The Dr Louise Newson Podcast - 218 - Tamsen Fadal: Speaking out about the menopause

Episode Date: August 22, 2023

On this week’s podcast, Dr Louise is joined by award-winning US broadcast journalist, podcast host and menopause campaigner Tamsen Fadal. Tamsen describes how she didn’t recognise she was menopausal after suffering from hot flushes, brain fog and heart palpitations, as she believed she was still having periods. This prompted her to find out more and support other women along the way, including spreading awareness via the #MenopauseTok campaign on social media. Dr Louise and Tamsen discuss the impact of menopause on careers, barriers to accessing treatment, the importance of being informed – and the growing voice of menopausal women on social media. Here are Tamsen’s top three tips:  Listen to yourself and your body and don’t miss signs that could be the perimenopause by putting them down to being busy or stressed. Try and carve out time just for yourself, even when things are really busy. Find your people: surround yourself with a community to support you through the perimenopause, menopause and beyond. Follow Tamsen on Instagram @tamsenfadal and Tiktok @tamsenfadal.   Tamsen photo credit: Jenny Moloney

Hello, I'm Dr Louise Newsom. I'm a GP and menopause specialist and I'm also the founder of the Newsom Health Menopause and wellbeing centre here in Stratford-Pon-Avon. I'm also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research,

bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newsome Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on a podcast, I've got someone with me who's from America. I've had a few people from America. And this is someone who I've been watching from afar,

really inspired by what she does. And she's a well-known journalist. over in America and getting known over here more as well. So her name is Tamzin-Fidel and she's got a bit of her own story, but she's a person with a mission like a lot of us are to really help as many people as possible who will listen and engage and move things forward for women. So welcome today to the studio. Thanks for having me. No, it's really exciting. So tell me a bit about sort of you, why you're in this space and what's been going on. Yeah, it's funny. I've had that question recently. because I didn't ever plan to get into this space.

I've been a journalist for a long time over 20 years here in the U.S. I've written a number of books. I wrote them on relationships and dating because I was in that space for a little while. But mostly I've been a journalist covering news of the day, covering stories that are happening here at home or globally. And it was a few years ago that I found myself on the bathroom floor in the middle of a hot flash with heart populations, unlike anything I've ever experienced before and not knowing what it was. I didn't know it was a hot flash at the time. I just felt out of control.

And I remember getting some help, leaving the studio, not finishing the newscasts the first time in 20 plus years, having not done that, not gone back to set, and thinking, what in the world is going on? And, you know, I went on a mission to figure it out. And I went from one doctor to another. And I went to an endocrinologist. And I went to a therapist. I was prescribed antidepressants. I had blood work done. They realized that my blood was in a range.

of what they call postmenopausal. And I thought, how is that even possible? I've had periods. I've had, but what I didn't realize is that I didn't know a lot about menopause or what was going on with me. And I had endometrium polyps. So I had been bleeding all along and didn't know I had been missing real periods. So I ended up there and I realized I needed to do something about it because I was just feeling out of control, brain fog, and started to do a deep dive into this space and what I didn't know and then what other women didn't know. And here's where I am today. It's so interesting, isn't it? Because I think so often we do get shaped by our own experiences, we have sort of something that maybe help us. But I was actually saying to some of my friends

who were also menopause specialists last night, a group of us went out. And I was saying it's really weird actually, seven years ago I was sitting in quite an eminent menopause specialist clinic in London. And I said to him, how do you know when someone's actually perimenopausal? And he said, look, it's really obvious sometimes, often it's really obvious for that person. And I was there sitting there actually perimenopause or myself. And I had no idea because sometimes when the symptoms come on very gradually, you can just blame life. And actually at the time I was developing a menopause website and it sounds weird now seven years on. But seven years ago, people really weren't talking about the menopause. And I was a medical writer as well as a

doctor and I thought, right, I'm just going to write some really basic things. And I was looking at the website recently actually, actually was showing a friend. And it literally had, what is the menopause? what is the perimenopause, what is HRT, and what is testosterone? Very basic information. And then as I started to see more patients, I realised that there was so much more that we needed to talk about. And it was quite incredible. But at the time, my brain was just not functioning or engaging very well.

And I thought, oh, it's just because I'm trying to fit in this writing as well as working, as well as having three children and trying to find all the excuses under the sun, why might be happening without actually. And every night I'm writing saying, brain fog, memory problems, irritability as I'm shouting to my husband. And I still don't piece it all together. But the stories now obviously are far more prolific, people are realising, but there's still a lot of medical gaslighting going on, actually, certainly in the UK, but I'm sure it is in the USA where I have a real problem and I suppose I'm more feminist, the older I am, but it's because

women are not being listened to a lot of the time. They're saying they've got all these symptoms and it's almost like it's in our head. Like, how dare we think it's related to our hormones? Or someone recently said to me, gosh, women just put everything down to their hormones. Well, why can't we blame our hormones for a lot of things? Because often it is related. What are Americans like? I mean, do you think American women are having much of a voice at the minute?

You know what I think? I think that American women are learning slowly but surely. I think there are a number of thought leaders and doctors out there that are louder voices in the space, which is what, you know, obviously what we have needed. I think that there's just still a lot of not only misinformation, but also a lot of doctors that don't know. And I hear one woman after another come to me and said, my doctor said they don't deal with hormones.

And I said, what do you mean they don't deal with hormones? Like they just don't feel comfortable prescribing them. And so women are afraid. And if you've gone to a doctor since you were, whatever, 25 years old or 30 years old, and this has been your doctor, this has been your gynecologist since the very beginning, and you're not, that person that you've trusted so, long, doesn't feel comfortable, it tells you something, most likely you're going to listen

and you're not going to question that. And so I think that we're putting women in my goal anyway, and I think yours is as well, is to empower women to not be afraid to question and then question again. And then if they're not getting answers, that makes sense to them or that are helping explain things a little bit better to move on to another doctor. You know, I still think there's a ton of misinformation out there. I'm grateful to so many people that are on social media that are trying to change a conversation, even if it's through a mechanism that we're not used to changing a conversation about medicine in, because that's the only way that we've gotten this conversation. You and I would never be talking today if there were not some loud voices out there, right?

Absolutely. And I think social media is a double-edged sword, but actually I think it's really, really useful because it's very empowering. And if the information is accurate, it's a way I can reach women globally that I could never have reached 20 years ago before social media. And Actually, it's so important because so many people really do feel alone when it becomes the menopause. And I get a lot of direct messages and I can't answer all of them. But when I read them, you know, people are really scared and they just don't know where to turn to. And in fact, one of the doctors who works with me saw a lady yesterday in the clinic. And 18 years, she'd been struggling and she'd actually become housebound and crippled with her anxiety. Her partner had left

her as soon as her vaginal dryness was so very. he couldn't have sex with her anymore. And she became absolutely uncontrollable actually. And all she was eating was chocolate buttons because she found any texture of food in her mouth was awful. And her family had just deserted her and her whole life had become a shell. She just wasn't functioning at all

and she was previously an actress. And you think, how can this happen in 2023 that somebody who's intelligent, who's English, who can speak English, their first language, not be able to access any help. And, you know, we see stories all the time, as you can imagine, we see about 4,000 women a month through our clinic. So when we meet every single one of the clinicians that work with me have horrendous stories that they hear. And we're not just one or two stories. There's lots. And I just feel like, why is it that it's happening? But the good

thing is, the conversation is starting. There's lots of people talking. But talking isn't quite enough. because once you've had that conversation and once you know something's going on, it's even worse almost. And I feel like I've, I feel sometimes quite embarrassed, happens in with what I've done in the UK, but globally as well, because I sort of lifted up this big stone almost.

There's lots underneath. And I can't put it back down. And women are now realizing what's going on. And they're saying, well, I'm not depressed. I don't need antidepressants. I don't need therapy. I don't need pain killers. I don't need blood pressure treatments.

I don't need sleeping tablets. I just need my own hormones and then they can't get them. And I know it's very difficult because some doctors are really, really scared of HRT and they're very scared of being sued. And, you know, they're very scared of any risks. And obviously the whole thing over the last 20 years has been about breast cancer. And of course women taking HRT are going to get breast cancer because women not taking HRT will get breast cancer.

It's very common. It affects one in seven women. But it doesn't mean that everybody who is on HRT and gets breast cancer, the HRT has caused it. But it has this massive fear. And then doctors are thinking, I'm going to get sued because, you know, patients develop breast cancer. But actually, as patients, and I'm one myself, then we can make decisions and we can choose, can't we? And I think this is where that choice for women has just eroded, really, hasn't it?

Yeah, it really has. You know, I talk a lot about breast cancer because I lost my mother to breast cancer at the age. 51. She was diagnosed her 44, went through a mastectomy, then another mastectomy, chemotherapy, radiation. I didn't realize at the time because I just didn't know what I didn't know. I didn't even realize until a few years ago that she had gone through, you know, a surgically induced menopause as a result, or medically induced menopause as a result. And when I look back at that, it makes me so sad. She had an estrogen-based breast cancer. I've always been very afraid of that. That was the dark cloud that's loomed over my life.

I'm 52, you know, since she died of five, 32 years that has loomed over me as my biggest fear and one that was in my mind when I found out that I was in menopause thinking like, gosh, what am I going to do? I'm going to have to suck it up and push through it because I'm not going to be able to go on HRT. And the first doctor I went to said, I'm not so comfortable prescribing that to you. The second doctor I went to said, well, try lexapro and antidepressant instead and see if that works for you to help get through some of the brain fog.

and that didn't work. That didn't help the symptoms that were making me incapacitated to do my job, really, because I couldn't even think straight. And then finally I found two other doctors. But this is through a course of like research and going and going and to expect women who are working a job and have kids and are taking care of a home and to now go and like, you know, doctor shop is not fair. And to have to question and question and question. And I really think that that's where my voice comes into the space because I want them to feel like they, one, or heard, two, don't have to have that fear, and they can make the decision themselves, whether they decide that's what they want to do. Because that's what's very important.

And they might decide not to do hormones. I'm not advocating hormones, but I'm advocating you can have that option there. And if you decide that that's what you want to do, you get to do it. And if you decide you don't want to do it and you want to go a different way, as we know, there are different pharmaceuticals that are coming on the market every day that are available to help different symptoms. And you can go that way as well. Absolutely.

I totally agree. I really feel very strongly that we can choose so many things in life. And in medicine, there should be a choice as well. You know, if I have someone sitting in front of me who's been diagnosed with raised blood pressure, I will talk to them about the choices of treatment. Some of them will have an ACE inhibitor, someone might have a calcium antagonist, some of them might have a water tablet. And we just go through everything with them. And if one doesn't suit, you go to another. And that's what we've always done in medicine. And to just say no straight off and ignoring any benefits, which is what we've done for far too long, I think is such a shame. And certainly I think we should be thinking about, well, what are the risks of not taking HRT? So, you know, for you, for example,

with your mother's sad story, you might have an increased risk of breast cancer regardless because of your family history. But it doesn't mean that taking HRT will increase that risk further. But whether you've got a family history of breast cancer or not, you still have bones that are going to increase your risk of osteoporosis. You've still got a heart. And we know that women have an increased risk of heart disease. And you've still got a brain. Women have have an increased risk of dementia when they're menopausal and so forth. And so a lot of women say to me, well, actually, I'm more scared of heart disease than I am of breast cancer. So I would like to do everything I can to reduce my risk. That's not unreasonable. Whereas other women will say to me,

every day I'm going to worry about breast cancer. And every day, it's just my biggest fear. And if I was taking HRT, I would blame myself if ever something happened. well, those women don't have to take each other. No one is forcing anyone to do anything. And I think this is where I feel that women are just sort of being sort of shoehorned or labelled all the same. And we're all different. We all decide what type of exercise we do or what we eat or how we live our lives. And so whether we take hormones or not, it should be a choice, but it shouldn't be a bond or no, which is what's happening far too often. And I'm sure it's the same in the US, but in the UK it's areas of deprivation, far lower prescribing, areas of ethnicity as well,

far lower prescribing. So there's, even across the board, there's a real difference. And inability to afford them, which is a big, big problem in the expense and whether or not you have the insurance and whether or not you've got a doctor to even be able to talk to about it. So all of those are things, you know, that have to be discussed too. So when you say that pass the conversation, what needs to happen, it has to happen on so many different levels, not just workplace, not just legislative, not to, there are so many different areas that have to be tackled, but I guess, you know, the one area that I feel comfortable in that I know well is to be able to push out information and to talk to as many people as possible and try to at least help

guide people in a direction to as simple as trying to find a doctor, right, that will listen to them because some of them don't have that. They don't even know where to begin that. They don't even know what's going on with them in terms of the symptoms, in terms of the the different symptoms of what they're dealing with. And I'm on social media a lot and the women that I have heard from on there, as you know, the heartbreaking stories and the difference of stories too, because everybody is so individual when they come about this and whether they've now gone through a divorce as a result of this or they've had to leave their job as a result of this or they're isolated, like the patient that you were talking about, it's not okay to have all those stories.

The one thing I'm grateful for, though, is that we're hearing those stories. So we know that there is a real problem and they're not just, you know, there's no way for us to talk about them or hear those. I feel like you write social media is a double-edged sword, but the fact that we're able to communicate with somebody that is, you know, in another state, city, country, across the world to be able to hear and help makes me feel inspired. Oh, absolutely. And you mentioned workplace. I mean, we've done various surveys now looking at women, how they're struggling with their jobs. And almost consistently, we find that it, the figures say, around 10% of women, in give up their jobs completely because of their symptoms and it's usually memory problems,

fatigue and anxiety actually. We did a study recently looking at NHS employees because about 40% of NHS employees are men or palsal women and around a third actually really wanted to reduce their hours and were not going for a promotion as well. And so a lot of women, even when they're going to work, they're underperforming, they're not doing as well because of the way usually that their brain is working. I was recently at a very high level meeting in the UK and it was about workplace and people were talking about the biggest breakthrough and I was thinking great we're going to be talking about how we treat women. It was talking about uniforms, how there's some new nurses uniform that's thinner and about fans and I just literally wanted to

switch my camera off and cry because how is that going to help people's brain work? And there's so much sort of responsibility put on the employer. But the employer, they can signposts, they can learn, they can educate. But that's not the same as they're enabling people to have treatment, isn't it? It's such a problem. No, it's not at all. I mean, it's like it's the lower end of things. And I'm appreciative for any conversation in the workplace.

But, you know, it also has to have action, real action that can help somebody on a day-to-day basis or help somebody feel better or help somebody get up in the morning, help somebody feel empowered to go after that promotion. it has to start there. It is such a problem because there's quite a lot over here about, you know, people working from home. Well, not everybody can work from home. They haven't got the jobs that they can work from home. And why should we?

I always heard the answer is a hybrid model. And I'm like, but not everybody can do a hybrid model with the job I do. It's just not possible. No, absolutely not. And so I feel like men and postal women are often treated like second class citizens, really. And then people talk about this transition and say, well, it's only going to last a few years. so let's help these women transition through the menopause. I think, well, actually, you can't just have a different job.

And you shouldn't have to wait. I don't really understand why we have to reduce our hours, because then that reduces our pay, reduces income. But it's also not good for the economy globally either, if it means that, you know, women that have been trained up through organizations, then suddenly have to withdraw. It costs, you know, companies, a lot of money to lose working women. It also reduces confidence, and I think that that's a really big deal.

You know, we have a lot of women that are the head of their household and women that are holding things together. And when you say to them, look, you're not going to be able to do what you were able to do at that level anymore, that hits confidence in a very, very big way. Absolutely. So what's been going on over in America that's made a big difference to women, do you think, over the last few months or so? You know, I think more than anything else is the fact that there's finally some really

vocal doctors out there that talk about it. I think the fact that women are hearing that there are other options out there and places for them to go to get information. There's a lot of these telemedicine companies that are available. I think there are a few big companies that are talking about work policy. So women feel like, you know, if they're there, you're spending so many hours at work right now. And if that's a place you can go and maybe get some answers or help, I think that's a good thing. There's a lot more work to be done with regard to that. And, of course, there's a lot more work to begin with regard to being able to afford hormones.

but before that to be able to understand them. And I think that that's where I try to come into that is really understand and dispute that 2002 study or at least explain what that study was. It makes me sad that it's been 20 years and we're still talking about the results of that women's health initiative study that did such a disservice to women. I'm grateful for the doctors who were practicing before that study and that have some type of understanding of what the landscape was and what it looked like and where we need to get back to. I mean, it's quite shocking, isn't it, that one study can have such a big impact on so many people. And I can't think of any other study in medicine, actually, that's had such an impact on half the population. And even so, we're still at half the prescribing. So before the WHO study in the UK, about 30% of menopause or women were given HRT, and now it's about 14%.

It's gone from 10 to 14%. It's not amazing those numbers. It's nothing, is it? Well, and the other thing is, is those women, you know, then, I think, you know, we're probably not working as long as women are today. You know, and that's the other thing. And I don't have those numbers, but I've seen them in the past. But the fact is, is that we're working well into our 50s, well into our 60s.

So the reason we aren't, I think the reason, is because women are out there doing things in the workplace and seeing problems or seeing an inability to be able to think or to concentrate or the anxiety that they have. And maybe that wasn't happening 30 years ago to the extent it is right now because we know what longevity looks like today. So, you know, when people say, I wonder why we're talking about it now. Well, we're talking about it now because we've added now, you know, so many more years to our career and we've taken away something that helped women.

So, you know, 30 years ago. Absolutely right. And the other thing is the incidence of early menopause. So menopause and younger women has really increased it actually over the first five, 10 years or so, we used to quote, one in 100 women under the age of 40. Recent studies have shown it's more like 3% of women. So three in 100. So that is that now?

Why is that increase? Well, we don't know, actually, for sure. But there are, I mean, even if you look at some of the reasons why people's ovaries fail, and sometimes it's due to medical treatments, for example, if someone's had a cancer, like a cervical cancer maybe, they might have had a hysterectomy, they might have had radiotherapy that affected the way the ovaries work. And the prognosis from lots of cancers is so much better than it used to be. Or childhood cancers, leukemias and lymphomans and so forth. And so the outlook is better so that a lot of those people are now living a lot longer lives.

And then actually we've been doing quite a lot of work, women living with HIV, because women living with HIV are more likely to have symptoms and less likely to receive treatment. And also, far more likely to have an earlier menopause. And that might be the relationship. of HIV itself or it might be a side effect of some of the drugs that these people take. But the outlook now for women living with HIV, their life expectancy is fantastic, whereas in the 70s and 80s, they wouldn't even make the menopause age, you know. And so there's more people living, like you say, for longer. But we also know the longer a woman is without her hormones, the greater the risk of diseases

as well. And I really worry about younger women. We know that a lot of women in the US and the UK and other countries who are having a hysterectomy, having their ovaries removed, yet no one's offering them replacement of hormones. And so often in the clinic I hear people who've had their ovaries removed at young age, you know, in their 30s. And then the surgeon will say, oh, let's just see how you get on. And it's like, you can't do that because hormones are biologically active in all our bodies. And there's a reason that that feeling of, you know, whatever it is becomes the norm, which is really. sad and people think they just have to live with it. Yeah, absolutely. And I feel that also there's this

sort of shame of almost giving in to hormones or people feel that they have to suffer a certain amount of time or certain length of time. And I think that's when it's important to be thinking about the health risks as well. And certainly a lot in medicine we treat to reduce risk of diseases. Obviously, that's why we give blood pressure treatments or often statins, for example, to lower risk of heart disease. So we don't wait for someone to get chest pain and angina. We try and reduce and prevent it, quite rightly so. And that's exactly the same with hormones. You don't have to have a certain list of symptoms or wait till one of the symptoms is so bad that you're giving up your job. And we also know from evidence the earlier women are taking HLT, the better for their future health as well.

I find it so amazing when I think about the fact, you know, I'm assuming it's the same in the UK, but, you know, you have a commercial on television for a prescription drug, and then it gives you the big list of all the problems that could possibly happen. With regard to estrogen and progesterone hormones, there's one outstanding one that scares women for the most part, which is breast cancer, yet that is the one thing that everybody is so frightened about versus all the other prescriptions that, you know, we've probably taken a lifetime that have all these other warnings outwardly as shown to cause that through tests, and we don't even have the right test. here. So, you know, that the testing and the studies, that's where I was saying earlier,

there's so many different areas to cover. So I'm grateful that there are different voices out there. There are doctors' voices out there, that there are advocates' voices out there, that there are real women that are talking about their experiences out there. And, you know, we're seeing bit by bit different employers talking as well. So it's not just a conversation, but it's people hitting different areas of this, because I think that's the only way to tackle it. So in 20 years, we're not in the same place, again, just having the conversation. Yeah, for sure. And I think certainly I've got three teenage children, got three daughters, and they're quite vocal, but they're really vocal talking to others who are older as well. And just those conversations, sometimes it's usually in the toilets where they overhear someone talking and then they say, oh, I don't want to go on a flex about my mum, but I think you should download her app. If you heard of balance and they're just, and it's just starting that conversation. Yeah, but it's brilliant because they also, they're really more aware of PMS, PMD, you know, I just think they'll be on it so quickly that they're not going to allow each other to suffer in the same way.

Just the stories I hear of women who are finding sex so uncomfortable or they've got no libido at all, but they don't talk to their partners because they feel so embarrassed, they feel so alone, they think it's just them. Whereas I think the next generation, of course, they'll be talking a lot more openly. And then they can support each other in ways that perhaps we haven't done over the last 20 years or so and only just doing now more virtually, like you say, through social media. But we need to have, you know, the conversation is even closer. So it's usually our friends or our relatives that will be persuading us to get help and treatment

because that's so important, isn't it? I think so too. And you know, the other area that this is maybe down the line or maybe it just goes along with all of it, is educating the men in our lives too. It's funny. My 11-year-old nephew asked his mom recently, they're on Instagram and at early age. He said, what is Aunt Tamsin talking about this menopause? all the time. He's 11. And she said, well, women go through hormone changes just like you do,

because he's, you know, he's 11 turning 12. And then my 83 year old father asked, too, this menopause you're talking about. I didn't know you could go through it so early. And I said, that I'm 52. And it's not early. I said, you know, it started before, you know, 47, 48 years old. And he said, I knew nothing about this when your mom was going through breast cancer. And that made me so sad. Because I realize that this is something that women have lived with by themselves for a very, very long time. And so to hear one end of the spectrum, an 11-year-old, the other end of the spectrum, an 83-year-old man, I thought, okay, well, at least the word's definitely getting out there somehow. Yeah.

People that are in our lives that might see things in us that we might not see in ourselves and might help us or encourage us to seek help. And I think that's important too. Absolutely. And also so many partners, male and female partners, get really quite worried and they don't know how to help or they don't want to offend. Right. And actually, once the conversation starts, they're so very.

relieved because they know it's not one of or the other, especially if their relationships affected or if it's their parent, you know, it's like, oh, okay, there's a reason. So once you've worked out the reason, then you can work out what to do. I couldn't agree with you more. I'm so grateful for, you know, voices like yours that are are willing to spend their time. I mean, I know when you're, you're seeing patients all the time and you've got so much going on, but you're willing to spend your other time talking about this because I think that that's the only way to educate and to help provide solutions too because somebody like me, I can't necessarily provide solutions. I can provide guidance, but it's encouraging to see that. And it's encouraging to be

able to do it across the world because I think that that's the only way it's going to happen faster. Absolutely. It's really good. I mean, I'm so grateful for your time and I'm really grateful for all the work that you do. And when I flick onto you on Instagram, you're seeing your lovely face and passing messages. And I think the more people hear from different people, the better as well. So it's great to be able to join forces. So before we finish, I always ask for three take-home tips. So I'd really like three things that you think women, wherever they are, whether they're in the UK, USA, one of the three main things that you really want people to do to take this

conversation further and make a difference. Yeah, absolutely. First, listen to yourself and listen to your body and don't push things off and say it's just anxiety because the kids or it's just because I'm stressed out at work. Like really listen to yourself because I think that perimenopause, is confusing. It's a cloudy time and it's a time where we can make excuses for some of those symptoms, and that's not always the case. Oftentimes, it's exactly what it is. We're going through this transition. So listen to that. Two, if there's any way to find some quiet time in your calendar,

I found that is critical for me. There's a lot of noise out there. We're all creating it. We're all absorbing it. But I think that that quiet time is essential, especially in this period. And I think third is to find a community around you that will support you through this. And so if you don't have the answers to something, because we don't all have the answers, maybe somebody that in your life does. I mean, those are really my three takeaways that have helped grow me and make me feel confidence of moving into this next chapter. Great.

Love it. So thank you ever so much. We can all learn from that, whether we're menopausal or not, really good tips as well. So thanks ever so much for your time. It's been great. Thank you. It's wonderful. Take care.

You can find out more about Newsome Health Group by visiting www. newsomehealth.co.uk. And you can download the free balance app on the App Store or Google Play.