The Dr Louise Newson Podcast - 259 - All about Dr Louise’s theatre tour Hormones and Menopause: The Great Debate

Episode Date: June 4, 2024

This week on the podcast Dr Louise meets comedian Anne Gildea, who will be joining Louise on her 34-date theatre tour this autumn, Hormones and Menopause: The Great Debate. Anne, a founding member of Irish musical-comedy trio The Nualas talks to Louise about her diagnosis of breast cancer, aged 45, and her ensuing menopausal symptoms, which she was unprepared for. She explains how her research inspired her to create her own show, How to Get the Menopause and Enjoy It. Louise and Anne discuss why they’ve come together to create a new show that will take you on a journey through the history of women’s health and lead you to see menopause and hormones in a whole different light. Finally, the pair share some of the reasons they think people should come to the show: It'll be a wonderful night out - a real sharing experience where you can also have a laugh. There’ll be lots to learn with new content and a sharing of knowledge. You’ll be able to ask questions and gets answers. Some shows will also have doctors available in the interval but Louise will answer questions on the stage as well. You can follow Anne on Instagram @annegildea   To buy tickets to the show click here Click here to find out more about Newson Health  

Hello, I'm Dr Louise Newsome. I'm a GP and menopause specialist and I'm also the founder of the Newsome Health Menopause and Wellbeing Centre here in Stratford-upon-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 News and Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today I'm doing something slightly different.

I'm recording my podcast in the studio. So I'm going to be filmed in real life with proper equipment, not just on my screen. And I've got special guests here today, Anne Gildy, who's come over from Dublin, difficult journey, which we'll explain in a bit. But she's here in real life. We're going to be talking about the tour that we're doing soon, which is going to start in the autumn. So welcome, Anne. Thanks for coming today.

You've seen the clinic, you've seen my second home, and we've got loads planned, haven't we? Yeah, I'm really excited about it, Louise, and it's amazing. There's nothing like meeting in person, and you just, there's something magic about picking up, the energy people. I think that's beginning to be lost in there's so much Zoom and everything now. It's just... It's exactly the same for when I see patients. It's very convenient. It's very easy to do things online, but actually, you just, the energy, the warm, everything, you just learn different things about people. You do and you just get a feel and it's an intuitive thing. Yeah. It's an animal thing. Yeah, absolutely. Totally. So I'm very grateful because there's a train strike today. So you have the hat.

The best journey. Oh my God, Louise. I had my whole journey planned. I got my tickets on either, all ready to go. And I went to the train station and it's like, there's no trains today. And I had a real menopause environment. It's like, oh, it doesn't compute. It was so funny.

Then it took me, I thought, well, I'll get the bus into Birmingham. There's bound to be loads of coaches to Stratford. I took an hour and a half on the bus. I've seen all the silver rooms of Birmingham. And then it was funny because I just had to make transport decisions. And my brain was saying you've used your brain well despite being men of brown. But I'm really, it was great. Because when Chris Davis, who's organizing the show, said, I want you to meet Anne.

I want you to look at her work. I had a little Google, had a read, had a watch, had a listen, had a laugh. And what you've done has been incredible. But I'm really keen to hear like how you got into even. thinking about menopause and let alone doing a stand-up comedy show of us. Well, I'd had this act, and it's the reason I know Chris, through other producers I'd worked with in the UK before, this act called The Newlist, and we were a comedy musical trio, and we toured a lot in the UK, and that was my Chris connection, and then we had come off

the road, we'd finished doing that, and so I needed to do something else, and so it was in my 50s by then and I thought it'd be really interesting to write something about being in midlife, but it was going off in every direction. So it was my partner, Paul, who said to me, he just gave me the title, he wrote it on the whiteboard, how to get the menopause and enjoy it. And he went, that's your title. And I was extremely resistant. Were you? Yeah, I just felt such negativity around the word menopause. Now, this is several years ago. It was during lockdown, And there is a real moment at the where everybody's talking about menopause now. But back then, it was still a little, a lot of silence around it.

And I just thought, well, at that point, I was post-menopausal. And I thought, I don't want to go there. It's medical eyes. It's just like kind of sweaty, irritated women. That's the image you get. And then I started reading about it. And the scales fell from my eyes. I kind of went into shock for a while.

Did you? Yeah, because I realized all it is. didn't know and I realized I knew nothing about my body I thought menopause was something that you just went through and then it's over I didn't realize the the long-term effect of that hormone inflation and and and so one of the first things I did was I went on HRT and I just thought you hadn't thought about it before I absolutely hadn't I think I had this I heard something about that women's, the world was women's health initiative study. The shadow of that was definitely still hanging over the whole HRT piece.

So I thought, well, I can't. I'd also had breast cancer. So I just thought, not for me. Even though my cancer wasn't estrogen positive, it was triple negative. But I just thought, no, it's, it's, there's too many negatives around it. It was just a received opinion without looking into it. And then when I just got all the facts, I was, yeah, shocked that I had such ignorance,

that there seems such general ignorance around what happens in our bodies. And I think particularly now because we all live longer and sustaining our health post-menopausely is so important. It's not just about treating those. symptoms. It's about keeping healthy into old age. Yeah. Menopause has been just portrayed as an annoyance actually. Yeah. You know, I know when I started doing first presentation like 10 years or so ago, just a group of healthcare professionals and just Googling menopause and thinking about it, it's always hot flushes, it's always night sweats. It's always middle aged, whereas we know

one in 30 women underage of 40 menopausal, so they're not middle age. It's always like overweight women with a fan with sort of beads of sweat. Yeah. And then it's sort of used a bit of a bust of jokes. Oh, she's menopausal, ignore her. Like, yeah. Like, it's just like very patronising, really. And it's something that actually women are very vulnerable when they're

menopausal, but they don't understand necessarily exactly how it's affecting our brains, how it's really affecting us as a bigger picture, because it's never been talked about it as a brain disorder. It's a blushy sweats disorder. Yeah. And like you say, it's something that will get through. And I think when people realize that you never get through the menopause and you want to make it a positive experience,

but if you haven't got the knowledge, how can you make something positive when you don't know what it means? Louise, that is exactly the part that I just had no realization of that. And I think what I found shocking was, I think it's something that every woman should know. And every man, actually. And every man, because, you know, it is an inclusive condition. Yeah.

You don't have to get it to suffer from it. No. But it's not to have negativity around it either, but it's just, you know, it's like thinking about the mental health issues around it, the low mood and a lot of women. I'm touring this show then. I wrote this show, how to get the menopause and enjoy it. And I've actually been on the road three years with it in Ireland now. And I saw talk to a lot of women.

and it's not just low mood. A lot of women talk about a lack of confidence then comes along. Like one woman told me she didn't feel confident driving on motorways anymore. Like it begins to, life can begin to contract a little bit. It really does shrink actually. And in fact, in the updated paperback of the book, someone called Joanna Harris, you might know she's an author. She raised a great book called Chocolat.

Talks about women being invisible. and how convenient it is for society, for women to be invisible. And I think there is a lot of invisibility in menopause and not wanted invisibility, but you're absolutely right. I know when I was perimenopause or I didn't want to go out, I felt really flat, just very joyless. You know, everything's a bit, you know, it's not just thinking intracial, you are wading in treacle.

Everything's an effort. And it's like, I just don't want to. It's just like, and this isn't, me and and then you compound it when people have got anxiety and thinking like you say not driving i see lots of women who don't go on a bus they don't go on the underground so then they're they're like where they go out is very small then they've stopped going to work they've stopped their identity as who they are it's it's really awful and it's happened for many many years hasn't it but yeah and i've talked to women too who maybe will be feeling that vulnerability too and then in their

job they're having to do presentations and suddenly they're having a heart floor And, you know, as these things build up, women do just go, I actually can't do this anymore. Yeah. And they just step out of the workforce. Yeah. Which, you know, it's 2024. I'm really shocked that we've got a treatable condition.

Yeah. That's treatable with safe treatment that the majority of women worldwide are not getting. Well, as you know, there's still so many doctors who will say, is it safe? and you have all those warnings around cancer that relate to, you know, the study. Yes, the study, the WHA study, which we know isn't actually relevant because the type of HLT we prescribe is different,

but even that study didn't show the effects that were put in the media and the medical press, actually, because it was reported in the wrong way, reported wrongly, actually, but even this risk of breast cancer wasn't statistically significant either, so it's irrelevant. Yeah, but you were saying,

a whole interesting piece too around the anti-inflammatory element of estrogen and this almost anti-cancerous rather than oh no it's bad when it's gone it's gone yeah that's exactly right so that the arm of the study that only gave estrogen so women who've had a hysterectomy in removal of the womb often only have estrogen those women when they were followed up had a lower instance 23% lower incidence of breast cancer so estrogen seems to be protective of breast cancer, which really blows people's mind when we've all grown up thinking estrogen is bad. But then also you think, you know, my 13-year-old daughter, who hasn't learned anything about estrogen at school. But it's like, Mommy, how can your own hormone

be a bad thing? Yeah. It doesn't make sense biologically that we have something in our bodies that our body turns against us. It just doesn't work like that. Yeah, but then that's another piece around having hormone replacement that, you know, I have met women who go, it's a natural process, menopause, and that's unnatural. So why would you? Just go with the flow. But that, you know, the whole... It's really interesting, isn't it, the whole natural thing? And I think, actually, when you unpick, what does natural mean? Because it's associated with aging, there's a massive philosophical and medical debate, is aging natural or not? Which is very interesting. We actually, as we were saying before, our life expectancy is so much greater than it

used to be. So actually, is it natural that we live to our 70s and 80s? Who knows? We don't know, but we never used to live that long, sure. But then also, there's a lot of conditions now, for example, raised blood pressure is related to aging as well. It's more common as we get older. But I wouldn't not treat someone's raised blood pressure because they're in their 70s because you If I don't treat it, that person has an increased instance of a heart attack. So we treat the blood pressure, get it lower to normal range to reduce the risk of a heart attack. With menopause, as you found out with your reading, there is an increased risk of a heart attack when people have our menopausal, taking H.R.T.

halfs that instance of the risk of a heart attack. So actually, you could argue it's in a similar way that we're doing it. Exactly. And it's just keeping... The big part for me was also the... link with bone loss as they call it and I didn't I didn't realize a fallen estrogen is correlated to that and I just noticed in the the women on my mom's side of the family this is a real you know we just we've accepted this idea of the

little old lady and the whoever would just shrink away like I say this at my show that my mom used to be the same height as me and now she's just the size of a coffee table you know the middle one in a nest but I Actually, I say the show and I laugh about it, and then I'm based in Dublin, but my mom actually lives in Manchester. And when I go to visit her, I do always do a double take and go, oh, you have,

she's got, she's really lost so much height. And that is, that's real menopausal correlation, isn't it? Yeah, and presumably she's not on hormones. No. No, because there is this shrinkage of the bones. We've got loss of bone density, but also the discs reduce in size, so all the discs between.

So there's just a shrinkage of everything, which then can reduce height. But obviously when you've got bone loss, there's increased risk of osteoporosis and the building of the bones, which is so common, yet we don't know. Well, many people don't realize

how common it is, what it means, but also that HRT can reduce and treat osteoporosis as well. That was one of the big reasons. I went on the HRT and because I was post-menopausal by the time I was reading around it, but I just thought long-term health, but that in particular, because I'd really observed it on my mum's side of the family. Yeah. And so you were quite open about having had breast cancer before.

Yeah. And thankfully everything's fine. Yeah. For you at the moment. But did you have any chemotherapy or treatment? I did. I had to stay. Talk about lack of knowledge, Louise.

I had a swelling on my breast, but I had this received thing that cancer was a lump, that I imagined it as a discrete lump. So it was kind of a swelling that was getting a bit bigger, and I went, oh, that's nothing. And then one day I showed it to my sister, and I went, do you think that's anything? She went, we're calling the doctor now.

And by the time I actually went to the hospital, It was actually, it was stage three. It kind of, it had gone to all my lymph nodes. I'd all my lymph nodes removed. And as well as I ended up having to have a mastectomy. And, yes, that was quite a shock. And did you have any extra treatment? Did you have?

Oh, I did. Sorry, yeah, I did. I had chemo first. I had eight rounds of chemo. And over four months, dense dose every two weeks. and then I had a mastectomy and then I had seven weeks of radiation. Right.

And then I got a fantastic reconstruction and the wonderful thing about getting the reconstruction is I had a DEP flap reconstruction so it's my own tissue. Yeah. Is I, you just, once it's all done and dusted, you move on and you forget. I forget that I cancer.

Yeah. And were you still having periods when you were dihares? Yes. And then the oncology, I was 45 years of age and the oncologist said to me, now you know that chemotherapy is going to shut everything down and given your age, your periods are probably not going to come back. Now, they did come back a little bit and then they just petered out again.

Here's the thing. And I talk about this in my show too. I would say, you know, I would say maybe about three weeks after I started the chemo, I started having awful night sweats. As I say, every night I was wringing out the bed sheets, my nightie, my boyfriend's neck. And I didn't go relate that with menopause. But of course, because it shuts everything down, it had also shut down the hormone production. And I was plunged into menopause, as so many women are when they're gone through chemo.

But there was never mentioned. And I suppose there's so much else going on. I wish I had been mentioned because once I'd been through treatment, I was so relieved. And I actually went to this brilliant hospital in Dublin called St. James's and all the doctors were amazing. And I was so inspired by the whole experience that when I came out at the other end of it, I just had this new love of life and positivity about moving forward. but I had terrible low mood. And I thought, well, that low mood is definitely not circumstantial.

So because I'm so low, this is a disposition. I have a disposition to low mood. This has just been that the cancer treatment had worked so well. So I was applying the science to my own mind and going, this is dispositional and low mood and I should go in antidepressants. And I actually was on quite a sense. strong dose of an antidepressant called Symbolta for four and a half years because I thought, I just had this disposition to low mood and I'll just medicate it away. I look back and I go,

that was totally a menopause or symptom. That's why my mood was low. And I wish I'd had information around menopause and effects of hormone depletion at the time because it would never have gone on antidepressants. It was totally about that. And that's why it felt strange. And then it would have been a good time to talk about maybe some hormone replacement and to try a hormonal way of balancing out the mood.

Yeah. And which has happened so often. I did a presentation yesterday to women and most of them have been offered or given antidepressants. And it seems so easy to... to get antidepressants yet so hard to get hormones, which is wrong and there's so much that needs to change. Yeah.

But empowerment is good. Education is good. You learn more when you're happy, don't you? Absolutely. But you know, with the antidepressants, it's like medicine looks at women and goes, oh, they're so complicated. I know.

Should we just tranquilize them? Yeah. You know, it is like that. You just tranquilize them away as they drift. Yeah. Post-reproductively, they just drift away into the twice. I like years. And there is a bit of put up and shut up.

Yeah. Because other generations have done it, why can't you? And then that makes it hard to ask for help. So, yeah, laughter is the great best medicine. Yeah. You learn more, as I said, when you're happy. So your show, which I've seen bits of, people are really happy. They really love it.

They love... I think what I can see and tell me if I'm wrong is that they can relate to what you're saying. In a way that they've probably not really... able to admit before that they're experiencing similar symptoms? That's what women say to me and write to me they go, you told my life. Yeah. And that relatability piece is so important in it. I think it's coming through just the story of being a woman.

And then when I add in the information, it makes it quite compelling. Yeah. And then I pitch the whole. peace around menopause as reverse puberty and I just say think back to when you went through puberty and your body starts producing all these hormones think of the profound effect and changes that had that ensued well now you're going through the other end of that there you know you're going through this depletion so it's a kind of an equal and opposite thing so because I talk frame it in that way then I talk a lot about grown up in the 70s and

80s and I just reminding women of things that are like things like the sanitary products we used to have like and and the intimacy and remembrance of that is always gets a good laugh. Yeah, but it's important. I think women need to understand that they're not alone. That's a really, really important because as we already said, it's really isolating. So your thoughts about the tour that we're doing, I'm quite, I've never been on. until before, I'm feeling quite excited, a bit nervous. You know what I'm really excited about?

Like, I, I, I, I'm really excited, I got really passionate about menopause when I started reading up about it. I'm really excited to be working with you because you're an absolute expert in the field. And I love hearing the, the, the, the, the facts coming from the mouth of, of, of, of, of, of an expert. And, like, some of the detail, you were, you were. explaining this to me earlier, the information is still not out there in the full, you know, the full breath of it. So that's the thing I'm really passionate about to be working with you

who's totally immersed in all cutting edge research around it and that you're continually talking to women with your patience and everything. You just know that. Yeah. I mean, I'm looking forward to sharing content that we've not spoken about before that I've not spoken about through my book, or other podcasts or other media, because there's a lot, I've been reading a lot of women's history books as well, actually. Yes, I think it's so interesting. And medical books from the past as well,

mainly written by men, I used to add male doctors, but just people's perceptions of what menopause is and how it affects women and the treatments. Oh, the treatment, like, for the wandering room, a womb in ancient Greece, are that they used to put leeches on women's cervix. I know. I know.

It's incredible what women have gone through and endured, but what they still are enduring now. So not of that we can tease out, which will be great. I'm really looking forward to working with you and how to, again, lies in something that can be very sad, but also very frustrating. But I want some of that frustration to keep coming out because I think if you're frustrated,

you're more likely to change things and to change the needle because this is this is actually something that's affecting 1.2 billion women globally it's not just something that affects a certain demographic or a certain type of woman we can't escape from it but actually to learn and to realize quite the injustice of what's going on as well and if it's if you're feeling all right you're definitely you know a friend or a relative or someone who isn't or is struggling to get help. So I'm hoping it will join people together. The thing I really like touring theatres is that women really love that environment.

They love coming out together in groups and it's wonderful to make people laugh. It just opens everybody and it's almost a spiritual experience. Yeah. So I think there's that layer. I get that. I've done a few book events and I did one last week actually down in Henley

and I was with Kate Muir who's absolutely brilliant and we're waiting to go on and just the buzz in the theatre normally in theatre people talk or mumble but there's this energy where people were really happy

that we did a question and answer as well and this lady she was so lovely she said I'm 82 I've been on HRT for 30 years I'm never going to stop it and actually the whole audience just claps they were all there with her in the room you know, really supportive. And I thought actually,

there's not many live groups where people are there together. You know, you're in your own little group, aren't you? Actually, the whole theatre would be able to get you by the end of it. That is the thing that women say to me, in my show that in the intermission, that it's like everybody, like the cue for the loo,

everybody's talking to each other. That there is suddenly, you've opened up the topic. And that 80-year woman was lucky, because I've met 80-year-old women who were, I've met 80-year-old women who had hysterectomies in the 50s and they were allowed HRT for a few years and then the doctor absolutely insisted

that they had to come off it. And, you know, that was the received opinion that you could stay on it long term. That was another revelation I had research in the show that actually you can carry on and that it actually does sustain your health. Yeah. Yeah.

Yeah. Yeah. We're so important people don't realize. So there's lots of myths that we want to dispel. Yeah. Yeah. Lots of facts that people can learn from. Quite a lot that people hopefully won't know or won't have put in context.

And I think having the show the content is really important. But we're also going to do a Q&A as well. So I'm hoping there'll be lots of questions from the audience. And that will vary every night, of course. And that's the exciting thing about, you bringing your knowledge into that environment because the specific detail you have, I've done a lot of research around it, but I haven't heard it expressed so clearly and just the nuance around things like cancer, not cancer, the subtle effects of what the hormones

are actually doing. It's really important information. Yeah, and I feel cheated as a doctor that I haven't been allowed to have this information. You know, I wasn't given it medical school. I wasn't given it as a postgraduate. I wasn't given it as a GP trainee. I've searched and researched myself. But it's all out there, but it's hard to find something when you don't know where to damn. But it's also you're bringing it all together. I think I'm sure, you know, I have never, when I read your book, I hadn't seen such a clear, concise, um, collation of all that detail. Yeah. So, well, hopefully there'll be lots and lots. And this, will just empower people to think differently, I think.

And what you were saying even about your show, making menopause positive, making it healthy as possible, making it something that is right for each individual as well, because, you know, neither of us are judgmental about others. We just want women to be able to decide and do what's right for them. So really great coming over to do the live podcast in real life. just really wanted to ask you three take-home tips. So I always ask the three tips. So three reasons why you think people should either buy a ticket for themselves

or buy a ticket for somebody else to come to see us in the show. I think that it will be a wonderful night out. I think I just know from touring around my own show, it is a real sharing experience. So I've had three generations of families come along. daughter, mum, grandmom, so there's a wonderful sharing and have a good laugh but learn. Yeah, yeah, really good. So I'm going to give my three, which I like I give my three reasons where people could come. I think firstly, it's going to be a different event. It's not going to be

something that people have heard before. So for new content really important. The other thing is the availability that they will have more of my knowledge that I can share to people, hopefully in a way that people can understand and take home from. And obviously, thirdly, the opportunity that people can ask questions and have answers. And some of the shows, I've got some of my doctors who work with me are going to be there in the show as well, so in the interval. So they will be able to answer questions, but obviously I'll answer questions on the stage as well. So thanks ever so much, Anne, for coming today. It's been wonderful having you here in person to do my podcast. My pleasure, Louise, and it's just wonderful to meet you.

Thank you. 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.