The Dr Louise Newson Podcast - 196 - Introducing The Definitive Guide to the Perimenopause and the Menopause with Kat Keogh

Episode Date: March 21, 2023

In this episode, Dr Louise is joined by Kat Keogh to talk about Dr Louise’s new book, The Definitive Guide to the Perimenopause and Menopause. Packed with advice and information from leading experts, it is the definitive, accessible and evidence-based guide to help you navigate your perimenopause and menopause. It covers key facts about hormones, family histories, the complete guide to HRT, libidos, mental and physical health, how menopause affects careers and relationships and so much more. Kat, who works at Newson Health, shares her top three reasons to buy The Definitive Guide to the Perimenopause and Menopause:  It gives clear, practical advice on talking about the menopause with your children. If you’re starting, at any age, to feel like your hormones are off balance, buy this book to find out everything you need to know about the role of hormones in your health and how to manage that. If you’re struggling and alone with the perimenopause or menopause, turn to this book for reassurance, support, knowledge and to be empowered. Order your copy here

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. Today on the podcast I've got with me a guest who's also been with me before. I've got a few guests now that I've interviewed more than once.

This person is very important to me. She's very special and I couldn't actually have done what we're going to talk about without her. So her name's Kat Kiyo and I've known her for a few years now. So welcome Kat back to the studio. Thank you, Louise. it's very nice to feel special and be back again. Thank you. So we first met about five years ago, four and a half five years ago now.

I just found the building that I was going to start my clinic in, the clinic that I was only going to have four doctors working in, actually. That was my business plan. And obviously now we have over 120 doctors and nurses and pharmacists and physicians associate, actually, who worked with me, not just in the clinic. It's not that big a building, but all around the country, as you know. And we went to a little cafe across the road from the clinic because the clinic was a building site. There's only cardboard boxes to sit in.

And we sat down and I said, oh, I've got this idea writing a book. And I've heard that you might be able to help me. And how much do you know about the menopause and perimenopause? To which you said. Nothing. No. No. I think at the time I was, so I'm, you know, I'm a health journalist by background.

And at that point, I think I had a very small baby. I was on maternity leave with my youngest. And, yeah, I, you know, full disclosure. I had an inkling about the menopause, just from, you know, general knowledge. I hadn't ever actually heard of the perimenopause until I heard you mention it. And I had to sort of style it out and, you know. But I think I was quite honest that I, there are things I don't know, but there are things that I can learn. And yes, I definitely have over the last five years.

Yeah, so I, as many of you might know, I, really. the first book on the menopause, or when I say the first book on the menopause is because I have written a few books before, but they're more academic books. So this was the first one I wanted and I went to Haynes, the publisher, a year before we met actually, and they said, no, we don't a menopause book. We're all men. Why would we talk about the menopause? And then it became one of their bestsellers. So we worked together on it really hard and really pleased. And then we worked together again on the penguin book, which they approached me actually. It was just a small book really. It was a short book and there were some health books. There was one on migraine

wasn't there. There was one on heart health, one on gut health and they wanted to do one on the menopause. So they approached me and I said yes, great. But it was quite small and I actually, it sounds really awful. When it came out in print, I wasn't too excited about it because I felt it was all right, but it wasn't as much as I wanted to do. And it did manage to become a Sunday Times number one bestseller, which I think is more of reflection that people wanted to learn more about the menopause rather than the book. Don't get me wrong. It's a good book, but it's sort of underselling myself, I suppose. But I always wanted to do, well, yeah, but I wanted to do like a bigger, better book almost. That's a bit more grown up. That's not so chatty. That's more

evidence-based. I'm quite scientific. As you know, I've got a pathology degree as well as a medicine degree. And I've spent the last 30 years translating medical and scientific literature for lay people and for doctors and nurses and pharmacists and clinicians. And I sort of have that as a skill. And I wanted to be able to use this even more with the menopause and try and get away from this fact that the menopause is just about periods, or it's just about fertility. Thinking about our hormones as biologically active, hormones that go into our bloodstream, that go to every single part of our body and the effects that not having those hormones can have. But do it in a way, but it's not just me talking.

It's about others that we can invite to be experts and to share their words and wisdom, but also not just to think hormones, think about lifestyle, think about nutrition, think about everything else as well. And so we had this great opportunity with the publisher's Yellow Kite to write this book. and I knew I couldn't do it on my own because I am very busy. And I think it's because of your journalism background, but also your huge knowledge about health in general, mean that you sort of stalk me and you know how my mind works.

Was that a fair thing to say? No, no, no, no. It's absolutely fair. It's the way I operate. And you're absolutely right. I think the opportunity with yellow kite for this book has been a fantastic one. And from day one, the aim was to have, you know, a book that sits on a shelf is a companion, like a family companion.

And it is, you know, the title, the definitive guide to Harry Menopause and Menopause. It is just that it is definitive. It's, I think, almost three times the length of your previous books. You know, dedicated chapters just on what are hormones. And not just looking at the menopause, looking at puberty, pregnancy, postnatal depression, periods. You know, it's a really thorough look at hormones throughout a woman's life. And you're absolutely right. It's got, you know, there are experts upon experts in here as well as yourself.

In everything from, you know, we've got Julia Samuel, the psychotherapist. He's got fantastic tips on talking to your children about the menopause, especially younger children, because we know that, you know, women are having children later in life. So the chances that you'll be menopausal and raising a young family if you choose to have children is more common these days. We've got Joe Wicks talking about exercise. And we've got Emma Alice Flint with some brilliant recipes. Dr Rajpar talking about hair, skin changes. It really is a compendium and I think you should be really proud of it.

Oh, thank you. Yeah. Well, we've also got Dr. Rupi talking about nutrition and eating healthily. how important that is. Yeah, it's interesting. So a lot of people who have books have a ghost writer and that person's ever mentioned, but I don't think, well, you're not, certainly not a ghost. You're more than just a writing. I'm quite pale. So it's really difficult. I mean, we sort of say, maybe you're a commissioning editor or I think you're just a partner in crime, actually, because you sort of amplify my voice, you work out the bits, you know, a lot of it is, I feel it's a

joint project, really. Italy. No, there's been a lot of. Lots of early weekends and late nights and just, you know, I think I've managed to go to weddings and then come back and, you know, come back to emails where you've gone through. And I remember, was it shortly before Christmas, I think we were looking through it as one of the last drafts of the book. And you looked at it exactly 24 hours before me. And we were working through it at the same speed and we could tell by the track changes. And I was, you know, just proofreading what you've written.

And it is quite a funny process when you write a book. It is actually. And I know when we met lovely Carolyn from Yellow Cites and she was a bit worried, but you know, how do you work together and what's it going to be? And we said, no, it's fine. We're fine. We're good with deadlines. We're organised.

But sometimes it all comes together at the end. And actually, this book, we made more edits than before. So the first time I saw it, I was sort of happy. second time I was happier, third time I was even happier. But then at the last minute we put in another chapter, which we were both a bit too scared to tell Yellow Kite about because they said no more changes. Oh yes, we wrote that in a weekend, didn't they? Yes.

And then I said, you know what? You know, most of my work is trying to think about women who don't have a voice. You know, there are people who would never come to my clinic or don't know where to go for help or don't realize what's going on. So we've got this other chapter, haven't we, that we added for people who maybe haven't been thought about before. We called it unseen and unheard, why the menopause conversation must be more inclusive. And so we've mentioned about women with eating disorders, women with addictions, alcohol, drug

addiction, people in prisons, people have had FGM, people in different communities that perhaps never even been written. Well, I don't think they've been written about in a book before. And I think I was too scared to tell Carolyn and I asked you to tell Carolyn that you did. But actually they're really pleased with that chapter as well, aren't they? Yeah, yeah. It's really good. It's kind of got a really good balance.

Well, it has got a good balance of the science, of the facts. But it also has a lot of women's experiences in there. Through some case studies, we've had a lot of women who've been fantastic and shared their sort of first person accounts of various. sort of symptoms or menopause with coexisting conditions. But also one of the big things about this book is that we ran a survey just before Christmas, early December, late November, early December 2020. I always think if you get over a thousand and a survey, it's a good sample size.

This isn't academic research, but a, you know, an extended straw poll research. And in eight days, almost 6,000 women responded, which was incredible. A huge amount, isn't it? Yeah, it really was. And the survey itself was to bring women's experiences to life in the book. So, you know, for example, in the chat tool about hormones, we asked women, you know, give women a list of hormones. Have you heard of any of these?

And you'd expect, you know, 99% of women had heard of estrogen. But when you went down the list, that knowledge. dissipated, you know, testosterone, quite few did, progesterone, not as many, and it was really interesting, but we also looked at not just the kind of physiological side of things like what symptoms women were experiencing, but also the social side of things, including conversations in the home. So, you know, probably one of the most startling findings was that three quarters of women or 75% of women had never had the menopause discussed in their home growing up, which is really telling of where we've been at over the last few generations talking about the

menopause. You know, I certainly don't remember talking to my grandmother about it. I remember talking to my mum about it, but I know that I may have been quite lucky in that respect. Yeah, I think, I mean, you're younger than me. My mother has only talked about it because she takes HRT and I've done a podcast with her before. And as you know, she's mentioned in the book. And that's the only reason. Otherwise I wouldn't. But I often think about my grandparents.

So we were very close to my, especially my mother's mother because my dad died so young. So they were around a lot. And my grandmother never drove, but a lot of her friends didn't drive. And they were, it wasn't a done thing to really work so much then. But a lot of them, I remember going around for cups of tea and being really bored. like listening to them and they were doing some crochet or whatever and needlework. But a lot of them had anxiety. They were so nervous of their husband coming home and finding them sewing when they should be doing some cleaning.

And it was all, I don't know, very different to our society now. But I wonder how many of them were hiding behind this sort of veil of the menopause, which we see in other communities that so many countries when I visit, you see less and less middle-aged women out. You see women with children and you see less women and you just wonder there's a cumulative effect or there's different reasons. But I'm sure some of it is because people don't know what's going on. They have less self-esteem. They have less self-worth.

They have less self-confidence. And it's easier to be hidden at home sometimes, isn't it? When we all have a bad pajama day or a mental health day, it's great sometimes being at home with a door shut. Don't have to put makeup on. You can wear your leggings. It's fine. But, you know, if I didn't take HRT, I would have those days every day because I couldn't be bothered to do anything.

You know, and I sort of wonder about that, but then they didn't know. So they weren't talking about it because they didn't know what was going on, I suppose, as well. No, and I think I remember when I was last on your podcast telling you about my grandma, my dad's mum, my dad grew up when I was sort of small holding in rural Ireland. And I was remember my mum telling me that my grandma really suffered from hot flushes. And her way of dealing with them was to run down to the bottom of the plot and scream down a well. And, you know, we don't all have wells to scream down. So I wouldn't recommend it.

But it's just indicative of that was her coping mechanism. And that was, you know, she was quite a formidable woman, eight children, you know, lots of grandchildren. And, you know, that was her menopause experience. And some of the, in the survey, we had the opportunity to give free text. responses, which is where you can really get a sense of people's experiences, as well as those statistics. It's that qualitative data. And there were some really moving comments in there, especially around the conversations, and I think it's actually made it into the book, but there was one woman who talked about how her mum had gone through an early menopause,

but had never said anything to her and her sisters, and how now her family kind of make a point of discussing it to support each other. And there were also people who are mothers of sons who make a point of discussing it with their male children. And I'm the mum of two small boys and I mean, they're only seven and just five. But my seven-year-old now, because he often peers over at my laptop, is that menopause, mummy? And it sounds silly, but I know that he's going to grow up knowing about this. And that's really important. Well, it's about normalising the conversation, isn't it? I mean, as you know, I've got three daughters and some of the conversations that we've had, usually in the car, actually, often when it's dark and there's maybe a couple of them with a friend in the back of the car,

talking about porn, about sex, about drugs, all sorts of things, which is great. And I think sometimes it's easy in me being a doctor because they know I don't get phased about anything. And even, And, you know, my younger daughter, if she has a bit of discharge, first time she's too scared to show me her pants and she's more open. And that's really important, actually. So these things I think are actually more embarrassing to talk about menopause, which is just something that does happen. But it's not normalising it so much to not think about how it affects people or how the treatments available. Because that's sometimes what's happening now, isn't it? Especially in the workplace.

It's, well, we'll talk about it. and it's really important to talk about all sorts of things, but we have to talk about it in the context that there is suffering, there are women that not being listened to, and there are treatments available. And women deserve to be offered the treatment that's right for them, which is not happening at the minute, as we know, to far too many people. But it is this conversation, you know, my 20-year-old,

quite often when she goes to toilet in places in London, she'll hear people talking in the toilets about their menopause or about their parents, you know, Oh, my mother's going through a really hard time at the moment. She can't stop crying. Jessica's quite a few times it's happened. She said to people, I'm sorry to each drop, but I don't mean to big up my mum or anything, but she's got this app called Balance.

It's free. Why don't you download it? And we'll ask your mom to download it. And these girls and women have been so thankful to Jessica. She's like, Mommy, this is the most empowering thing ever. I feel like I'm really helping people. And, you know, as you know, she has really bad migraines. And when she's spoken to others with migraine who've been older,

she said, well, could it be your hormones that are related with your mind? Oh, yeah, I often, just before my periods, my migraines are terrible. Well, perhaps you could top up with a bit of estrogen. No, estrogen's HRT. No, actually, she said it's not associated risk of breast cancer. It's really safe through the skin. You can have it. Oh, right, you know.

And it's those sorts of conversations that I think are really important. You know, we don't want, I don't know about what you think your children are a bit young, where I didn't have that, let's sit down now and talk about sex. and I'll show you a cheesy book to my children. It was very much led by what they want to hear, and it was all at different times, and sometimes they'd have a bit of information, and then three weeks later they'd ask you something else,

and then the full question would ask when you're not expecting it. But that's how conversations go, aren't they? Yeah, I think it's making it so that it's easy to ask and understand. You know, like your son, he's not sitting down and analyzing and thinking about vaginal dryness, reduce libido. He's just seeing it as a word. And the conversation will start with time. And it's a need-to-know basis as well, isn't it?

But it's an inclusive language that's being used rather than, oh, no, you don't need to know about the menopause, darling. That's not until you're an older woman, you know. No, yeah. So there's a difference between having the talk. Like you say, just embedding it in your everyday relationships. And, you know, that's another thing that the book's got, as I say, it's got talking to children about menopause.

It's also, you know, talking to colleagues about it as well. And we've got some really good expert views from people like Liz Earle, Paraness. We'll see talks about, you know, having a heart flush when she's about to get up in the chamber in the House of Lords and losing her train of thought. And it's really refreshing to hear someone who's got such a public persona and such an important job. And, you know, she's a lawyer by background and that feeling of forgetting something. and not knowing what the next thing's going to come out of your mouth. And she gives some really good advice about talking to your colleagues about it and saying to colleagues, you need to help me, because this might happen to me at the moment,

this is why, but also here's what you can do to help. And I think, you know, a lot of times as women, we don't want to ask for help. And we should do in cases like this. I mean, menopause isn't it an illness? It's not an affliction. It's something natural, but that doesn't mean it's something that has to. to be endured if you're struggling. Absolutely.

And I think there's this whole conversation, isn't there, about it's a natural process. We're medicalising it. Well, actually, being in pain and childbirth is natural. But most people have some sort of pain control. And that's where this misunderstanding of what the hormones are, what the menopause means. And I think this is why the book, when I have my children, we use Dr. Spock. I don't know if we were grown out in the 70s, the Dr. Spock's book. And whenever there was a problem, my mom would always get to Dr. Spock to have a little look, what were going on.

And then she bought me a copy when I had my first daughter, Jessica. And there are sometimes those things you just want, like a motherly advice, but you don't want to be nagged. So you just want it from a book. And that's what I sort of thought about with this book. I want it to be the Dr. Spock of the menopause, really. So it can be, wouldn't it be nice in every household? So you can dip in and out, you don't have to read the whole book. You can just pick up.

And I think for teenagers, reading, we've got some information about PMS, you know, premenstrual syndrome, that's going to be really useful for a lot of people or the workplace. Anybody that employs a woman should be reading this book because they'll get more understanding about what it is or what they can do as an employer. So it's written, I think, in a way that people can hopefully think about the menopause in a different way. I mean, it started, the introduction is quite raw, isn't it? I don't know whether we have to have a warning, but we start talking about the mental health aspect of the menopause really early on, don't we? Yeah, and it's important, I think, to cover all bases. Like you say, it's got advice about the workplace.

It's got advice about the home. It's got a really, really thorough rundown about treatments, which is, you know, kind of the core of the book as well. It's got, you know, really detailed chapters. Also looking at those, you know, holistic, side of things because it's not, it goes beyond HRT, it looks at lifestyle, it looks at exercise, the importance of exercise, the importance of a good, healthy, balanced diet. And I think you say in the chapter about diet, you're not going to prescribe a diet in inverted commas. These are just

principles that you can embed into your, you know, your daily life. It looks at, you know, what needs to change in the future as well. And you've quite openly addressed different groups. And teachers, CEOs, politicians, doctors, you know, it covers an awful lot in one book. And it's quite a weighty book. There's no getting around it. It is. It's a hardback. That feels very, very grown up with lovely colours. And actually, when at first I looked at it and it's black and white inside, and I thought, oh, that's a shame. I wanted it more pictures. But actually, it works really well. The colour is very visual on the cover, bright colours, but it's something quite calming about.

as well. Yeah, it's not a slab of text and it's broken up quite nicely. You've got, as you say, case studies, we have boxouts about the survey findings. So, you know, for example, we've got a chapter looking at skin and hair in lots of detail, you know, suggested skincare routines if you're struggling with dry skin or you might have had a resurgence of acne that you hadn't seen since your teenagers. So we talk about how, from the survey, what other things women are experiencing with their skin as well. And then every chapter also has timeouts. So they're kind of moments to pause either at the beginning of a chapter or towards the end and almost, you know, think about this. Take a second, take a step back. And then at the end, you know,

you can consolidate your learning from the chapter as well. But it's not, it's a long book, but it's written in a way that's really accessible. It's, you know, quite clear language, quite straight to the point in a good way. Professional handhold is probably the best way to describe it, I would say. Oh, that's, yeah, I think that probably is the only thing that I'm a bit uncomfortable. It's a bit personal about some of my stories and why I do what I do and my various insecurities. And I think that's the bit that I feel uncomfortable with. But I think it's actually quite good to be transparent. And a lot of people I know misconceive who I am and what I'm doing. So actually to have it all out there to hear a bit about my background is not a bad thing.

It's not being, nothing that I do has been handed on a plate to me. I was at a conference recently and someone was talking about some of the bullying that I was getting. He's a professor in America and he said to me, Louise, it's not actually what you do. It's just because it's you that people are getting annoyed. And I saw that it's interesting. And he said, yeah, there's lots of people talking and saying that they think that you've got a lot of money. that you've had from your parents and you've got a rich father. And I said, well, isn't that interesting?

Maybe I should just tell them all. I don't have a father. And he died when I was young without any life insurance. So everything I have, I've worked for without any handouts from anyone. But what's the point of telling people, you know, it's like being bullied at school, isn't it? They're always going to find something negative. So actually, I think, you know, I am a menopausal woman who wants to help other perimenopause

and a menopausal woman. And this is trying, hopefully, to... move the needle on to someone said to me ages ago, you can glance back and look forward. Let's glance back, but not forget the misogyny, the absolute gender inequality that's gone on with hormones in the past. But hopefully the book, the work I'm doing, the work we're all doing will help these future generations will help from here now to maybe make people have grown up thinking about the menopause and the perimenopause about hormones. But more importantly, about women's health as well.

So in a public way, Kat, I want to thank you very much because I could not have done this without you and your phenomenal brain and encouragement and support it's just been incredible. And I'm really looking forward to, a bit apprehensive, but I'm looking forward to some of the feedback. I've already got some ideas for another book,

but I'm not going to divulge yet. So don't go anywhere. And actually, Kat, some of you might know, works with us anyway, within the News and Health group. So all the content that's on the balance menopause website and content on balance and all sorts of other articles. Kat is very heavily involved.

And she runs our editorial team. Works very closely with our clinicians. So all our work can be peer-reviewed and referenced. And she's got a huge amount of work that's going on behind the scenes to enable anybody from across the world to be able to access evidence-based information, which is so crucial. So before we end though, Kat,

I've got to give you three take-home tips, but I'm going to ask you actually three reasons why everybody should buy a copy of the book. And think. Reason number one, if you have children and you don't know how to talk to them about your menopause by the book, it's got a really clear, practical and effective tips. on how to start those conversations with younger people and help bring about understanding in the home and help bring about some clarity for children as well, because I think that's really important. Second reason, if you've ever experienced any hormonal changes in your life to this point,

whether you might not be perimenopausal yet or menopausal, you might be, you know, still having periods. and you want to find that a little bit more about how hormones affect your body and the processes behind it and the knock-on impact when hormones can be slightly out of kilter. That's another really good reason. And the final reason would be if you're someone who is struggling and is feeling confused or alone by the book, it will give you the information, it will give you the reassurance, it will give you the power to look at your own health,

do something about it if you are struggling with symptoms. And it's something you can pass on to friends as well. Excellent. That's it. Very good. So I look forward to when people do order it, if you've got any reviews, obviously put them on Amazon, and we really look forward to reading them and hearing.

And look forward to getting you back onto the podcast when we've written a fourth book together, Kat. Very much so. Thank you for having me. Thanks, Kat. For more information about the perimenopause and menopause, please visit my website, balance-hifference.com, or you can download the free balance app,

which is available to download from the App Store or from Google Play.