The Dr Louise Newson Podcast - 141 - Helping organisations change their culture around menopause with Sarah Davies, Talking Menopause

Episode Date: March 1, 2022

Sarah Davies is an experienced business coach and trainer who previously spent over 15 years in senior international corporate roles and as a head-hunter for senior executives. Sarah supported her sister, Dr Louise Newson, as business manager, six years ago when Newson Health menopause clinic was launched. Seeing how devastating the consequences of the menopause affect personal and professional lives, Sarah set up Talking Menopause to educate and support men and women across all levels on the impact of menopause at work.  In this episode, Louise and Sarah look back on starting their respective journeys into menopause care and support services, and discuss the real-life impact of the perimenopause and menopause in the workplace. Sarah shares some of the outcomes of her workshops and webinars and describes how Talking Menopause stimulates cultural change within organisations. Sarah’s advice to workplaces: Everyone should be aware of the peri/menopause and respond to it as a normal process for their employees and their partners. Consider the practical side; where is the safe space for women to escape to? What are the practical solutions for women suffering at work? And to women at work: Don’t suffer in silence, talk to a friendly colleague, download the balance app and go and see your healthcare professional if you’re not getting the right level of support. There’s a lot of help out there. You can learn more about Sarah’s work at www.talkingmenopause.co.uk

Hello, I'm Dr Louise Newsome and welcome to my podcast. I'm a GP and menopause specialist and I run the Newsome Health Menopause and Wellbeing Centre here in Stratford-Bron-Avon. I'm also the founder of the Menopause charity and the menopause support app called Balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. So today with me, I have someone I've known actually all my life. She's my older sister, so older and wiser, you might say, and she's been working in the background in menopause for a while, but never trained as a doctor.

We have very different backgrounds, very different qualifications, but now she works pretty much all the time about the menopause, which we'll talk about in a minute. So it's my sister, Sarah Davis, So hi, Sarah. Thanks for joining me today. Hello. Good to be here. Thank you. So you're three years older than me. And a lot of people think I'm older because I'm far more boring and all I do is work and all I've ever done is work. Whereas you're far more interesting and sociable than me. So obviously I went off to medical school.

I don't think we've got anyone in our family who's medical, have we, who's medically trained. No, not at all. So I sort of went off. We've always been very respectful of each other's careers and what we've done with our lives. Then a few years ago, I was setting up my clinic. And as many of you know, I set it up privately because I wanted to get some of my friends off antidepressants and I couldn't get a job in the NHS. So I was working just one day, a week, in a local hospital. And I needed someone to just help me, really. So I reached out to you to say, is there any way you can help me? Obviously, you live

nowhere near me. And how come we would make this work? And at the time, I don't know that you knew much about the menopause and you said, yeah, I'll help you. And then the rest is history, if you like. I know. I often quote that one conversation we had literally sitting around your kitchen table and it was so out of the blue and you said, I'm going to set up a menopause clinic. And it was, oh, okay, fine. And what does that really mean? And I remember within 20 minutes, we had literally mapped out the patient experience. Do you remember a flowchart of how it would work? And yes, you're right. I knew very little about menopause. my background is corporate life. I've always massively admired you as a doctor and I remember you

always being impressed with my linguistic skills, which I thought was crazy given the amount you have to remember as a doctor. And I often remember sitting in my oak-handled office as a headhunter in London and I remember phoning you in the lunch breaks and you were rushing around doing your home visits as a GP and thinking I really want to give more back to society. And without realising, at the time, my work as menopause has really done that. And I think what was even an eye-opener for you, wasn't it, who knew so much about menopause, but the actual extent of the suffering worldwide. I mean, obviously, I focused mainly on the UK. It was just so shocking and very quickly, do you remember we weren't sure whether people were going to turn up at the clinic? And then before

too long, there were women borrowing money from families or friends driving up from Cornwall down from Scotland to see you. And yeah, and I think it was really shocking actually because I really, like I say, just wanted to help some local friends. I've been a medical writer as well as a doctor for many years and I set up the Menopals Doctor website as you know and that was stemmed from a very good family friend, Anthony Galley, who we went out for lunch, didn't we in London? I'd just been awarded the Fellowship of the Royal College of GPs.

Went out for family lunch and he said, didn't he, you should set up your own website. And I just went, oh, really, Anthony, I don't know how to do that. And then the next day I got this link to menopausedoctor.com. And they'd already started. So I'd worked very hard on that. And then I'd sort of launched the clinic and I really only wanted to do one day. And I remember we opened it in the August time. Yeah.

And my birthday's in August. I remember our mother saying, well, you're not very busy, are you? You've only got one patient and you've got none the week after. And I said, well, that's fine. I don't really want many people. I just want a few people who maybe can't get the HR2 that they should have maybe from their GP or the right advice. And then suddenly you kept saying, Louise, it's getting busy.

These people are phoning and this was all before COVID. We did no remote consultation. Must be about six years ago now. Yeah, it was because a nice menopause guidance, the National Institute of Health and Care Excellence came out six, just over six years ago. And it was after that, I opened it. And so then I remember you kept phoning me and saying, there's this lady who sounds really, really desperate, who's really upset and did it.

And I said, well, I'll get her in. And then I'm increased to do it. two days a week. And the stories that we were hearing were very different to any stories that I'd heard in general practice, because in general practice, obviously I'm in control of my patients and any that was suffering. I would try and sort them out very quickly, so there was not any of this suffering. And so I remember actually the notebook that I had and I used to write quotes on it, and I'd go home to Paul, my husband, and say, someone's just told me they have no joy in their life, that they have left their partner and that they've stopped working because they can't

concentrate. And I had no idea that women were suffering in this way. And you didn't either, did you? No, not at all. And actually now sitting here now reflecting back on that time, there were two stories that just sprung to mind. And one was a lady who called me about her partner and she was at her wits end. And I remember her saying, you know, my female partner is really struggling. She's almost, she's so, so low and depressed. She's almost suicidal. And we helped her, but thankfully she had such a supportive partner who knew really nothing about menopause either. And she was so grateful for the effort we made. And then there was somebody else, I remember, who had actually been admitted to a psychiatric hospital who just should not have been there.

And she knew she shouldn't be there. But she was guided by medical staff and felt she had no other option. And then as it unraveled, and then you and I realized that we were both perimenopausal, didn't we? Which I put my symptoms, which I've never like a number of women, or that's about 30%, isn't it? I've never had a hot flush in my life. But mine was very much anxiety. I felt exhausted wading through treacle the whole time. Brain fog, very erratic. But like most women, because everybody, male and female are on that crazy treadmill of life,

thought that it was the pressures of life and my periods had got really heavy for about four years. Two days a month could hardly go into the house but of course I was waiting for them to stop, not get heavier. And it was Sophie, wasn't it? Your then, was she 12-year-old daughter? Yeah, yeah. Who joined the dots for you.

Yeah, and I just got my notebook here, actually. And the first lady I saw, I said, she had 15 consultations related to her menopause in the past 18 months. She was at her wits end. She had bought a notebook and documented everything during the consultation. Because her brain was so bad, she couldn't remember anything.

And then she came back three months later and she felt wonderful I put here. Her friends noticed a huge difference. And her partner said, I wish you'd done this years ago. And she put, I do not like what this has made me. And, you know, it's really, really awful. So we started doing this. And then I remember you helped me write some notes up because I went to go and see the then chair of the Royal College of GP. Helen Stoits, Lampard, amazing lady, to say, Helen, I'm really, really worried, actually,

that women are having to pay to come and see me because they can't get evidence-based treatment on the NHS in the form of HRT. And a lot of women, as you quite rightly say, can't afford to come. They shouldn't pay. I should not be running a private clinic. But also, I was starting to hear stories of women going to other private clinics where they were not getting treatment. A lot of them were getting compounded bioidentical hormones, which are neither licensed or regulated. And I said, I'm really worried actually because women are struggling. And at that time, I had tried to get HRT from my local GP and I had been refused. And I said, look, if I can't get HRT, what about women who aren't speaking English at a first

language, who aren't educated? How are they struggling? And she was very, very lovely, but looked at me and said, but you've got a hidden agenda almost, you know, you're wanting to promote your clinic with this work. And I said, I'm really struggling because I really want to help education. I want the college to be involved in education. And I want women to we listen to. And, you know, and I understand for her, she'd never heard these stories because she's a really fantastic GP. So that was six years ago. I'd love to say that the Royal College is doing a lot of menopause education and sadly they're not. I'd like to say that

we're not seeing women who can't afford to come to my clinic. And I'd like to say that we're can't. I'd love to say that I've closed my clinic, but I can't. We now see. Or you are just focusing on very extreme cases, very complicated health conditions, which is really what you'd want to be doing. Which we are as specialists, but we're still not. I'd love to say it's just me working in the clinic, but we have 80 clinicians working in the clinic and we see over 3,000 women a month. And I'd love to say that we can see everyone that we want to, but I can't even do that because our waiting list is thousands. And obviously, I'm doing a lot of other education work, as you know, through my not-for-profit company. We've founded the charity. We've got the balance app. And I'm also working as an

NHS advisor. But it's not quick enough, is it, for these women who are suffering every single day. No, and not when you think it's six years, but we've been involved in the world of menopause. It's a long time. And yes, you know, we were just saying before we started, there isn't a day go by at the moment without a menopal story in the media. which is absolutely wonderful. Even Nicola Sturgeon was talking openly about her menopause, which is really fantastic to have those role models. But when we look down to those raw basics of the webinars I'm running day in, day out and my colleagues,

the problem is still there. That accessibility to the right treatment and also that knowledge and awareness. For example, every time I say at webinars and I've said it thousands of time now, very sadly and shockingly, the average medical professional and average GPs have very little or no menopause training, which is not them personally necessary to blame. It's the system and the medical training. But I'm so shocked that I even have to say that because also I've worked in customer services internationally for 12 years, as you know. And if other service organisations provided such a poor level of service to such a huge client base, i.e. at some point 50% of the population, it would be all over the press, something would be done about it. And that's as basic as it gets, really.

And that's what I really, really struggle to understand. You know, I, as you said, at the beginning, I'm not a medic, but a lot of our sessions that we run for women-only employees in the workplace is helping them really prepare for their perimenopause and menopause be equipped with the right level of information, signposting them to balance, to really make sure that they have that knowledge and education to have their toolkit when they go and see their GP, for example, and have that confidence to be able to say, I've done my research, I've got the symptom checker, I'm of an average age or might not be because we know it affects so many younger women as well.

Please could you consider me for as being menopausal and please could I discuss my options? Yeah. And so just for those people listening, obviously you don't work for the clinic anymore, Because when I moved my clinics to Stratford-upon-Avon three years ago, you're down in Bristol. I needed people in. So you couldn't. But I decided to sort of introduce you to someone who I'd worked with West Midlands Police. Because at the time, I was working with West Midlands Police.

And it was very interesting, actually. So West Midlands Police are the second biggest police force on me in the UK. And someone called Linda Bailey reached out to me just as a random email to say, could you come and talk? We've got a menopause support group at work. So I thought, well, this would be interesting. And I went to go and listen. And they were the most, they still are, the most amazing group of women, about 20 of them,

sitting around an oval table. And they were all just sharing their stories. And they were all talking about how they'd reduced their hours, how they had, a lot of them had stopped doing shift work, how they had looking forward to their retirement when they were 50. They were going to take early retirement. They were going to be with their grandchildren and whatever. But they couldn't really take the grandchildren to the park because their joints were

stiff and sore. They had no energy. they were drinking lots of wine. And I sat there and thought, what's going on? They're all menopausal. And most of them were on antidepressants. So when I said to them, what about HRT, oh, no, no, no, that's far too dangerous. So then I spoke to Yvonne Bruton, who as you know is a very formidable person in the police and said,

Yvonne, I cannot talk to you about any policies or any adjusted work packages, but all I can do is educate you about HRT and about treatment choices and about symptoms and about what the menopause means. and about the health risks. So I was there, as you know, for a year. It was amazing because they were very embracing and the demand really increased for awareness. And so then obviously I introduced you to Linda and you set up your company talking menopause, didn't you? So around that time. Yeah, that's right. And Linda had set up a menopause programme and initiative really across West Midlands police after her own experience when she was off work for three months and literally

went from running 100 front-line staff as a police inspector to overnight not having the confidence to walk out of her front door and didn't manage to find the right level of treatment at all through that three months. But luckily, had a male manager supported her back into work. And then she decided to put menopause on the map. And yeah, I really wanted to take menopause into the workplace. Menopause is still now where mental health was probably five or six years ago. It's very much where maternity and pregnancy was probably 20 years ago. You know, when I remember being very nervous telling my manager that I was pregnant about 18 years ago. And I look back to the early days of it when we were running face-to-face conferences,

a lot of police. The emergency services actually have been really quite at the forefront of menopause at work. And some of the first conferences that we ran for Devon and Cornwall Police were over-subscribed. We had 120 women in the audience. Our largest was 180 women. desperate to find out and know, and you can laugh thinking 180 menopause of women in one room, but it was absolutely amazing. And one of the key things for organisations is really important is to try and find some senior role models. And certainly across those emergency services

and even some NHS Trust and councils I've been working for, for example, recently, when they have a senior role model at the top of the organisation, who is actually taking menopause seriously, it really helps because so often conversations start at a grassroots level between women suffering at work and the menopause support groups, which are so invaluable, as you just mentioned, the example at West Midlands Police, because too many female employees at work feel so isolated and alone, think they are not normal. And as we know, about 10% on average leave work altogether. But if the women start, having the conversations is really supportive, but actually it's very hard often to then make

changes in the organisation or encourage managers to be aware. Because at the moment, until the treatment is more accessible for women, it's really important that the organisations do have that confidence around menopause and that awareness and acknowledgement. As one of my male clients, David Wilkin from South Gloucestershire Council, said to me recently, it's not as though women suddenly get an email saying, you're perimenopausal. This is what it's all about. So it's such a journey and a very complicated journey for any individual going through the menopause. And it's a journey for the organisation as well, how they understand menopause, increase awareness, increase visibility of it, included as part of that diversity and inclusion agenda, as well

as well-being, gender and actually know how to support and signposts their colleagues with practical solutions. It's not just about policy, a lot of organisations say, oh, we need a menopause policy. Well, policies have a time and a place, but often just gather dust on the shelves. It's about the practical solutions and practical guidelines that are so important about what reasonable adjustments individuals might need while they're on this journey until they can get the right treatment and feel better and on an ad hoc basis because, you know, women don't want to work less, do they? Most women can't afford to reduce their hours, for example. So it's really important that ad hoc flexibility around reasonable adjustments is discussed, but we know that

only about 10% of women actually have the confidence to have a conversation with their managers. Yeah, I mean, it all makes me really, as you know, because I've said quite a few times, really sad, actually. So if we think of other hormone deficiencies, because obviously the perimenopause and menopause is a hormone deficiency. So is there any workplace that doing any work on underactive thyroid for people that are hypothyroidism? Do they have any adjustments? Do they have any? Of course they do. Because why is that? Because they go and get thyroid. Exactly. The accessibility is there. And I think there's two issues really. Awareness is absolutely crucial. So as you know, I get migraine. Jessica, my daughter has really disabling.

migraines. So we need to have awareness about migraines that affect one in seven people, more common in women, can lead to massive absenteeism from work. Lots of people take time off work. For those people that don't understand migraine and think it's just a bad headache, they need education because when people have migraines, they often can't think properly, they can't, Jessica gets very coordination goes, she can't even walk up the stairs without falling over. I can't remember anything and I learn my speech sometimes. So, workplace have to be aware and I would love it if I had a migraine at work. Someone said, Louise, you look dreadful. Go to bed, take the day off, come back when you're feeling better.

So I absolutely think any chronic condition workplace have a responsibility, but that's about awareness like you say and time posting. If I was having a headache or a migraine every single day, I'd like one of the people at work to say, Louise, I think your treatment's not working. Do you need to go and see a doctor? And hopefully, actually, migraine is really underserved, but I might see a specialist. So actually, we're now talking about the menopause. It doesn't affect one in seven people. It affects 100% of half the population directly, so 51%. So I can't think of any, well, there shouldn't be any organisation that only employs men.

So every employer has somebody. Exactly. But actually, isn't it awful that you're having, and I'm. I know the story's really upset you, to listen to these stories of women that have to have support, they have to have adjustments until they get help. For a lot of women, they never get help for something that has medical health risks as well. So mental health, like you say, has been really good. But if someone was really depressed, clinically depressed, they would also hopefully receive treatment too. Exactly. And so it's just sad that, you know, you, you know,

do all these amazing webinars of awareness and a lot of women are on it who aren't just line managers. They are people who are experiencing symptoms. So they've got a personal interest and professional interest. But then they could easily get help. And I find whenever I do any workplace work,

if I said to people, right, tomorrow I'm going to come back and do a clinic, it would be amazing. You know, and actually, how awful that people can't get this treatment. I know. And we get so much feedback. back, you know, or at the end of our sessions, or thank you, you've really now given me the confidence to go back to my GP, and often it's the word back to my GP, as opposed to just to my GP, and, you know,

it's such a light bulb moment for them. You know, one that's recently that really sticks to mind, as I think I told you, but a lady from university hospitals, Bristol and Western, and we ran an online conference for, and she wrote to me and said, I need to write to you, I'm 58, I'm bald, I'm black, I'm saying I'm black because in our communities we just don't talk about women's health challenges. I thought I had dementia. I thought I needed therapy. I feel so liberated. I managed to stay awake through the whole day of the conference, which was unbelievable.

I've been suffering from years since the conference last week. I've been talking about my brain fog to everybody shouting from the rooftops. Thank you. Thank you for the bottom of my heart. I shouldn't have a job, to be honest, in a lovely ideal world. I really, really shouldn't. And hopefully that will change. And Linda and I, for example, we're both qualified mental health first aiders.

Why isn't menopause included in that training? Because as you and I well know, the psychological symptoms affect women so much more. The three from all the thousands we've worked with that affect symptoms that affect women most at work are definitely anxiety, brain fog and excessive fatigue. Yeah. And we did, I'm sure you know, this survey of lots of women. nearly 4,000 women and we found that 59% had taken time off work due to their symptoms. But what was really shocking was that half, so 50% of those women who answered the survey had either resigned or taken early retirement due to their perimenopause or menopause. And a fifth of women are

not going for promotion. And it's no surprise, is it? If your brain isn't working and you're feeling tired, you are going to reduce your hours. You are going to take a suboptimal job. And The other thing is this is why awareness and what you're doing is so important is that this survey shows that only 5%, so one in 20, actually had menopausal symptoms put on their sick notes. So a lot of women, and I'm sure you hear the same, are being told on their sick note, it is anxiety or depression or headaches. Exactly. Stress. So then their occupational health departments, even their line manager, might be misjudging them as well.

and they're not signposting them to the right help because, you know, their sickness record is incorrect. And I think that no one should be judging anyone for any illness, but there is this stigma. And actually as a GP, I used to put menopause at quite a lot on sick notes. And the first time I did it, it was actually for someone in the police force, one of my patients. And she said, gosh, what's going to happen? And I said it's going to start a conversation. And I think that would be a really positive conversation. But actually, the work we did in the the police is that a lot of women didn't even know their symptoms were due to the menopause because they hadn't been given information. And it's not all of the work you do is not just about

women. It's about men being educated as well. And what's the response like for men having education? Well, it's interesting. And actually one of our clients, Shropshire Fire, made menopause training mandatory for their managers, which was amazing because over 90% of, or 95% of their managers are male. And it was face-to-face workshops and they sat there with their arms clothes. and when we asked them what menopause meant to them at the beginning, we struggle to even get a word out of them. But then actually, once we started talking about it, they realised that indirectly they were going to be affected.

Some of them were affected, realised that their partners were going through it. So actually, incredibly supportive, to be honest. Yes, it helps if any male or female has had a personal story. But I think you can't be gender-specific. I know somebody who, for example, worked for a female manager. She tried to talk to her female manager about her symptoms. Her female manager was very dismissive, didn't want to acknowledge them, and the poor woman ended up going off sick with stress.

Again, no menopause absenteeism criteria for two months. So the men are really supportive. We ran part two of an open menopause champion course this week, and it was really interesting because we had a bunch of, probably on average middle-aged women from Devon and Somerset Fire and Rescue. So quite front-line staff, some of them, working shifts. And then we had a bunch of employers from a law firm, from new law solicitors. Now, one of those individuals training up to become a menopause champion to really signpost

and staff and increase awareness was a 20-year-old male law student. And we did role play. And he was amazing. He role-played as a menopause champion. And he was confident, he was empathic, he was reassuring. And when we talked to him afterwards, he said, well, he thinks his generation, and I think he's probably right, thinking of our children who are close to that age, are actually a bit more open about whether it's be mental health or what it might be in supportive.

But how amazing that, you know, a 20-year-old male law student is training up to being a menopause champion, for example. Which is great, because it's normalising the conversation. But we don't want it normalise that people think symptoms are normal. So anyone who is listening who is suffering or knows someone who's suffering or hasn't had the conversation even in the workplace need to be thinking about it so we can really normalise but also signpost so that people can be empowered. And even we did some research recently just within the app by asking people whether using the app has increased their ability to receive the treatment that they want. and 65% who had used it for three months had received HRT, which is what they wanted, compared to the national average of around 10 to 14%, which is great. But also the vast majority over 80% felt empowered and they also felt supported

because, again, it's about talking and sharing and knowing how to get help. And also you need people as advocates. So if they haven't had the right treatment that they want or the right advice they want, they know it's quite okay to go and see someone else. And we've talked about doctors, but a lot of the time it might be nurses or prescribing pharmacists or someone in a hospital. So, you know, there's a lot of education work doing, certainly through our not-for-profit with the society to really improve healthcare professional training.

And I feel that really is ramping up at the moment because the more healthcare professionals speak to men or pals or women and feel out of their comfort zone because they haven't had the training. now they are getting training. So it'd be really interesting, Sarah, actually, to have you back in two or three years' time and hopefully hear how your jobs train. So rather than feeling so disbared with the stories that you'll be doing more of this awareness and getting the conversations out there. So it's incredible the work that you're doing. And we'll put some links to it on the notes at the end. But just before we finish, could you maybe just give some three take-home tips, but I'd like to split them up. So I'd

Like two for workplaces, what they could do if they're thinking, oh gosh, we don't do anything. Yep. And then one for someone who is working but is experiencing symptoms and doesn't know where to go. Okay. So workplace, the key thing is everybody needs to be aware of it. So very much start having conversations, talking to everybody about it, making employees realize that it is. employees realize that it is a normal process that every female employee will go through and there'll be a lot of partners also being affected with work. So conversations. Secondly, consider some of the

practical sides. So one that springs to mind is where is the safe space for somebody to just have a break, to escape to? One woman told us this week, last week, it was 222 steps from where she lectured at the university to the closest toilet, for example. So what are some of the easy, practical solutions to support individuals suffering at work? And for the women themselves, I would say, don't suffer in silence. It is normal what you're going through. Talk to others. You're more likely to talk to a friendly colleague at work. Download the balancer app and have confidence to go back to your GP or healthcare professional if you're not getting the right level of support. There's a lot of help out there and I think that is the key thing is

don't continue to suffer in silence. We've all been there. Absolutely. I think that's so important. And look out for your work colleagues as well. Absolutely. I wish someone had swatted at me when I started to get more cheerful and my appointment lengths were longer because I kept forgetting things and just slowing and not being quite as dynamic with patients. So if someone had popped into my room and said, oh Louise, read this leaflet. Do you think this would be Exactly. Could have saved me a few months of stress. So it's amazing the work you're doing.

We look forward to seeing how things progress. And thanks ever so much for your time today, Sarah. Thank you. Lovely to be with you. For more information about the perimenopause and menopause, please visit my website, balance-manopause.com. Or you can download the free balance app, which is available to download from the App Store or from Google Play.