The Dr Louise Newson Podcast - 114 - Writing ‘Preparing for the Perimenopause and Menopause’ with journalist, Kat Keogh

Episode Date: August 31, 2021

Dr Louise Newson’s new book, ‘Preparing for the Perimenopause and Menopause’ is now released by Penguin Life as part of the Penguin Life Experts series. Health journalist, Kat Keogh, worked with Dr Newson to write the book, and in this podcast episode they discuss the importance of creating factual and engaging information about the menopause, not just for women but their partners, children, friends and colleagues.  Kat Keogh has worked as a health journalist for 15 years and currently writes for a nursing journal. She collaborated with Dr Newson on her first book in 2019, the Haynes Manual on the menopause, and Kat is passionate about writing to not only educate but empower women in their perimenopause and menopause journey. Now that she has all this knowledge from working with Dr Newson, she is better prepared for menopause than her grandmother was, whose only means of coping was to go and shout down a well at the bottom of her garden!  Kat's 3 reasons to buy Dr Louise Newson’s new book:  For women, it's all about empowerment. Have the knowledge to get the best treatment for you.  For men, it’s a great window into understanding what’s happening in a woman’s life at this stage, whether that is your partner, friend or colleague.  For a teenager, it will be an eye-opener. Teenage hormones and menopausal hormones can be an explosive combination. This book is very easy to read and can be digested in small chunks.    'Preparing for the Perimenopause and Menopause' published by Penguin Life, is out now and has reached Amazon's Number 1 Best Seller on its launch day, 26th August.

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, Kat Keo, who I've known for a few years now, we were introduced actually by a journalist when I was starting to write my... first book, the Haynes Menopause Manual, I needed some help because I have very little time and lots of knowledge. And so someone called Sarah, she very kindly introduced me to Cass. And then she came up to Structupon-Avon to meet me and we had a nice cup of coffee and, well, I don't

pick coffee, but we had a drink. And yeah, the rest is history, as they say. So welcome, Kat. Thanks for joining me today. Thanks, Louise. It's lovely to be here. So just tell me a bit about you and what you do in your background, if you don't mind. to put everything into context. Okay, well, I'm a health journalist by trade. I've been a journalist now for about 15 years. Day job, I work for a nursing journal, but I also do projects like helping your good self out.

And, you know, previously I've worked at the mail on Sunday on the health desk. So, you know, health is my passion, really. So I've been really lucky because, you know, I've combined the writing with the sort of health aspect, which is brilliant because you, you know, selfishly you get to learn an awful lot but also for the reader you know you get to impart lots of knowledge from talking to people like you so yeah it's such a skill actually isn't it and i mean i've been a medical writer for 20 years and i have had the privilege of writing a lot for well when i say

patients are not all patients but you know none healthcare professionals i should say and you can really reach so many people by getting it right and i think certainly in the space of the menopause and Merri-menopause, journalists have been fed wrong information for so long. And so it's very easy for someone at me to criticise journalists, but how can I criticize? They're just doing their job and they're regurgitating and writing about what they've been taught. But it is so powerful to be able to reach people who are the ones that are suffering when it comes to the perimenopause or menopause or the ones that are indirectly suffering when you think about men. So when you were approached by Sarah a while ago and introduced, did you know much about the menopause and perimenopause? or what were your thoughts initially?

I probably fudged it at the time, but I really didn't. I think when I first met you, I was getting on for about three years ago now. I was on maternity leave after having my second baby. I think I was just probably very tired. And I must admit, I do remember having an initial phone chat with you. And I think I was like, must have been on the tube and lost signal and I had a phone message from you.

And we spoke on the phone and I remember having to, after I got the phone, having to Google what perimenopause actually meant because I've never really heard of it. And, you know, I'm a health term list and you'd expect me to have really heard about it before. But no, it just wasn't in my vernacular at the time. Menopause was, but only from, you know, I'm, gosh, I can't remember a whole. I'm now 38. So, you know, at the moment I'm not at the age where many of my friends are menopausal.

So the only real experiences I can remember is hearing my mum talk about it. or not my grandma, but hearing stories about my grandma. Yeah, so not an awful lot. So this has been, like I say, it's brilliant from a selfish point of view because I've got all of this knowledge and facts now. So in the next few years, you know, I will know, hopefully you have an idea of what's happening and when, which I wouldn't have had at all had I not met you.

Which is fantastic. Because I remember you come in when we met in real life and you had a big notebook and you kept writing and writing and writing on this notes. And I could always feel how your brain was connecting and learning all these things, but not just learning them. You're wanting to know more and wanting to get behind the facts. And it's all very well me telling you things, but you've got to make sure that they're real and they're true. And what I'm saying is right. And then we managed to persuade Haynes to do the book.

And I was very clear that I didn't want you to be thought of as just a ghost writer because actually I sort of say to people as like you're my stalker actually. you sort of get behind everything that I do. I'm actually outside your house right now. But you have to, you have to immerse yourself because you know, you want someone to read an article or read a book or listen to a podcast or anything, pick up my magazine and you want that person to, you know, one be informed and the way that you write things,

you know, you've got to make sure you've got the facts, but it's engaging. And it's all about empowerment. well because, you know, the difference between picking up a paper or a magazine or a podcast versus a textbook is you've got to put those facts into context, make them relatable. And I suppose that's what was really a dream sort of working with you is that you talk to so many women anyway and partners, you know, you've got a massive reach on social media. So I suppose that's where the stalking aspect comes in that I can, you know, just, I know that

every morning you'll post something on Instagram. and within minutes you'll have dozens and dozens of comments from people either saying that's exactly how I feel or, you know, and it's amazing because it's seeing the reach that you have on social media just shows how important it is that you get the facts out and you get the balanced information out. Yeah, absolutely. It is really important and I know, like I knew I wanted to write this book, but I knew I couldn't do it justice if I was getting home every night and I'm exhausted because I'm doing so many other things. things. But I also knew that I had this big wealth of information. So it's very different if some other books where, for example, a ghost writer has to find the content and then write it in someone. So I have written books before, but they were more factual for healthcare professionals. So this is my first non-health care professional book, if you like, but I very much wanted it to be a two-way process. So I wanted your involvement, but I didn't want you to just hand me the

final thing for me to sign off. So we had a very reactive time and really shaped and developed something that I'm really proud of. And now, first forward, we've now brought together another book, haven't we? Which this time, we've managed to get perimenopause in the title, which I'm really pleased about it. So it's called preparing for your perimenopause and menopause. And so just explain a bit more about this book, if you don't mind. So the Penguin book, that's out late August, I suppose that's taking it to the next level, really. It's got all the facts in. It's got all the detail in. This time, it has much more. in terms of stories from women who've been there.

It's very much that thing of making sure that the reader, when they pick it up, knows that they're not alone. So this has got a lot more kind of first-person accounts or either women that you've met along the way or women that you've helped through your clinic. And it's really practical. I mean, there's a lot in there. There's a lot to cover in this guide.

They're called expert guides. And that's what they really are. It's kind of boiling down the essentials. but doing it in a really digestible way that you could hand this book over to your partner or your daughter or your son or your work colleague or even your boss. You know, it's not a book that's just for a woman who's menopausal. It's kind of for everyone who's got an interest. And really that should be everyone because it is such a, you know, it's an all-pervasive issue. And, you know, go into that quite a lot in the book about how it's, it's not an illness, it's not a disease, it's a hormonal deficiency.

And in the same way that, thank goodness, there's been lots of provisions made for women during pregnancy or after childbirth in the workplace. There's still some way to go. But, you know, it should really be, people be as open as they were talking about pregnancy. Even more open, really, isn't it? I think, you know, if I broke my arm, I wouldn't be embarrassed talking about it at all. And in fact, I get lots of sympathy because I'd go into work with a plaster cast. But I think one of the ways I think a lot about how to reach people, but one of the things I've been thinking the last few weeks is actually let's forget it being a women's problem.

No. Let's just talk it as something that happens and affects everyone. So if it doesn't affect you directly, it will affect you indirectly because you'll be a man knowing a woman. But if we look at the economics, so let's think about it as an economic problem. So let's not think about women. Let's not think about how awful their suffering is. let's think about how much it's costing the global economy. And actually it's many, many billions of pounds or dollars or whichever

country you're in because of lost productivity, women actually being prevented from working because of the menopause, but also the cost of the healthcare. You know, I just read yesterday that since COVID waiting list for the NHS 13 million people on a waiting list. And I was talking to someone very half in the NHS yesterday and his priority is to look at these people. And I was saying, well, there'll be a lot of people there who will be perimenopausal or menopausal waiting investigations for palpitations, for headaches, for urine problems. There'll be people waiting for joint replacements or for scans of their hips, knees.

And a lot of this will be reduced by cheap, easy, very accessible menopause care. And he took a while actually to actually think about that. And I said, but this is what we have to look at. Actually, we can free up money to those. that need it and also we can free up appointments and reduce the strain on not just our healthcare system but other healthcare systems across the world and you know a few years ago before I did all this menopause work I wouldn't have even thought like that I'd have just it's just women with hot flushes so just we give them HRT and that's fine but then you think

about all these women and actually there's now a lot of work doing quite rightly into polypharmacy so this is when people take more than one medication yeah a lot of women we see here in the clinic are given antidepressants, things like gabapentin, amatryptylene for nerve pain, pain killers for their headaches, antibiotics for urine infections, and so on, and so on, and so on. Actually, once I've been on HRT for a few months, they've actually come off a lot of these medications. And they're quite heavy-duty medications as well. Amatryptylene, it's my partner takes that for cluster headaches. My God, you know, I don't know whether it's an excuse, but you can't wake him up in the morning.

It's really hard. I mean, I saw a 36-year-old lady a few weeks ago in my clinic who had early menopause, and she had such bad vaginal dryness. She said it felt like acid had been poured between her legs most days. And at night time, she really couldn't sleep. And I'd given her some HRT. She felt a lot better about a year ago. And then she went to get some from her GP who said,

no, you're too young to be menopause or you don't need that. All her symptoms came back. So she saw a specialist, and they said, it's a coincidence. It was your hormones. You've got something called vulva dinia, which means pain, as you know, around it. So we'll give you amatryptylene. And he gave her a very high dose, 100 milligrams, which is a very, very high dose, probably four times what we've normally given.

And it was really knocking her out, but not really. It was taking the edge off the pain, but not really affecting it. So she came back here to see me with her poor partner who was in tears, a whole consultation. And she said, I've given her work as a teacher. I actually cannot carry on my life like this. it's so horrendous. And I said, well, what about having your hormones back? She said, would you really let me?

Because that's the only thing that's helped. And she just said, my goodness me, she says, this is a young woman who's got a future ahead of her and it's been stopped. Not because of hot flushes, not because of sweats, because of this extreme, extreme pain that no one has helped. And the treatment, as you know, costs pounds. It's really not difficult. But it's having, I think, tools that we can, like you say, empower women.

isn't it? So they can then actually say to their doctor, well, I'm sorry, but I think it is related to my hormones. And, you know, I understand you might not know much or have been even much education, but what I've read really points to this. And I also know, I mean, we've got a chapter, haven't we, about early menopause in the book, because it's really important these women are addressed. Yeah, and I think it goes back to that sort of building up your personal knowledge base will really help. I mean, what's been great for me over the course of the last few years, even in my own friendship group, you know, I've got friends who are HR managers. And occasionally, you'll get a text from them saying, what was the name of that book again?

Or what's the website? And it's brilliant to be able to direct someone just so is the link. You know, and it's the same I had a close family member last week saying, you know, I've got a friend, she thinks she might be perimenopause or is there anywhere that's good to go to? So I said, you know, try the balance up, try the Haynes Menopause manual, try, you know, your website. and it's the same with the new book. It's just, you know, a kind of one-stop guide. And, you know, when you go to the doctors, I think it's something like research shows

that the average appointment's like 9.2 minutes. Health professionals, as you know, they're time pressed, they're stressed. There's a backlog because of COVID. So actually, if you, you know, feel like you might have these symptoms, you've almost got your shopping list of how you're feeling. And you can say to that health professional,

here you go, this is how I'm feeling. is it in a nutshell. That's so much more powerful than waiting for the question to be asked. And then coming out of that consultation or that appointment, feeling like you haven't quite got to the number of what's happened. I think so. And I think, you know, we always used to say sometimes in general practice, oh, I just want the woman who needs a pill check to come through.

So this is some young person fit and well who needs contraception. And actually, most pill checks now are done by nurses, as you know. But I would love it if one slipped through to me because I think, oh, that's great. because it will take me probably five or six minutes to explain the pill and contraception, give leaflets. A lot of the young women or girls knew a lot about contraception because they'd really thought about their choice. So it was a very informed, empowering consultation where the patient got a good result. I felt good because I knew what I was doing. It was very, quite formulaic medicine, but it was good.

I wouldn't want to do it every day or all day every day, but actually to have one or two of those in a really busy day. Just was like, great. Yeah. But then I think the menopause at the minute, a lot of doctors and nurses are thinking, oh, I'm too busy. I don't want menopause. I don't want these women complaining, la la la, la, la. Whereas actually, as you say, if the women are empowered, they've gone to the balance act, they've downloaded a house report. Yeah. If a woman came to me as a GP and said, I'm menopausal. These are my symptoms. This is what I'd like. I know HR

too safe. I'd like the gel and I've got a womb. I'd like progesterone. Then it's like, wow, actually, I've got eight minutes now to talk to you about that. And I might not need all those eight minutes because the woman's already listened to podcast. She's read the book. She's watching videos and it's really empowering actually. And so that's how I want to, a lot of the work that I'm doing outside my clinic through my not-for-profit and everything else is giving clinicians the tools that they're really confident because what happens now is a lot of patients and women do that. And then the doctors think, oh, I don't know how to prescribe HRT. The computer's telling me it's really dangerous. So I bet not. So although she's telling me it's probably,

safe. I'm not sure I believe her. So let's give her some antidepressants because I'm learned. And that's not the doctor's fault. It's because they haven't had the training. Yeah. Yeah. We can improve the training. And I'm sure with you working for the nursing journal that you can sort of hear and see there's a big interest from nurses as well, isn't there, for leading menopause care? Definitely. There really is. And I think it's that kind of, you've hit on it then. It's that lack of initial training. It's that you wouldn't tend to cover of menopause on a pre-registration nursing course. You know, if you're a practice nurse, then this is different because you'd be dealing

with it a lot more. But you say that, Kat, but they should actually. So every nurse that sees an adult should. So if you were a cardiology nurse, if you were a urology nurse, if you were a nurse with a special interest in rheumatology, for example, you will definitely be seeing menopause or women, but you won't be looking out for them because you've not had any training. No, no, but you'll see them, but they might not present with how I'm feeling. it might just be a side issue.

But I've certainly found that, that I know that you've had a massive upsurgeon, surgeries getting in touch with you for training, which is brilliant. And I think compared to when I first met you three years ago, there is much more of an appetite for knowledge now, which is brilliant to see. And that's both sides, I think. That's both in health professionals themselves,

also in the public and not just women. Absolutely. You hear that kind of, have you got a menopause, workplace policy or menopause banded about. And actually that's just the starting point. Yeah. You know, it shouldn't be tip box. And, you know, if you're a manager, whether you're, you know, working in HR or just a line manager, you should be able to feel confident to be a sounding board for someone if they want to talk about the menopause, but equally if they don't, that's fine. But just knowing that there's someone there who's supportive is really important. And also someone

that might pick up your symptoms, you know, I wish five years ago when I was struggling with all these symptoms, but thought it was just because I was working too hard, I wish someone had knocked on my door and come into my room and said, Louise, you're running a bit late, you're a bit chaotic, you keep forgetting patient's names. Is there anything going on? Have you, you know, what are your periods like or something? Or just giving me a booklet, I would have realised what had gone on, but I didn't. That's kind of way where some women have that almost like the penny drops where someone goes, is of any chance you might be pregnant.

Yes. Oh, God, yes. Maybe I am. Because I, you know, in my life, my mum had cancer when I was about eight. So she went straight into a surgical menopause. It's early 90s. So I never really had those, you know, my mum would talk to me about being, remember her being on HRT, but this was, you know, the 90s.

I was year and I was probably too bothered about going out to play. So we never really talked about it. But I always remember her saying my, well, it's, my dad's mum, so her mother-in-law, she lived in a rural part of Ireland, and her sort of version of HRT or her treatment was going to a well at the bottom of the field and shouting down the well. She had hotbeds. So that in my family was about the measure of the chats around menopause, but now since working with you, my mum would say, or there's someone on the telly talking about it, my sisters will talk to me about it, and it's brilliant. And that's how it

should be. Yes. And I think it's great because we've got some celebrities. I'm not star-struck at all. You know, all these women, they just have different roles, don't they? And getting people like Lorraine Kelly and Davina McCall to talk is very, very powerful, actually. And there is now this Divina effect following the Channel 4 documentary. And a lot of my friends who are GP say, Louise, I used to be prescribing HRT once or twice a day and now it's eight, nine times a day. And I'm thinking that's great. And, you know, what Davina and obviously Kate Muir, who is behind the program, has done for the history of the menopause, actually, is going to be phenomenal. We're just starting to see it. And the work what we started to do with the menopause charity

is just quite instrumental, actually, making a real difference to future generations, I think. I remember talking to friends, I think, in the days after the documentary aired, and it was saying, I was at football on a Saturday morning watching my kids and all the other moms were talking about it saying, have you seen it? And I can't imagine that happening a few years ago. And it's right. It's the, you know, people like Davina, Lorraine, you know, Meg Matthews, it's fantastic what they've done in being basically talking about their own experiences. And it helps other women either recognize similar stories in their own or have the confidence to, you know, approach their doctor or talk to their partner or children about, you know, the way I am at the

moment is because of X and you know. I think it's also joining the doctor, isn't it? So talking about it is one thing, but actually knowing that there's treatment as well and actually knowing that the treatment is just reclaiming your own hormones, it's not a medication, it's not a drug, it's not something with side effects and actually for most types of HIV, it's not even something with risks. And I think it's always been sort of a bit shameful to talk about it and also like you're giving in to something which you shouldn't.

It's almost like, I don't know, it's weird, isn't it? because a lot of people when they have a childbirth, they'll talk about how awful and painful it was, but you always, I think the menopause people feel they have to have a bad experience or it has to be really bad if they ask for help. And we know lots of people aren't going to the doctors because they feel it's wasting the doctor's time.

But actually, if you think about it as something that causes disease and increases risk of disease, it's really fundamental, especially now in times of COVID, you know, COVID, long COVID, none of this is going away. So we need to really make our immune system as strong as possible. And one of the ways of doing that is by having estrogen because it helps the way our immune cells work. I think that's one of the things that perhaps isn't quite as well recognised, I think, is the long-term risks. Yes. Medi-cardiobascular disease, osteoporosis.

It's not sort of talked about so much and it's so important. Absolutely. I mean, there was just a study that came out just recently showing about reduction of risk of dementia with women who take HRT, especially body identical HRT. And that's really, really important because most of us are scared of dementia. You know, there's something like osteoporosis, a lot of people don't know about, they don't realize how bad it can be for a lot of people. But we all know what dementia is and we all know how we don't want it

and we don't want our family to be subjected to having us with dementia. So it's so important to know that we actually have a treatment that reduces the risk, but people don't know that. So there's some really big messages that we need to keep delivering, don't we? And there's quite a lot in the book. What's good about the book is that it takes each thing in turn. There's a chapter on diet, but not a diet, just around how a balanced diet is, it goes hand in hand with your medication, exercise as well,

because I know that was, you know, one of the things you were saying that it's not about suddenly getting a really expensive gym membership or buying all this. It's about figuring out what you're interested in, what you might enjoy and keep at that. And it's got lots about the long-term risks and, you know, benefits of treatments. It looks at mental health.

I mean, there's a whole chapter looking at sleep. I know you were really passionate. about having that in because that's a big issue. I think because it's quite bite-sized, it's something that you can give to a colleague or a partner or a teenage daughter or son and say, read this. Yes, and it's got a nice, bright, simple cover, hasn't it? And it's written in a way that you don't have to read, cover to cover.

I mean, I know my husband just laughs. I keep bringing home different sort of self-help books and various, you know, different books and they're all next to my bedside. But sometimes I just different and out. And I just get a quote, or I just get some. something and actually one sentence can actually change my life sometimes thinking, you know, I was really something about meditation recently and just little things. You think, yeah, actually that means a lot. That makes sense. And I think there's a lot of people who think all I do

is think about HRT. And I don't touch the, I think I know a lot about HRT, but I also think about this whole holistic approach and about choice and about future health, actually. So, you know, So HRT obviously is replacing the missing hormones or topping up the missing hormones, but we have to have responsibility for our health. And I think we also have to have responsibility for keeping away from doctors once we know what's going on. And so a lot of that has to be done with diet and exercise and actually sleep and other things. So I think we've tapped from other experts as well, haven't we, in the book, which has been

really useful. Yeah. I mean, there's everything about sort of good skin health. you know, how to do a pelvic floor exercise step by step, which is a good one, you know, breathing exercises, different poses for yoga, you know, and it's all simple, it's all relatable, you know, this isn't a sort of 10-week planned to do you know, absolutely. And even I just got my hairdresser actually to say that, which hairbrush are. I think what's good about it is people that you've worked with and you've spoken to along the way.

So, you know, we've just got loads of really good expert advice in there, stories from women who have been there as well. And then, you know, they're all wrapped around or threaded all the way through that is your expertise. And I think, like you say, it's something you can dip in and out of as well. It's an enjoyable read and it's, I suppose, about making menopause a really empowering part of your life. Because it's such a huge, is it, third of your life that you are postmenopausal? At least, yeah, for a lot of women, it's even longer. So we have to embrace it and we have to make the most of it. So I'm really grateful for your time to talk about it.

And I'm also publicly, very grateful for all your time and effort. And also your amazing approach and patience, really, to keep working with me on this. It's been brilliant. And so I just looking forward to seeing it in the flesh because I so haven't seen it in the printing us yet. So we're very excited. So before I end cat, I would just like to ask. ask three tips for why to buy the book. So I'd like one tip for a woman to buy it, one tip for a man to buy it, and one tip for a teenager or a child to buy it as well.

Okay, right. Tall order. Okay. For a woman, I suppose the tip is it's about empowerment. It's giving yourself the knowledge to get the best treatment for you and giving yourself the tools to lead a happy life, I think for men, a good window into understanding what's happening at this point in your partner or a colleague's life. And I think for a teenager, it'll probably be a good eye opener to see. Because, you know, teenagers and menopausal hormones, you know, can be quite an explosive combination. But I think this will be, and it's written in a way that's really easily digestible. So I think anyone of any age could read it. So what we're basically say is that it should be in everybody's bookcase and probably in every library and workplace as well.

So there's no reason not to buy it is what we're trying to say. We're not here for plug for the book. We're here for a plug to improve knowledge to empower women. That's the most important thing. Absolutely. I think you've hit the nail on the head. It's for everyone really. And that's what, you know, menopause is everyone's business. It's not just something just for, women, it's not a taboo subject. It really is everyone's business because it affects, whether it's not you, it will affect you indirectly. And, you know, this is a really good, solid guide to the sort of gauntlet of symptoms, treatments, you know, and also, you know, most importantly, the strategies that you can put in place to have a happy menopause, a fulfilling sort of stage

in your life, really. So brilliant. Thank you ever so much for your time today, Kat. Thank you. Thank you. For more information about the perimenopause and menopause, you can go to my website, menopausedoctor.com.uk. Or you can download our free app called Balance, available through the App Store and Google Play.