's then I've got HRT and of course my memory came back and I could write a shopping list but it really made it clear to me what was happening to so many women's friends and that terrible fear when you do that

and you can't tell anyone I didn't tell anyone about it but I just thought I was going mad and having seen my mum going mad My poor mom, you know, she was fantastic and a really hardworking lady who worked for the Citizens Advice Bureau, you know, was always trotting around in high heels. She, you know, she had a huge amount of energy. And suddenly, you know, she was repeating herself of two seconds. And it was really, really hard. So one of the amazing things that's come out of this for me and for my daughter, I think, is that I've studied estrogen and Alzheimer's. And the research is still in baby steps,

but the effect that estrogen has in your brain is extraordinary. And there's been some work at the Mayo Clinic looking at women over seven years on transdermal estrogen and looking at their brains before and after. And the ones who've been on estrogen are not showing the deterioration and are not showing memory loss and tests. Some of the ones who have taken nothing are showing the beginnings of amyloid plat, Alzheimer's. And that's a tiny study. It's not many women.

You know, I interviewed the people who did the study. But for me, that's the most important thing on earth. that's the thing I want to tell everybody. And, you know, there should be more studies. And why is Bill Gates putting $50 million into some other kind of Alzheimer's approach? Why are people looking at women and pulling attention to women first and then, you know, it'd be great to help the men too.

And I don't know how to help them. But, you know. Yeah, but it's still half the population, isn't it? And actually, dementia is far more common in women. And for many years, we've all been told us health care professionals, it's because women live longer than men. And it's not at all. due to that. And we know that estrogen has such an effect. It's really important for the metabolism

of the brain, but also testosterone. And there's a very small study that shows that testosterone reduces this amyloid deposition in the brain, which is linked with Alzheimer's. But there's so little, most research that's been done with testosterone in women, as you know, is libido, which don't get me wrong, libido is incredibly important. But, you know, if your brain functions better, your libido will improve as well. And, you know, there's such little funding in women's health, but even less when it comes to menopause. And every article that you read in the medical press always talks about the WHOI study, which again, helps back to older evidence and older HRTs. So we need to be doing more research. Absolutely. We've got lots of women who are prepared to undergo trials and to be

monitored, but there's no funding for it. It's absolutely shocking. Well, this is why we need the menopause charity, Louise, and luckily, luckily you founded the menopause charity. So tell us a bit about that, because I'm helping you with the charity too, and we're just in the initial stages. So, I mean, the charity is obviously something I tried not to do because it's a huge amount of work and, as you know, it is proving to be a huge amount of work. But we wanted to do it to obviously reach as many women as possible because you've already said it's not just women in the UK, it's a global health crisis actually that menopause isn't being addressed and the charity is a really good way of helping that and helping as many women as possible if we get it right. And

what's been hard, hasn't it, Kate, is there's so many things the charity could do. There's a huge amount because this is such an unmet need. But over the last few weeks, we've been trying to focus, focus, focus, and the programme that you've done so brilliantly is helping us focus that. And before the programme was really launched, we're very lucky that we've got Davina as one of our main ambassadors. We've also got Lorraine Kelly and we've got Liz Earle as well, who are just such amazing women, but we've also got lots of supporters, really incredible people who want to support the charity.

But more and more, we know that women need more information. We know women need more helping the work. place. We know women need to keep their jobs and their partners, everything else. But actually, what we know is that more and more women need to take HRT actually because of the evidence. So we've decided our main priority is to try and find ways of improving access for women who want to take HRT to be able to have it rather than being refused or given antidepressants or given anything else. And so that's something that we're really going to start to campaign. with the charity and we've got the most amazing team of people working with us haven't we?

So hopefully make it happen that we're all quite amateur with this. But fearless, we are fearless. Because I think we've got a good cause. Absolutely. It really matters. It will change millions of people's lives. It totally does, you know, and I think some of the work I do, I think, well, actually, even if I've only helped one person,

that's one more than I helped yesterday. But I think working together and I think women are, good at working together actually and I think they're quite vocal and they're quite persistent and don't want to stop so it feels like the beginning of a really exciting journey that I think you know we can continue forever and menopause is never going away it's not a fashion it's really here to stay forever so if we can lay sound some really good foundations in the charity that's going to be something that hopefully we can always be proud of as well yeah So there's a lot happening and hopefully the charity will have announced even more about what it's doing by the time this podcast comes out and we can talk more about things.

But also we've got Kate's book to look forward to which is coming out in a few months which what's the title of the book? Unfortunately, not my decision, but I think it's quite funny. Everything you need to know about the menopause brackets but we're too afraid to ask. But, you know, that's what it says in the tin. And I think it will probably be out maybe near October now, actually. But either way, I continue to campaign until, you know. Yeah, well, you can come back and do another podcast when the book comes out because the Channel 4 documentary, for those of you that haven't seen it,

you need to watch it. And if you have seen it, then you should let your friends and family know about it to watch it as well. So it's been really great talking to you. and I'm just really amazed with how much you've learned such a short space of time. So before we end, I would like to have three take-home tips, if possible. And I think because you're so clearly passionate about the plant-based body-identical HR2, which you have every right to be, what three reasons would you give for taking HR2? Oh, God. You know, immediate saving your life, saving your work, saving your relationship,

making your body work, it's fantastic instantly. And then in terms of long-term health, I think the research there is fascinating. And if you are in a family that looks like it has osteoporosis or Alzheimer's coming down the pike, I would be paying a lot of attention to good HRT. And actually, the third thing I want to say is not about HRT, is I want to say to all women,

tell your menopause story and tell your perimenopause story. Because everybody I talk to now tells me their story, and then they tell more people. And menopause is so different for everybody. And I think we really, really need to talk about it more and more and more. And some of these stories are beautiful. You know, I'm really happy. It works out really well for me, you know.

Absolutely. I think that totally we learn so much by sharing. And to be not inhibited by sharing and not feel embarrassed because I think the more we talk, the more we realise there's things we can help each other. So thank you ever so much. It's a big break. Thanks, Kate. Thank you.

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