The Dr Louise Newson Podcast - 226 - From PMS to menopause: why we need to talk about hormones

Episode Date: October 17, 2023

Content advisory: this podcast episode contains themes of mental health and suicide* It’s a family affair on this week’s podcast as Dr Louise is joined by her eldest daughter Jessica for a special episode on the eve of World Menopause Day. Jessica talks frankly about the impact of PMS and coping with hormone changes with migraine, as well as the strategies that helped her. Mother and daughter also discuss the importance of demystifying menopause and hormone changes through honest conversations between families, friends – and even complete strangers. This World Menopause Month, help us start the most menopause conversations – ever. Everyone’s menopause is individual and to help others understand and manage their menopause, we must break taboos, educate and start the conversation. How to get involved Have a conversation about the menopause Log your conversation on the balance website Share that you’ve got involved by tagging us on social media, using the hashtag #PauseToTalk *Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email [e-mail]  

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 on the podcast today, because it's close to World Menopause Day, I thought I would do something a little bit different and speak to one of my children.

So I have three daughters, and my eldest daughter, Jessica, has kindly agreed to join the podcast to really break more taboos, talk about hormones from the views of a 20, nearly 21-year-old, which are quite different to me as a 53-year-old. So welcome Jessica to the podcast. Thank you. Thank you for having me. So a few years ago, if I'd said to you, I'm going to get you onto a podcast that's had nearly five million downloads and you're going to be talking about menopause and hormones. What would you have said a few years ago? I would think about how when you first tried to get us to do a family podcast, when your podcast

had first started, and no one could keep a straight face and we couldn't do it. And I remember you going, right, that's it. We're never going to do a podcast together. And here we are. Here we are. Trying to do a podcast together. So let's see what happens. So that was about five years ago because I had the three of you on a sofa in my room at the clinic and you just giggled the whole time. But since that time, since that time, since that. that time, you've learnt more about hormones in a personal way and also just because that's all I do is talk about hormones. So I'm really keen to just listen and think about what it must be like for someone in their teens and 20s because your generation is very different to our generation

and my generation is very different to your grandmother's generation. And one of the things that's really different is you learn more about things seemingly on social media than you do from your mother or your parents or your peers sometimes, which is great, but not all the information is accurate. But also, you talk a lot more openly to your friends than I ever did when I was your age. When I was at university, we did talk a little bit more because we were medics, but we still didn't share even things about our periods, what it was like to have a period or even what contraception we were on, whereas now you talk quite openly, don't you, about all sorts to your friends? Well, yeah, I think in general, like the conversation is a lot more open with people of my generation,

but also I think the way that I approach these conversations is always very open and very much, oh, did you know, like, fun fact, you don't have to struggle with like X, Y and Z, or did you know that this is linked to your hormones? And I find that the way that I approach those sorts of conversations with my friends or even just like people that I meet day to day, it means that there's a very open conversation and sort of very honest communication and respectful communication between people. And I think the more I've learned about the menopause, about hormones, and about how it can affect your day-to-day functioning, the more I've been able to positively impact people

talking to them and guiding them towards some of your work and things that we've read and, like, balance and everything like that. Because you've had some really empowering conversations with people your age and people my age well, haven't you? Yeah, definitely. Definitely. I think everyone seems to have a connection to the menopause or maybe they've got their own story with their hormones or with their periods. Everyone has something to talk about it. Everyone's had a period where they've been misinformed. And I think a lot of people, I think most people I talk to are just confused. So it's always nice to bring some clarity. Well, you're absolutely right, because when you're confused, you can just

sort of get overwhelmed and then you don't know where to believe or where to go or who to trust. And I sort of learnt quite a lot about your own hormones in lockdown, didn't I? Because we were living together very closely. And I realised then that not only were your periods very heavy, but you were also very flat at the beginning of every month, weren't you, in your mood. Yeah. And I think it took about three months for you to notice and be like, can we do something about this? Yes, because you're a trombonist, don't you? You can say what you do.

Where are you a student? I'm studying classical trombone at the moment at the Royal Academy of Music, so I'm going into my second year of my undergrad degree. And you're also a really good artist as well. Yeah. If anyone visits my mum's clinic, Newsome Health, you'll see all of my artwork on the walls where I'm artists in residence. You are indeed.

And your use of colours is really bold, and wonderful and really quite empowering. But I realised when you were at home, in COVID when there was little to do, and you were playing trombone a lot, you were practicing a lot, you were also doing a lot of painting and drawing, there were a few days every month that you didn't.

And I remember you once, you walk past the study here, and you just said, oh, what's the point of playing music? Yeah. I was like, what are you on about? And then I sort of sat you down and said, hmm, it really seems to be a pattern because it's always the first few days of the calendar month

and your periods were quite regular then, but you were obviously getting very heavy periods. And then the sort of penny dropped that it was a few days before your periods, you were feeling quite low and couldn't be bothered to do anything, really. Is that right? Yeah, I remember the conversation because we were sat on the brown leather sofa in the kitchen. And I just remember feeling, I was just so detached from myself. I just felt this, like, weird weight that came from nowhere and I never had sort of any negative thoughts attached to it. but then when you're feeling negative and sew down, it's like super confusing

because you don't know what it's connected to and then you're overthinking all the interactions that you've had or, you know, oh, maybe I don't actually like trombo. Maybe actually I don't enjoy painting. And then you realize, oh, it's just because you have low eustrogen because that's what it's like at that point in your cycle. Everything, like, makes way more sense. Yes, but at the time you didn't realize

you just thought it was a phase that was happening. No, not at all. And so then knowing it was related to your whole, hormones, obviously was a discussion. But before we talk about how we've helped you to improve your symptoms, is also many people who follow me on Instagram will know that you suffer with chronic migraine and I feel very guilty because I've given you the gene that clearly I have. My mother's got, my grandmother had. We've all had migraines and still have migraines, but each generation it seems to have got worse and you've definitely really had a very difficult time. And you've tried so many

different treatments with your hormones. And as many people know, migraines just don't like any change. Our brains like homeostasis, they like everything the same. And so when hormones change, then some people, not everybody, but a lot of people find their migraines can be worse, don't they? Yeah, completely. I mean, with migraine, it's all about keeping things consistent and making sure that everything is controlled and managed, whether that's hormones or whether that's your blood sugar levels, so things like I only eat food with a low glycemic index, or how much exercise you're doing, or, you know, like I'm teetotal. We're both teetotal. Both of us don't drink because of our migraine, and we feel so much better for it.

So yeah, I think you have to manage things to keep this sort of homeostasis across the board. Yeah. And think about a lot of things that people don't normally have to think about day to day. No, no, because certainly your middle, well, my middle daughter, your younger sister can do what she likes, eat what she likes, and she doesn't get migraine. She's really, really lucky. But we constantly have to think we're going to have a late night, the impact it will have on us and everything else. So there's a hormonal change and obviously that hormonal change gets exaggerated during the perimenopause. And a lot of people, I was listening to a podcast today, I'll share it with you later about migraines. And the expert was saying, yes, migraines are far more common in women that.

men, especially around the time of the 40s and also teenagers. That's so weird. But we don't know why. Well, let's just use some common sense because our hormones fluctuate. But also, I hope you don't want me saying, but age 20, lots of 20-year-olds need contraception. So your contraceptive choices are more limited when you have migraines as well, aren't they? Yeah, I can't have the pill. Yeah.

So because they combined oral contraceptive pill and actually the progester and only pill have a very small risk of clot with them. With migraines, there is a small risk of stroke, only very small, but obviously in medicine you don't want to give too small risks to somebody. So the general consensus, especially when someone has migraine with aura or more severe migraine, is we try and avoid oral contraception. So when I was trying to decide what would be the best advice to give you, obviously I've already said you had heavy periods and you need a contraception and you've got migraine and you want something that's really reliable, then actually the choices really do narrow.

And I know you did try one of the protested and only pills, but it brought a lot of spots to your face and you felt quite low, didn't you? Yeah. Yeah, it's not good. So that wasn't right. So then I thought, well, the implant, once it's in, it's harder to reverse. And I thought, well, you'll probably get side effects with it. And I am, as many listeners probably know,

I'm a bit concerned about the implant because it's switching off your implant. your ovaries working. Therefore, you get low estrogen and probably low testosterone as well. And what side effects would that cause? I'd be more than a bit concerned with that. Yeah. And I think a lot of this, like the conversation at the beginning, it's your body, it's your choice. You have to help decide what's right for you. And, you know, we're not saying on this podcast that what you're doing is right for everybody, but everyone deserves to know the information and then they can choose what's right. Well, yeah. And what I do is right for me and works incredibly well for me. Absolutely. So then you decided to have this low-dose coil, didn't you?

Yeah, so it's the marina coil, which has localized progesterone, which stops the lining of the wound building up. And I've had a coil maybe three, four years now. And it's amazing. I mean, the main reason why I got it was it wasn't for contraception. It was for management of my periods because they were so heavy, they were so awful. And now I don't have a period at all. and maybe bleed for maybe like one to three days a year and that's it. Yeah.

Which is amazing. Which is incredible, isn't it? And you actually have a low dose marina, so it's a J-Dess one. So it's a small one. It only lasts three years, but you've had yours replay, so it's still in date. And so it just produces a small amount of this synthetic progestogen to the lining of your womb, so it keeps it thin. If the lining of your womb is thin, then you don't shred it, so you don't have periods.

So that in itself is really lovely, and it is a treatment for heavy periods. So even if you didn't need contraception, then it's still a really good choice. And it's quite liberating, isn't it, to not have periods? Yeah, completely. It's amazing. So you had that. And then with your migraines, obviously there are lots of reasons why people can have migraines and lots of triggers.

And there are lots and lots of different treatments. Some people respond very quickly to a treatment, what's called a prophylactic treatment, so it stops the migraines being triggered. But a lot of these medications have side effects with them. and you are someone that's super sensitive to any medication. So you've been under four different neurologists. You've now got the most amazing neurologist in London who, coincidentally, I went to medical school with and he is a complete saint and hero.

He's incredible. Yeah, but what you've tried seven or eight prophylactic treatments, haven't you, over the past? And you've given them good time to try. They've caused all sorts of side effects. So you've been given other treatments as well. and you've also really managed your lifestyle. You've looked at your posture, you've looked at your sleep, you've looked at your stress, you've looked at absolutely everything.

I mean, your lifestyle is far better, I think, the most 20-year-olds in the planet. But the other thing that we sort of talked about together was about your hormones because not only were you feeling flat and the J-DES might stop some ovulation, but we don't know, but you were still getting this sort of feeling very flat and obviously migraines can make you feel very low. we know that, but it was also to try and stop any hormonal variation, to try and smooth things out. So one of the things that you do is to use estrogen, isn't it? Yeah, it's amazing.

So how do you use the estrogen? So I use estrogen patches, which I change twice a week, and they're amazing. They've completely changed my life. And, you know, I went through quite a lot, which you know, obviously over the last couple years with migraine and obviously migraine causing severe depression and all that kind of stuff. You know, my migraine's far better managed now, which is really lovely. However, I know that I would not have got through everything that I went through if my mood had not been stabilised through taking estrogen at all, because I was so, I was in such

a rough place and I was so low and flat, and I just know if I hadn't have had estrogen to sort of maintain my mood consistently, so I felt the same day to day and I didn't have like random dips or just this complete heaviness added on to me that I don't think I'd be like here talking today on this podcast. Yeah. You know, that's why I think it's so important to talk about this and to raise that sort of awareness because I think you can't underestimate the impact that hormones can have on someone's life. That's so important, isn't it? And for people listening might be a bit confused thinking, goodness me, a 20 year old is not menopold. and she's using HART.

And HART is just hormone replacement, three letters, meaning, and it doesn't always replace. All you're doing is topping up your hormones. And what's interesting is, as you know, you're having the 17 beta-Eastodial, the natural estrogen that your ovaries produce. And actually 100 micrograms that the maximum dose patches is still a low dose compared to if you were having the contraceptive pill.

We know that HRT can't be used as a contraceptive because it doesn't always switch off the ovaries because the dose is low. But what we are doing is enabling you to have enough so you have a steady state all the time. And I know there's been a few times, especially when your migraines have been bad and your mood's been low.

And then I phoned you and spoken to you and I said, have you changed your patch? It's Friday. Did you change it yesterday? And there have been a few times, haven't there where you said, no, I haven't? Yeah.

Well, you know, throwbacks of when I had memory loss from migraine. and couldn't really function very well. And as soon as you sort of reminded me of that, it just, because you have this amazing ability, but whenever I phone you, whenever I say, you know, hello, how are you or something? Or you go, why are you calling?

And I'm like, I'm just going to say hello. And you can hear exactly in my voice, like what's going on. So you go, oh, you haven't eaten, have you? Or no, you need to eat now. Or have you drunk enough water? You just know, you can just hear it. It's like some psychic ability. Maybe I am.

secret witch but you know doing a lot of um gp training really teaches you about consultations and it's the non-verbal clues that actually have enabled me to diagnose so much more so someone might be telling you one thing and you're looking at the way that they're positioning themselves or the way they're not giving you eye contact or the way their voice is changing and that's what i've learned for the last 25 years so on the phone i can still hear and also obviously from knowing me absolutely so well as Absolutely. And, you know, and it has made a really big difference. But then one of the medications you were on, actually, you have asthma as well. And you were given an asthma medication, which actually caused a lot of your mucus membranes to be really affected. And you were getting a lot of dry skin, dry eyes, dry mouth, but also some vaginal dryness as well. But also before that time, you were getting some urinary symptoms and frequency too. and I don't mind telling people, but I use some vaginal pezzarise since after having a hysterectomy, I was getting a lot of irritation, recurrent urinary tract infections.

And so I use something called intraosa, which is DHEA, which converts to estrogen and testosterone in the vagina. Well, it was awful. Like, walking was painful. Like, I was so aware of the dryness in my vagina all the time. It was really, really painful because obviously the, the tissues are the same in your lungs as for your vagina. So if you're doing something which will impact your lungs, it will also impact your vagina. So yeah, it was awful. But as soon as I had the pezzaries prescribed, that wasn't an issue anymore at all. It's amazing the impact that it had.

Yeah, and then you stop the inhaler because you saw a respiratory consultant who changed your inhaler because of the side effects everywhere else, of course. Yeah, different side effects. And then you didn't use the pezzaries and then you still exist. some of those symptoms, didn't you? Mm-hmm. So now you're using them again regularly. Yeah, and it's great. Yeah.

And it's very interesting because the more we learn about sort of vaginal dryness, but we call it in the menopause, GSM, genitone, U and Re syndrome of the menopause. But actually, it's not just of the menopause. It's of the perimenopause. It's of hormonal changes. We know postpartum when someone's had a baby, they can get these changes. But there's a lot of young people who are more, it's not so much dryness, but just more aware of their vulva and vagina.

We shouldn't be aware of it. Well, I also know, like, a lot of people that consistently struggle with things like UTIs and cystitis and things like that, which you know can be helped by using vagina pezzaries. Yes, yeah. So there's the estrogen-only vagina pezzaries or this intra-rosa, so they can be transformational for a lot of people. And it's quite shocking how few people know about them at all. I know. And I know that you obviously talk very closely and openly to your friends,

but you've had various conversations in toilets with people you don't know about hormones, haven't you? You told me not that long ago you were in the toilet, a public toilet, and two girls were getting quite upset having a conversation, weren't they? Oh, yeah, I remember this. Yeah, I was in the cubicle and both of these girls were just, they were very upset and very emotional, and they were talking about how their moms were massively struggling with their menopause

and that their moods were changing. you know, they were really depressed, really anxious. I think one of their mums was unable to go out the house, like that sort of thing. You know, memory's starting to go. And they were just, you know, they kept on saying, God, it's just such a shame because obviously you can't do anything about it other than what. They sort of like really quickly came out the cubicle and I was like, look, I'm so sorry to interrupt.

I don't want to intrude at all, but I just wanted to let you know that that doesn't have to be the case because obviously, you know, the menopause is just a long-term hormone deficiency. So if you supplement those hormones, you're not going to have all of the symptoms. And obviously I spoke about your work and everything like that. And they were both just so grateful. They were like, please, can I give you a hug? And that happens quite a lot. And I just think it's so sad that there's barely anyone that I talk to about the menopause or hormones. And they go, oh my God, yeah, I knew that too. Everyone's just like constantly misinformed and misled, which is such a shame. It's so awful, isn't it? It's so much unnecessary.

suffering and you volunteer sometimes at the Tate as well. Sadly, they've changed the light bulb so you can't go there at the minute. But the last time you went, there was somebody who was really suffering as well, who was probably my age, maybe a bit older. And she was so grateful to have spoken to you, wasn't she? Yeah. I constantly, when I have conversations like that, people just go, oh my gosh, you've made my week. That's incredible. I'm so grateful to have met you, all that sort of thing. But I just think it's such a shame that it should have to take. me overhearing a conversation in the street to then go up and talk to them about it. And, you know, obviously I approach it in a very respectful way.

But it shouldn't take me overhearing to then talk to them. It shouldn't be like that. People should just be informed. Well, people shouldn't be suffering in the first instance. That's what I get so frustrated about. But I think it's the fact that it's unnecessary suffering as well. It's just so unjust. Absolutely.

And I need to thank you actually because of you. I've got this Instagram account because of your artistic talents. And because I suppose I was, well, I still am really shocked and sad with all the stories I hear at the clinic. And it was you that set up a menopause doctor account, wasn't it? Yeah. And I just, it's so cute because back then you were like when you had maybe 20 followers and you were saying, oh, I need to post every day because they've got to get the word out, got to help out all these people. And still now you think, oh, I need to post every day. got to get the word out, I've got to help all these people. And it's so true, like, your message hasn't changed. Your, you know, your core morals are exactly the same, but you're such a kind

and loving person. And none of that has changed at all, you know? No, I suppose the only, my problem is I always think I'm not very good mother because my work is just all consuming. Which isn't true at all. But it seems to be, it is a group effort because, you know, you're all involved. But actually, I remember when I first started, you might remember this, my Instagram, I'm a, after a few weeks, I put a post about vaginal dryness on, and Sophie text me on the train coming home. She went, will you take down your Instagram account? She said, the boys are making fun of me.

This is awful. And I said, yeah, you're more important than my Instagram account. Of course I will. And she went, oh, hang on, I think you are helping people. There's some really nice comments. Yeah, I don't think Sophie would mine now. No, well, she's a real supporter. Well, yeah, of course, we all are.

Yeah, so, but it is uncomfortable sometimes, having these conversations. And I think actually as a doctor, it's easier to have conversations, but it's also easier for people your generation to have conversations because for a lot of people, even just mentioning the word vagina, is really awful, whereas you guys are just so much more open. But I think though, you know, if I approach a conversation with someone, and it's obviously I'm like quite secure talking, well, I am secure talking about it. I am comfortable talking about it. And it sort of lets them know that actually it is a safe space to talk and it doesn't need to have this sort of whispered tone around it. And if I sort of talk blatantly about that sort of thing, I think that

helps other people develop confidence in talking about that. I think so. And it's so crucial when we think about our mental health. As you know, I'm going to Australia and when this is out, I would have been to Australia, talking about mental health and hormones, very exciting. But I mean, spending the whole weekend, actually, going down this rabbit hole, looking at the role of neurotransmitters and the role of estrogen and hormones. in our brain. And actually, estrogen is made in our brain as well. It's not just made in our ovaries. And I bet lots of people don't even know that. Well, so the estrogen reschedule on every cell in the body. Well, there is. But we've always taught that estrogen is made in our ovaries,

which it is, but it's also made in our brain. So I think that's absolutely fascinating, showing that how important estrogen is in our brain. And for some women, like you say, they can become very flat, very low. And as you know, there is an increased risk. of suicide and some people with very, very low moods out there. And sometimes it can run in families as well, this hormonal sensitivity. So people that have PMS are more likely to have postnatal depression, more likely to have a severe time in the perimenopause and menopause. And grandma, so my mother-in-law has been on the podcast, or fact my mother has as well. But grandma very clearly talks about this dark cloud going over her and she wasn't enjoying her life. She

wasn't enjoying her children. She didn't know what was going on and being married to your granddad Alec, who was a GP, he still didn't know what was going on. But I think what's really sad, as you know, is that her sister, Auntie Bar, actually took her own life on New Year's Eve. And for many years, it was blamed on the boyfriend that she had because they argued a bit. But then Grandma recently a few years ago said, oh my goodness, Auntie Barr had a hysterectomy as well. We never thought about that link. And that's, as you know, the thing that keeps me going all the time thinking about how can we explain to people that hormones are not just about periods. They're not just about bleeding. They're not just about contraception.

They're about mental health as well. And it's not just about perimenopause and menopause. People who have PMS and PMDD can be really, really affected. And some people say, well, it's only a few days a month. But a few days a month is a lot of time when you're young. and it shouldn't happen. Well, yeah, and it's also, it's not just, yeah, maybe it's those few days and months where you're, like, severely affected, but actually you're going to be reflecting on that

and worrying about those few days a month for the rest of the month, you know, and even if it, I know it's not, but let's say it is just about, like, periods and contraception, which it isn't. Obviously, there's so many other things attached to that. But even if it is just about that, that should still be taken far more seriously than it is. I totally agree. So many people are missing out on school, the university. their jobs just because of heavy periods. I'm not saying just, but because of heavy periods.

And then when we look at PMS and PMD, as you say, just before our periods is when our hormone levels are low. So our estrogen, but also progesterone as well. And some of you might have listened to my podcast I did with Dr. Hannah Ward talking about the importance of progesterone. So for many women actually having a higher dose of vaginal progesterone, as well as estrogen, can be very transformational. And the way that we respond to hormones is very individualized. So the way we respond, the dose that we have. And that's why it's so important. And I really strongly feel, what I know in medicine,

we've always been taught treat the underlying cause. Yeah, completely. And so if it's a hormonal cause, why would you want an antidepressant or why would you want some other medication? You know, it's different in migraine because we don't always know what the cause is. But even with your migraine, what you've done is stripped it right back and worked out the triggers and removed those triggers rather than having layers and layers of drugs.

and some of the drugs that you were offered really had a lot of side effects but even one you mentioned earlier gave you memory loss. I mean, your migraines might be better but if you can't remember anything and I mean, you don't remember how to play music. It was awful.

Yeah, I couldn't read music. I couldn't read full stop. I forgot things like how to walk up and downstairs. I forgot how to play chombone. I didn't know all the words for different colours, things like that has a massive impact. And I remember, you know, you were saying about a study which has been approved for women who were menopausal to have a trial with this

drug which I was on to see if it improves our symptoms. And I remember when you told me that and I just burst into tears because the side effects are so awful and I feel emotional talking about it now. The fact that women are being given that rather than just supplementing the hormones that they're, you know, missing or have a decline in, it's not fair at all. Absolutely. So there's so much to change, but, you know, you're quite a kick-ass generation, and I think you won't allow things to happen like that. I think one of the things that we're really trying to do, obviously, with balance,

and the work I do is empower women, and then they can make a choice. If they want a medication that has side effects, absolutely fine. If they don't want hormones, absolutely fine. But actually, if they know the important role of hormones, then, of course, trying them is absolutely fine as well. Yeah, it's all about the evidence-based decision-making. Indeed. And when you don't have the evidence, then you go on any clinical evidence that you have. And also, you can use the knowledge and know that it might be limited,

and then you try and individualise it to you as a person. So there's lots we need to do. And I hope in 20 years' time, when you come back on the podcast, when you're older, wiser, I'm going to be very old then. Am I not going to be invited than any of that time period? 20 years, this is it? No, but I'm meaning the next generation, when you're going to be older, you've got other generations coming on that you're all going to be so much more empowered,

it's going to be easier to get treatment. It won't be the minority of women who are menopausal receiving treatment. And actually a handful of women with PMS receiving hormones, I hope it will be more mainstream. But one of the ways that will help is, you know, your knowledge, your information, that what you're doing actually is more important in some ways than what I'm doing because you're going to be able to really impact on so many people in different ways. So before we end, Jessica, I'm going to throw something on you which you haven't prepared for, is I always ask for three, I always ask for three take-home tips for all my guests, and you're no exception. So three things that you think are really important for people, men and women,

or boys and girls of your age that should know now about their hormones rather than waiting to their older. Okay. Let's have a think. I mean, I think one of the most important things is for people to realize that it's not a taboo topic. It's okay to talk about those sorts of things. And I think actually a lot of people, like let's say my friends have brought up their topic with their parents. A lot of their parents are grateful that they've had the initiative to bring up that topic. So I think that's really important. I think the key phrase of saying, I know it's, you know, it's not applicable to me and my hormones, but knowing that the menopause is a long-term hormone deficiency is incredibly important and I think it completely reframes the way that you think about it and I met someone the

other day actually I didn't tell me about this and this woman said that she like the menopause for her was always just called the curse and you didn't even talk about it you know so I think seeing it is a long term hormone deficiency there's a lot better and a lot more factually correct as well and the third take-home tip is also that PMS can be treated you don't have to live with it you don't have to deal with it you don't have to just accept that you're going to feel rubbish for a few days a month or however long it is. And that actually I feel the same every single day of the month, like mood-wise. I'm completely stable. And I think a lot of people are very shocked when they hear me say that. And, you know, hopefully as more and more people develop an awareness, people will be less shocked and go,

yeah, I know, like I feel the same. Excellent. So there we go. There are my three take-homes. Very wise words from a 20-year-old. So thank you so much, Jessica, for your time. And hopefully I will invite you back within 20 years. So you can give us an update.

But what you've shared today, and thank you, it's always quite hard sometimes, sharing personal stories, but that's the way we learn as well. So thank you for your time. Well, yeah, of course. So I'm very open about all that sort of stuff as well, because how else I think people learn a lot from hearing about other people's experiences. So if I can, you know, positively influence someone with something that, you know, at the time was negative for me, then it's a win-win.

Totally. So thank you very much. Very welcome. You can find out more about Newsome Health Group by visiting www.new.combe. And you can download the free balance app on the App Store or Google Play.