The Dr Louise Newson Podcast - 212 - How to thrive at work during the menopause

Episode Date: July 11, 2023

This episode looks at how hormone changes impact women in the workplace and in their personal lives – and why do many women put their own needs last? Dr Louise is joined by Dr Claire Kaye, an executive career coach and former GP specialising in perimenopause and menopause in the workplace. Dr Claire explains how career coaching can help bring about clarity and focus, particularly when you’re dealing with physical and psychological symptoms during the perimenopause and menopause. And both Dr Claire and Dr Louise offer advice on how to navigate these changes and overcome negative emotions to prioritise your own health and wellbeing. Dr Claire’s top three tips for building self-esteem: Recognise what it is that you’re feeling, take a few minutes to work out what it is that’s an issue for you at the time and label it Ask yourself ‘what might help here?’ or ‘who might help here?’ Pick one really simple thing that will help and feels really comfortable: and do it. You can follow Dr Claire on Instagram @drclairekayecoaching, LinkedIn @drclairekaye or visit her website 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. So today on the podcast, I want to welcome you Dr. Claire Kay, who I've been emailing for a while and like many of my guests have never met in real life, but I'm meeting on the screen for the first time today. And like me,

she's a GP, but like me, she's not a GP anymore. So I'm going to hear a bit about what she does and let's see where the conversation goes. So hi, Claire, welcome today. Hi, thanks for having me. So you trained as a general practitioner. Yes. So I was a doctor for about nearly 20 years and I was a GP and I did, as you would imagine, lots of women's health and I did also lots of mental health. But I particularly had a special interest as well around frailty. So a lot of what I was doing was talking to people and spending time with people. And I really found that after a period of time that I was starting to develop this sort of sense

of really enjoying the consultation and spending time with people. And I realised that actually that for me was one of the big things I got a lot of enjoyment motivation from. So I gave up clinical medicine about five years ago, maybe a bit more. And I became a qualified executive career coach. And I specialise in career development and also perimenopause and menopause in the workplace. So helping women to thrive in the workplace during that period in their life. It's really interesting, isn't it? And I don't know about you, I'm sure I'm older than you, but when I was at medical school in the 80s and 90s,

I didn't get any training about the consultation. It was all about, well, the preclinical obviously was about the pathology, the biochemistry, the physiology. And then it was all about disease and pattern recognition and trying to work out what the disease process was. And we never really got taught much about how to talk to patients. And you get on this conveyor about sometimes and you think about the patient as a disease rather than the person who has a disease that's affecting them and each disease affects people in different ways. Did you get much training when you were younger?

Well, I was really lucky because when I was a GP trainee and I think actually this is probably shaped the bulk of my career, I had a trainer who had been trained herself by John Lorna from the Maudsley. And he had basically created this consultation model, which is like a way of. of talking to people, which basically puts people in their story. So rather than just being somebody's cough or somebody's sore foot, you would be looking at the whole person to try and get to know them, but also to understand what that meant to them having a cough or a sore throat and the implications of that. So from a very early stage in my career, I was really learning to talk to people in a different way, which I think, as you say, is quite unusual. And that for me just gave me huge amounts of satisfaction and joy. It's really interesting, isn't it? So I, because I did hospital,

medicine for many years before changing into general practice, I'd sort of got into my ways, which is a bad thing to do. And then I had a very inspirational trainer, like it sounds, you did, John Sanders, who was just brilliant, but he made me play with a consultation. And, you know, for example, if you see someone with a sore throat, it's quite, oh, right, they either need antibiotics or they don't. And I remember once there was a young lad came one day, and he had a sore throat. And I thought, oh, come on, you know, what are you? doing coming to see me. But I thought, no, I've got to listen to John. And so I just pushed the consultation route or changed it and said, oh, could you just let me know, why have you come today?

And I thought he might say, oh, it's because the only time I can make an appointment. But then he started to look down, no eye contact and said, it's because my mother's in intensive care. And I've been told that if it's a bacteria of affection, I can't see her and I really want to see her because she's so poorly. And I just thought, oh my goodness me, Louise, if you had I've asked that question, you could have just dismissed him. And it's the more you probe in the right way, the more you get back as well from people. And I think one of the things medicine does do is give you confidence to ask maybe quite awkward questions that you maybe wouldn't. And I sometimes get in trouble with my friends because I'm quite direct and I will ask questions. But, you know,

I think not to be scared to ask and to change a consultation. I think what I really enjoy in general practice was to be able to play with the consultations and if you've got more energy, you can really do it and you can really, really, and then you get to know people in a different level and then they open up to you more. And then, you know, I've had so many women who have been scared because they've had some irregular bleeding and it would be very easy to just fill out that form and get them sent off. But then when you say, well, why are you worried? Well, my granny and my mother had ovarian cancer. Well, sometimes I'll tell you something completely different and it's a reason for them just coming in to see you.

And the bleeding is actually nothing of any consequence when you've taken a proper medical history, but you realise they're more worried about something else. And it's a real privilege, isn't it, when you can talk to people in the right way? Yeah, definitely. And it's really interesting what you're saying about asking the right questions,

and that's very true. But I think it's also about listening to the answer. And that's, I think, very much the space that I sit in. And it's almost that sense of listening is really powerful for both parties. And I know when I was GPing, I would sometimes, and I sometimes time myself,

is how long I didn't speak for at all at the beginning of the consultation. And if you imagine somebody's there for, you know, 10 minutes, sometimes I wouldn't speak at all for five, like literally nothing except for nodding and smiling or, you know, listening with my nonverbal cues. And that power of, as you say, you know, how the experience that you had with that boy

and with women coming in about their bleeding, etc., That's when you get to the nub of the issue. And sometimes it's the first time that that person has even realized that that's what's going on for them. They know they need to have a conversation about their throat, about their bleeding, but they don't realize what it means to the impact for them. And sometimes that, just that space, that safe space to talk and to be open is really powerful. And I suppose that's really what happens in the coaching room as well. And I think that to me feels very important.

You know, we were talking about this before, but the sense of listening and how I genuinely feel that most people have never truly been listened to for a prolonged period of time. And that makes me sad because the power of being heard is remarkable. It's amazing, isn't it? And I think it's become less, not just as people have become older, but I think society has changed as well with so much more fast-paced. when I read statistics of how few people sit around a table and eat their meals together or when I speak to patients who I see who have really struggling with their perimenopause or menopause and with their intimate relationship and I'll say, have you spoken to your partner? Oh gosh, no. No, he wouldn't understand.

But you've told me you've been married for 25. Yeah, I know, but he's my best friend. No, no, no, I can't tell him. I can't tell him. And you think, gosh, what do these people do? And I'm very, very fortunate because I'm very close to him. my husband and my mum actually as well and I share a lot. But I'm also very good at reflecting and thinking in my mind. But if you don't talk, you don't realize what's significant and what is

insignificant or what's important or what's common as well, I think, isn't it, sometimes? But I think talking can feel scary for people in the sense of they're worried that they're burdening somebody or they're worried that they're going to be judged or that they're going to be seen in a different way or that perhaps what they're saying is a bit weird. And actually that can stop the talking process for a lot of people. But again, I think whether it's in the coaching room or the GP room or in any sense where you've got that space where you've got a non-judgmental ear, where you are literally going to be heard. And it's almost like you've got a metaphorical hand holding yours in the sense of just there's no judgment here. There's just support and advocacy.

that's a space that's very precious. And I mean, I know when I first had coaching, I kind of found it, I mean, it literally changed my life. And I've never been happier and I'm very grateful to it. And it was that space just to open my mouth and to be able to speak and to be heard. But then to realize I had all the solutions. I just didn't realize that I did. And that sense of empowerment that came with that was hugely,

oh God, it's liberating and such a relief. But I probably would never have got that if I'd said to a friend or can we talk about it because I don't know about you, but there's always the advice monster. You know, if someone says something, they go, oh, yeah, but I've got the answer. You should do this and you should do that. And that's what's different in my world is that there's a good coach anyway, we'll never give you the answer, which sounds really counterintuitive. Yes, which can be quite frustrating. And yeah, I've had a little bit of coaching, not just for me, but for the business as well, because obviously the business has really expanded.

And even actually when I do yoga, one of the yoga instructors says everything that you need is here within you. And when I first heard that, I thought, oh, that's silly. I always. And then actually the more I do yoga and listen to this instructor, and I think actually that's right. But then having, like you say, the coaching that I've had, like I've only had a little bit, I always want the answers. But actually the answers that I get told often aren't the answers I want to hear. So isn't it better to be?

work out yourself is so important, isn't it? Yeah. I mean, I always talk about coaching like noise. So basically when somebody's feeling stuck or lost or unsure or not showing how to move forwards or don't know how to optimize the situation or just that sense of like unsettledness and you don't know what to do and you don't know where to go but you can't really find the answers, there's all these things that go around in your head and actually it feels really noisy in your head like oh on Tuesday you wake up you think I'm going to do this and on Wednesday you think no I'm going to do that and it's really difficult to know the right path and then if you compound that with the external noise that goes on from friends and relatives and colleagues going oh but I love

you and I think you should do this and I know you and you should do that and it can feel very confusing and so you have this internal noise and then this external noise and it's really hard to know what the right path is so what lots of people do is they find somebody that they kind of trust and love and go I'm going to do it their way or what they suggested because they know me and they love me. So that's probably good. And actually, it can feel quite uncomfortable and it's often the wrong path. And what coaching does is it gets rid of all the noise. And it gives you this sense of clarity and focus and direction because it helps you work out what you want and how to get it.

And in a way that feels comfortable to you. So it's this, again, this sense of often the first time that people have had to be, particularly women have had this opportunity to work out what they want, not what they think they should want or they feel obliged to want or guilty if they want it, but actually what they genuinely want. And that might be something massive or something really tiny and it doesn't matter, but it's that sense of finding that and then working out really easy, simple steps that feel manageable to get there. And just having somebody to metaphorically hold your hand and ask the right questions sort of push you and to hold you. And as you said, with your yoga teacher, it can feel,

if somebody says, or you've got all the answers within, that can feel particularly when you're feeling stuck, an overwhelming statement. It's a true statement, but it can feel overwhelming. But with somebody that knows what they're doing, it can actually be just done very gently that you don't even realize it is happening. And actually you suddenly think, oh, I actually don't want to be on this treadmill or actually, I want to where I am on this career path or this life that I'm in, but I'd like to try something else, but I'd like to try in a really safe, easy way first, and then I might build on it, or I might not, I'm just going to see. And that sense of permission is really an amazing thing that happens because you start,

not because the coach does it, but because you're starting to believe in yourself a little bit that your thoughts and points of view and your values actually matter, which they do for everyone. Absolutely. It's so important, but isn't it interesting that, you know, you're saying that it's more women and you're seeing more women. And why is it that you think that it's more women that need to have somebody to talk to? Do you think it's partly because as a woman, we do take more responsibilities, maybe we are more caring and nurturing. This is the generalisation, of course.

But for a lot of women, they do have this. And we're always at the bottom of the pile as well because certainly even just in my small family, I'm only as happy as my least happy child. And I've got three of them. Me too. So it really varies. But actually, I know if I'm in a bad mood, my whole family, it just seemed to not be happy.

Whereas my husband's in a bad moon. He just takes himself off for a cycle ride and it doesn't really impact the family. But then sometimes we, maybe do women feel more guilt? Do we feel bad if we're burdening and talking about how we feel? Or do we find it more difficult to open up? Well, I think we are generalising. I think we should just say that first of all. But I think that from my experience with the women that I see,

I would say, and for my own experiences, I think a lot of what you're saying is absolutely right. I think there is a sense of this guilt and love and wanting to be everything for everyone. And that feels like we have to be a bottom of the pile. But I think the biggest thing I see and seeing women particularly is this negative self-talk. Everybody has self-taught, this voice in our heads.

and for a lot of women it tends to be very negative and for a lot of women the negative self-talk tends to be very loud. So it's this sense of I'm not a good mum unless I do or I'm going to make this really nice meal because that's my way of showing love or I'm going to work really hard and model you know being really successful at work

and then if things don't go so well it's not only you're not doing well at work but you're being a poor mum and you're not supporting the family and this voice gets very loud and I think women's confidence women's negative self-talk, women's sense of disempowerment is very challenging and gets particularly bad during the perimenopause and the menopause time. And that's also a point in their lives when they often are sandwiched in this sort of, you know, having maybe if they've got families slightly older children where the needs are even bigger than younger children, I think. And, you know, older relatives that they're caring for, plus, you know, being often the peak of their career.

and it's this sort of overwhelming burden that almost they have to put themselves at the bottom of the pile and that's where I would say actually that's where people sit but it doesn't have to be like that and it's not selfish to claim a bit back and it doesn't mean that you have to take away from anything or anyone by starting to see what you can do for you in the sense of support and well-being

but also building your confidence and knowing that you have value and that you matter and that doesn't overtake everything else, but it just means that you're not right at the bottom. It just means that you're in the packing order somewhere. So I think it's incredibly complex why women feel like that, but it is incredibly important to try and address. Yeah, and it is important, isn't it?

Because I've become, wrongly or rightly, more selfish as I've got older and busier. So, for example, if I don't do yoga regularly, I just feel less focused, I've got less physical energy, but I've got less mental energy as well. So actually taking some time out to do yoga when I could be playing a game with one of my children or going for a walk or phoning a friend actually is a really good investment. But it's taken me quite a long time to realize that I have to do that or making sure that I take my lunch to work that I've made before.

Because if I don't and I buy something, I know it will trigger a migraine. So I have to have a bit of time in the evening to cook or I usually batch cook anyway. But I still, you know, making sure that I'm looking after myself, it's that whole. mask, isn't it, in the airplane? And it takes quite a long time to realize that actually, if I'm healthier and better and physically and mentally stronger, I can actually do a better job looking after everyone else. But it seems so obvious when I say it, but it has taken me 52 years to realise. Actually, you can't just put yourself at the bottom the whole time. No, exactly. And I always think about it as if you're a car and if you're trying to drive your

car from A to B, whether that's looking after your children in the world. workplace, doing whatever it is, then in order to get from A to B, you have to have fuel in the tank. And you can fill it up with little bits, like maybe it's yoga once a week, or maybe it's, you know, eating healthy every day, or maybe it's trying to, you know, prioritise your sleep or these little things that are hugely important. Or it might be something bigger where you, you know, start to think, actually, I need to fill up my tank properly this time. And maybe actually the thing that's depleting me is, for example, my work. And actually, it doesn't fit with my value system or it doesn't make me feel joy, is there something else? Maybe there is, maybe there

isn't, but maybe that piece of work it feels like more of a bigger fill up, if you like, of fuel. And that sense of that we think that, particularly as women, that we can get for me to be with no fuel and do it with a smile on our face, is impossible. It isn't. Your car doesn't work unless you fill it up and it's working out what you need to fill up the tank and for some people that's small things regularly so for some people it's just small things every so often and other people it's big things but it's knowing what your fuel is is vital like you're saying you know you know that if you take some food to work that's a much better prospect for you for the whole day and probably the whole week and it kind of takes into that concept of that it's really well known

about being in flow that sense of being in the zone so I suspect when you're doing your yoga you're very much in the zone of your yoga. So there's that moment there that, you know, you're 40 minutes or your hour, that you're doing it that will be incredibly fulfilling and calming, etc. And good for your body. But I suspect for you and for other people, it drip feeds into the rest of your week. You feel more vibrant, more fulfilled, like more able to cope with things. And that sense of being in flow, there's loads of evidence that that drip feeds into all the other bits of your life. So working out what fills you up, makes you feel good and puts you in the zone, whether that's cooking, something creative,

take the dog a walk. It doesn't matter what it is, but doing more of it is is really valuable to help combat that lack of self-confidence, negative self-talk, feeling depleted. It's just a really valuable tool. And I think you're right saying that it often takes us a long time in our lifetimes to work that out. So if there's someone younger coming along who's listening to this, that'll be amazing because maybe they can start perhaps younger than you and I did. Yeah. And also it's not just age, is it? You throw low hormones into the mix, so perimenopause or menopause. One of the very common symptoms is reduce self-esteem, feelings of low self-worth. And often the psychological symptoms we know are far more common than the physical symptoms. The power of hormones in our

brains is really important, but there's so many women who are charging ahead in their career, they're feeling great, top of the game, and then hits them like a bus. And I've spoken to a lot of people in organisations who said, oh, I thought it was my career promotion or my changing job that made me feel like this. But now talking to you, I realised that it all happened at the time that my period's changed or had a hysterectomy or whatever. And then they realize, but people are really struggling and a lot of women I've spoken to have said, well, of course, now I'm menopausal, I can only expect to work part-time or I could only expect to have a lower-paid job because of my hormones. And, you know, society has changed. And I think that is quite right

for a lot of women. I would not be working as a doctor if I didn't have hormones on board because I was really struggling with everything. Some people are fine, but it seems a shame that we need to put these men and pools of women in a box. And we've heard a lot with policies and various things that, well, let's just help them by, you know, reducing their hours or changing the air conditioning or whatever. But actually that's helping, well, that's not helping, sorry, that's actually stripping them of some of their identity as well. And I find that's really difficult.

And for every woman, choice about treatment is very individualized. And we're not going to talk about that now. But it is about the ability of women being the best. version of themselves when they're perimenopausal or menopausal. And it's having those tools to not feel that they're failing in workplace because actually for a lot of us, work identifies who we are, doesn't it? Yeah, definitely. And I think a lot of women describe it, and I would put myself in this category as well, it's almost like you lose your mojo. It's that sense of, you know, oh, gosh, I'm getting really worried about this now, or I don't know how to make a decision, so I'm obviously not good

anymore or I couldn't go for that promotion because I'm really, you know, sometimes I forget things in meetings. So obviously I'm seen as not very good anymore. That sort of negative conversation that goes on your brain. And it's a self-fulfilling prophecy because, you know, if you're not sleeping well because you're going through the perimenopause and that may be from night sweats or maybe just insomnia or maybe you've got more anxiety, which is making you have sleep problems. And then you go into work and you're having problems with decision making anyway, but we all know when you're tired, it's even harder. And it's just, is ever, you know, decreasing cycle that makes women feel like they can't do and are useless and

rubbish. And actually, that's just wrong. It is just wrong because women are just as good as they were, if not better than they were five years ago. It's just about ensuring that the infrastructure is in place and the choice and the control and the sense of being able to move forwards and not being put on the scrap heap because, as you say, something has changed in their body, which has affected every bit of their body and as you say a fan is not going to fix it but there are things that we can do for me a lot of it is around understanding all the amazing resources that are out there getting a sense of control working out what you want having the permission to you know really take steps forwards in whichever way forwards is for you all of that is so important and that sense of being

heard and listened to and not thought of as rubbish or invisible all this sense of sense of useless because it's very damaging to the individual, to the families, to the communities, and also to us as a whole entire nation, because let's face it, what is it something like 13 million women in the UK are perimenopausal or menopausal at this present time. It's huge. So we have to see it differently. We have to see it as retaining, supporting, but more educating and just allowing people to get back to themselves and feel like themselves again in whatever way they need to do it,

whether that's through medication, through lifestyle, through other resources, through coaching, through TBT, it doesn't matter what it is, but as long as women choose their path that feels comfortable for them and works for them, but having that confidence to do that. It's so important, isn't it? Especially when you look at the number of women who are leaving the workplace totally or reducing their hours. And we need to. know more and more, there's all these movements to try and increase, you know, people having their jobs over the age of 50 or whatever. And there's very little about how to really focus just on perimenopausal and menopausal women. And I feel that it's so important that they're

identified and individualized as well, because some of the conversation has been led by people who really haven't suffered at all and don't understand what it might be like to be menopausal. And other people who don't really want to understand maybe. But it is very different. You know, I get bad migraines. And one of the things that got worse for me was my migraines. And I can't work when I have migraines because I can't think. I can't speak.

I slur my words. I sound dreadful. You know, no one wants to come and see a doctor who can't think. It's slurring their words. But actually, having the education that those migraines could have been made worse because maybe if I don't eat lunch, as I've said, I'll get a migraine. But also it could be, well, Louise, are you eating well? Oh, Louise, could it be related to your hormones?

Oh, Louise, are you stressed? Or is there something else we can do? It doesn't matter what's causing my migraines, but it wouldn't it be lovely for somebody in the workplace to be able to look at it in a very holistic way? Give me, like you say, the education. And then I can decide, well, do I want to take medication? Or could it be the fact that I'm stressed at home?

or could it be the fact that I'm perimenopausal or could it be the fact that I'm not in the right job? I don't know. That's for me to understand. But it's making sure that I am allowed to have all that information and then make the decision, rather than being sort of forced into one corner made to be feel that I had this chronic disability

that means I can't go on in my career, which I think is happening for some women. And then that really is stripping them of who they are and what they've always wanted to become. And then if they've got reduced self-esteem, they're going to feel more of a failure as well, which this downward spiral. And that's happened to women for centuries, actually. And it's not improving for some people, which is such a shame. Yeah, I totally agree.

But you know what I find just so rewarding in what I do is that I see women in that situation all the time, literally every day. And through the power of the right questions like you were saying right at the very beginning of this and through listening and through allowing them to rediscover who they are. Most women don't have a clue what they like, what they're good at, what they could bring to the conversation. They honestly have no idea. And just even starting there and working out what they stand for and their values and their purpose starts to rebuild this sense of self. And what I see is a massive change from some people feeling like they can't, that they should leave work, that they are useless, that they are adding nothing, to actually starting to see their value and where their

voice sits and what they bring and how that helps both others and themselves. And actually, I suppose my biggest message is that it doesn't have to be this way. And I think that's probably what I hear from you anyway, it doesn't have to be this way. And there's so many things out there that can help women through your messages, through my messages, you know, there's millions of resources out there. And I think it's just a about choosing the one that works for you, whether it is HRT, whether it's coaching, whether it's a combination of both, whether it's communication, whether it's education, whether it doesn't really matter what it is, but finding out what's right for you. And it doesn't have to be

that you're on the scrap heap. It shouldn't be that. It's wrong. And I suppose I would encourage every person just to sort of take a set back and just ask themselves a few questions like, you know, what does good look like for me? Who and what might help me? What are the first steps, where would I feel comfortable starting with this? And just even those little conversations that you start to have yourself, a little bit of self-coaching is really powerful. And I'm a massive advocate for self-coaching, which I could talk all day about, but I won't today. But, you know, if anyone's interested, then just contact me. Yeah, absolutely. And we'll put your contact details in the notes. But another day, obviously, I'll bring you back to just talk about

self-coaching, but it's so important because there's so much we can do from within, but often we can't always unlock it. So it's been really great talking to you, Claire, and very inspirational. But before you go, I wouldn't mind three tips. So for people that have heard this and do feel that they're not getting forward or they're not being listened to or the word coaching can be a bit scary, what are the three things that really, in your experience, to help with self-esteem to start helping people get into the right zone to go in the right direction to improve their health. I think the first thing is to recognise what it is that you're feeling. So just taking a few seconds, it doesn't have to be a big piece of work that you do,

but a few minutes to work out what it is for you at that particular time is really an issue and almost label them. So whether it's, you know, anxiety, whether it's feeling low, whether it's whatever it is, but label it. So you can start to realize what's going on, first of all. And then ask yourself, well, what might help here or who might help? So it might be that you want to educate yourself more like, you know, going on to, if you feel that it's perimenopause or maybe you want to go into your app, which I love. And, you know, that sort of thing.

Or it might be actually I need some extra support. Maybe I'll start speaking to a friend. Maybe I need to have somebody to help me with this. So that's a sense of, you know, what's going on with me? what or who might help me to begin with. And then just once you've written out a whole load of options of what you could do, just pick one really simple thing that feels really comfortable that you could do tomorrow and do it. It might be sending one email. It might be having one app. It might be contacting one person, but just do it. And once you start this process and you just do

tiny little things that feel manageable, you'll start to rebuild that sense of who you are and what you need and how to move forwards. Great advice. I'm going to start thinking about what I'm going to do tomorrow. But it's really useful and thanks so much for your time today, Claire. It's been great. Thank you. Thanks so much for having me. For more information about the perimenopause and menopause, please visit my website, balance, balance, or you can download the free balance app, which is available to download from the app store or from Google Play. Thank you.