Woman's Hour - Navigating the perimenopause; Increase in online accessing of child sexual images; Nawal El Saadawi's death at 89

Episode Date: March 22, 2021

The average age of menopause is 51, and menopause itself only lasts for one day, because it simply marks the one-year anniversary of your last period. Perimenopause, on the other hand, refers to the period of time in which you’ll have cycles, but start to experience ‘menopausal’ symptoms. Three quarters of women experience significant symptoms during the perimenopause, yet there is little in the way of evidence based information available. Comical descriptions of symptoms including hot flushes and mood swings are widespread and prevent essential details on the myriad of other symptoms and signs a woman is perimenopausal. Maisie Hill is a women's health advocate and author of Perimenopause Power. She joins Emma to discuss the symptoms and her toolkit of tips and techniques women can use to help themselves.Last year the National Crime Agency assessed there were at least 300,000 individuals posing a sexual threat to children in the UK, and warned of a spike in online child sexual abuse offending during the pandemic. The Stop It Now helpline, a part of child protection charity the Lucy Faithfull Foundation, is a nationwide service which offers advice and support for men viewing illegal sexual images of under 18s or feeling they are on the verge of doing so. They have reported an increase in people seeking help for their illegal online behaviour since the beginning of the 2020 Covid-19 lockdowns. Emma speaks to Donald Findlater, Director of the helpline since it started in 2002.The pioneering Egyptian feminist Nawal El Saadawi has died at the age of 89. She was a doctor, feminist and writer who was described as "the Simone de Beauvoir of the Arab World" and as "Egypt's most radical woman'. BBC Cairo correspondent Sally Nabil joins Emma to talk about her life and work.

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, I'm Emma Barnett and welcome to Woman's Hour from BBC Radio 4. Good morning. We find ourselves at another Monday and on the eve of a year of national lockdowns. Today we're going to start the programme looking back at the life of the trailblazing Egyptian feminist Nawal al-Sadawi. She wrote, I will die and you will die. The important thing is how to live until you die. Yesterday, she died at the age of 89. But what a life that we'll be reflecting on shortly. She also wrote, yet not for a single moment did I have any doubts

about my own integrity and honour as a woman. I knew that my profession had been invented by men and that men were in control of both our worlds, the one on earth and the one in heaven. We will hear Nawal in her own words from when she appeared on Woman's Hour. But considering it's Monday and we're living in strange times

where we have our freedoms curtailed in a way most of us thankfully are unused to, what are the words that get you through, that help you through difficult times or even just get you going on a Monday morning? Personally, I'm always minded to reach for the wise words often attributed to the human rights campaigner and former first lady, Eleanor Roosevelt. A woman is like a teabag, you never know how strong it is until it's in hot water. But what about you? What are those words?

I've actually got that on a pin cushion. What's it for you that you just reach for, think of, perhaps have on a photo, a card, your friends sent to you? Tell us them. G us up a bit today. 84844, that's the number you need to text us. Check with your network provider for those exact costs or on social media at BBC Women's Hour or email us through our website.

Those words that get you through or perhaps someone gave them to you at a particular moment. Tell us about that moment as well, if you'd like to. We'd really like to hear those insights and stories. programme, a very rare insight into what the operators of a phone line trying to help men who have accessed or want to access child abuse images, what those operators are trying to achieve and what's happened during the last 12 months of lockdown in that particular part of behaviour and what's going on with that around it as a crime. And perimenopause. Can the symptoms leading up to menopause be harnessed as a power? To the women I bumped into yesterday walking along a canal in London

who told me that they listened to Woman's Hour and good morning to you if you're listening right now. They just told me all they need is a public loo at the moment and could we please sort it out? Well, we do have powers here at Woman's Hour. I'm not sure we can quite sort that one out. but i can't promise anything beyond you look very powerful to me and i definitely wanted to hear what you had to say about menopause so if you are listening get back in touch if you are listening and you are in this situation right now or you've been through it and

you've got some words of advice do get in touch on 84844 with your experiences and any tips that you have will be coming to that bit later in the programme. But yesterday, the news broke that the pioneering Egyptian feminist Nawal El-Sedawi had died at the age of 89. A doctor, a feminist, a writer, who was described as the Simone de Beauvoir of the Arab world and Egypt's most radical woman. Here's a clip of her speaking to Nikki Badey on Women's Hour in 2015. Patriarchy is something very difficult. And we as clip of her speaking to Nikki Bady on Women's Hour in 2015. Patriarchy is something very difficult. And we as women, we have to understand that it's very difficult to eradicate the psychological patriarchy deep inside the psyche of men and women. And how do you begin to change that deep-seated psychological belief in patriarchy?

In fact, I am very much against the marriage system itself. Monogamy for women and polygamy for men. I am against that. The name of the father. We inherited the marriage system and it's very patriarchal. Children take the name of the father, not the mother. So there is a dichotomy. There is a very chronic disease in our culture, the world culture. So what if your daughter wanted to get married? My daughter didn't marry. She doesn't. She's against. My daughter against the marriage system.

And do you think she got those beliefs as a result of watching your fights? No, no, no. It's her work. My daughter, she has PhD political economy. She threw her certificate. She became a poet and writer. So she has her own. She's very radical. Nawal Al-Sadawi, in her own words. I'm joined now by the Cairo correspondent, Sally Nabil, to find out a bit more about her life.

Sally, how controversial a figure was she? She was a very controversial figure up till today. She is the woman who pushed social and religious boundaries really hard. She went against all odds. She was one of very few female writers who dared to speak their hearts and minds really freely and loudly. An outspoken critic of many social norms and religious views, some even accused her of being blasphemous because she dared to criticize what she described as traditional views of religion. She campaigned really heavily against all forms of oppression against women, including sexual oppression in particular. She cast light on FGM and how a horrific practice this is. She was a victim of FGM herself at the age of six. And this is why in some of her books, she has shed strong light on

that. And thanks to her efforts, this FGM has been criminalized in Egypt more than 10 years ago. But still, it is very much in place, especially in the countryside, because it's closely tied to traditions rather than the law. I mean, imagine a woman back in the 1970s writing a book entitled Women and Sex. That was unheard of in Egypt, a largely conservative society. So she is a woman who took a step that many would be discouraged to take. What sort of criticism was directed at her and her legacy and from whom? Because it was political and religious, wasn't it? Political, religious and social. She angered a lot of people by her courage, to be honest.

I mean, she was a target for Islamists who were quite active in the 1980s. Islamist groups committed a lot of violent acts and picked up arms. And throughout the 1980s, theyist groups committed a lot of violent acts and picked up arms. Throughout the 1980s, they threatened her life, they sued her, they accused her of blasphemy. And also, she paid a heavy price for her views when she was briefly detained in 1981. And given the continuous threats she received, she had to flee Egypt or rather live in a self-imposed exile for nearly a decade. And she came back in the late 1990s. But in her recent years, she was also criticized by some of her fellow human rights campaigners who said that she supported our current president, Abdel Fattah el-Sisi, who was criticised for his

iron fist rule and his heavy crackdown on opponents. So she kind of angered a lot of people throughout her life. Thank you very much for giving us an insight, a very brief insight. I know there's much more, but a lot of people actually getting in touch with us this morning saying her death has prompted them to reread her works and keep going with reading her work and she said she would write all those books again if she had her life over our Cairo correspondent there Sally Nabil telling us some more there about Nawal El-Sadawi who's died at the age of 89 Kathy says such sad news and a prompt for me to reread Nawal's works I saw her at a festival in Bristol some years ago and she

was just brilliant so forceful her message remains current for today perhaps never more so and you are brilliantly flooding our console our text message console here and our social media message boards here with your words that get you through uh grace says uh best motto don't agonize organize uh george elliott quotes come in here it's never too late to be what you might have been. Sydney Smith, Reverend Sydney Smith said, the greatest of all mistakes is to do nothing when you can only do a little. Do what you can.

That gets Janet through, who's listening. Good morning. Catherine, the days may be long, but the years are short. A thought that has helped me on those long days, stuck at home with a baby during lockdown and helped me the first time around outside of lockdown Chrissy hello to you these words have got me through many triathlons and I use them faced with challenging times or tasks I can I am I will and I absolutely love we've even

been sent a photo of a poster this morning just to finish off this bit and I'll come back to your messages again shortly from Katie who says a quote I absolutely love and I have it framed in my home as a constant reminder of what life can throw at me, all sorts of things, but I will not be beaten down. They whispered to her, you cannot withstand the storm. I am the storm, she whispered back. Thank you for those. Brilliant. Keep them coming in. 84844. But as we look back at the last year at what has changed or perhaps got worse or even been overlooked, there's one behaviour which is almost unspeakable and seems to have increased during the pandemic. Those searching for illegal sexual images and footage of children. And this morning on Woman's Hour, we're going to spend some time trying to look at this trend and understand how it's being handled from several perspectives. Last year, the National Crime Agency assessed that there were at least 300,000 individuals posing a sexual threat to children in the UK

and warned of such a spike in online child sexual abuse offending during the pandemic. The Stop It Now helpline run by the child protection charity the Lucy Faithful Foundation is a nationwide service which offers advice and support for men viewing illegal sexual images of under 18s or feeling that they are on the verge of doing so. And it has also reported an increase in people seeking help for their illegal online behaviour since the start of lockdown. I'm joined now by Donald Findlayter, director of the helpline since it began in 2002. Good morning, Donald. Good morning. How big a problem is the online use or searching for indecent images of footage of children?

And I'm just going to be clear here, we're not going to use the term child pornography. Yes, thank you. I think internationally there's a move against using the term child pornography simply because it almost attributes a consent and it kind of sanitises the term when we need to be very clear that the majority of the images that are being seen are being viewed are images of children being abused and therefore pornography is not an appropriate term to use except it clarifies why

people are using them they're using them for sexual gratification for themselves. How big is the problem? Well a few years ago now the National Crime Agency as you gather makes estimates of the scale of risk sexual risk to children and certainly certainly estimated that 80 to 100 000 people on any one day are viewing sexual images of children online in the uk so it's that kind of scale in terms of the nature the scale of the problem in terms of what the police are doing about it since 2015 uh when they were arresting maybe 400 people per week for that behaviour. That's now kind of scaled up. We're arresting somewhat like 9,000, 10,000 people a year now for this behaviour.

But the problem is still 100,000 or more. And therefore, that's part of the reason for wanting to be here. We can't simply wait for the police to arrest people. There has to be more to be done as early as possible. We can do it because if we can work early on these things, we can stop this behaviour becoming entrenched. Indeed, we can stop some people doing it in the very first place, which is good for them, but it's particularly good for children.

Yes, so there's a preventative element of your work in this. 49% of your callers to your helpline are men who are concerned about their own behaviour or thoughts. What can your call handlers do with cases like that? OK, so if I just tell you, the call handlers have had a range of professional experiences, social workers, psychologists, police officers, indeed educators. So what we can do, number one, when someone calls us, we need to explore with them the reason for the call. What are the specific circumstances they're calling about? And this 49% are people concerned about themselves, mostly because they've behaved illegally typically online so we need to

understand what they've been doing over what period of time they've been doing it and we will certainly want to start by acknowledging that they recognize they've got a problem okay so so now we move on from there the first thing we do we're a child protection charity we're going to want to make sure that children around them are safe that they don't represent an immediate grave risk to a child. And because we'll need to agree with the caller circumstances that they might shift in order to reduce that possibility. That's number one. Number two, we're going to go into some kind of short and long term or longer term kind of goals with them. Number one is managing your immediate risk then. So how do we get you to agree?

A, you've got a problem, you called. B, what can we do to help you manage the immediacy of that risk? When might you do it again? And how can we agree with you that you won't go back online looking at those self-same images? So how are you going to manage the temptation to do that? How are you going to avoid the triggers or navigate those triggers differently and then we'll put it put it put with agree with them a strategy for how they're going to manage in the longer term there are we have an online

self-help program kind of like a treatment program available freely but they can access there are 19 massive modules for them to engage with. So this is a long journey for them to take. There are reading materials we can refer them to, and we can encourage them to come back to talk to us on the helpline about progress, or indeed to talk to a loved one or a partner or a friend about what is a very difficult subject. So we're here for the short term, but also for the long term to make sure there's long term change. Well, as I said, we're going to hear from several perspectives on this. And it's important to get an overview from you. But I think it's important at this point to

hear from someone who called the Stop It Now helpline when he was arrested. This is Chris, and the male voice you'll hear belongs to an actor. Why did you start searching for this sort of material? I sometimes feel that people think offenders wake up one morning and decide, I want to look at child porn today. But the truth is that to get to actively searching for this material takes years and quite often requires a number of different pieces of a complex jigsaw all to fall into place at the same time. I started viewing legal adult pornography at an early age, 12 or 13, and over my teenage years I spent a lot of time viewing explicit legal material that was shaping my developing brain and I almost feel I became reliant on it. Porn for me became a kind

of support blanket and when my relationship with my ex-wife began to break down and I had difficulties with my job causing increasing stress and anxiety I became more and more reliant on it. Viewing porn became like an addiction and in my very depressed state my usual go-to sites were no longer providing the same level of relief, which led me to looking elsewhere. I've spent a lot of time assessing why and how I got myself into this position, and there are very clear cycles at play as I move further towards sexual images of under-18s. It began with me taking a slight risk in the things I was viewing, stronger legal material, getting a release and then dealing with the shame of what

I'd done. But when some time passes and there have been no consequences, I began the cycle again with another step towards more risky material. This process takes a long time, and each time the boundary preventing you from searching for the material becomes more and more eroded. I would often be up early in the morning, and this would be a time when I would view material as I knew I'd be alone. As time went on, I'd also engineer times when I could be alone during the day by missing family events or saying I didn't feel too well, and I would become very protective of my phone as well. I justified my actions because I didn't view anything on the internet as real. I was able to disassociate this from reality, and as I had no perception of the impact my actions were having on children in the real world,

I was able to continue on my spiral. I feel shame at my actions, but I start every day now by hoping I can show society I can turn my life around and provide a positive contribution of some kind. What were you looking for? How did it make you feel? It was like an addiction and in order to satisfy the urge I had to find something that provided that. I think that a very large part of the excitement that surrounded it was not the material itself but the illegal aspect of it and how it made me feel in the moment. Once the moment was gone, it was followed by shame and remorse, which depressed me even further.

Had you fantasised about children before? I had never fantasised about children before and I do not now. A large part of the thrill associated wasn't the material itself, but that I shouldn't have been doing it. I believe firmly that I was able to act in the manner that I did because my offences were non-contact offences, and I viewed the internet as something completely separate from reality. I genuinely believed I wasn't hurting anyone, and that allowed me to continue down the path I outlined before. Are you still in a relationship? When I was offending I was married but my actions destroyed that relationship and massively

impacted my ex-wife and my children as well. We both agreed to a divorce and I've only recently re-established contact with my children which took almost four years and huge legal fees. The impact and effects of my offending have caused irreversible damage to a number of relationships. Since my offending, I have had short relationships with a few women, all of whom I've disclosed my offending to early, and this was accepted by them at the time. Both social services and the police were unhappy with my last relationship as she had a young son. This impacted her much more than it did me, and as a result we agreed to separate, and I haven't seen or heard from her since. I've chosen not to look for any further relationships right now,

as I know the impact my historical offending could have on partners, even though they haven't done anything wrong. Do other people know what you did? All my family know what I did, as do my children and a number of personal and family friends. There's been a very mixed reaction, with some being prepared to offer me their support, but the nature of the offences and people's very correct idea of how abhorrent they are has meant I've lost friendships. My family have all stood by me, and without my parents and close family, I feel perhaps I wouldn't be around anymore to try and make a difference in some small way for myself and, more importantly, for my children. I've focused my energies on making sure those who have given me their time

get to see someone who is doing everything he can to improve his life and atone for his actions. Would you do it again? My answer is a very strong no. Each person who heads down this path has their own reasons for reaching this point despite a lot of similar themes. And I can only reaffirm that I have no interest in destroying my life again. I'm incredibly lucky to have been given a second chance and I will not waste it after so much faith has been placed in me by my family and friends. Chris, you called the Stop It Now helpline when he was arrested and that voice was of an actor's. We're talking to Donald Findlater, who's the director of the helpline since it began in 2002. Donald, is Chris a paedophile?

From that account, I would say not. If you understand a paedophile is someone with a primary sexual interest in prepubescent children uh this man from that we just had an account from chris um is such a typical story of people viewing sexual music children online of a of a of a of a primary sexual interest in adults met through pornography use in part um and then migrating to viewing increasingly egregious material, extreme material, including material involving children. That doesn't mean he can't become a paedophile over time if this becomes his sole interest. But at the moment, I would say not. Because there seems to be a disassociation with what he's actually looking at,

where he said, I genuinely believed I wasn't hurting anyone and because it was a non-contact offence. And I think that's a very frightening but important thing to explore. Look, I entirely agree. And one of the primary pieces of work we do in education and treatment programmes is get these men to think about the people in the images, the children who have been harmed, because frankly, at the time that they're viewing this material in a sexually aroused state, they're viewing it as pornography for their own personal pleasure they're not thinking at all about the individual and the circumstance they're in and important that they need to do that journey and recognize the harm those children have suffered and that they and

the shame that they need to engage with about them taking pleasure from that harm. In terms of the work that your helpline does, a large part of it is also supporting those who are looking for advice about someone in their life who's going through this or gone through this. And let's have a listen now to Sarah, not her real name, who was supported by your Stop It Now helpline when her husband was arrested. Her words are also voiced by an actor. My husband of 25 years was arrested nearly five years ago for the possession of indecent images. I had no idea what he was doing until the police raided our house early one morning as I was upstairs getting ready for work.

He must have realised the implications, but he kept on saying to me, I'm not a paedophile, even as the investigating officer was telling me that these are the kind of crimes that break up families. All of our electronic devices were removed for scanning and my husband was taken to the local police station for questioning. I was left in the house on my own with no information or even a contact telephone number. Eventually, I looked up the number of the local police station and rang to ask what was going on. I was convinced that there must have been some mistake. I drove over to the police station that evening and was able to speak alone to my husband for the first time since the police had arrived that morning.

It was at that point that he confessed to viewing pornography for 10 years, including illegal material for the last two years. To begin with, I was in a state of total bewilderment, hopelessness and confusion, and I certainly felt depressed about my own circumstances, especially when I was living in the family home on my own. I also had to deal with the extreme fear I felt about other people finding out and whether there might be attacks from ignorant people directed towards myself, my family, my pets or my property. My two daughters reacted very differently. The elder girl was tearful and outraged, then intensely curious. She immediately wanted to have contact with her father to ask him lots of questions about the house and the wives.

It had been viewing a large number of very extreme images and was fortunate to escape a custodial sentence. There were signs that I just didn't recognise for what they were. First of all, my husband had a long history of depression and low self-esteem. He was increasingly struggling at work and was worried that he might be forced out of his job. Our relationship was pretty good, or so I thought, and I tried to get him to speak about his feelings, but he never let on about the legal pornography and worse. He's always been quite obsessive, so I thought he was looking at forums about the topics that interested him sports extreme dieting etc he struggled to sleep and increasingly he wouldn't even make it up to bed instead he'd stay for hours on the computer downstairs

I knew he was computer savvy unlike me but I didn't suspect he was looking at anything disturbing because I sometimes use the same computer as him and knew the login details. Obviously there was a section on the computer that he was concealing from me. I wish now that I'd been less naive and trusting and more suspicious. I've remarried and moved away. Many women do choose to stick with their partners but I knew our marriage could never be the same again because he'd been betraying my trust for the past decade. Also it would have constantly been apologising to me and I don't think a successful relationship can develop on such an unequal footing. Furthermore as a teacher

I would not have been able to continue my career unless I had distanced myself from him eventually the girls both rebuilt their relationships with their father and they have a good relationship with me too however that has been under strain at times because I've moved on and rebuilt my life whereas they feel sorry for their poor father who's depressed and living a pretty impoverished life now they say they understand but I'm sure there's a part of them that thinks I should have stuck with him. Sarah there who was supported by the Stop It Now helpline Donald who runs that helpline is taking us through this.

We started our conversation with you by putting the year in context. A lot of people thinking about a year of lockdown because it's the eve of when Boris Johnson announced it tomorrow. What has happened, do you think, over the last year to make this worse? Or is it that we're monitoring it differently? And for people who are concerned about the policing of this, you're a former probation officer. Are we doing a good enough job?

OK. Are we doing a good enough job? The UK globally is doing probably the best job I've seen in terms of tackling all forms of child sexual abuse, including online of any police force, indeed, any country in the world, whether we're in the vanguard of all the developments and others are learning from us, which doesn't mean we've got it right yet. It just means we're getting better and there's a bigger push now towards prevention.

And one way I can demonstrate some level of success is the fact that year on year since 2015, we've had more and more calls to the Stop It Now helpline from people either concerned about their own behaviour online or concerned about the behaviour of a loved one. And that's a vital thing that people in households are noticing and doing something about it. Noticing a partner, an adult loved one, or indeed a teenager in the family doing something egregious online. We need to notice and take action as soon as we possibly can.

Why COVID? Why has this made it worse? Well, frankly, if you talk to the porn companies, they will tell you there's been a vast increase in the viewing of adult pornography online. And sadly, a proportion of that will end up migrating towards viewing sexual images of children. People are bored, people are depressed, people have limited recreational possibilities. But people will give themselves all sorts of excuses as to why they do bad things.

And sadly, COVID and the restrictions we've all had to live within provide some of those excuses. So I don't take any kind of delight in saying that. But there's no reason people should break the law in this way. But there's every reason to say there is help available to stop. Whether you're the person doing it or whether you're a partner or a mum worried about someone in your household doing it. For goodness sake, take an interest. Get in touch with the Stop It Now helpline

if we can help you in any way. Donald Findlay, to director of the Stop It Now helpline since it began in 2002. So, I mean, some reassuring words there, but also some very troubling insights around the trends around this. And we'll make sure that all of the contact details to any support services are made available

on the Women's Hour website. And I should say, if you've missed any of our are made available on the Woman's Hour website. And I should say, if you've missed any of our previous discussions here on the programme or any of our items, I mean, for instance, last week, we did a great deal around, in fact, the culture of the police and reporting techniques and the relationship women specifically have with the police. If you missed any of that, do catch back up on BBC Sounds. Brain fog, bloating, rage, poor memory, headaches, sleep disturbance might sound like your typical day, week, month or even year. And if so, any combination of these sorts of symptoms could mean you're at the beginning of what's known as perimenopause, aka the lead up

to what's technically a one day event, the menopause. To explain more, the author, women's health advocate and acupuncturist Maisie Hill, whose new book, Perimenopause Power, is trying to debunk myths around this part of a woman's life. Good morning, Maisie. Good morning, Emma. It's great to be back. Well, we've got a message here. Thank you for some telepathic programming, women's art. I've been feeling very peri for the past fortnight and I am listening, says Anna. So Anna's definitely tuned in hard to this. Menopause itself lasts in one day. Just tell us about that first of all. Yeah. So the average age for menopause to take place in the UK is 51. And let's, well, let's say

your periods stop at the age of 50. You then 12 months later go through menopause, which is a one day event. Let's say at the age of 51, perimenopause, on the other hand, is the period of time leading up to your period stopping when you might experience symptoms, length variations in length of your cycle, all these kinds of things. But you still have a cycle. But this is what perimenopause is. And often when we're talking about menopause, what we actually is what perimenopause is and often when we're talking about menopause what we actually mean is perimenopause and then after after menopause your post-menopausal but yeah menopause itself is just one day because perimenopause i was looking up the actual word you know it's it's it's the perimeter of it's the leading up to it's the bordering of the actual thing i still can't quite believe that and i remember learning that myself that menopause

itself was one day um and it's everything else that runs up to it. It seems far too short for something that I've heard a lot about from people and not least, you know, the women in my own family. Tell us about the symptoms because they are vast in some ways, aren't they? Oh, yeah, they are really vast. And I think that's what can make it tricky for women to identify that that is what's going on. And often because they can be explained away by other things that are going on in life so you know we can have symptoms like you know we typically associate you know the menopausal women with hot flushes and irritable weepy you know we have this idea in our head and you know symptoms like that can be

taking place, but it can also be things like bloating, breast tenderness, joint pain, vaginal dryness, irritability, rage, you know, palpitations, changes to skin, body composition. The thing about hormones is they impact absolutely everything. So when you start to get hormonal shifts then you know you start to notice that in a multitude of ways but what I've been really keen with the book is to just make people really aware of that that's what's going on because you know once you are in the thick of it and let's say you have less memory recall and you've got brain fog and things like that and you're tired then it can make it harder to actually seek out the help that you know you need but you know there's extra barriers to actually getting that help a big part of your advice and the work that you do is around

tracking now I love taking notes it's a big part of my of my working life. And I can't advocate for that strongly, stronger enough, really. But I wanted to ask, tell us a bit about why you think that's important. But also because of how large this list can be, sometimes can it also be quite a thankless task because you might be adding up two plus two and getting five. Yes, I take your point. And I do think, you know, with that range of symptoms, it can, you know, some of my clients are like, oh, gosh, there's a lot going on here. But I think just noticing that in itself is helpful. And what I'm really passionate about when it comes to cycle tracking is that we are collecting data. And that's data that we can use ourselves. But it's also very important data when we do seek out professional help. And let's data that we can use ourselves. But it's also very important data when

we do seek out professional help. And let's say you go to the GP, then that's really helpful information that helps them to do their job better and for us to get the help that we need. But it doesn't have to be complicated, you know, just keeping track of the length of your cycle, when your periods start and end, what your experience of your periods is like, and, you know, any of the other symptoms that might affect you at points in your cycle or throughout your cycle. Because when it comes to perimenopause, there are subtle shifts that take place probably a lot more in advance of your period stopping than people realize. And, you know, that's really important information to have to hand because it can inform the ways that you're supporting

your health and the way you're living your life. I remember recently a conversation where I talked about, you know, being quite nervous about the menopause, you know, looking to those who are older in my life, to my elders, and having heard various things from them. I mean, a lot of it has been about that they didn't really know what was happening to them. And that's always more frightening if you were getting a lot of messages about more information needing to be out there. But the name of your book, Perimenopause Power, it perhaps turns that on its head slightly. And I have to say, I'm very struck by a couple of messages I've had since that conversation here on Women's Hour, which was, please, I got an email, I remember this from a woman saying, can you stop saying, or can women stop saying how awful it is? It isn't awful for everyone. It can lead to a whole

other stage of life that is actually been brilliant for me. And I think we need to stop frightening younger women. I'll read a couple of messages out in just a moment but what would you say to that yeah 100 and you know i do think uh the language around it you know can be quite worrying things but i do think ultimately knowing that information is really empowering and you know regardless of the symptoms that you experience in perimenopause it is a fantastic window of opportunity that's what the scientific literature refers to it as in order to make changes to your health and life that again, impact the decades that follow.

But what I hear from my clients is that once your hormones start changing and oestrogen drops, stop caring about what other people think of you so much and you stop the people pleasing and you have better boundaries and it's easier to say no. I mean, I'm having a whole party. I mean, you know, there's going to be there's going to be Bloody Marys, tampons are going to be the stirrers. When you know, when my period goes, it's an absolute rave and you're all invited, I promise you, regardless of how it feels getting there. But I'll heed your words. Kate says menopause has

been the most transformative experience of my life not without challenges of course but it's absolutely forced me to look at what nourishes and depletes me i'm now here in my second spring post-menopause and i've never been happier so much of the suffering is caused by my fear of aging and misogyny onwards exclamation point oh i'm high-fiving you that's perfectly put well that's i mean i have, I wanted to read that because I think it's a very important point to make because we do also have, and I want to make sure I read this from Petra, a message here saying, perimenopause for me was devastating and empowering. All of the old emotions, I reconciled relationships, memories, they rise to the surface and they forced me to face them and let go i learned to forgive others and accept myself it's been the most empowering outcome but devastating of course is how she began this message loving yourself is liberating and i'm flourishing in my post-menopause years and feel stronger sexier and happier than ever can we can we talk about sex at this time yeah we can why not i think we need to get that in here you mentioned vaginal dryness

but the run-up to menopause and then sex thereafter tell us about what you've you found in your work well there can be big variations here so some people experience a drop-off in sexual desire and others experience a huge increase in it so it can really vary and of course that's going to depend on the context of your life and your relationship or dating experiences. But sometimes there can be huge frustration there because once oestrogen starts to decline, then there's less lubrication and the vagina is more likely to experience damage. The vulva, you know, that changes and becomes less plump as well so sex can become less comfortable and particularly when

we're talking about penetrative sex which not all sex needs to be involving penetration um so some women will say it's really frustrating because they experience an increase in desire but don't feel like their bodies are cooperating with them and it's just I think there's you know there's a whole chapter about sex in the book, but it's really important to know that there are strategies and there are things that you can access through your GP or in, you know, other professional areas that are going to support having a fulfilling sex life because sex doesn't stop at 50. Yes. Well, and also just to talk about relationships, because that's also a theme on the messages here, people reappraising their relationships. Because it is a chance to really look at the roles, the various relationships you have in your life, whether you're talking about professional ones, romantic ones, ones with children and other family members. It's like a chance to really look at that and say, is this what I want for my life?

Are you going through any of these symptoms yet? Oh, great question. So I turned 40. So I am in what some researchers would well have coined very early perimenopause, which is different to early or premature menopause. And because the classical definition for perimenopause is that your cycle length starts to vary by seven or more days, and you have an experience of menopausal symptoms. But these researchers have found that actually there's a more subtle change that takes place before you get to that point where your cycle might start to vary by, let's say, three or four days, which is me. And you start to get symptoms around the time

that your period starts. So that might be insomnia, night sweats. You know, I fell asleep last night with my feet out of the duvet because my period is due so you know I would say that I'm in that category where the my hormonal landscape is starting to shift but I'm not in the thick of it yet not in the thick of it but but talking to those who are Maisie Hill perimenopause powers the book thanks very much for talking to us that's all for today's woman's hour thank you so much for your time join us again for the next one hi russell kane here i just want to tell you about evil genius it's the show where we take legends and icons from history everyone from henry the eighth to gandhi

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