Woman's Hour - Menopause, Female Victorian detectives, Hair thinning

Episode Date: October 1, 2024

Menopause campaigner and Labour MP Carolyn Harris, and Dr Paula Briggs from Liverpool Women’s NHS Foundation Trust join Nuala McGovern to discuss the findings of the BBC’s latest Panorama: The Menopause Industry Uncovered.Who was the first detective? You might be thinking of Sherlock Holmes. In a new book by Sara Lodge, she reveals that the first detectives were actually women, 40 years earlier than Sherlock. Sara joins us to tell us more. Hair loss comes in many forms, from thinning to complete loss. In his new YouTube series, Hair Stories, hairstylist Michael Douglas, with over 37 years of experience working with women’s hair, explores women’s unique stories and the personal connection they have with their hair. Joining Michael is Katie O'Callaghan, who experienced hair loss and ultimately chose to undergo a hair transplant.Conservative MP Mims Davies has said that the number of women wanting to work for and with the Conservative Party is "diminishing". To discuss this and the ongoing Tory leadership contest, Nuala is joined by Lara Spirit, Redbox Editor for The Times, and Ailbhe Rea, Associate Editor, Bloomberg UK.Presenter: Nuala McGovern Producer: Emma Pearce

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Hello, good to be back with you. First off, thank you for all your messages and thoughts in response to yesterday's special programme on the Tune Baby scandal and the imminent excavation. I'm going to play a little of one of our remarkable contributors a little later this hour. Also today, some of you may have watched

the Panorama episode last night that raised questions about how HRT, hormone replacement therapy, is prescribed privately. We're going to hear reaction and also address any concerns that you may have. Also coming up, I've enjoyed reading about the mysterious case

of the Victorian female detective. That's Sarah Lodge's new book. She will be here with me on Woman's Hour. Plus, hair loss. Now, this is something that affects at least a third of women.

That's according to Harvard University. We're going to hear the story of one woman, Katie, who has gone through it. Also, Michael Douglas, the renowned hairstylist who helps women experiencing it

will be with us. But I do know this is an issue that will resonate with many of you. And if you would like to share what you've been through or what you're going through perhaps when losing your hair do get in touch. You can text the programme the number is 84844

text charged at your standard message rate. On social media we're at BBC Women's Hour, or you can email us through our website. For a WhatsApp message or a voice note, that number, 03700 100 444. You might have seen Tory MP Mims Davies. She said that the number of women wanting to work for and with the Conservative Party is diminishing.

We're going to hear more from the party's conference as their leadership contest continues. That is all coming up in the next hour. But let us begin with the menopause and how best to treat its symptoms. As I mentioned, the focus of last night's Panorama. So this programme focused in particular on the private sector. England's health watchdog, that is the Care Quality Commission, the CQC,

it's looking into what it calls information of concern at clinics run by Dr Louise Newsome, who is well known from her TV and media appearances. She has come under criticism for over-prescribing by giving high doses

of hormone replacement therapy, or HRT. And more than a dozen patients from her privately run clinics, which are called Newsome Health, told the BBC's Panorama programme that they've experienced complications because of it. Newsome Health says it strongly refutes these claims. But awareness, we do know, of the menopause has grown significantly in recent years, both by women seeking help and with many employers

introducing menopause policies to support them. We also know that prescriptions of HRT increased by almost a third in the past year in England. That's according to the most recent figures. So given some of the questions, perhaps concerns the documentary

has raised about the prescribing of HRT to manage symptoms of menopause, it may have left you wondering or confused, perhaps, about your treatment. Well, joining us to discuss it all is Dr Paula Briggs, Consultant in Sexual and Reproductive Health at Liverpool Women's NHS Foundation Trust. Good morning. Welcome. Morning. And Carolyn Harris, Labour MP for Swansea East and the chair of the Menopause All Party Parliamentary Group.

You're also very welcome. Thank you. Well, let us begin, Paula, with you, your reaction to the programme and perhaps summarise a little for those that weren't watching it. So the programme focused on the commercialisation of menopause from supplements to private providers and my feeling is that women should not need to pay for menopause care. NHS GPs are able to manage menopausal women. What they do need I think is mentorship, support in order to be able to do that. So when you talk about mentorship or support I mean where does HRT fit into that because that was really I suppose a central part of the programme? Yeah very much so so you know managing the menopause is a very individualised thing not all women experience severe symptoms but some do

so the history is very important. Talking about holistic care is also very important. Just giving HRT isn't enough. We need to optimise blood pressure control, weight management, talk about diet, lifestyle. But for many women, HRT makes an enormous difference. And we have guidelines to support safe delivery of menopause care for women. And part of the focus of the programme was about what could potentially happen if care is routinely provided outside of guidance. And I'm talking about the use of high-dose oestrogen, for example. We know that that can cause excessive thickening

of the lining of the womb, which is a risk factor for endometrial cancer. And so, you know, that's the reason why we do have guidelines to promote patient safety. OK, and we'll get into the guidelines and how come they're not adhered to in a moment. But when it comes to HRT, what is a normal dose? So standard doses that have been licensed now, HRT can be delivered as tablets, as methods that are delivered through the skin like patches, gels, sprays and they all have an upper limit on the summary of the product characteristics

which comes within the pack and that dose has been worked out carefully by studies that don't have to include a large number of women. These are pharmacokinetic studies, which show what happens when you give different doses. Sorry, I'm going to stop you for one second, just because I don't understand a word. Pharmakokinetic, what is that? It's just the levels of the drug within the blood.

Okay. So I'm thinking with this, you would need to be having regular blood tests. No, I think that's one of the things that has kind of become too commonplace. You know, I started doing menopause care as a GP in kind of the early 1990s. Most of our patients at that time were using oral tablet medication. And as things have progressed, we understand now that tablets can increase the risk

of blood clots. And therefore, there's almost been a blanket switch to medication through the skin. And there is a current feeling that some women don't absorb well through the skin. Now, I think in that situation, it's illogical to keep increasing the dose outside of the license, because the drug hasn't been tested at that dose. And if we have patients who fail to absorb through the skin, then we need to look at other options. You know, there are other ways of delivering hormones for those patients who don't absorb or don't appear to absorb. But the other thing is, you know, there are clear-cut menopausal symptoms, hot flushes, night sweats, for example. But the mood-related symptoms are much more complicated and it may be more appropriate to use a standard dose HRT and to add other medication to manage those other symptoms.

Like what? Like antidepressants if the patient is depressed or anxious and I think the other thing that's happened recently is with all the publicity which is great you know women should have information to make choices about how they manage their menopause, but there is a huge amount of fear. And women, I think, are extremely anxious about what's going to happen. And that's not really fair. I mean, I think menopause at the end of the day is a life stage, and we all manage that life stage differently. And we should all have access to choices and methods of managing that life stage differently and we should all have access to choices and methods of managing that life stage but you know I don't want women to feel frightened about it and I don't want women to feel frightened now because they can see their GP if they're worried about the dose that they're

on and their GP hopefully if they're not sure what to do can collaborate with a local specialist provider. I suppose though the issue with that and Carol I'll come to you in just a moment for your thoughts on this. GPs as we have heard repeatedly from our listeners they feel at times with some GPs that they were not listened to or that GPs just didn't have that training initially to know how to deal with the menopause. I took a quick look this morning the NHS has menopause clinics. When I was looking at UCL on its website this morning, it says an appointment could take at least six months, could be a year.

Also, when I looked at Freedom of Information request that the iNewspaper had acquired last year, it says the average wait for a first appointment at a menopause clinic is almost double the NHS England's 18-week target. So we're getting up there to seven months on average. at a menopause clinic is almost double the NHS England's 18-week target. So we're getting up there to seven months on average. So you can understand women's frustration and perhaps why they're deciding to try and find another way. Yes, so can I just answer that?

Because the British Menopause Society have now taken the trainer out of the equation and that was the bottleneck. And we have a very comprehensive menopause certificate, which is done online with assessment and with certification at the end. And I think, you know, not all GPs will be able to have an interest in women's health. And, you know, we should focus on the GPs that want to deliver more advanced services in women's health. And, you know, I really want to make the point here that there are some exceptionally good GPs out there who I think are being almost kind of included in that group

that GPs are not able to do this. GPs are able... I'm not making any mass generalisation. I very specifically took the word some there and from people's experiences. Paula, please go ahead. So no, it's just that, you know, I think we focus on the GPs that are interested. The Women's Health Ambassador, Lesley Regan, is very keen that we develop intermediate services

within the community to improve access to care. And I think anything that we can do that improves access to care is better for for women let me bring in carolyn your thoughts on the program so far and perhaps a little of what you're hearing from paula right first of all um i was disturbed by the program because i am terrified that women will stop taking the hrt as a result of that program because it was it was quite frightening actually i'm not going to pass comment on whether people are prescribing more than it, because I'm not a doctor. I can't tell anyone how much to prescribe.

What I would say is I was one of those women who thought I had mental health problems and took antidepressants for eight years, believing that I had a mental health problem because I did not understand what the menopause symptoms were. So I wasn't telling my GP about all the other symptoms, which I know now are related to the menopause. And that's the problem. There's a lack of awareness amongst women as to what the symptoms are and what they can expect. There's a lack of knowledge generally coming from medical schools. o ddysgu yn gyffredinol yn dod o ysgolau meddygol. Nid ydynt yn dysgu menopws i ddegrwydd cymaint lle mae GPau'n gweithredu

gyda'r gwybodaeth y mae angen iddyn nhw helpu pobl i ddod i'r sylwad hwnnw. Fel y canlyniad, mae llawer o bobl yn mynd yn ôl i'r GP gyda symptomau gwahanol, ond nid ydynt i fynd i'r pwynt lle maen nhw'n cyrraedd diagnoes menopws hyd yn oed o'u llwyth o'r llinell ar ôl eu bod wedi cael eu presgriwio antidepreswm, ar ôl eu bod wedi cael eu presgriwio tablets gofod, ar ôl eu bod wedi cael eu gynharachu bod yna dimengia o dimengia cyntaf neu fibromyalgia. Felly, ie, mae rhai meddygwyr gwych yn gweithio yn y GIG sy'n yn ffantastig ar ddelio â chlwch gan bobl. Ond yr hyn rydyn ni angen yw pob meddyg, brilliant doctors working in the NHS were absolutely fantastic at dealing with women's

health. But what we need is every doctor, whether they're interested in women's health or not, to have a basic understanding of what the menopause is, so women wouldn't have to go to private clinics or wouldn't have to turn to alternatives. I went privately and I put my hand up and say, I actually went to Louise Newsom because I was of an age where I was terrified but what was wrong with me and I didn't think my GP would actually give me HRT so I went to Louise Newsom once I had that letter and I knew that I had I tried the products for several months I went to my GP and they were quite happy to actually prescribe a hair charting for me. So you almost became informed informed through that process there's a number of issues that are coming up the first thing I should say as well and I'm sure people

if they watched the panorama program last night would have seen this as well it was a ticker that went across every now and again that you should consult your doctor before changing any of your medications, whatever your concerns are or may be. But, you know, Carolyn, I do need to pull you up on one thing. You mentioned the guidelines there that you're not a medical professional, but you are an MP. And I am wondering, because the focus has been talked about these prescriptions, which are at a much higher dose that are outside the guidelines, outside the recommended dose. Why can that happen legally? That is for the BMA, I would have imagined, to actually be able to justify what is a nice guidelines.

I mean, I am a politician. I have no medical training at all. I just know how I felt, and I know how women coming to me feel. I had no problem with my prescription. I had no trouble with my dosage. I was one of those lucky women who instantly felt better, placebo effect or what, but dramatically, dramatically changed my life,

completely changed my life. Other women will have not have been successful whether they privately or with a with the nhs doctor will have to play around with medication with dosage with product you know that is a matter for a professional medical professional and the patient but it's for them and i'll come back to paula that point. But what I'm also for you related, do you feel there needs to be more regulation in place for private clinics? I think there needs to be better, better availability in the NHS so women wouldn't need to go private. to Paula for a moment. What about that? How can clinics operate in this way, prescribe at higher doses? Something that was mentioned in the documentary would be if many women were on 75 micrograms to 100 micrograms, some of the prescriptions were 300 micrograms, just to put

it in context for our listeners. How can that happen, Paula? It's not outside of any legal framework? I go back to guidelines. Guidelines are there for patient safety. Now, any one of us may, for a very small number of women, need to prescribe outside of licensed doses, but it's a minimal amount. I think the real worry on the programme last night was that this was common practice. And one thing I'd say about a private clinic is that they're working in relative isolation. And that's not the case in the NHS. I don't think women with a history of cancer should be dealt with in a private clinic, because we need to collaborate with their oncologist, with their gynae cancer surgeon, and the same with women with breast cancer. You know, that ease of access to colleagues is really important for patient safety.

I just want to read a statement that did come in from Newsome Health, which was a focus of the documentary. It says, as the UK's leading menopause clinic, Newsome Health utilises a wealth of clinical experience and data, as well as the best available scientific evidence to treat every patient on an individualised basis and provide the best possible menopause care. This is particularly important in an area of health that is chronically underfunded, undervalued and under-researched. We also have just received a statement from the NHS. Dr Sue Mann, the NHS's National Clinical Director for Women's Health, said access should be equal for all women and every GP should be following clinical guidance on menopause

and ensuring that when a woman presents with symptoms, a conversation about menopause happens first time. We have some pilots happening on this already. We will be writing to local health teams to reiterate guidance. You're nodding there, Paula, and I want to get to some of the messages that have come in in just a moment. But, you know, I was struck with some GPs don't have an interest in women's health.

Surely that's their job. They don't get a choice, do they, on which patients they get to treat or not? No, and I agree with what Karen... It's going to be 50% at some point that go through it. All GPs need some women's health care and I think things are changing with universities and with curriculums and certainly with GP training but general practice is an incredibly difficult job. We need to retain young GPs, they're desperately needed in primary

care, rather than see them go into private practice and kind of have a very narrow practice, for example, just providing menopause care. What we aren't seeing is the increase in the number of women who are experiencing abnormal bleeding because of the increase in the use of HRT. So things need to be balanced and everything in moderation is better. What I was also struck with as I looked into the figures on this, I believe there's 13 million women in the UK that are perimenopausal or menopausal. It is one million that are on HRT. They kind of worked it out at approximately, according to government figures, 15 percent, which is a small number if it's 75 percent that are actually experiencing symptoms? I think, you know, for many women, the symptoms will settle early on. All women, as I said before, should have access to HRT in safe doses to minimise side effects like bleeding and optimise how well they feel

during the menopause transition and beyond. I want to read some of the messages coming in from our listeners. Okay, let's begin with Caroline. As a 51-year-old perimenopausal woman, I need to join this conversation. My GP has a special interest in women's health, but has no time to talk through this.

It is a prescription. Come back to me in a month to discuss, but I'm left trying to deal with my symptoms and the contraindications. The menopause is so much more than hot flushes and depression, as the doctor mentioned.

It has been the hardest six years of my life with aches, pains, heart palpitations, anxiety. I still feel like I'm floundering in the dark. Here's another from Anna in Nottingham. Your contributor about menopause and HRT said GPs can handle menopausal women. They can't. And that's why there's such a demand for private support. I couldn't get support from my GP. Numerous appointments going round in circles and all the time my mental and physical health One more. The woman is living on another planet are suffering in silence, being gaslit by untrained GPs, unwilling to update on women's health. One more. The woman is living on another planet to try and get this stuff sorted. Start off with getting an appointment then discuss menopause. Just doesn't

happen. Though all the women I've known, none have been happy with the way GPs have dealt with this. Obviously that's just a small sample that came into me in the past few minutes during our conversation. But back to you, Carolyn. when you hear that and you've watched the program what needs to happen well training education and training and awareness raising you know that's something i've been fighting for for a few years now okay a few years why is it not happening

well it is it is happening but the, it is. It is happening. But the frustration I feel that we are still having these conversations about good and bad. You know, this is women's health. There's 51% of the population. It's 2024. Why are we having discussions about whether women can access treatment? Women should have full and open access to treatment and resource through their menopause they need the information to make the decisions about

their own health care I'm sick and tired of women being fobbed off with or get over it go and talk to your friend I've had women being told go and talk to your mother and ask her it's wrong women need equal access to quality care in the primary health sector so they haven't got to go outside of that to get any kind of help and support to get them through their menopause. I want to thank you. Sorry, Polly, you want to come back? We'll cook one. Go ahead. I'm not on another planet. I've been a GP for 20 years, changed specialty, now working in secondary care. I can see it from every side and we are making a huge amount of progress this is not something that you can change overnight and the worry is what we've

seen in the programme last night is when things move too quickly we need to get the infrastructure in place to support GPs and practice nurses in primary care to get this right for women and their families. Interesting they'll move too quickly. Carolyn complaining it's moving too slowly. Moving too quickly, you think then by extension more clinics popping up? Just explain that before I let you go. I think it takes time to change. It wasn't easy for the BMS to put that training package together.

It was a huge investment in time. And we have already had 100 people complete that you know that's going to change women's care so much and JP's working together in networks will also improve access for women and care for women and we're doing that in Liverpool where I work so that we've got an intermediate care in women's health hubs all of these things are improving the current situation. So, you know, I really honestly feel very sorry for women who are symptomatic and struggling to get care,

but I don't want them to think that nothing's happening in the background and patient safety is absolutely paramount. I will say yet again, you should consult your doctor before changing any of your medications. Thanks so much for the conversation, Dr Paula Briggs, Consultant in Sexual and Reproductive Health at Liverpool Women's NHS Foundation Trust and Carolyn Harris, Labour MP for Swansea East

and Chair of the Menopause All-Party Parliamentary Group. Thank you very much. Now, to detectives. Whether in real life or fictional, they often capture our imagination. But some of the best-known historical figures carrying out detective work, the ones that we remember, are often men. I'm thinking Sherlock Holmes, Hercule Poirot.

But a new book reveals that some of the first real life detectives in Britain were actually women. And they were on the scene 40 years before Sherlock was even created. That was back in 1887. They are discovered in a new book, The Mysterious Case of the Female Detective. It's by Sarah Lodge. And she takes a look at the real and the fictional sleuthing characters. Welcome to Woman's Hour.

Thank you, Nuala. So what made you want to write about these women? I suppose I should also ask, what is a Victorian female detective? Well, what made me want to write about them was really a very specific incident. In 2012, the British Library reprinted these two Victorian pulp fictions, one of them called The Female Detective, the other Revelations of a Lady Detective. And these are fictional casebooks. But in the introduction to one of them,

it said, of course, there were no women detectives in 1864. And I don't know if this has ever happened to you, but I just thought, I don't believe you. And so I went away and I looked at these sort of digitized newspaper sites, which of course we have access to now. We didn't used to. And in the times for the early 1870s, I found these small ads for private inquiry agencies offering experienced male and female detectives. And I thought, good Lord, there really were women doing this job. And after that, I was just completely hooked. And that's the reason I ask is,

how would you define a Victorian female detective? Because we often associate it with a police force, right? But you're talking there about some private inquiry, so it's more private investigator. Yeah, there are lots of different kinds of female detectives. There are women who are working with the police in stations as detective searchers, looking at women's bodies and their clothing often,

but also outside of the station. So picking up pickpockets, luggage thieves, people on the buses who are defrauding the bus companies and even fortune tellers who are breaking the law. So they're doing lots of work outside the station. And then there are also these private inquiry agencies. Doesn't it paint us a picture, however, of Victorian society? Because I found it really interesting to read about

how the changes in society as Victorian times took hold, whether it was like because of industry transport or the clothing, the bustles. And that gave rise to different types of crimes, which also meant we needed a different type of female detective. Yes, absolutely. It's partly changing transport networks. That one of the things I really noticed about these early female detectives working with the police is that it's partly train crime. You know, so whether it's somebody in the first class waiting room who is picking up a suitcase and looking as if it's his own, but it's actually not.

Or sometimes it's cases of sort of sexual assault or claimed sexual assault in train compartments. It's buses where people are pickpocketing from people sort of spreading their skirts over other people and then nicking their purse. There are all sorts of things going on that are creating a situation where crime is rife. And you have these details of these fascinating women that were holding this particular role in society. Do you have a favourite you'd like to tell us about? I have lots of favourites. I know. But one of them, I think one of the things that really came to me, you know, I thought this was

going to be about gender and it is, but it's also very much about class. And so a couple of my favourites, one is called Anne Lovesey. And she's working with Birmingham Police Force. She's actually living in Moore Street right next to the station for at least 36 years. Now, everybody told us that women's work, if they were working with the police in the 19th century, you know, it was absolutely casualised. It was just officers, wives and so on. 36 years, no pension, no, you know, they're just getting paid on a kind of case by case basis. But she's, that's a career in the police. And then, you know, Emily Oxley, who's in Cardiff,

who is the wife of a policeman who then, as many policemen did, opens a private inquiry agency. He's not very well. He's retired early at 41 from the police force because really I think police work has broken his health. And she's running the company. And we do see that in your book that it was often the wives of police officers, or indeed the widows that took on these roles. I suppose by osmosis, they had picked up policing tricks and tips, and then went on to do it themselves. It's true. But I'm also just astonished, Nila, by the extent to which all across the country

police forces are just using these women for sting operations, some of which are really risky. So, for example, Hannah Lawton, who's in Manchester, she is used to pose as a fence, really. There are some burglars who've stolen some jewellery, some shawls, some clothing.

They've been seen making off across the fields in the rain. And she has to go to the hop, pull in and pose as a kind of clothing dealer from Bradford. She accompanies them to back Foundry Lane, offers them money, and then lures them to the station where the police pick them up. There's a lot of points there that that could have gone wrong.

Absolutely. Because there's a description in your book of the work of the female detective, and I love this, as intimate, patient, uncomfortable and fraught with moral ambiguity. While we often think of the male detective as an individual working somewhat removed from society somewhat shadowy figure and the female detective instead is in a household perhaps surrounded by people Absolutely, I think because we think of literary detectives

we often think of people almost as an architect seeing the crime as an observer removed. Exactly. And one of the points I make in the book is that actually the business, the real business on the ground of detection is collaborative. And it often involves people doing these long jobs which are not glamorous, where they don't have control over the investigation. But these women are being put into situations, sometimes in the long term, to try and say smoke-eyed and embezzler. And they're posing as a lodger waiting to see if the wife is visited, or she gets letters or something like that. So they're solving these kind of grand larceny cases,

but not in the way that we think of a Poirot or a Holmes solving them. They're actually having to kind of bed in. They're in these embedded roles. And I suppose valuable because they're almost invisible because they are, and I put in inverted commas, a mere woman. Exactly so. I mean, one of the things I say in the book is that in a way, a kind of plain and commonplace woman is actually more valuable than somebody. I saw that. That was some of the descriptions of what they would look for.

Like Miss Scarlet or something. We have private inquiry agencies say, you know, I definitely employ a 70-year-old because nobody would suspect them. They're a bit like mosquitoes. If you don't see them, they're much more effective. Can be dangerous, though. This is why women are employed as detectives in the Victorian period. To a very large degree, it's because they can get inside properties in a way that men just can't because they're free from suspicion.

During this time, the Divorce Act was brought in so that was perhaps not an easy path but it was a path for men and women to leave unhappy marriages. People had to obtain proof to obtain a divorce and for women to provide higher standards of proof so adultery

I suppose was a big part of the work as well and I spoke previously about the moral ambiguity that female detectives were often in because it might be woman spying on woman. Absolutely. We tend to, you know, rather hopefully think of the female detective as a member of the sisterhood, you know,

that she's kind of defending her fellow women. And the Victorians thought, you know, in fantasy terms about female detectives in the same way they had female detective heroines. But in reality, sadly, in a legal system that favoured men, women were often being employed to catch out fellow women. And 1857 is really the key date. But because before that, and it's incredible to think of it now, but you actually needed an act of parliament to get a divorce. So nobody's getting divorced, really, other than aristocratic men, or very few. And after 1857, the numbers are still small, but

suddenly a window opens, and all of these abusive, all of these unhappy, incompatible marriages, suddenly men and women can see a path out. And the person beckoning on that path is the female detective. So it's really a part of women's history. It absolutely is a bit of women's history. It's kind of an uncomfortable part of women's history. But even if they're not always serving the interests of a particular woman in the case, and often they're not. I think when people read these cases in the newspapers, they're thinking, well, maybe I could get a decree, Nisi.

And then maybe they might turn in the newspaper to the small lads. And maybe they go and see the detective, the lady detective, who can help you get a divorce. But she can also help people who are troubled with black male family secrets. Maybe your husband left you, you know, he just lit out for the territory, and you don't know if he's dead or not. If you were to remarry, you'd be committing bigamy. What are you going to do? Who are you going to call? And I, you know, in some ways, the female detective is kind of agony on with a gun. You know, these agencies are open day and night.

And they say, you know, you can come and tell us about your private, legal, familial, social troubles. And I think a lot of their clients were women because women were, you know, they were gaslit a lot of the time. They didn't know, you know, where their husbands were in the evenings and they didn't always really have the right to go and look for them. And so these agencies, which many women ran their own agencies as well, which was a step forward for feminism

also was happening. Fascinating stuff, looking at gender and quality of Victorian times through the lens of the female detective. Sarah Lodge, our book is The Mysterious Case of the Female Detective. Thanks so much for coming in to us. Thank you very much. Now, yesterday's

programme was all about the Irish Tum baby scandal. 796 young children who died in the care of nuns at a mother and baby home between the 1920s and the 1960s. Their bodies were put into a disused sewage tank. A new excavation of the site is about to get underway,

so I went to Tuam in County Galway to speak to the people who brought the story to the world. That includes journalist Alison O'Reilly, who says not everyone wants the story to still be making headlines. Ireland, you know, has got a mentality of, ah, look, that was then. Why are you still dragging that up

but your relatives of mine saying don't tell me you're still going on about that story oh for God's sake but the attachment theory is there in black and white it's real attachment is real destruction happens when you separate

a child from their primary carer so how damage is not created and people think that that's just years ago and you move on and look at you, weren't you adopted into a lovely family and didn't you have a great life? There's damage. The women in their 90s who had their children taken and died,

they do not go to sleep at night without saying the rosary and those women know the pain. So how can you say to them, listen, you know that child you lost when you were 18, will you stop going on about it? You can't. You never forget the loss of a child. You never forget it. You just have to learn to live with it. Will you continue with this story after the excavation, whatever has been found or

not found? Absolutely, yeah, because it started with 796 children who are missing and they're still missing. So if they don't find all of them, then where are they? You know, we have to know what happened to these children and it remains open ended and they're Ireland's missing children and they have to be found. Alison O'Reilly there

and you can catch up with the full programme on BBC Sounds. Just search for Monday, the 30th of September. And if you live in the UK and believe you could be related to one of the children buried at the Tum home,

please do go to the Women's Hour website where there's contact information for the team doing the excavation and identification. They do want to hear from you. You can text Woman's Hour on 84844 or on social media. We're at BBC Woman's Hour or indeed email us through our web. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody.

Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's

Baby. It's a long story, settle in. Available now. Now, I want to move on to hair. For many it is more than just part of their appearance, it's a reflection of their personality, of their style, of their identity, their self-expression.

But what happens if you start losing it? Hair loss comes in many, many forms, from thinning to complete hair loss. It can happen suddenly, or it can be gradual over time. It is said to affect many women at some point in their lives. There's a new YouTube series, Hair Stories,

the hairstylist Michael Douglas, with nearly 40 years of experience working with women's hair, explores women's unique stories and the personal connection they have with their hair. So with me in studio is Michael. Good morning, Michael. Good morning. Thanks for having me. We also have Katie O'Callaghan joining us,

who experienced hair loss and ultimately chose to undergo a hair transplant which we don't often hear that often from women. Katie, you're also very welcome. Thank you, hi. And I think, you know, let's make radio visual. I have to describe, I'm looking at Katie, she's looking

her hair is brunette tousled kind of shoulder length. She has a little bit of it tied up on top with her gorgeous big hoop earrings. Michael, your hair is kind of, it's tied back today. So it's kind of, what would we call it? You're the hairstylist.

Dishevelled. It's dishevelled today. It's very fashionably dishevelled though. I've styled it for radio, let's say that. And my own is red. Yours is looking great actually oh gosh if I get that from

Michael Douglas I'm delighted must be a bit of body in there a bit of a wave very nice bit of a wave is that your natural colour

by the way that is my natural colour wow how lucky are you well I hated it as a child as many a redhead will know you kind of

it can be the bane of your existence but when you grow into it you're happy with it but that it's kind of funny isn't it because sometimes we don't realise how much hair is part of our identity. I imagine people were describing me, they'd probably first say she has red hair. You know what I mean? It's

something that you say. There's something kind of paradoxical about it, I think, the hair thing. It's like you either hide behind it or you embrace it. And it's a bit like you saying, I didn't like it as a child, but now you love it. You know, what I'm always trying to do is get people to fall in love with the hair they've got, not kind of drift and try and find something they haven't, you know. Well, let's talk about Katie, because you've had this part of your life, a number of periods, when you noticed some hair loss. Did you know what it triggered it? And what was that feeling like? And I'm going to throw it out to our listeners as well, 84844 if you've experienced hair loss, because I think this will

resonate with many. Go ahead, Katie. I think my hair has always been a bit of a benchmark for my health. I think even from being a child, it's kind of been almost like the barometer of how I've been sort of mentally, physically, from sort of having to deal with there was some childhood trauma through to um lots of things happening in my 20s and then the past 10 years especially have been a real mixture of um it's been a bit of a roller coaster there's been this grief um there's been early perimenopause um and so just I think big life events that are often out of our control for me I was a bit like almost like a volcano uh which was always gonna erupt at some point and as I got older my hair took the full force of this build-up of stress and um of suppressing a lot of things for a long, long time because it has to go somewhere.

So what did you do? I mean, I noticed after COVID my hair fell out quite a lot. I would say even about 30% of it a couple of months. And I just, every time I pulled the hairbrush through my hair and it just kept coming out or in the shower, it was just mounds of it. It alarmed me, but yours was to a more extreme degree. So I'm just wondering how you felt about it, howounds of it. It alarmed me, but yours was to a more extreme degree.

So I'm just wondering how you felt about it, how you managed it. Well, I felt terrified, I'll be honest. It happens in different stages of my life. A big lot of hair loss happens after I'd had my daughter about nine years ago now. And I put that down to, oh, you know, lots of people have postpartum hair loss, but mine just seemed to be extreme. And then I was a single parent as well on top of it so I thought okay

it's just a lot happening in my life and I kind of battered it off and hoped that things would get better and then more hair loss kind of happened again I lost someone very very close to me very suddenly and you know grief is like a sledgehammer um and there's no getting away from it you have to kind of live with it and you know it's very central to your daily life and for me again loads of hair loss and how much if you don't mind me being brutally frank how much hair did you lose how bad did it get it was really noticeable so i was i was hiding my hair loss for a long time using, I was wearing hair scarves wrapped up. I was using hair extensions in my hair. I was styling my hair in certain ways. I was using that spray that you can get that covers up your roots. You name it, I've tried it. I've bought it. I've used it. If there was a gold medal in hiding your hair loss, I would get that medal because I just, you know, hours of my life I've spent trying to cover it up. But what I was shocked about watching Hair Stories,

which is going to be on YouTube, and Michael, as he speaks to you and others, you didn't tell those closest to you that you were losing it. Why? No, I didn't tell anyone. And it's really, it's very difficult for me to look back on not telling people because I'm really quite an open, talkative person. And I think talking is extremely healing.

The irony is the one thing that I needed to talk about the most, it makes me quite emotional to talk about it now, but I just was so embarrassed. And for anyone who's listening to this who you know has any kind of hair loss problems will know that there's there's nothing really like it when you can't even bear your own reflection in the mirror some days and you don't know what to do about it it's such a lonely place and I didn't want to burden those people closest to me because I thought once I opened up they would then

constantly be thinking Katie's dealing with something that's really stressful really worrying to her and I just wasn't ready to go on that journey so I kept everything close because for me I just thought this is probably the easiest option is to almost pretend it wasn't happening for a long time and I you know in all honesty I was praying for a miracle you know I was trying everything I was all these vitamins and and you know I was coming up with the craziest sort of things to try to try and help my own hair she has the greatest laugh I put broccoli all over my head one night um you I've slept upside down off the bed another night trying to get the blood

to rush to my head. You know, because when you're desperate Sure, sure. You will try anything. And you did have a hair transplant, which we can come back to in a moment. But I want to throw over to you, Michael, because there's various figures

that we see, but we know that many women will experience this at some point in their lives. How much do you hear about it from women? An enormous amount. I mean, during lockdown, one of the things I did is I went live on Instagram every day for half an hour and just offered people hair advice. You know, I had nothing else to do. You know, there were so many people that wanted the advice. And then it was like a massive focus group every day for half an hour of women saying, this is the problem I've got.

And I just couldn't believe the amount of people suffering with hair loss. And there didn't seem to be any good solution out there for them. So I would say probably 200 to 300 DMs a week on Instagram alone of people suffering with hair loss. A lot of it is also just a psychological thing, where they feel like they're suffering with hair loss, but they're not is also just a psychological thing where they feel like they're suffering with hair loss, but they're not. There is actually a symptom called hair awareness where you become so paranoid about the hair in the shower and you start looking at your

receding hairline and then you become so obsessed with it, you can't get out of the repeating pattern of worrying about it. So that is a thing. So first of all, I need to establish when I'm speaking to somebody whether they're just suffering with a paranoia around it or whether it's a real problem. But yeah, I mean, it's massive and there doesn't seem to be any good solutions. When I met Katie and I could see, we were in Cyprus and she had this headscarf and I can spot it a mile away, really, when someone's slightly hiding something with their hair, because that's what I do. I thought, I've got to ask her about this, know and then she went oh yeah well I've had a hair transplant I was like tell me everything you know and it was such it was such a great moment to get I could see her like wanting to get this stuff out you know all these feelings out and I

was just ready to receive all the information when I saw the extent of the hair transplant and what she'd been through I was like god is there any awesome information. When I saw the extent of the hair transplant and what she'd been through, I was like, God, is there any way we could tell this story? Because my two or three hundred people who message me every week about this would value all this information so much. And that's really where hair stories came about. And hair transplant is, of course,

might be a step too far for some. It has worked for you. And I'm delighted for you for that. But do you, Michael, is there anything that you advise for people whose hair is thinning as a hair stylist? Yes. I found one mine was beginning to fall out I just chopped it Yeah okay yes that's a good idea I mean

what a hairdresser does what I do is deal with the hair that's there but when you're losing it going to a hairdresser for advice is not actually that helpful because if it's not there there's not a lot they can do with it. What we can do is disguise it and mask it. And there's little tricks like putting a parting in on a diagonal, which separates the hair more evenly on either side of the head. There's ways of making it look a bit thicker, but that's not really addressing the problem.

The best thing to do really is go and see a trichologist, which is a kind of doctor of hair and scalp. And they will try their very best to determine why you're suffering with the hair loss. And if you can get to the underlying problem there, that's when you can start to do something about it. And that's what Katie did eventually, is go and see a trichologist. And they came to the conclusion the best thing was a hair transplant. Yes, indeed. You know, you're not a scientist. You're saying go and see somebody who is scientific in that particular way. But it is so interesting to hear, Michael, that so many women come to you and that that was part of the issues that they were experiencing. Do you feel it's different,

Michael, the way men and women approach hair loss? I was thinking about this this morning, and I was wondering, is it different now generationally? Because... I actually don't think it's that different I mean I see lots of men especially young men but this is what I'm thinking generationally maybe it's different now and petrified that they're losing their hair

I mean I know a young lad is at 18 he is definitely going to be bald by the time he's 25 and actually a hair transplant wouldn't help him either because by the time you transplanted the hair you're losing more than you're transplanting. And then you're essentially taking it from the back and filling up the front,

but you're losing it at the back, you know, so you're playing this game. Right. So actually, a lot of it is trying to get people to come to terms with the fact that this is happening to them. And there's a great conversation I have with lots of men that are bald, and they said, the day I decided it was gone. To shave. I was set free.

And I have never thought about my hair ever since that day. And I, it's unbelievable that I put myself through a 10 year process of letting go of it. Perhaps easier for men to shave their heads than women. Totally. Women is a completely different game. Back to Katie. How was the hair transplant? Difficult decision? Easy decision?

It took me about at least two years to come to that decision. Lots of trips to the doctors, lots of doing research myself, going to different hair specialists, thinking of doing a Brittany straight away, get it shaved off, just embrace it. And I couldn't bring myself to do it so the hair transplant i was very fortunate that i found an incredible doctor in liverpool and very sympathetic and talked me through um what the process would be but also made me fully aware that there are you know sometimes no guarantees that this is my hair this is the result today but i know myself that you know the future could be very different for my hair my hair could fall out again um and that's something that I've had to be open about this now because if that is my future I want to embrace it rather than hide that's so interesting you want

to embrace it so to me listening to you it almost feels like some of the fear of that is gone compared to the previous you. Massively. And for me, speaking to Michael, when I met Michael and I met Davina McCall at the same time. Who is your partner? I should throw in which people may not know. The award winning, thank you. The award winning Davina McCall, go ahead.

You know, I had some amazing conversations with them both around my perimenopause journey and also about hair loss and it really it changed everything for me I mean the the idea of going into the hairdressers and how somebody cut my hair has been so terrifying for so long and I don't know Michael Michael took all that kind of it melted away because the setting was right and it felt safe and it was but I know some listening may not be able to afford a hair transplant or want to go that step. But it's interesting to hear you say you may have to embrace it in the future.

It's a conversation that won't be the last one we'll have here on Hair on Woman's Hour. Hair Stories is on YouTube from this Thursday and every Thursday from 7pm for the next eight weeks. I want to thank Michael Douglas and Katie O'Callaghan for sharing your stories. Now, let me move on. It is day three of the Conservative Party conference. It is well underway.

And with the party potentially having a woman in the leading role, that could be Kemi Badenoch, Robert Jenrick is closing the gap. It seems it's Conservative women and their thoughts on female issues that have been making the headlines. So far, we've seen Liz Truss taken closing the gap. It seems it's conservative women and their thoughts on female issues that have been making the headlines. So far, we've seen Liz Truss taken to the stage. Camille Badenoch comments

that maternity pay has gone too far and calls for a boost in prize. Being a conservative woman are just some of the issues that have been raised. There's a lot to unpack. Let's speak to Lara Spirit, Redbox editor for The Times, and Alvare,

who's associate editor at Bloomberg UK. You're both very welcome. Let me begin with Kimmy Badenock, currently leading in the polls, but maybe not as certain. Lara, what do you think? Yes, so there's a new poll from Sky News and YouGov this morning that finds that her lead has narrowed. Back in August, she had an 18- point lead among the party's grassroots over Robert Jenrick. And now Jenrick has narrowed that lead, it seems to just about four points. So whether or not that has anything to do with the row that we've seen over maternity pay in recent days isn't clear. But it's certainly clear that Jenrick's team feel pretty buoyed by these. How did the

maternity pay comments go down with the party? So I think it's fair to say that the rivals universally distanced themselves from those claims, as indeed did Kemi Badenoch herself, who said that some in those rival camps had misinterpreted her suggestion that it was excessive. She said actually she was making a point about business regulation and that some of the comments from rival camps who seemed to jump on it as an opportunity were not a fair representation of her views. But I think in recent days, actually, as of yesterday, we've seen the focus more towards Robert Jenrick now over his claim in a campaign video that British soldiers were killing terrorists

abroad as a result of human rights laws. Now, I think the focus is truly on him. It has been this morning. And certainly, I think after Kemi Badenoch faced members yesterday and didn't commit what seemed to be any gaffes in fact actually got in a comparison between herself and Margaret Thatcher her team will probably be feeling that actually she might have turned a corner. Some other candidates Laura you've mentioned Robert Jenrick you've got Kemi Badenoch. Yes so there is Tom Tugendhat who is the the third of those candidates, and James Cleverley, who is the fourth of those candidates. So these four candidates that were here in Birmingham watching this. And who decides, how do they decide who gets the top spot? So it's sometimes forgotten, actually, when you speak to people here in Birmingham,

that the MPs actually have another say before the final choice is made by the members. So MPs will vote when we get back from Birmingham to whittle down those candidates to three and then to two. And then the membership, the party's grassroots, will vote on those final two, and they will decide the final candidate who will be the next Tory leader at the beginning of November. Let's talk more about women.

Alva, former PM Liz Truss was there. She made her appearance. Any thoughts on her performance? Well, I mean, it's been really interesting because, you know, this is a party that should be really reeling from a historic defeat in the in the last election. But they gave a very warm welcome to the prime minister responsible for one of their worst moments in recent years, of course, her mini budget. She really did attract more of a crowd than any of the leadership candidates. She's still incredibly popular. Her views on tax, which informed that mini budget, are still really the kind of the toast of this conference. So I think in a way, I mean, she also said that she would have performed better in the general election than Rishi Sunak, even though she lost her seat and Rishi Sunak didn't, obviously.

And what was the response to that, for example? Well, I guess a lot of members like her. I mean, you have to remember that the membership never really chose Rishi Sunak. This is a group of people that never particularly wanted him to be prime minister. He only became their leader when there was no other choice. So I'd say that they, I mean, there's a plurality of views among the Tory membership, but I'd say the vast majority of them actually believe her. And I think that just speaks to the sort of wider state of mind of the Tory party right now that with Labour not having the strongest start and sort of wobbles over freebies and donors

and so on. I think there's a real sense here that their defeat wasn't that bad. And actually, victory again in five years is within reach. Okay, which is which is really interesting to observe. Let me go to the comments of MP Mim Davies. She said at a fringe event that the number of women wanting to work for and with the party is diminishing and called for pride in being a Conservative woman to be boosted. Just brief thoughts on both of those points. First to you, Elva.

Well, the Tory party has had a growing woman problem since actually Theresa May was Prime Minister. This has actually been a theme at every conference I've come to. But I mean, we can't quantify it. But I think Lara would probably agree that it is really striking this time how few women there are. I mean, it's maybe a ratio of about nine to one. And most of the women are the journalists. I actually said the exact same ratio to somebody last night.

It is quite extraordinary when you look here. And obviously, it's not particularly scientific for us to say this, but I would just say eyeballing it that you can certainly see a really big disparity here. I think there's a question of young people generally, obviously fewer than one in 10 under 30s. I think it was voted for the Conservatives in the most recent election. But then there is a question about getting young women actually involved in politics and specifically in Conservative Party politics. And I certainly think what Minns Davies, who is the shadow women's secretary, is saying here is that it's very difficult to get them to actually be engaged with the party. And looking around you here at Birmingham, it just seems that she's correct about that and they need to do more. Coming back around full circle, back to Kimmy Baden, of course, maternity pay, a woman's issue, a man's issue as well, I guess we could say, when it comes to parents. But is there any other women's issues that are getting oxygen at the moment in our last 30 seconds? Laura, first to you. I think not specifically at this conference.

I think the candidates have been careful to talk about issues like domestic abuse, like violence against women and girls in recent weeks and months. But it hasn't been one of the real abiding questions here at party conference, I think it's fair to say. Alva? I think that's fair. And I think even the fact that Kemi Badenoch being a black woman becoming Tory leader would be a massive achievement for her and a big moment in British politics. I don't think that she would own it in that way because that's not really her style. So it really is not a big feature of the discussion here. Times, Redbox editor, Lara Spirit and Alva Ray,

associate editor at Bloomberg. Thank you both. Join me tomorrow from 10. I'll be speaking to a woman who specialises in ancient DNA. Dr. Beth Shapiro will be here to tell us how looking at the DNA of our ancient ancestors can help us fight the impact of climate change. Also, a comment coming in.

I've never related with someone on the programme more. Talking about Katie. She has described every crazy remedy I have tried after losing my hair during an extended period of a stressful work environment during COVID times. She perfectly describes the embarrassment I felt every time I looked in the mirror

and took a progress photo of my balding crown getting worse, not better. The feeling of dread when people were sitting behind me in meetings. I'll talk to you tomorrow at 10. That's all for today's Woman's Hour. Join us again next time. It's election time in the United States,

but this is social media's world and the election is just living in it. Accurate information about elections, unfortunately, is not as entertaining as false information. Join me, Marianna Spring, as I uncover how life online is shaping American people and American politics. None of us know what's going on, but we do all know that something isn't right. Deep fakes, polarizing algorithms, hate and conspiracy theories. To me, there's no other logical explanation. That entire thing was staged. Why Do You Hate Me, USA? from BBC Radio 4.

Listen now on BBC Sounds. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy.

And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.