The Dr Louise Newson Podcast - 230 - Confronting my menopause fears

Episode Date: November 14, 2023

Raquela Mosquera joins Dr Louise Newson in this episode to talk about the turmoil, anxiety and unexplained bleeding she went through during her menopause. Raquela is the mum of Joe Wicks, the fitness coach who kept the country moving during lockdown and who has also appeared on Dr Louise’s podcast. Joe put Raquela in touch with Dr Louise after she confided her worries over her symptoms. The anxiety, brain fog and isolation led to Raquela leaving the job she loved, but adjusting her HRT has transformed her life. Listen to Raquela and Dr Louise share tips about how to get the right HRT dose and type to suit you to get the maximum benefit. Raquela’s three tips:  Educate yourself on the symptoms of the menopause and right down all your symptoms before seeing your GP, including when these symptoms started and what can make them worse. Be a menopause warrior. Chat about your experience to friends and family to reduce the stigma around the menopause. Don’t be scared of HRT. Go to your GP and talk about whether it could work for you before making any decisions. Listen to Dr Louise’s podcast with Joe Wicks here  

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 the podcast, I'm very, very excited and delighted to introduce to you, Regella, who I've known for a little while and actually seen and watched her become even a better version of herself. So she's here in the podcast studio today. So welcome. Thanks

so much for joining me. Thank you Louise. And thank you for inviting me on to the podcast today. Oh, so I was trying to work out how long I've known you for and it's, I don't know, it feels like about a year. Would that be fair enough, do you think? I think it's over a year. Okay. And so tell me, if you don't mind, just tell me a bit about why we connected or what was going on at the time when you reached out to me. Well, I think what had happened was I started bleeding nine months after my period had stopped. And I was very, very concerned. And my son actually knew you and got us in contact. And then we had a conversation on the phone, which was reassuring.

You know, you sent me off to have tests. And it was all very quick. But for me, really important because I can be someone that can get quite anxious around. things that I don't know what's going on in my body. Yeah. So yeah, that's how we met. Yeah, and you're not alone. I mean, we all want to be healthy.

We all want to be well. And when something doesn't have a necessarily actually bleeding can really scare people. And you'd already started a bit of HRT, hadn't you? Yeah. And you'd reached out. So shall we disclose who your son is because people will probably know your son more than they know us? But he's happy because I checked with him before.

So do you want to say, because you're so proud of him. So I think you should say who your son is. Yes, well, I'm proud of all my boys. My son is Joe Wicks at the body coach. Yeah. Who's phenomenal, isn't he? Oh, he's mental, yeah. It's just, I mean, like I say, I'm proud of all my boys.

But, you know, the work ethic that he has and, you know, his dedication to want to get the nation moving and the world moving, you know, and so they can have better lifestyles, you know, through eating, exercising and getting more sleep. And I live by them, blinds, you know. Absolutely. And, yeah, I mean, I've been connected with Joe for a little while, and hopefully those of you listening have already listened to the podcast that we've done together. And he's phenomenal because he's got so much energy, but he's also got so much warmth and compassion and he really does care. And I'm not going to talk out of turn,

but I've spoken to quite a few well-connected people, celebrity people, and they become quite selfish as they become more famous. and Joe is very selfless. He's very caring about his family. He's got really good core values. And he wants good people around him. And that's what we all want, actually. But more importantly, and for those of you've watched the documentary for Joe,

about Joe, we'll know that things haven't always been easy. And everyone's got a backstory. And it's so easy to look at people superficially and think, oh, aren't they lucky, aren't they? And it's very easy on Joe's Instagram. His children all look so perfect that we're so happy. They always, you know, they've got a beautiful house. And we all know, any of us have had children, I'm sure I have never asked Joe, but I'm sure he can't tell me that having three children is a piece of cake.

And he can't tell me they're always as happy as they are on their Instagram as they are behind the scenes because that's children, isn't it? That's the way it goes. And it's a challenge. And life has been a challenge for you as a family, obviously. And then the menopause is a huge challenge for the majority of us. There's no doubt about it. And often what it does is it can actually trigger things how people, were before. So anxiety, if you've been anxious before, it can make things worse. If you've had

low moods, it can sometimes re-merge. And Joe absolutely adores you. The feeling is so mutual, as you know, your adoration for each other. And he messaged me, so I'm really, really worried about my mum because she's worried. And it wasn't really, because she's bleeding, it was because she's worried. And I remember speaking to you because I was driving down to London, and I said, fine, I'll give her a ring straight away. And as much as I tried to reassure you that it was very unlikely that you had cancer, you were actually, no disbjecture, you weren't really listening because you were convinced that you had something awful and I understand completely. So you had some tests and you don't have cancer, which is great, isn't it? Yeah, absolutely. And then we changed

a dose and type of your HRT and it's really important actually because about a third of women we see in the clinic are already on HRT. And a lot of them have been said, well, your symptoms can't be due to your hormones because you're on HRT, so it must be due to something else. And I always say to people, what I want to do is optimize your hormones properly, so you're on the right dose, the right type for you at that time, because sometimes it can change with time. And then let's see how you improve or not improve, as the case may be. And I'm sure I probably said the same thing to you. And so we've sort of fine-tuned your HRT, haven't we over the last few months? And hopefully you're going to tell me that you feel better. I know you do looking at you, but,

but, you know, compared to how you were before. Oh gosh, absolutely. You know, I mean, I think going on HRT and, you know, the other things that I take within my package of HRT has definitely changed myself. You know, I'm not so anxious. I've got more energy. And I'm just feeling better with myself, you know, I'm a bit scatty anyway, you know, but that, brain frog, frog, the brain fog, sorry, the brain fog that I had, you know, has much subsided. So that's really good. But yeah, you know, I just found the whole experience really hard. From the time that I started to feel very different in myself in that, you know, I started to get a lot more anxiety. I was working in a job which took a lot of responsibility. I was working with young people from the age of 11 plus and I run a

mentoring program. So a lot of the situations that were coming to me were really quite intensive and quite hard to listen to, you know. And what I found myself becoming very, very, very, irritable, which, you know, I'm a very empathetic understanding and thoughtful and a really good listener. And I was finding that I was going off on it, you know, thinking about other things and, you know, not being able to feed back what they'd said because my brain was really foggy. And I found that there was one client that I was working with and her child was on the at risk register. And she wasn't helping herself. And what I found normally in them situations, I can be really empathetic and understanding. And I didn't feel empathetic and understanding. And I thought,

I'm done. I can't do this job anymore. But I went to the doctors and looked for a solution and said, look, this is how I'm feeling. You know, I don't understand how I'm feeling because I've not experienced this before. And what he said to me was that I think that you're suffering from secondary trauma and depression. And did you think you were? Well, I felt really crazy. I mean, I'm a crazy person anyway, you know, and I'm someone that's been in and out of therapy for a long time. So when I was going to therapy during this time, like normally it would help me. You know, I would go away thinking, okay, I feel better now. But it didn't seem to be that therapy was helping in any way, shape or form.

So that's when I went to the doctor and I said, look, I don't know what's wrong with me. I just can't seem to get right. You know, I've had my therapy sessions and, you know, I still come out and I'm still feeling the same. I feel more anxious. I feel more tired. I don't have like that get up and go. with my job, which I totally loved. And then he advised me to go on to antidepressants. And obviously, at the time, prior to that, I would always say, no, I don't want antidepressants. I'm going to go

and do something and talk to a therapist or go and have massages to try and sort of bring my anxiety levels down. And what happened here was that I was so desperate that I wouldn't give me anything. Of course. I understand that. Totally. And then, you know, and when he said to me it was going to take two weeks to four weeks for it to kick in, I was like beside myself.

I was like, you know, like I was hyperventilating thinking, I can't feel like this for another two weeks or another four weeks. I just, you know, I just feel out of control of my whole body. You know, it's like, you know, when you're premenstrual. Yes. You know, when you're on your period and, you know, you have all these emotions that are really high and then you bleed and then you're fine. Yes.

But it was like I was at level all the time. And that's really common, right, actually, to describe that because I'm sure you know, just before your periods is when your hormone levels are naturally at their lowest. And we've all grown up for years thinking, that's normal. That's what happens. We were expecting to, and even my mum the other day, we're saying, yeah, but Louise, that's normal.

One to two, three or four days before your period. That's what we always felt like. It's like, but why is it not? more, why are we allowed to have three or four days every month? So times that by 12, 36. So it's a month a year where we're feeling like this. That's not. And again, a lot of women I see who have that. All you do is top up the hormones in those few days. But it's exactly right. It's the same feeling because it's the same thing happening to your body. You've got low hormones, but they're not going to increase because you're not getting periods. So it's this heightened alert really, isn't it? It's a really scary

feeling. Yeah, absolutely. You know, and actually it wasn't until I had, because there was a bit of stigma as well with the menopause. Oh, no one was talking about the menopause. I didn't know anything about the menopause. I wasn't educated in any way. I didn't know anyone that was going through the menopause. So, you know, at the beginning for me to even like speak to about it. So, or there was, but we weren't talking about it, if that makes sense. So there was a lot of stigma, there was a bit of shame. Oh, God, I'm getting older. You know, this is a sign of being old.

And the emotions and the feelings that were attached to it, I was just crying all the time. You know, I just had no control over in my emotion. Someone would say, hi, you're okay. You know, I'd be crying. But everyone knew me as an emotional person anyway, but I'd go, but I don't know why I'm crying. You know, when normally I would be able to say, this is why I'm upset.

Yes, course, course. And it wasn't actually till I watched DeVina's program. I think it was the first one where she was talking about the menopause and how many people in very high-profile jobs were leaving their jobs and how people were going to the doctors and they were putting them on antidepressants. And it almost, the penny dropped. It was like, oh my God, that was me. You know, I didn't leave my job because I stopped loving it.

in it, I left my job because I wasn't coping with it, you know, and I didn't have as much empathy and compassion. And I felt that I was doing a disservice to the clients that I was working with. So I just thought, you know, my anxiety was everywhere and I just thought, I can't do this anymore, you know, and that's one of my worst regrets is that, you know, that I left a job that I absolutely loved because I felt that I had outgrown it, but actually, I wasn't equipped with knowledge to understand what was going on at the time. It's so sad, isn't it? Because that happens all across not just the country, but the world,

where women are either giving up their jobs or they're not doing the same job that they should be doing or they're reducing their hours. And it's horrible. And I understand why you do it. And there's always a lot of talk about, oh, well, let's just give women fans. Or let's reduce the temperature in the rooms. Actually, that's not going to help the way that your brain is working, is it? No, absolutely not.

So you're on HRT and you've got the right hormones for you at the moment and they're helping you in so many ways. I mean, you are a completely different person than when I first spoke to you. Your energy, your confidence, the way you look, the way you sound, the way you are is amazing. And has Joe noticed a difference? I know whether they've noticed a difference. So I just, you know, because it's like, I don't, and I've not asked him that question. And I've not asked anyone that question actually.

So that's really interesting. And I will go back and I will ask my children that question. He's told me that he's noticed a difference. Oh, okay. So then that's a really good thing. But yeah, I definitely feel different. Even though I can be crazy at times, I don't feel crazy out of control, you know. And I do feel more brighter.

You know, I do feel like I've got more energy that I can go to the gym. And I can, because what I found as well when I was going through the menopause is that I felt that I didn't want to socialise. Yes. So I became very much an introvert and being at home a lot, you know, because I found it hard to engage with people because I'll be, you know, sweating and I would be, you know, like anxious. And I didn't feel that I had communication with people with that made sense. It's very common, very common and it's very difficult when you do research, not that much research has been done in the menopause, as you know. It's all about vaso motor symptoms, flushes, sweats.

There's a bit about vaginal dryness. There's not about how hard is it to empty the dishwasher because you're feeling really fed up. How hard is it to put on a load of washing? Or do you stop taking your children to the park because you can't be bothered and you just put on the telly? Or do you stop going out with your friends because you're just feeling awful and you haven't got that energy and umph and that's quite hard to measure but i hear it all the time from people and i know myself when i was experiencing symptoms you just put on your jogging pants when you get home you close the curtains and you're like i'm done that's it and you go out

and i was still having my job so i was going out outward facing i was fine as soon as i come in that is it forget it i can't and it's you end up and you can see but also your own friends are doing that as well because if they're a similar age, so you go from this high energy and then you say, oh, it's because the children are busy or there's, you always make excuses, don't you? And it's really hard. And I can see how women then become very isolated. And you don't really want to phone your friends up and say, do you know what, I'm feeling really rubbish.

And I don't know why, but I'm just not myself. It's not so easy to do that, is it? No. Well, I found it really hard anyway. But I just noticed that, you know, like I'm not going out. I'm not interacting with people. I'm hiding. You know, it's like I was hiding from the world.

Yeah. You know, and I think a big part of that as well is when I started going to the menopause and they, you know, I acknowledge that I was going through the menopause through DeVina's program. I went straight to my doctors and said, I want to go on HRT. You know, I need to go on HRT. You know, and I think as well is they don't always get the dose right, you know, and it's not always the right one for you and I think that's okay to keep trying you know don't give up on it

you know keep trying and then you'll come up with a combination that you need it's like what you've done for me is you tweaked my medication as well and I think from that point I really started to notice a difference in myself I noticed when I first went on it but it was I still had the anxiety I still had you know the isolation but I think once the balance was right I was right and it's like I'm like I kept them going to everyone and I'm back I'm back you know because I just felt just like yeah not great at all yeah and you're absolutely right and I think most of us and many people I speak to you don't realise what it's like to be back until you are back and I know when my dose isn't right because I have quite bad migraines and I get them anyway just because I've always will but they become more frequent without anything else changing in my and also I get very bad. sort of joint and muscle pains and I just feel quite flat and tired. And it's very subtle, but I know that, oh, my hormones just need tweaking a little bit. And then when they do, you think, oh, that's good. Because otherwise it's quite scary, you know, thinking what else is going on. And that's why it's so

important that people are reviewed. They're seen by a specialist who really understands. And we do that in medicine all the time. You know, if you had broke your arm and you were in pain, I would start off giving you one type of painkiller and if that didn't work I would give another one or I'd change the dose and you know we do that in medicine but somehow for women's health and menopause it's like you have this and then you just shut up and carry on it's like we can't listen to women and we can't understand or we don't want to understand and I think that's happened for far too long that women have just been said well it's your menopause just get through it oh it's your periods just get through it and you know And I really worry, I worry a lot about all sorts of things, but I worry about menopause of women,

but I worry about younger women as well. And women who have bad PMS that we've explained, but also lots of women have an earlier menopause, and it might be a transient short-lived thing if they've had maybe some treatment for some cancer. It might have affected the way their ovaries work. But there's also quite a lot of people who have eating disorders, and they've become, you know, a certain weight. and then their periods don't restart or they stop. And they're basically having an early menopause.

But who's looking after those people? Yeah, yeah. And again, it's down to education, isn't it? And they're not being enough information or understanding about what's going on with our bodies. Yeah, absolutely. I mean, I've got three daughters. And obviously, the only thing I do is talk about the menopause. So they're very ophae with it.

But my 12-year-old had her biology, less or science, whatever, they learned about it. about menopause, they learned about estrogen, no one told them obviously about testosterone, and they just said they were hormones that helped with pregnancy from your ovaries. That was it. It was nothing else. Menopause is when your period stop, end of, that's it. And it's quite shocking. And girls now, I mean, my teenage is a very ophay talking about all sorts of things, obviously, but about the hormones, they want to be in control of their body, they don't want hormones to control them. And they were, want to know what the options are and alternatives. And I spoke to one of my daughter's friends

who's 20 yesterday because she has migraine and she's on the pill, but she shouldn't be on the pill. And she's been given an alternative, but actually that still has a small risk of clots. So why would she be on one? And we were talking and she said, but I've just been on the pill since I'm 14. And I don't know what it would be like to have my own hormones. And it's all about contraception when I see the doctor, not about how I feel or what my skin's like or what my headaches are like. or what my energy is like. And this is where as women, we need to be thinking, well, actually, we're not just somebody that's either pregnant or not or is thinking about contraception or not,

or the menopause is about whether we're pregnant, can get pregnant or not. It's about how we are in ourselves and how our hormones are affecting, and we often don't know how they're affecting us until we get them back. And as you can imagine, there's lots of people I see who are on antidepressants, and that's it. they've been told you carry on your antidepress, never even been allowed to have hormones. And I think that's really sad, actually, isn't it? Yeah, no, definitely.

I mean, I've got a friend that recently, well, three years ago, she went to the doctors with all the symptoms, and they wouldn't give her anything. And she went back two weeks ago and still won't give her anything. And I don't understand that I have actually forwarded on your number as a possibility of someone that would be able to help. And the thing is now, I think when I first, when okay I'm going through the menopause again after de vina's program that was so insightful you know in that don't take hormone replacement because you're going to get cancer you're going to get cervical cancer you're going to get breast cancer that was what was associated with HRT

you know and what I love about you know you do in your podcast and you know other people sort of talking about the menopause because it has created conversations which have definitely been needed and I think that people are understanding more. And I think like, so when I knew I was going through the menopause, I did a WhatsApp group with some of my girlfriends and I called it in the menopause forum or something. You know, so that, you know, I'd go, oh my God, I could not sleep last night.

You know, I was just sweating. And just to allow people to start talking themselves about their symptoms and owning that actually, yeah, maybe I'm going through the menopause. And a lot of my friends in the beginning were really skeptical about going on HRT, but they could see a couple of us that had gone on it and how different we were. Yes. You know, and it was almost like, oh my God, I need to try that.

I need to give that a go, you know. And I've always said, you know, like sometimes doctors will not give it to you, you know, but you have to be like I think I remember someone saying, you have a right to ask for these things. they may not give them to you, but you can say, look, I know what my symptoms are. I believe that I'm going through the menopause, you know, and is there any way that I can be, have a trial on HRT to see whether that improves my mental health and wellbeing? Because it does.

You think you're going crazy. I totally agree. And, you know, we've got guidelines for menopause, care. We know that the majority of women benefit from HRT. we also know that women are allowed to choose. And we also know that in the UK, it's only about 14, 15% of menopals, women take HRT. So it's really low. Most people don't realise how low it is.

And in areas of deprivation, it's as low as 2% of menopals or women. So we need to allow women to know what's going on to their bodies and then allow them to make a choice. And I feel that very strongly it's about having a choice and knowing that there are options available for them. and even those women on HRT, they are allowed to ask for different doses and types as well. And, you know, we've got to just keep going by helping other people because we learn from each other. And, you know, women are great at talking when they're feeling well and can really help.

And I think the work that we're all doing together is just helping join the dots and allowing people to listen and decide, which is really, really important, isn't it? Absolutely. And also, just like a question really, is that I've got some friends that are in their 60s who are still experiencing the symptoms, but are saying, you know, I'm through the menopause now. I've been told I've through the menopause and I don't need anything now. Yeah, and that's really common now. I mean, no one is through the menopause. The menopause is defined as, you know, your period stopping, but it's also defined as your ovaries not working. So your ovaries, once they stop working, or they've been taken out. from an operation, they are not going to come back and work. So it means that the hormones will be low forever. Symptoms obviously can come and go, symptoms can stop, symptoms can start. Some people have very awful symptoms, some have no symptoms. But actually, it's not just the symptoms, it's about how the low hormones affect our bodies. And we know that low hormones are associated with an increased risk of inflammation in the body, increased risk of diseases, as you know,

heart disease, osteoporosis and so forth. So a lot of women say, oh, I'm through it. But actually, when you talk to them, you say, well, what's your sleep like? Do you get any muscle and joint pains? What are you having any urinary symptoms? Are you got any libido? It's your skin changed, a hair changed. Oh, yeah, yeah, yeah, but that's because I'm 64 now. It's part of age. So we often say to people, well, there isn't any evidence to show that HRT is harmful. They used to worry about older types of HRT, but the ones we prescribe are very safe. You can still have. them when you're older and then try it and see and a lot of women say well i'll try it for three months and see if i feel any better and then they come back and go wow i'm sleeping better my muscle

and joint pains have gone i can laugh and skip and cough without weeing i can you know my skin and hair are better my mental state's better i thought it was just because i was getting older but even women who don't have many symptoms we often give low doses too because we know even low doses can help protect the bones. And we know that one in two women over the age of 50 will develop osteoporosis. Very common condition that none of us want. So if we're taking something to reduce our risk

just of osteoporosis that would affect 50% of menopause or women, well, that's not a bad thing either. No, no, no. So, yeah, there's lots of choice. And I think that's really important. But I'm really grateful for your time and really grateful that you've shared your story. because it's hard talking about how you've been feeling.

And obviously, Joe is a huge public figure. And I'm really grateful for him and you for allowing us to have a bit of an insight of what it's been like and sharing. Because it doesn't matter who you are, you're still going to become menopausal and you can't predict how it's going to affect you. So before we finish, I'm really keen for just three tips. So for women that have listened to you, Rags, and thought, oh, right, yeah, I'm struggling. What can I do? She sounds like she's in control. what three things would you say to women who are listening?

I'm going to have to put my glasses on and I hate putting my glasses on. I hate them. Right. The first one is to educate yourself on the symptoms of the menopause and when attending a doctor's appointment, write down all your symptoms, including when they started and what can make the symptoms worse. Yeah, very good.

Does that make sense? Yeah, totally does. Be a menopause warrior, as Devin McAul advocates. talk openly to friends and family and work colleagues about the symptoms and effects of the menopause to help reduce the stigma. Yeah, very good. An all right one? I love it, yes.

And then three, over the years, there has been a lot of scaremongering about HRT. But recent evidence says that the risk of a HRT are very small and usually are outweighed by the risks. When you get symptoms such as hot flushes, night sweats, mood swings, vaginal dryness, reduce sex drive, go to see the doctor, discuss it with your GP and discuss what HRT therapy are best suited to you. But, you know, life on HRT has given me my life back. So don't be scared of it, you know, explore it before you make that decision on whether it's right for you or not. Oh, amazing. And I love the way that you've done your homework. I'm very, very impressed. It's very good.

I'm really honestly so indebted to you and it's been wonderful and I've really enjoyed talking to you today so thanks ever so much no thank you louise thank you for having me on and I hope that it will help someone it will help lots so thank you thanks you're welcome you can find out more about newsome health group by visiting www.newsonhealth.combe. And you can download the free balance app on the app store or google play.