• Brain fog is moments of forgetfulness or wooliness
• Decreasing hormone levels have an impact on brain function
• Changes are usually temporary and can be improved by taking a holistic approach to treatment

We know it helps to keep a sense of humour – and yes, when you discover your car keys in the fridge or forget your best friend’s name, you can roll your eyes and have a laugh at your own expense. But after a while, when your mind goes blank during a work presentation or you forget to pick up your child from an event, brain fog can become worrying or even terrifying.

What is brain fog and why does it happen?

Brain fog isn’t a medical term, but it describes those moments of forgetfulness, confusion or ‘woolliness’, where you just can’t think straight. It can present itself in numerous ways, including struggling to find a simple word, forgetting things, reading the same page of a book over and over because you can’t take in the information, or not being able to maintain a train of thought.

It doesn’t just occur in menopause – your brain can feel sluggish when you’re jetlagged, hungover, or poorly with a cold or flu. Some people experienced it as a symptom of COVID. However, difficulties emerge during menopause when menstrual cycles become irregular and are skipped [1].

RELATED: The menopause brain: why it might be feeling strange and what you can do about it

This is because oestrogen, progesterone and testosterone have significant roles to play in your brain – it’s an area of much interest in the academic world with increasing evidence and awareness of the multifaceted role they play. Therefore, the decreasing levels of these hormones in perimenopause and menopause can have an impact on function. Of course, not every woman will experience brain fog but a study that followed a cohort of women through menopause found about two thirds reported memory complaints [2].

How does brain fog affect women?

Cognition complaints at menopause include difficulty recalling words and numbers, disturbances in daily life (misplacing items like keys), trouble concentrating (absent mindedness, losing a train of thought, more easily distracted) and forgetting appointments and events [3].

RELATED: Driving anxiety and the menopause

Reassuringly, although these learning and verbal memory complaints are inconvenient and can be worrying, research has found that a normal range of function is typically maintained – about 11–13% of women show clinically significant impairment [4].

Brain fog associated with menopause is also usually temporary. Neuroscientist Dr Lisa Mosconi has carried out the largest examination of the menopausal brain to date, and says that during the menopause your brain goes through a transition, a renovation of sorts, and needs time to adjust. Your brain will compensate through increased blood flow and energy production, and eventually will rebound.  

A study that measured women’s cognitive performance found that during premenopause, verbal memory and processing speed improved with practice and repeat testing but during perimenopause, this improvement with practise was not seen. However, in early postmenopause, performance did, once again, improve with practise, demonstrating that the decline in learning or cognitive performance was time limited [5].

For some women, however, the withdrawal of oestrogen in perimenopause can have a more serious impact, and make them more vulnerable to Alzheimer’s disease. That’s why taking steps now to support and protect your brain is so important.

RELATED: Brain fog or dementia?

Is there a treatment for brain fog?

While it can be comforting to know most cognitive issues won’t last, it can still be frustrating to deal with them during the menopausal transition and for some women, it can be debilitating, especially if it leads to social anxiety.

It is worth speaking to a menopause specialist about any concerns you have as they will be able to advise on a holistic approach and help determine what steps you can take.

Evidence suggests that HRT can have a positive impact on cognition when given in the perimenopausal or early postmenopausal period [6]. Women who have undergone a surgical menopause are also thought to be more likely to benefit cognitively from HRT [7].

Now, here comes the science bit – it sounds complicated but it’s worth knowing! Oestrogen increases the number of connections in your hippocampus [8], the part of your brain important for memory and certain types of learning.

Testosterone strengthens nerves in your brain and contributes to mental sharpness and clarity [9]; it also strengthens arteries that supply blood flow to your brain, which may be crucial in protecting against memory loss. Researchers have closely studied how testosterone levels affect men, especially in areas like memory, recall of information and decision making with promising results reported after testosterone supplementation [10].

Anecdotal evidence from women we speak to seems to suggest the same. Newson Health carried out an audit of its peri- and postmenopausal patients – women who were already established on HRT (oestrogen and/or progesterone) completed a questionnaire measuring their menopause symptoms before and after testosterone was added to their regimen. The audit found testosterone significantly improved concentration and memory.

Progesterone works to regulate cognition, mood, inflammation and repair and function of cells, including nerve cells. You can read more about the role of hormones here.

RELATED: Can HRT reduce your risk of dementia?

How else can I manage my brain fog?

There is no silver bullet for treating brain fog but, like with other menopause symptoms, you can help to manage it by looking at your lifestyle and making any necessary adjustments.

Exercise, particularly aerobic, is known to boost memory and can improve your mood and sleep. Your brain needs good quality sleep so that it can process, repair and improve memory retention. However, it’s not always easy to sleep when you’re suffering from night sweats, restless legs, anxiety or other menopausal symptoms. A calming routine can help, and some women find magnesium useful for helping to calm the body.

RELATED: Should I take supplements during menopause?

Dietary tweaks can also benefit the memory – ensure you are getting the right balance of vitamins, including vitamin D (low levels have been linked to poor cognition and low mood) and limit highly processed foods and those in saturated fats.

According to Alzheimer’s Society there is some evidence that eating a Mediterranean-style diet can reduce the risk of developing problems with memory and thinking, and getting some forms of dementia.

RELATED: How the Mediterranean diet can help menopausal symptoms

If you find your memory lapses embarrassing, don’t be tempted to avoid company – socialising can stimulate your memory. It can also help to treat your brain like a muscle – it needs exercise to keep it functioning at its best. Mentally stimulating activities, such as playing board games, crafts, reading, word and number games, learning a language, can help.

Planning ahead can help with the anxiety that can arise from brain fog. Keep a diary and within it schedule preparation time for any tasks that need doing, plus breathing space in between appointments so you get a chance to refocus and prepare.

Finally, remember to be patient with your brain and practice self-compassion. Yes, you might muddle up your child and pet’s names, walk into a room and forget why you’re there or scramble around for a word during a work presentation, but your brain is undergoing a huge renovation project and will eventually be all the better for it.

References

1. Maki P.M., & Jaff N.G. (2022), ‘Brain fog in menopause: a health-care professional’s guide for decision-making and counselling on cognition’, Climacteric, 25(6), pp570–578. https://doi.org/10.1080/13697137.2022.2122792
2. Greendale G.A., Derby C.A., and Maki P.M. (2011), ‘Perimenopause and cognition’, Obstetrics and Gynecology Clinics. 1;38(3): pp519-35. Doi: 10.1016/j.ogc.2011.05.007
3. Maki P.M., & Jaff N.G. (2022), ‘Brain fog in menopause: a health-care professional’s guide for decision-making and counselling on cognition’, Climacteric, 25(6), pp570–578. https://doi.org/10.1080/13697137.2022.2122792
4. Maki P.M., & Jaff N.G. (2022), ‘Brain fog in menopause: a health-care professional’s guide for decision-making and counselling on cognition’, Climacteric, 25(6), pp570–578. https://doi.org/10.1080/13697137.2022.2122792
5. Greendale G.A., Huang M.H., Wight R.G., Seeman T., Luetters C., Avis N.E., Johnston J., Karlamangla A.S. (2009), ‘Effects of the menopause transition and hormone use on cognitive performance in midlife women’, Neurology. 26;72(21):1850-7. doi: 10.1212/WNL.0b013e3181a71193
6. Sharma A., Davies R., Kapoor A., Islam H., Webber L., Jayasena C.N. (2023), ‘The effect of hormone replacement therapy on cognition and mood’, Clin Endocrinol (Oxf). 98. pp285-295. doi:10.1111/cen.14856
7. Sharma A., Davies R., Kapoor A., Islam H., Webber L., Jayasena C.N. (2023), ‘The effect of hormone replacement therapy on cognition and mood’, Clin Endocrinol (Oxf). 98. pp285-295. doi:10.1111/cen.14856
8. Luine V., Frankfurt M. (2013), ‘Interactions between estradiol, BDNF and dendritic spines in promoting memory’, Neuroscience, 3 239, pp.34-45. https://doi.org/10.1016/j.neuroscience.2012.10.019
9. Celec P., Ostatníková D., Hodosy, J. (2015), ‘On the effects of testosterone on brain behavioral functions’, Frontiers of Neuroscience. 17;9:12. doi:  10.3389/fnins.2015.00012
10. Hua JT, Hildreth KL, Pelak VS. (2016), ‘Effects of Testosterone Therapy on Cognitive Function in Aging: A Systematic Review’, Cogn Behav Neurol. 29(3):122-38. doi: 10.1097/WNN.0000000000000104

The post How to beat menopausal brain fog appeared first on Balance Menopause & Hormones.

Menopausal women are the fastest-growing demographic in the UK workforce, yet a 2022 survey by the Fawcett Society found one in ten women leave work due to their menopause symptoms.

This week, Dr Louise is joined by Oonagh Ferson, who researched the experiences of perimenopausal and menopausal women in the workplace as part of her MSc in HR management at Queens University Belfast.

Oonagh shares her research findings and some of the stories of women she interviewed, and with Dr Louise discusses the impact of perimenopause, menopause and other conditions such as PMS and PMDD in the workplace.

Oonagh offers advice on how women can thrive at work, including the three things she believes would make the biggest difference to women in the workplace:

1. A bottom up approach, where employers sit down with women and ask them: what would help you? What can we do?
2. Even though it may be difficult at times, advocate for yourself: be open with your employer to secure the support or adjustments you need
3.  Having open discussions, using clear language and avoiding terms like ‘the change’, can help dispel the stigma around menopause  

There is a chapter dedicated to menopause and the workplace in Dr Louise’s bestselling book, The Definitive Guide to the Perimenopause and Menopause. Order your copy by clicking here.

Click here for more about Newson Health.

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Doctor Louise Newson, I’m a GP and Menopause Specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today on my podcast, I’ve got someone called Oonagh with me who reached out to me a while ago and very kindly sent me a copy of her master’s dissertation, and it was focused on menopause in the workplace, which is something that we talk about a lot, and the stories I hear of women giving up their jobs or reducing their hours because of their symptoms, and they’ve been unable to get help. Sadly, the stories are still there and I hear them most days. So welcome to the podcast Oonagh and thanks for joining me. [00:01:31][80.0]

Oonagh Ferson: [00:01:31] Thank you for having me. [00:01:32][0.8]

Dr Louise Newson: [00:01:32] So do you mind just saying a bit about your background and why you decided to do this dissertation? [00:01:36][4.3]

Oonagh Ferson: [00:01:37] Yes. So I, began studying September last year, master’s in HR management at Queen’s University, and it came to sort of deciding on our dissertation topics. And for me, I kind of had a personal interest in this topic because my mum, unfortunately, had gone through a pretty rough time with menopause and, she was still working full time. And I just, you know, trying to see what support was out there for women in the workplace. There didn’t seem to be a lot. So I wanted to take the opportunity to research it and, you know, hopefully come up with some answers that could perhaps help women who are struggling with this in the workplace. [00:02:21][43.3]

Dr Louise Newson: [00:02:22] So you interviewed some women didn’t you? [00:02:25][2.6]

Oonagh Ferson: [00:02:26] Yeah, I interviewed 18 women in total. I was very lucky. I attended the event that you spoke at in Belfast organized by Roisin who runs the the menopause support group and now charity [Menopause Together]. So I’m sure you know, she’s a powerhouse of a woman. She does amazing work. And so she was very, very supportive and allowed me to sort of hand out a flyer at that event. And, luckily, I was actually inundated by responses of women wanting to share their stories and experiences. So, yeah, I got some women speaking from their own personal experience, and some were speaking from sort of an organisational perspective. And obviously it all surrounded menopause and work and the issues with retaining women and, the loss of knowledge and experience. [00:03:13][47.2]

Dr Louise Newson: [00:03:14] Yeah. And it’s such a problem. So, many years ago, before I opened my clinic, there was a report coming out talking about menopause in the workplace, and I’m quite ashamed to say, but they were talking about it on Radio Four, and I thought, what a waste. Surely just give people some fans, let them get on with it. And I had no idea the impact of menopause in the workplace, because I knew actually very little about menopause in general, rather than the flushes and sweats, because that’s all anybody spoke about. And then a couple of years after I started working for West Midlands Police, and Fire Brigade, and the first meeting I went to, I was listening to women telling me how they’d reach 50. They were going to take retirement, because they often do retire earlier in the place, but they were really struggling to know what to do because even in their retirement, they said, I don’t think we’re going to be having a great retirement because we feel so tired. We’ve got muscle and joint pains. We find just…I remember one lady saying, just lifting up my grandchild to put him on the swing in the playground is really uncomfortable. So we end up just sitting watching telly. I don’t take him out at the same time. I want to spend more time with my grandchildren, but I don’t really feel any pleasure in things. I don’t really want up for two holidays. And then someone else was saying, oh, I’ve changed my shifts, so I’m not working on the beat anymore. I’m doing an office job because I’m finding it really tiring. I don’t go for any overtime, so we have less money coming in. And I was just saying to them look, I don’t know how to help you in the workplace, but what I can do is educate you about the menopause and the treatments available. And most of them were taking antidepressants most, and this was seven years ago, so most of them hadn’t even heard of HRT. So I just spoke to them about the menopause, what it means, what it is, what the symptoms are. And then we did a big survey, and we found that 78% of women who were menopausal didn’t know they were menopausal until they were given the right information. And I was really shocked, actually, that these women were just, well, that’s my bag. That’s it. And even when they realised they were menopausal, they weren’t able to get the best help, support, advice and treatment. So they were still struggling. And the top three symptoms that were affecting their ability to work were fatigue, anxiety and memory problems. So giving these women a uniform change or a fan would make no difference to most of them. So how does that echo or how does that compare to what you found with your research? [00:05:42][148.5]

Oonagh Ferson: [00:05:43] Yeah, definitely. Many of the women had shared that it was sort of a shock when it all kind of clicked, and they realised that all of these symptoms are being, you know, a result of starting the transition through menopause. So, I don’t know. Well, I know, across the board there is a sort of knowledge gap. Even we’re coming from somewhere like Northern Ireland, and we’re notoriously quite conservative. So I had wondered, perhaps, was that part of the reason? I know myself. I’m only 34, but going back to sort of my sex education at school. It certainly wasn’t discussed in any great detail, and it was just sort of like you mentioned the sort of, you know, hot flash and maybe you feel a bit moody. And that was about it. So certainly women who are older than me, my mum’s generation, if that’s what I had, they certainly had a lot less than that. And again, the culture surrounding it is it’s very still, unfortunately quite a taboo. And it’s not something that women feel comfortable disclosing in the workplace. I found in my research, a lot of women shared that they would perhaps, maybe have managers who were younger than them or male, and that really kind of put them off, feeling that they could divulge their symptoms or that they were struggling or required any sort of adjustments. [00:07:04][80.5]

Dr Louise Newson: [00:07:05] And do you think they’re nervous because of how people might respond to them in the workplace, or what are their main reservations for not wanting to talk about how they feel at work? [00:07:14][9.6]

Oonagh Ferson: [00:07:16] I think it’s sort of that double-edged sword with, you know, ageism and sexism, the very negative stereotypes that are unfortunately still quite prevalent, that you’re over the hill or you’re losing the plot and you’re hysterical, all these very ridiculous things. So that maybe you’re not capable of doing your job anymore. You can’t be entrusted with responsibilities. And as you know, the menopause is going to intersect at a time in a lot of women’s lives where, you know, now’s the time for them, they might be, able to sort of advance in their careers, but the symptoms are so debilitating in many cases that they don’t feel confident to put themselves forward for promotion. And, you know, they don’t feel maybe that they’re able to work full time anymore due to lack of support and or maybe going part time or exiting the workplace altogether. [00:08:09][53.1]

Dr Louise Newson: [00:08:09] Yeah. Which is a real concern and certainly echoes what we see in here. And so there’s a lot of women who are going more part time. There’s a lot of people that are not going for a promotion, and a lot of people who are taking sick leave as well. And it could be quite a long length of time, sick leave. We did a study a while ago, and 18% of women who answered had had at least eight weeks off work. Now I can cope if one of my staff or team are off for a week or two, but eight weeks, it’s really hard for someone else to pick up that job, isn’t it? And I spoke to someone a while ago and she said, well, of course, because I’m menopausal now, I have a very different job to how I had before. And I said, hang on a minute. What do you mean? Why do we have to have different jobs because we’re menopausal? And obviously, if you’re having symptoms that are untreated, then it is really difficult to carry on doing the same job. And I only was working one day a week as a GP when I became perimenopausal, and I had several months of not recognising my own symptoms, believe it or not. But I remember looking at patients who I’ve known for 20 years and just saying, hang on, can you just tell me that again? And I couldn’t remember, like what they were telling me. I couldn’t remember what happened last time they came in. And obviously I would have my notes, but normally my memory is very good and I was really struggling, but I was also, I couldn’t remember drug doses very easily. And that’s really disconcerting when it’s your sort of craft, your bread and butter is to be able to, you know, pivot and change and talk to patients and then prescribe the right medication. And then I’d look at my examination couch and think, oh, I wish I could just lie down and have a little doze. I’m really tired. And people at work were saying, oh, you’re just quite slow. You know, you’re taking longer. And I would do home visits and I couldn’t remember where people lived. And I’d have to get the map and it just everything took so much longer. And I thought, oh, it’s just because I’m juggling too much. I’ve got three children, not two, and I’m not coping very well. But then even when I recognised, if there’d been a menopause policy at work, which there clearly wasn’t, what would I do? I couldn’t….it’s not about a uniform. I’d never had a hot flush. If they’d said to me, reduce your hours, well you can’t work less than one day a week as a GP because you won’t have enough clinical experience. So I would have had to have just given up my job. And I know a lot of GPs do give up their job. Lots of people give up their job about 10% because of their symptoms. But what really frustrates me is that the majority of women aren’t getting any treatment for their menopause. [00:10:42][152.3]

Oonagh Ferson: [00:10:43] Yeah, I think as well, a lot of, women that I interviewed had mentioned when they had eventually decided to see their GP and, you know, seek help they found, basically a lot of medical misogyny. GPs some of the women had, discussed were extremely dismissive, and I think that is very disheartening you know, for many people, that would be your first port of call. You’re going to go to your GP and then to feel that you’re dismissed there. It’s just really going to knock your confidence. Also, unfortunately in Northern Ireland, like many other places in the UK, it’s a postcode lottery for, you know, whether you can go to a dedicated menopause clinic, if there are any, in the trusts where you live. So there’s just, you know, so many things that they’re up against while they’re trying to navigate through this time in their life and again, sometimes very debilitating symptoms. Juggling your career, home life, care and responsibilities. [00:11:45][62.0]

Dr Louise Newson: [00:11:46] Yeah. And I think it’s also hard for employees because no two menopausal or perimenopause women are the same. So the symptoms I had affecting me are different to one of my colleagues who is exactly the same age as me. And so you can’t know exactly how many symptoms are related. And of course, that will be external stressors, like you say, people maybe at home or with a personal life or family life, or there might be stressors in the workplace. And so we can’t blame everything onto our hormones. But you don’t know how much is related. And then the workplaces don’t know how much are related either. And I feel like sometimes there’s too much onus put on the workplace, taking responsibility for menopausal women. I don’t know whether that’s something that came through with your research. [00:12:30][44.7]

Oonagh Ferson: [00:12:33] I think my takeaway from, you know, having completed the research and speaking with all these brilliant women who gave their time, is that the workplace needs to really make a proper effort here. It’s not just enough to have a menopause policy, just something that many places just download off the internet. It needs to be a live document. It needs to be well researched and, you know, very simple things organisations can do that are very cost effective and, sort of on your own website, there’s lots of free resources and, you know, you can download things. So I think even seeing, you know, that these are in the workplace, maybe just having a poster up, it generates discussion. And that’s very, very important. That helps dispel the stigma that still surrounds this. But unfortunately, I think a lot of women feel that the onus is actually on them. They need to go and seek, you know, are there any resources here? Is there a menopause policy? It’s not something that’s very well advertised or openly discussed. So that can cause, you know, feelings of alienation in the workplace. [00:13:41][68.8]

Dr Louise Newson: [00:13:42] Yeah. And certainly we’ve done some posters through the balance-menopause.com website where there are awareness posters so you know about headaches and joint pains. So making people realise that it’s not just about flushes and sweats, but actually what’s also interesting is it’s not just about menopause, it’s obviously perimenopause. But also PMS and PMDD are related to hormones. So it’s more about hormonal changes. And so I mean, how you have a hormonal change, you know, policy is quite difficult, but it is really relevant because there are some people that say, well, I’m not menopausal yet, so therefore this isn’t relevant to me. And of course it is if you’re getting perimenopausal symptoms and there are those women who have PMS or the more severe form PMDD, where they feel horrendous for three or four days a month and they say, oh, well, it’s just the way I always am. But actually, if you’re working full time and three or four days a month every month, that’s equivalent to a month a year, you’re really struggling and to know there is a hormonal component is really important, but also so that employers can recognise that women who are still having periods, for example, can still have symptoms. And some women actually tell me it’s their heavy periods that are the most debilitating for them. And one lady recently said I was on a board meeting. I could feel that I’d leaked through everything, despite wearing extra sanitary protection for her three-hour board meeting, she said I had to sit there and wait for everybody to leave before I stood up because I knew I couldn’t explain what had happened. And that’s really awful, actually, you know, so but it’s also, I think some people are scared of saying in the workplace, could you be menopausal because they worry about the response that menopausal or perimenopausal woman is going to have to that? So I don’t know whether that came out at all in your research about how to approach women, like if you as a man or a non menopausal person, recognise your colleague might have some symptoms and they’ve changed, you might have known them for many years. How do you bring that up? [00:15:56][134.2]

Oonagh Ferson: [00:15:57] I think, you know, you need to respect that for some women they may regard this is sort of a private, you know, medical matter and they don’t want to discuss it. But there are instances where if it’s not discussed, then how can the reasonable adjustments be made and how it can help be offered? So I think asking maybe open-ended questions in those instances where, you know, you’re sort of allowing them to take the lead and just maybe take their time with things. It’s about, you know, having trust and respect and perhaps appreciating that not everyone wants or feels comfortable being very open and and discussing it. But I think, just sort of letting these women know that, should they want to come and discuss it, that you’re very open to that and that you’re approachable as a line manager. That all makes a big difference. [00:16:49][51.8]

Dr Louise Newson: [00:16:49] Yeah. And that is really important. And I feel lots of people think they’re walking on eggshells when they’re around menopausal women. And they have to be careful. And I know when I was experiencing symptoms, I was quite short-tempered and irritable. And maybe if someone had said to me at work, do you think your menopausal, I might have bitten a head off and got quite cross because I was still having periods, although they had become very scanty. But actually, if someone had said, oh, I’ve got this booklet, or why don’t you download balance and have a look? Are your hormones changing? Because I think saying, do you think your hormones might be changing as opposed to do you think you’re menopausal actually sounds a bit less confrontational somehow, doesn’t it? [00:17:29][39.5]

Oonagh Ferson: [00:17:29] Yeah. There was a, a really good sort of study regarding the bottom up approach and, and I and, you know, taking feedback from women who had kind of, you know, already experienced this sort of discussion in the workplace as to whether or not they divulged that they were menopausal or perimenopausal, and, you know, how they felt that went. And it was sort of a list of do’s and don’ts for line managers. So perhaps something like that in an organisation would be very beneficial. It’s sort of I’m a, you know, a real advocate for taking a bottom up approach. I think, why would you not go to the, you know, the source and, sit down and discuss with these women? I’m sure they would appreciate, you know, when they’re directly asked, well, what can we do? What has helped you? What would help you? It’s very simplistic. But I think it goes a long way. [00:18:20][50.4]

Dr Louise Newson: [00:18:20] Yeah, absolutely. And involving people as much as possible and knowing everyone’s different is hugely important. What frustrates me, as I’m sure you’re aware, is that, you know, there is treatment that can improve the majority of women, and it’s first line treatment from all the guidelines, yet only the minority of women, and it’s certainly in Northern Ireland, definitely the minority of women are taking treatment. And as you say, they’re finding it difficult to get it as well. And so then workplace are trying to help like put a sticking plaster around almost. And we know that some symptoms can last for many years. I’ve seen women who’ve had symptoms for decades. But it’s not just about the symptoms. It’s the health risks. So if I was younger and became menopausal in my 20s and 30s without treatment, I have an increased risk of heart disease, osteoporosis, diabetes, clinical depression. So if I’m going to be in the same workplace organisation for 30 years, for example, I’ve got an increased risk of diseases, which is then going to mean that I’ll be off work with those. So actually it’s really important for not just symptoms but for future health that we are trying to address treatment options. And I sometimes sort of compare it to if someone has a broken arm or leg, they might be able to do their job. They might have to have some adjustments because they’re in pain, or they can’t use a keyboard if they’re broken their wrist or whatever. But as an employer, you would still encourage your colleague to go and get treatment. You wouldn’t see them with a abnormally shaped arm that’s really painful to because they’ve fallen over for and say, oh dear, shall I give you a different chair to sit on? Or would you like to go and sit at home and see what happens, and we’ll just talk about it? You’d say, well, look the hospital’s down the road, do you want a lift, take a bit of time off if you’re in pain, and then we’ll just adjust things as you come back, and then hopefully you’ll be back to how you were before and you’ve had your treatment. And that’s the biggest stumbling block with a lot of this workplace, is that the women are not able to get help and treatment. So then it’s compounding in the workplace really isn’t it? [00:20:29][129.0]

Oonagh Ferson: [00:20:30] Well I think as well, in more recent years, this is sort of the first time that we’re seeing women working through their entire menopause cycle. Whereas, yeah, you know, years ago, women, as she had mentioned before, maybe at the start of perimenopause may have retired or there were a lot less women in the workforce generally. But in more recent years, especially cost of living, the retirement age increasingly rising. All of these factors mean that women are in the workplace and they’re staying on in the workplace. It’s the fastest growing demographic are women in this age bracket. So that’s something certainly that can’t be ignored. And absolutely it needs to be addressed. [00:21:11][41.5]

Dr Louise Newson: [00:21:12] Which is great. But then it’s not great because there’s so much suffering and women are less likely to be promoted and have more senior positions, aren’t they? [00:21:21][8.7]

Oonagh Ferson: [00:21:21] Yeah. And that’s very unfortunate. You know, again, this is a time in many women’s lives where they’ve put the work in, they’ve put the years in. They have all this great knowledge and experience. And unfortunately they’re, you know, just left the feel so unsupported that they’ve lost confidence. Their symptoms are impacting them so much. That’s the feeling. There’s no other option but perhaps to, you know, exit the workforce altogether. Or as we were discussing reducing hours. And it’s, one of the ladies that I interviewed described it as brain drain, you know, and I thought that was a good way of putting it. It is. The workforce is losing all these highly educated, skillful women, and it could be prevented. [00:22:04][42.8]

Dr Louise Newson: [00:22:05] Absolutely. And most of us don’t want to not work or reduce our hours. And it’s all very well saying, well, we can have flexible working or we can reduce our hours, but that is associated with reduced pay as well. And if you already stretched with your income, why should we have to reduce our pay and income because we’re not receiving the right treatment for something that’s affecting us? It doesn’t make sense. You know, it’s and also, I mean, I look and think about absenteeism for other conditions that are associated with the menopause. So for example, migraines can be far more common in the perimenopause and menopause. There’s billions lost every year by people with migraines not being able to work, and mental health issues as well. We know clinical depression increases in the menopause too. There’s lots of people that are of wfork with depression, and then there’s a lot of women we see and speak to all the time who are having investigations for their symptoms, so they’re having heart tests for their palpitations, they’re having brain scans for their poor memory. They’re having bladder tests for their urinary tract infections. But every time you go and have an investigation, if you have, especially if you’re working full time, you have to take time off work, don’t you, to go and have the tests. And then see that the doctor for the result. And so even if you’re not taking time off work because you’re feeling awful, you’re still taking time out of the workplace that you wouldn’t have to do if your symptoms were addressed early and you didn’t have any of these other symptoms. [00:23:40][95.0]

Oonagh Ferson: [00:23:41] Yeah, that’s true. And as well, surrounding all these issues of, you know, taking time off and, you know, possibly leaving altogether, this also contributes to the pension gap because we all know there’s the gender pay gap, which is a factor. But the link then goes on to the pension gap. So that’s gonna hit women later as well in their retirement as well as, you know, maybe the interim when they’ve left work and they’re they’re struggling in between then perhaps when they are feeling better. But it’s, you know, time for them to retire and their pension is also affected. So there are, economic factors. [00:24:19][37.8]

Dr Louise Newson: [00:24:20] Yeah. Of course. And so did you find your research rewarding or frustrating or surprising? [00:24:26][6.3]

Oonagh McKenna: [00:24:28] Unfortunately, I heard some really sad stories, actually, some horror stories. One that sort of stuck with me was, I interviewed a lady who’s a union representative, and of course, you know, she maintained confidentiality. She didn’t name names or the name of the organisation or. But she went under represent a lady who worked in a care home as a care assistant. And, obviously through no fault of her own, she was perimenopausal. She had a bleed in work and was working somewhere like a nursing home. They obviously have to be very careful and strict with hygiene and and things like that. But she was actually pulled into a disciplinary meeting for supposedly breaching the hygiene regulations because she had had a bleed in work. And something like that is just so shocking that someone would have to sit and go through, you know, further humiliation, that there was absolutely no empathy there. And that was truly shocking. And that’s one of the horror stories that has really stuck with me. It was just unbelievable. [00:25:33][65.6]

Dr Louise Newson: [00:25:34] It’s really shocking because, you know, it’s now 2024. We’re not living in the Victorian times. We’re not living in the Dark Ages. Women shouldn’t be shamed and named and treated as an inferior because something’s happening to their body, and especially when obviously this treatment available, but especially if we know there’s something that’s happening, we should be offering support, whether we’re friends, relatives, colleagues, who we are. Because, you know, I always at work want to treat people the way that I would want myself to be treated. And so stories I hear and I hear them all the time are not that way. And I can’t believe that people can be like that, especially when we’ve got more knowledge and information that we should all be sharing with each other to reduce the suffering, because there is still a lot of suffering, isn’t there, by women? [00:26:26][52.2]

Oonagh Ferson: [00:26:27] Yeah. And I think something as well to, another thing somewhere like the care sector that women work there predominantly more than the men in these sort of sectors as well. Women who maybe aren’t, English isn’t their first language, that’s another barrier that they face. There’s again you know, culturally, perhaps they wouldn’t feel as open discussing something like menopause in the workplace. So, there’s just so many factors to consider, and it is difficult. But actually, for me, especially having completed the research, that sometimes all it does take is a conversation generating the discussions. And, you know, just letting women know that there is support there and, you know, they can come to their manager and sometimes that goes a long way. [00:27:17][50.3]

Dr Louise Newson: [00:27:17] Absolutely. And certainly one of the things I realised in the poli,ce is that a lot of women had been signed off with depression, anxiety, and then they were really relieved to know that it was their menopause. It wasn’t that they had clinical depression. They didn’t need antidepressants. So a lot of the work certainly that I’m doing is about empowering people so they have the right knowledge and tools, and then they can try and get the right information, support treatment that, that they want. So certainly the conversation starting in the workplace is really important. And so I’m very grateful for you sharing your time and your, your great research as well. So before we end three tips, really, if you don’t mind. So three things that you think would make the biggest difference to women in the workplace. [00:28:01][43.8]

Oonagh Ferson: [00:28:02] As I had mentioned, the bottom up approach, you know, you can do all this research, which is very well, you know, you’ve got great intentions doing that, no doubt for organisations, but sit down with women in the workplace and go directly to the source, ask them, you know, what would help you? What could we do, that sort of thing? I think importantly, women also need to advocate for themselves, as difficult as that may feel to them. But if you aren’t open to an extent with your employer, then they can’t possibly provide, you know you with any support or make these reasonable adjustments that will ultimately, hopefully make things better for you and easier for you at work. And just again, about trying to dispel the stigma and, that still surrounds the menopause. So I think that can be done again just by having open discussions, not using euphemisms like ‘the chan and, you know, use the actual word menopause. It’s not a dirty word, it’s not a bad word. And the more, open discussions we have using the appropriate language, then I think that that will also go a long way and make the difference. [00:29:19][76.2]

Dr Louise Newson: [00:29:19] Yeah, really good advice. So thank you so much for your time and look forward to seeing how this conversation develops to help more people stay in the workplace, but also enjoy their work and make the most, and have the careers they want. So thank you ever so much. [00:29:34][14.7]

Oonagh Ferson: [00:29:35] Thank you. Thanks. [00:29:35][0.8]

Dr Louise Newson: [00:29:40] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk, and you can download the free balance app on the App Store or Google Play. [00:29:40][0.0]

The post Managing menopause at work: how to help yourself and your colleagues appeared first on Balance Menopause & Hormones.

Menopause often happens at a time when you are juggling a career, relationships and caring responsibilities.

Here Dr Nadira Awal, a GP and menopause specialist, joins Dr Louise to discuss her work in raising awareness of the menopause and the importance of partners and families understanding what their loved on is going through.

Dr Nadira’s personal experience of the menopause helped drive her passion for educating and supporting other women, especially those in ethnic minority communities who may not feel able to speak openly about it. She talks about increased health risks owing to genetics, particularly with diabetes and increased blood pressure, and the challenge of treating a woman’s symptoms holistically in a ten-minute GP appointment.

Follow Dr Nadira on Instagram @pauseandcohealthcare and on Facebook at Pause and Co Healthcare.

Click here for more about Newson Health

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast, I’ve got a fellow GP, someone who I’ve met a few times in real life, unlike some of my other podcast guests. Who’s very inspirational. Who’s doing a lot of work behind the scenes actually to really help women in many ways. So, Nadira, thank you so much for coming on my podcast today. [00:01:20][17.6]

Dr Nadira Awal: [00:01:21] Thank you, Louise. Thank you for inviting me. [00:01:22][1.4]

Dr Louise Newson: [00:01:22] So we’ve known each other for a while and recently we met again in Liverpool, actually. I’d gone up to the Royal College of Psychiatrists conference, annual conference, and you were there as well. And we were in the same group, actually. They kindly invited me to be on the panel. And you were talking about your own experience, actually, weren’t you? [00:01:40][17.8]

Dr Nadira Awal: [00:01:41] Yes, that’s right. Which has gone down very well on your Instagram post, which I’m very grateful for you sharing. So thank you very much for that. [00:01:47][6.5]

Dr Louise Newson: [00:01:47] Well, I felt a bit naughty because I stepped away from the panel to go in the front row so I could take a few videos. And your one was just amazing. And we just look just now and it’s had nearly quarter of a million views. It’s resonated with a lot of people. And I’ve been told off quite a few times for talking about my own personal menopause experience in the media by other health care professionals. But actually, if I wasn’t a menopausal women and if I didn’t take HRT and if I hadn’t struggled, I think doing my work, I could still do it, but I couldn’t do it with as much energy and passion and determination as I do. So I think people like to know, this is going to sound really awful here, they like to know that healthcare professionals suffer and are human and actually sometimes struggle. We don’t get it right the first time, and I had to see a specialist to get the right dose of HRT that was right for me, and I learned a lot from him actually. He really taught me, actually, and I’ve still got his clinic letter telling me to increase my dose because my level was low and I clearly wasn’t absorbing it well and increased the dose. And it really made such a difference. And I’m very grateful to him. But you talked about your struggles to get the right dose from your own doctor and having to see a gynaecologist. And you know, we are humans, aren’t we? And we can’t always access the right person first time or know everything. And it’s very different when it’s ourselves that are experiencing symptoms. [00:03:11][83.1]

Dr Nadira Awal: [00:03:12] Completely agree with you, Louise, actually. And almost as clinicians, we’re probably the worst patients, aren’t we? We’re completely in denial of what’s happening to ourselves and it’s actually makes it a little bit more fuzzy to connect the dots together. And you actually need that outside approach to sort of say, actually these are the things that are happening to you. But yes, you’re completely right. It’s made me more passionate talking about the menopause, educating my patients, educating anyone who will listen, really. So it’s not just about the patient, it’s about their family as well, and how the menopause can affect everybody, really. So it’s not just women, it’s the men need to listen as well and really appreciate what’s going on. [00:03:49][37.1]

Dr Louise Newson: [00:03:50] Because you’ve got two young children. When I was experiencing symptoms, my three children were obviously a lot younger and really were suffering, but not realising. I just presumed I was very irritable and short tempered because having three children is difficult. Having any children can be hard. And I just thought, oh I can’t cope very well. And then I sometimes think about this one time that I was called in by two of the partners because I’d prescribed a lady some morphine who had some really awful arthritis of her knees. Terrible. She was housebound and I just gave her Oramorph. So it’s not even, as you know, a controlled drug. And I put it on a repeat prescription because she couldn’t get out to the pharmacy and her daughter lived a long way away and it was causing a lot of work. So she just had one bottle every month. And I said to her, well look, I’m leaving the practice soon so if I put it on a repeat, it will be very easy for you to get it. And I used to inject her knee every three or four months or so if it was a lot more painful. And she tried so many other painkillers and this was the only one that worked for her, she’d just take a spoon in the morning and a spoon in the evening. Anyway they called me in to say, how dare you do this? This is absolutely outrageous and you shouldn’t do this because people could overdose on morphine. I said, well, she’s 91. She probably would have overdosed if she was going to. And I will take full responsibility because I’ve signed the prescription. I’m an independent prescriber. And then I walked away into my room and I burst into tears. And Helen, who now actually works for me, came to my room to cheer me up because she’d never seen me cry at work before. And looking back, I know it was related to my hormones and I knew I was going to get too cross to sort of retort to these two male doctors who were telling me off in their room. So I withdrew and then just thought, well maybe I am really dangerous, maybe I shouldn’t be doing this, maybe I shouldn’t be looking at what’s best for my patient and catastrophising, really, and then had no self-confidence, feeling of low self-worth and being very tearful. And those are all classic perimenopausal symptoms, aren’t they? [00:05:45][115.6]

Dr Nadira Awal: [00:05:46] Absolutely. Yes. There’s so many women and myself included, that you do feel like you’re questioning what you’re doing on a daily basis. And, you know, we’re always describing, we’re always hear about it on social media, that we’re the sandwich generation. We’re looking after our elderly parents. We’ve got young children. As you know, in that podcast I talked about, you know, I was renovating my house and I had my young children as well, dealing with builders on a daily basis. And it was really difficult. So you think, oh, gosh, you know, there’s all the stress that’s coming with it. You know, we lead busy lives. I mean, think about it, 100 years ago, women weren’t working. They were looking after the children, but not really. We had potential. We had maids. We had people who were helping, looking after our children, the sort of family network as well. And so, we’re well worse now. We’re busier. You know, we’ve got full time jobs. We’re trying to hold down a job. We’re trying to hold down a relationship. We’re trying to look after our children. There’s a lot of social media sort of presence as well, and saying that actually we should be better at things. We’re always negating ourselves, aren’t we? And I think it’s important to actually be really empowered and say we’re doing a great job. You know, we’re working really well. We’re looking after our kids. They’re happier. You know, if you think about it, we were talking about this the other day, that actually our parents’ generation only took us to the zoo. You know, we didn’t have things like soft play. We didn’t have iPads and we didn’t have mobile phones. We went out on our bikes and we just came home at dusk didn’t we? So, you know, whereas now we have to entertain our own children. And it’s hard work. [00:07:16][90.2]

Dr Louise Newson: [00:07:16] It is, it’s very different. Yeah, we used to just play in the street and sometimes remember to come home for a meal and so it’s very, very different. But also I was talking to somebody in America yesterday, actually it was Sunday and I was trying to arrange all week to speak to this person. The only time I could find was on Sunday. I’ve just got back from being with my husband in the Lake District and my mother-in-law wanted to come for supper, which is great, lovely. But then I had to cook supper. So as I was talking to this woman, I said, oh, look, I’m really sorry you’re going to hear the oven door open and close. And I’m chopping some vegetables because I’m cooking at the same time. And she said, I love the fact that you’re multitasking. And I said, but, do you know what? I sometimes joke with my children and say, Goodness, I could do so much more if I didn’t have children? But actually I also laugh about it because I’m a lot more productive because I’ve got three children, because if I have five minutes between, I don’t know, picking one of them up or taking one of them somewhere or doing that, I will do that work in five minutes. Whereas before, with or without children, I’d probably be thinking, I’ve got all day, I could just have a little cup of tea and I’ll just listen to the radio and then I’ll sit down and my nice tidy desk whereas I literally just am something on my phone while the kettle’s boiling and then I’m going to the next thing. [00:08:27][70.3]

Dr Nadira Awal: [00:08:27] But on the other hand, you’ve got women who’ve not had children. And they’re busy with their life, aren’t they? And they’re busy doing all their extracurricular activities or holding down their job as well, and busy and yeah, so. [00:08:38][10.6]

Dr Louise Newson: [00:08:38] But I think it’s also the way that women’s brains are wired and it is a gender difference. So it’s not just about children, of course it’s not. But I think women are used to multi-tasking. They’re used to, you know, if they’re working, sitting in meetings, thinking right, what am I going to have for supper or what am I going to do at the weekend? Whereas men, and this is a generalisation of course, but in general men a lot more focused. So I think it’s good and bad, actually. Women probably need to focus maybe sometimes a bit more. But actually that ability, which is often lost in the perimenopause because our hormones work very well on our brains, don’t they? And for many years we’ve just learned about flushes or vaginal dryness and the menopause just being a natural process. But actually, for a lot of us, it can really affect the way our brains work and think and function can’t they without hormones. [00:09:30][51.5]

Dr Nadira Awal: [00:09:30] Absolutely. And I actually use the analogy and I’ve used this in interviews actually as well, where women spin lots of different plates and they’re spinning, yeah, the work plate, the kids’ plates, you know, kind of life at home plates, the relationship plates. And sometimes it’s okay to drop your plates. And what you don’t do is you don’t try and pick up that plate, piece it back together again. How about you just drop all your plates, smash them, make something new? And that’s kind of how I describe the menopause as well. You know, this is a new stage of your life. Don’t try and be what you were in your 20s. Let’s try and embrace it. It’s actually, you know, don’t think I can do everything I did in my 20s and I can do it now. Make it new, make it exciting. And that’s that’s what I’ve done. [00:10:12][42.0]

Dr Louise Newson: [00:10:13] I really like that. I think that’s a really good analogy, actually, because we are different. Our life experiences are different, aren’t they? And I feel it’s a bit like, if you’ve got the privilege of being able to plan maybe when you want to have a baby, you want to make sure if you can that you’re healthy, that you’re not smoking, that you’re not drinking alcohol, that you’re taking folic acid, that you’re fit and hopefully not too overweight or whatever. So you can make sure that, you know, you’re giving everything the best chance for those next nine months. Obviously, for some people it doesn’t work like that, but it’s still something that we always advise as medical practitioners. If people can, this sort of pre-conception counselling really, isn’t it? Whereas I think with menopause it’s even more important because for most women it’s decades, not nine months. And so actually to have some time before your brain goes that you can’t read a book or listen to a podcast or think about everything, almost think about, right, how is my hormonal health? How is my perimenopause and menopause going to be as healthy as possible? And you’re right, you know, what we ate when we were 20, we probably can’t get away with eating in our 40s or 50s. [00:11:20][67.7]

Dr Nadira Awal: [00:11:22] No, and we digest things differently don’t we as we enter the perimenopause because the oestrogen declines and so the gut becomes more inflamed. So when it’s inflamed, you don’t absorb the good bacteria. And you know, the gut microbiome makes a big part of the menopause, doesn’t it? So if the gut’s inflamed, you know, obviously you’re not absorbing all the right nutrients, therefore you might get that gut changes as well, the diarrhoea or the constipation, and therefore you might get joint aches as well. So, yes, you know, which we’ve both experienced, I think so. [00:11:50][28.1]

Dr Louise Newson: [00:11:51] Absolutely, I mean it’s this anti-inflammatory properties of our hormones throughout our body are really, really important and misunderstood. And and you’re right, actually the sort of bowel symptoms are very, very common. I mean, for many years I’ve seen so many women with irritable bowel syndrome, didn’t think about the hormones at all and even heartburn and like you say, diarrhoea can be related to hormones. So there’s all these symptoms that affect people in different ways, different stages, different types of women, but often they’re not recognising and I know a lot of the work I do, but also the work you do, is trying to educate and allow women to understand what’s going on. And traditionally, if you Google menopause, it will be a white middle class woman who is, usually got a fan or just has a glass of water with her hand on her brow, and that’s not most women. And I did a presentation recently, at an international conference about ethnic disparities with menopause. And we were asking women what their views of the menopause were. And some people from ethnic minority groups said things like, It’s a dirty secret, it’s a shame, it’s an embarrassment, it’s something I want to hide away. It’s something that we just have to endure and suffer. And all these words I feel, are really sad because it shouldn’t be something that you have to just battle through. And there are certain groups of populations that I think it’s harder to reach as well, isn’t it, culturally? [00:13:22][90.7]

Dr Nadira Awal: [00:13:23] So, absolutely. I mean, if you can think about it, my parents’ generation, so my mother never, ever talked about sex, ever. You know, my mother never talked about it. My sister, who’s ten years older than I am, didn’t talk about sex. And it’s a cultural thing. It’s something to be feeling almost ashamed about. Or it’s about being hidden. You can’t really openly discuss about it. My cousins and I, you know, there’s five of us, and there’s six months between all of us, and I remember about ten years ago, and I’ve already been married 18 years, so ten years ago we were talking about sex and I’d been married eight years by that time. So you can imagine it’s something that is just not culturally talked about and not open about it as well. So my my focus is about talking in the ethnic minorities. It’s about being open with them and saying it’s okay to talk about it. So yesterday, you know, we’re trying to change the mindset of the older generation, but the newer generation who are, you know, have social media, they can see that actually they’re getting their education through that, which is great, you know, but change doesn’t happen instantly. Unfortunately. It comes about slowly. And so people are becoming educated through social media, through your podcasts, for example, as well. And, you know, Instagram and Facebook, it’s great. Tik Tok. But change needs to come and it is rolling in, it is getting better. And I think it’s really important to be educated. So I go to mosques and I very openly talk to women about the menopause and there’s lots of giggles. We know we do it very, very, very informal. And it’s so important. And I use questionnaires as well. I think it’s important. So anonymous questionnaires and I have people, you know, saying do you find sex is important? Do you find that sex hurts? And it’s anonymous so they don’t feel ashamed of it, which is great. But I think we need to talk about it more openly, Louise. [00:15:09][106.3]

Dr Louise Newson: [00:15:10] And I bet you hear stories that are sad. I know I’m overwhelmed with sadness actually listening to so many stories from women from all over the world. But I’m sure when you go to the mosques and people know it’s safe to talk about. [00:15:24][13.5]

Dr Nadira Awal: [00:15:24] I have to say the most interesting one is I worked in a quite a socially deprived area, quite locally to where I am, and actually I had a lady come to me and she went, My vagina is so dry, I just can’t have sex. But my husband really wants to have sex, so I just have to lie there and just basically take and I hate it. And I said, Well, do you say no? And she said, no, because it’s part of my role as a wife. I need to have sex with my husband. And I went, You can say, no, it’s almost like rape. And she went, No, it’s not rape. It’s my husband. I went, If you say no, it is rape. And it was really quite distressing, actually. And I said, Look, let’s give you some vaginal oestrogen and let’s talk about HRT as well. And she came back to me, went, actually, sex is so much better with some vaginal oestrogen. [00:16:10][46.2]

Dr Louise Newson: [00:16:12] Yeah, and it’s, I’ve heard so many stories that are similar. A first lady who spoke to, it was many, many years ago. And I suppose the beauty of the clinic that I have I have longer to talk to women. In general practice to having eight, 10 minutes is quite hard to ask intimate questions. But because on the questionnaire it talks about libido, I will usually, if it’s appropriate, ask women about sex and if it’s uncomfortable because vaginal dryness means nothing to a lot of people. And it’s one of those horrible terms. It’s really difficult, isn’t it? Because then you talk about vulva vaginal atrophy, and if you look up the word atrophy, it means withering or wasting away, well I don’t want to think any part of my anatomy is withering or wasting away. So and it’s not just about penetrative sex sometimes, it’s actually externally can be very painful. So a lot of women don’t want to be touched or explored or anything happening in that area. And one lady said to me many years ago, she said she had no libido, She loved her husband. And really, you know, their relationship was good, but she had no interest. She said, I would prefer to drink toilet water than have sex with my husband, but he needs to have sex. And we do sometimes. And I said, Well is it painful? She said, Oh, gosh, yes. It’s like having a red hot poker shoved inside me. And I said, Well, do you tell him? She said, No, because I know it won’t last very long. So I just lie there and just wait for it to finish. And I said, Don’t you tell him? She said, No, but I can’t because I know how much he wants sex. And there’s so many layers to that conversation aren’t there? And I feel really sad to think that people are in relationships that they can’t even talk, but also more sad that there is a treatment that’s available that women are not able to access in an easy way. [00:17:57][105.4]

Dr Nadira Awal: [00:17:57] Yes, I completely agree with you, Louise. The impact on relationships can be quite horrific, actually, can’t it? And you can actually see that some people actually have marital problems as well. And you see people separating sometimes, unfortunately. [00:18:09][11.5]

Dr Louise Newson: [00:18:10] Yeah. I mean, divorce rates really do increase in the perimenopause and menopause. And often, like you said earlier, you know partners need to understand, really need to understand as well. And we see a lot of people in same sex relationships. And if two of them are perimenopausal or menopausal at the same time, it can be a double whammy, of course. But it’s not just the immediate partner, it’s the wider community, as you were saying. And certainly a lot of the work that you’re doing, with ethnic minorities, the communities are there, more than for a lot of us Caucasians, actually. But they don’t know how to help because they can’t understand. And I think that’s really important. And I was talking to someone recently who’s based in India, and I really worry because menopause age is often younger, you know the average age is probably in their early 40s as opposed to early 50s. And there’s an increased risk of diabetes, heart disease in these women. And we know that in the menopause there’s an increased risk of heart disease and diabetes. And so it’s a double whammy that really needs to be discussed more, doesn’t it? [00:19:15][64.9]

Dr Nadira Awal: [00:19:15] Absolutely. Unfortunately, sort of our genetic makeup is that we are increased risk of heart disease. We are increased risk of diabetes. Often our parents and grandparents have had these health conditions and yes, we can change it through lifestyle, but actually we can’t change genetics. And you can appreciate actually, you know, our diet is often made up of a lot of carbohydrates, and so we’re increasing our risk even further as well. So it is really, really important. Yes, we maintain a healthy lifestyle and have a look at our guts. Having a look at kind of our exercise and we are getting better, definitely. But if you can appreciate when you see that lady who comes in from an ethnic minority background, we’re having to deal with her diabetes that might be poorly controlled. We’re having to deal with her blood pressure that’s maybe poorly controlled. As GPs, we’re having to do that in ten minutes. And yes, you know, there’s a lot of information out there that says no this is menopause related. Not everything is the menopause, it’s not the panacea, you know, giving someone HRT, it’s not the panacea, it’s about the holistic approach to that woman as well. [00:20:17][61.8]

Dr Louise Newson: [00:20:17] I totally agree. And I think it’s a shame, actually, because there’s so much conversation that’s trying to be negative about HRT. We know that in the UK, about 14% of menopausal women take HRT. Worldwide, it’s as low as 6%. So it is low, but it’s a bit like treating blood pressure. I never as a GP and I’m sure you hopefully agree, I would never just put someone on a blood pressure lowering treatment. It would just wouldn’t be doing my job properly. I would talk about lifestyle, I would talk about exercise, I would talk about the different types of drugs and the different side effects they might get and how we might need to change the dose or maybe add in another drug because often two lower doses of drugs is better than just increasing one. And I would review and things would change. And often there their treatment actually, if you get it right and their lifestyle improves, you can lower the dose as well. But it’s the same with menopause. It’s not just, oh, here you go, have some HRT. That would just not be doing our jobs properly. It’s about what it means, because I’ve done and I’m sure you have done many home visits where you open the kitchen cupboard and literally packets of medication fall out. But you think you’ve been prescribing really happily for years. And the women and men have said, Oh, no, doctor, I read the insert. There’s no way I was going to take that medication. And I’m thinking, Well, no wonder your blood pressure hadn’t gone down because you’ve never taken this medication. So if we want to improve concordance, compliance, if we want to really work in a partnership with our patients, they have to have a full understanding. But they also need help to change and improve their lifestyle, to look at their mental health and other things that are going on. You know how you said before this sandwich generation, well, you know, HRT is not going to improve the fact that they’re looking after their mother in a care home who’s 100 miles down the road and they’ve got children and whatever else. And certainly, often as a GP, a lot of my role was sort of also listening and understanding and saying to women and men when they were having difficult times, I can’t change your life, but I can help you improve the way you deal with it. And that makes quite a difference, doesn’t it? [00:22:26][129.1]

Dr Nadira Awal: [00:22:27] Absolutely, Yes, sort of. I always use the analogy with my patients. I’m like your satnav. I can help guide you and tell you which way to turn. But really, it’s up to you to make the decision making. And whichever way we go, the ultimate destination is going to be the same. And the ultimate destination is death I’m afraid, you know, which where we get it or how we get there. It’s, you know, we can either have a great journey together or we don’t have a great journey together. [00:22:51][24.4]

Dr Louise Newson: [00:22:52] Yeah. That’s so important, isn’t it? And I learned so much in my training year as a GP, actually, with Dr John Sanders, who is my trainer in Manchester, about looking together with your patient. And everyone’s different and everyone’s expectations of what they want. You know, I could be expecting all my patients to do a regular yoga practice and do a headstand three times a week because that’s what I do. Well, of course, some women are very happy just sitting on the sofa watching telly. And actually, who am I to judge? They probably have a far better time than me, constantly working and fitting in yoga in between a hectic schedule, but actually it’s working out what they want. And this is the same with HRT. If a patient or a woman really doesn’t want it, that’s fine. But they have to understand the risks of not taking medication as well as the risks of taking it. The same as the risks of eating McDonald’s or, you know, smoking. I would never judge a patient and treat them differently because they decided to carry on smoking. But I do feel it’s my role to tell them that smoking is not the best thing for their health. But I think being a GP actually gives you some great skills where we’re not judging, we’re not preaching and that helps with all the education work certainly I do, and you do as well, because we’re used to dealing with different people and speaking to people in different ways and giving them the information in the way that they want it as well. Because you know what I might give a professor of neuroscience who’s a patient might be very different to someone in inner city who doesn’t speak English as their first language. They both are entitled to as much information as possible, but they might want it in different ways and different stages by different people as well. [00:24:38][106.0]

Dr Nadira Awal: [00:24:38] Absolutely. And I think it’s really important. As you say, it’s a professor of neuroscience or neurosurgery, for example. Even though they’re a doctor, they probably know nothing about the menopause, actually. And actually, it’s really important to explain it in layman’s terms as best as possible. And actually, I often find that my patients actually have more education than I do. And it’s great. I love it. I love hearing from my patients, actually, what the latest research they’ve found. And I will embrace it because you have to embrace it. [00:25:07][28.2]

Dr Louise Newson: [00:25:07] Yes, I love it. I mean, when we when I first started as a GP, the internet only really started going. And it used to be the front page of the Daily Mail saying, I would like this treatment. And then you look at it and it’s been a study of four people have found that something and you’re like, Oh, but now actually they learn from their communities as well. And there’s a lot of pushback about social media, but actually it can be very useful if it’s done in the right way. And it can also allow people just a bit of space to think and they can communicate with others that they might not meet in a mosque or the supermarket or a church or with their local communities. And it allows them probably to ask things in different ways because they are more anonymous as well, which I think is really important. So the huge amount that we need to do. There’s a huge amount, we need to carry on educating women, men, families, but also health care professionals as well. And all the work you’re doing is helping with that. Well it’s great to connect and I hope we can carry on doing things together. So before we finish, though, Nadira, I’d really like to ask you three tips, actually. So three tips of how women and healthcare professionals and anybody so professional or nonprofessional people can just become more educated, more empowered to help more people. [00:26:23][76.0]

Dr Nadira Awal: [00:26:24] I think the key thing is, as a GP, I would really appreciate if somebody, if they were concerned about the menopause itself, I think my top tip is download the questionnaire. Have a look at it. Fill it out beforehand. Tell me your symptoms within that first two to three minutes. So we’re both singing on the same hymn sheet just so that we know we’re tackling with menopause. Please don’t be alarmed if I’m going to be ordering blood tests, looking at vitamin D deficiency, looking at iron levels, looking at your thyroid function. I won’t be prescribing HRT on the first consultation. I have ten minutes as a GP. I need more information from you. And the menopause isn’t the, you know, it’s not the only diagnosis out there. You know, it’s really tough as a GP, we need to rule out more sinister causes. So I think that’s my top top tip. Two other tips. I’d say be wary that actually women of ethnic minority, we often need higher doses actually compared to our Caucasian counterparts, everybody absorbs their oestrogen differently. And that’s my third tip. So please, if you’re going to the maximum doses, check oestradiol levels. You know, we’ve got a lab for a reason, you know, so just everybody is individualised. Everybody has a different story. So please tailor it to your patients. [00:27:41][77.1]

Dr Louise Newson: [00:27:42] Very good. Very good. Everything we do in medicine should be tailored to our patients. So important. So I’m very grateful for your time and keep doing the work you’re doing. And thank you again. [00:27:53][11.0]

Dr Nadira Awal: [00:27:53] Yeah, thank you, Louise. Thank you. [00:27:55][1.4]

Dr Louise Newson: [00:27:59] You can find out more about Newson Health group by visiting www.newsonhealth.co.uk. And you can download the free balance app on the App Store or Google Play. [00:27:59][0.0]

ENDS

The post The juggling act: how to navigate menopause and midlife appeared first on Balance Menopause & Hormones.

Raquela Mosquera joins Dr Louise Newson in this episode to talk about the turmoil, anxiety and unexplained bleeding she went through during her menopause.

Raquela is the mum of Joe Wicks, the fitness coach who kept the country moving during lockdown and who has also appeared on Dr Louise’s podcast. Joe put Raquela in touch with Dr Louise after she confided her worries over her symptoms.

The anxiety, brain fog and isolation led to Raquela leaving the job she loved, but adjusting her HRT has transformed her life. Listen to Raquela and Dr Louise share tips about how to get the right HRT dose and type to suit you to get the maximum benefit.

Raquela’s three tips: 

1. Educate yourself on the symptoms of the menopause and right down all your symptoms before seeing your GP, including when these symptoms started and what can make them worse.

2. Be a menopause warrior. Chat about your experience to friends and family to reduce the stigma around the menopause.

3. Don’t be scared of HRT. Go to your GP and talk about whether it could work for you before making any decisions.

Listen to Dr Louise’s podcast with Joe Wicks here

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. [00:00:54][43.3]

Dr Louise Newson: [00:01:03] So today on the podcast, I’m very, very excited and delighted to introduce to you Raquela who I’ve known for a little while and actually seen and watched her become even a better version of herself. So she’s here in the podcast studio today. So welcome. Thanks so much for joining me. [00:01:19][16.5]

Raquela Mosquera: [00:01:20] Thank you, Louise, and thank you for inviting me on to the podcast today. [00:01:23][3.4]

Dr Louise Newson: [00:01:24] So I was trying to work out how long I’ve known you for. And it’s, I don’t know, it feels like about a year. Would that be fair enough, do you think? [00:01:31][6.8]

Raquela Mosquera: [00:01:32] I think it’s over a year. [00:01:33][1.1]

Dr Louise Newson: [00:01:33] Okay. And so tell me, if you don’t mind, just tell me a bit about why we connected or what was going on at the time when you reached out to me. [00:01:40][7.2]

Raquela Mosquera: [00:01:41] Well, I think what had happened was I started bleeding nine months after my period had stopped and I was very, very concerned. And my son actually knew you and got us in contact. And then we had a conversation on the phone, which was reassuring. You know, you sent me off to have tests. Yes. And it was all very quick. But for me, really important because I can be someone that can get quite anxious around things that I don’t know what’s going on in my body. So that’s how we met. [00:02:15][34.0]

Dr Louise Newson: [00:02:16] Yeah. And you’re not alone. I mean, we all want to be healthy. We all want to be well. And actually bleeding can really scare people. And you’d already started a bit of HRT, hadn’t you? And you’d reached out. So shall we disclose who your son is? Because people will probably know your son more than they know us. But he’s happy because I checked with him before. So do you want to say, because you are so proud of him. So I think you should say who your son is. [00:02:42][26.8]

Raquela Mosquera: [00:02:43] Yes. Well, I’m proud of all my boys. My son is Joe Wicks, the Body Coach. [00:02:48][4.6]

Dr Louise Newson: [00:02:49] He’s phenomenal, isn’t he? [00:02:50][1.0]

Raquela Mosquera: [00:02:50] Oh, he’s mental. I mean, like I say, I’m proud of all my boys, but, you know, the work ethic that he has and his dedication to want to get the nation moving and the world moving, you know, and so they can have better lifestyles, food, eating, exercising and getting more sleep. And I live by them guidelines, you know. [00:03:14][24.1]

Dr Louise Newson: [00:03:15] Absolutely. And yeah, I mean, I’ve been connected with Joe for a little while and hopefully those of you listening have already listened to the podcast that we’ve done together. And he’s phenomenal because he’s got so much energy, but he’s also got so much warmth and compassion and he really does care. And I’m not going to talk out of term, but I’ve spoken to quite a few well-connected people, celebrity people, and they become quite selfish as they become more famous. And Joe is very selfless. He’s very caring about his family. He’s got really good core values and he wants good people around him. And that’s what we all want, actually. But more importantly, and for those of you who’ve watched the documentary about Joe will know that things haven’t always been easy and everyone’s got a back story. And it’s so easy to look at people superficially and say, oh, aren’t they lucky? And it’s very easy. On Joe’s Instagram, his children always look so perfect, so happy. They always, you know, have a beautiful house. And we all know, any of us who have had children, I’m sure I’ve never asked Joe, but I’m sure he can’t tell me that having three children is a piece of cake and he can’t tell me they’re always as happy as they are on their Instagram as they are behind the scenes because that’s children, isn’t it? That’s the way it goes. And it’s a challenge. And life has been a challenge for you as a family, obviously. And then the menopause is a huge challenge for the majority of us, there’s no doubt about it. And often what it does is it can actually trigger things how people were before. So anxiety, if you’ve been anxious before, it can make things worse. If you’ve had low moods, it can sometimes reemerge and Joe absolutely adores you. The feeling is so mutual, as you know, your adoration for each other. And he messaged me, and said I’m really worried about my mum because she’s worried. And it wasn’t really because she’s bleeding, it was because she’s worried. And I remember speaking to you because I was driving down to London and I said, that’s fine. I’ll give her a ring straight away. And as much as I tried to reassure you that it was very unlikely that you had cancer, you weren’t really listening because you were convinced that you had something awful. And I understand completely. So you had some tests and you don’t have cancer, which is great, isn’t it? [00:05:21][126.5]

Raquela Mosquera: [00:05:23] Yeah, absolutely. [00:05:24][0.7]

Dr Louise Newson: [00:05:23] And then we changed the dose and type of your HRT. And it’s really important actually, because about a third of women we see in the clinic are already on HRT and a lot of them have been said, well, your symptoms can’t be due to your hormones because you’re on HRT, so it must be due to something else. And I always say to people, what I want to do is optimise your hormones properly so you’re on the right dose, the right type for you at that time, because sometimes it can change with time. And then let’s see how you improve or not improve, as the case may be. And I’m sure I probably said the same thing to you. And so we’ve sort of finetuned your HRT over the last few months. And hopefully you’re going to tell me that you feel better. I know you do looking at you, but you know, compared to how you were before. [00:06:12][49.0]

Raquela Mosquera: [00:06:13] Oh, gosh, absolutely. You know, I mean, I think going on HRT and, you know, the other things I take within my package of HRT has definitely changed myself. You know, I’m not so anxious. I’ve got more energy and I’m just feeling better in myself. You know, I’m a bit scatty anyway, you know, but that brain fog that I had, you know, has much subsided. So that’s really good. But yeah, you know, I just found the whole experience really hard from the time that I started to feel very different in myself in that, you know, I started to get a lot more anxiety. I was working in a job which took a lot of responsibility. I was working with young people from the age of 11 plus, and I run a mentoring program. So a lot of the situations that were coming to me were really quite intensive and quite hard to listen to, you know? I found myself becoming very irritable, which, you know, I’m very empathetic, understanding and thoughtful and a really good listener. And I was finding that I was going off on, you know, thinking about other things and, you know, not being able to feedback what they’d said because my brain was really foggy. And I found that there was one client that I was working with and her child was on the at risk register and she wasn’t helping herself. And what I found normally in them situations, I can be really empathetic and understanding and I didn’t feel empathetic and understanding and I thought, I’m done. I can’t do this job anymore. But I went to the doctor’s and looked for a solution and said, look, this is how I’m feeling, you know, I don’t understand how I’m feeling because I’ve not experienced this before. And what he said to me was that I think that you’re suffering from secondary trauma and depression. [00:08:29][135.4]

Dr Louise Newson: [00:08:30] And did you think you were? [00:08:31][0.8]

Raquela Mosquera: [00:08:31] Well, I felt really crazy. I mean, I’m a crazy person anyway, you know, and I’m someone that’s been in and out of therapy for a long time. So when I was going to therapy during this time, like, normally it would help me, you know, it would. I would go away thinking, okay, I feel better now, but it didn’t seem to be that therapy was helping in any way, shape or form. So that’s when I went to the doctor and I said, look, I don’t know what’s wrong with me. I just can’t seem to get right. You know, I’ve had my therapy sessions and I still come out and I’m still feeling the same. I feel more anxious, I feel more tired. I don’t have like that get up and go with my job, which I totally loved. And then he advised me to go on to antidepressants. And obviously at the time, prior to that, I would always say, no, I don’t want antidepressants. I’m going to go and do something and talk to a therapist or go and have massages to try and sort of bring my anxiety levels down. And what happened here was that I was so desperate that I went give me anything. [00:09:48][76.6]

Dr Louise Newson: [00:09:49] Of course, I understand that totally. [00:09:50][1.0]

Raquela Mosquera: [00:09:51] And then when he said to me it was going to take two weeks to four weeks for it to kick in, I was like beside myself. I was like I was hyperventilating, thinking I can’t feel like this for another two weeks or another four weeks. I just feel out of control of my whole body, you know? It’s like when you’re premenstrual. You know, when you’re on your period and, you know, you have all these emotions that are really hightened and then you bleed and then you’re fine. It was like I was at that level all the time. [00:10:24][32.9]

Dr Louise Newson: [00:10:24] And that’s really common to describe that because I’m sure, you know, just before your periods is when your hormone levels are naturally at their lowest. And we’ve all grown up for years thinking that’s normal. That’s what happens. We were expecting to and even my mum the other day was saying, yeah but Louise, that’s normal one, two to three or four days before your period. That’s what we always felt like. But why is it normal? Why are we allowed to have three or four days every month? So times up by 12, so 36, it’s a month a year where we’re feeling like this. And again, a lot of women I see who have that, all you do is top up the hormones in those few days. But it’s exactly right. It’s the same feeling because it’s the same thing happening to your body. You’ve got low hormones, but they’re not going to increase because you’re not getting periods. So it’s this heightened alert really isn’t it. It’s a really scary feeling. [00:11:16][51.1]

Raquela Mosquera: [00:11:16] Yeah, absolutely. You know, and actually, it wasn’t until I had because there was a bit of stigma as well with the menopause. Oh, no one was talking about the menopause. So I didn’t know anything about the menopause. I wasn’t educated in anyway. I didn’t know anyone that was going through the menopause so, you know, at the beginning for me to even speak to about it. Or there was, but we weren’t talking about it, if that makes sense. So there was a lot of stigma. There was a bit of shame. Oh God, I’m getting older, you know, this is a sign of being old and the emotions and the feelings that were attached to it. I was just crying all the time, you know? I just had no control over my emotions. Someone would say are you okay? I’d go ohhhhh, I’d be crying. But everyone knew me as an emotional person anyway. But I’d go but I don’t know why I’m crying, you know, where normally I would be able to say, this is why I’m upset. [00:12:17][60.3]

Dr Louise Newson: [00:12:17] Course. Course. [00:12:18][0.9]

Raquela Mosquera: [00:12:19] And it wasn’t actually till I watched Davina’s programme, I think it was the first one where she was talking about the menopause and how many people in very high profile jobs were leaving their jobs and how people were going to the doctor’s and they were putting them on antidepressants. And almost the penny dropped. It was, oh my God, that was me. You know, I didn’t leave my job because I stopped loving it. I left my job because I wasn’t coping with it, you know, and I didn’t have as much empathy and compassion. And I felt that I was doing a disservice to the clients that I was working with. So I just thought, you know, my anxiety was everywhere and I just thought, I can’t do this anymore, you know? And that’s one of my worst regrets is that, you know, that I left a job that I absolutely loved because I felt that I had outgrown it. But actually I wasn’t equipped with knowledge to understand what was going on at the time. [00:13:20][61.5]

Dr Louise Newson: [00:13:22] It’s so sad, isn’t it? Because that happens all across not just the country, but the world where women are either giving up their jobs or they’re not doing the same job that they should be doing or they’re reducing their hours. And it’s horrible. And I understand why you do it. And there’s always a lot of talk about, oh, let’s just give women fans, well, let’s reduce the temperature in the rooms. Actually, that’s not going to help the way that your brain is working, is it? [00:13:46][24.3]

Raquela Mosquera: [00:13:47] No, absolutely not. [00:13:48][1.5]

Dr Louise Newson: [00:13:50] So you’re on HRT and you’ve got the right hormones for you at the moment, and they’re helping you in so many ways. I mean, you are a completely different person than when I first spoke to you. Your energy, your confidence, the way you look, the way you sound, the way you are is amazing. And has Jo noticed a difference? [00:14:10][20.3]

Raquela Mosquera: [00:14:13] I don’t know whether they’ve noticed a difference. I just you know, because it’s like I don’t and I’ve not asked him that question and I’ve not asked anyone that question so that’s really interesting. And I will go back and I will ask my children that question. [00:14:26][12.8]

Dr Louise Newson: [00:14:27] He’s told me that he’s noticed a difference. [00:14:28][1.4]

Raquela Mosquera: [00:14:29] Ok, then that’s a really good thing. But yeah, I definitely feel different. Even though I can be crazy at times, I don’t feel crazy out of control, you know, And I do feel more brighter, you know, I do feel like I’ve got more energy that I can go to the gym and I can because what I found as well when I was going through the menopause is that I felt that I didn’t want to socialise. So I became very much an introvert and being home a lot, you know, because I found it hard to engage with people because I’ll be, you know, sweating and I would be, you know, like anxious. And I didn’t feel that I had communication with people if that made sense. [00:15:15][45.8]

Dr Louise Newson: [00:15:15] Very common. Very common. And it’s very difficult when you do research, not that much research has been done on the menopause. It’s all about vasomotor symptoms, flushes, sweats, there’s a bit about vaginal dryness. There’s not about how hard is it to empty the dishwasher because you’re feeling really fed up. How hard is it to put on a load of washing or do you stop taking your children to the park because you can’t be bothered and you just put on the telly? Or do you stop going out with your friends because you’re just feeling awful and you haven’t got that energy and oomph and that’s quite hard to measure. But I hear it all the time from people and I know myself when I was experiencing symptoms, you just put on your jogging pants, when you get home, you close the curtains and you’re like, I’m done, that’s it. And you go out. And I was still having my job, so I was going out, outward facing I was fine. Soon as I come in that is it, forget it. I can’t. And it’s, you end up and you can see, but also your own friends are doing that as well because if they’re a similar age. So you go from this high energy and then you say, oh, it’s because the children are busy or this. You always make excuses and it’s really hard. And I can see how women then become very isolated and you don’t really want to phone your friends up and say, you know what, I’m feeling really rubbish and I don’t know why, but I’m just not myself. It’s not so easy to do that, is it? [00:16:31][75.6]

Raquela Mosquera: [00:16:31] No. Well, I found it really hard anyway, but I just noticed that, you know, I’m not going out. I’m not interacting with people. I’m hiding. You know, it’s like I was hiding from the world. You know, And I think a big part of that as well was when I started going to the menopause and I acknowledged that I was going through the menopause, through Davina’s programme. I went straight to my doctor’s and said, I want to go on HRT. I need to go on HRT. And I think as well they don’t always get the dose right, you know, and it’s not always the right one for you. And I think that’s okay to keep trying, you know, don’t give up on it, you know, keep trying and then you’ll come up with the combination that you need. It’s like what you done for me is you tweaked my medication as well. And I think from that point, I really started to notice a difference in myself. I noticed when I first went on it, but it was I still had the anxiety, I still had, you know, the isolation. But I think once the balance was right, it’s like I’m like I kept on going to everyone I’m back. I’m back, you know, because I felt just like, yeah, not great at all. [00:17:47][75.6]

Dr Louise Newson: [00:17:47] Yeah. And you’re absolutely right. And I think most of us and many people I speak to don’t realise what it’s like to be back until you are back. And I know when my dose isn’t right because I have quite bad migraines and I get them anyway just because I always will, but they become more frequent without anything else changing and also I get very bad sort of joint and muscle pains and I just feel quite flat and tired and it’s very subtle, but I know that, oh, my hormones just need tweaking and a little bit and then when they do you think, oh that’s good, because otherwise it’s quite scary, you know, thinking what else is going on. And that’s why it’s so important that people are reviewed. They were seen by a specialist who really understands, and we do that in medicine all the time. You know, if you had broken your arm and you were in pain, I would start off giving you one type of painkiller. And if that didn’t work, I would give another one or I’d change the dose. And, you know, we do that in medicine. But somehow for women’s health and menopause, it’s like you have this and then you just shut up and carry on. It’s like we can’t listen to women and or we can’t understand or we don’t want to understand. And I think that’s happened for far too long, that women have just been said, well, it’s still menopause. Just get through it. Oh, it’s your periods. Just get through it. And, you know, and I really worry, I worry a lot about all sorts of things, but I worry about menopausal women. But I worry about younger women as well, and women who have bad PMS, that we’ve explained, but also lots of women have an earlier menopause and it might be a transient, short lived thing If they’ve had maybe some treatment for some cancer, it might have affected the way their ovaries work. But there’s also quite a lot of people who have eating disorders and they become, you know, a certain weight and then their periods don’t restart or they stop and they’re basically having an early menopause. But who’s looking after those people? [00:19:41][114.0]

Raquela Mosquera: [00:19:42] Yeah. Yeah. And again, it’s down to education, isn’t it? You know, and there not being enough information or understanding about what’s going on with our bodies. [00:19:52][9.6]

Dr Louise Newson: [00:19:53] Yeah, absolutely. I mean, I’ve got three daughters and obviously the only thing I do is talk about the menopause. So they’re very au fait with it. But my 12 year old had her biology lesson or science or whatever they learned about menopause, They learned about oestrogen. No one told them, obviously, about testosterone. And they just said they were hormones that help with pregnancy from your ovaries. That was it. It was nothing else. Menopause is when your periods stop, end of, and that’s it. And it’s quite shocking. And girls now, I mean, my my teenagers are very au fait talking about all sorts of things, obviously, but about the hormones, they want to be in control of their body. They don’t want hormones to control them and they want to know what the options are and alternatives. And I spoke to one of my daughter’s friends, who is 20, yesterday because she has migraine and she’s on the pill, but she shouldn’t be on the pill. And she’s been given an alternative, but actually that still has a small risk of clot. So why would she be on one? And we were talking and she said, but I’ve just been on the pill since I’m 14, and I don’t know what it would be like to have my own hormones. And it’s all about contraception, when I see the doctor, not about how I feel or how what my skin’s like or what my headaches are like or what my energy is like. And this is where, as women, we need to be thinking, well, actually we’re not just somebody that’s either pregnant or not or is thinking about contraception or not, or the menopause is about whether we’re pregnant, can get pregnant or not. It’s about how we are in ourselves and how our hormones are affecting. And we often don’t know how they’re affecting us until we get them back. And as you can imagine, there’s lots of people I see who are on antidepressants and that’s it, they’ve been told you carry on your antidepressant, never even been allowed to have hormones. And I think that’s really sad, actually, isn’t it? [00:21:41][107.5]

Raquela Mosquera: [00:21:41] Definitely. I mean, I’ve got a friend that recently, well, three years ago, she went to the doctor’s with all the symptoms and they wouldn’t give her anything. And she went back two weeks ago and still won’t give her anything. And I don’t understand that. I have actually forwarded on your number because as a possibility of someone that would be able to help. And the thing is now I think when I first went, okay, I’m going through the menopause, again after Davina’s programme, that was so insightful, you know, in that don’t take hormone replacement because you’re going to get cancer, you’re going to get cervical cancer, going to get breast cancer. That was what was associated with HRT, you know. And what I love about you doing your podcasts and other people talking about the menopause because it has created conversations. [00:22:34][52.4]

Dr Louise Newson: [00:22:35] It has. [00:22:35][0.1]

Raquela Mosquera: [00:22:35] Which have definitely been needed. And I think that people are understanding more. And I think like so when I knew I was going through the menopause, I did a WhatsApp group with some of my girlfriends and called it the menopause forum or something, you know, so that, you know, I’d go, oh my God, I could not sleep last night, I was just sweating. Just to allow people to start talking themselves about their symptoms and owning that actually, yeah, maybe I’m going through the menopause and a lot of my friends in the beginning were really sceptical about going on HRT, but they can see a couple of us that have gone on it and how different we were. And it was almost like, oh my God, I need to try that. I need to give that a go, you know? And I’ve always said, you know, like sometimes doctors will not give it to you, you know, but you have to be like, I think I remember someone saying, you have a right to ask for these things. They may not give them to you, but you can say, look, I know what my symptoms are. I believe that I’m going through the menopause, you know, And is there any way that I can have a trial on HRT to see whether that improves my mental health and wellbeing? Because it does, you think you’re going crazy? [00:23:54][78.9]

Dr Louise Newson: [00:23:56] I totally agree. And you know, we’ve got guidelines for menopause care. We know that the majority of women benefit from HRT. And we also know that women are allowed to choose. And we also know that in the UK it’s only about 14, 15% of menopausal women take HRT. So it’s really low. Most people don’t realise how low it is, and in areas of deprivation, it’s as low as 2% of menopausal women. So we need to allow women to… to know what’s going on to their bodies and then allow them to make a choice. And I feel very strongly it’s about having a choice and knowing that there are options available for them. And even those women on HRT, they are allowed to ask for different doses and types as well. And, you know, we’ve got to just keep going by helping other people because we learn from each other and know women are great talking when they’re feeling well and can really help. And I think the work that we’re all doing together is just helping join the dots and allowing people to listen and decide which is really, really important, isn’t it? [00:24:58][62.4]

Raquela Mosquera: [00:24:59] Absolutely. And also, just like a question really is that I’ve got some friends that are in their sixties who are still experiencing the symptoms but are saying, you know, I’m through the menopause now. I’ve been told I’m through the menopause and I don’t need anything now. [00:25:15][16.8]

Dr Louise Newson: [00:25:16] Yeah. And that’s really common now. I mean, no one is through the menopause. The menopause is defined as, you know, your periods stopping, but it’s also defined as your ovaries not working. So your ovaries, once they stop working or they’ve been taken out for an operation, they are not going to come back and work. So it means that the hormones will be low forever. Symptoms obviously can come and go, symptoms can stop, symptoms can start. Some people have very awful symptoms. Some have no symptoms. But actually, it’s not just the symptoms. It’s about how the low hormones affect our bodies. And we know that low hormones are associated with an increased risk of inflammation in the body, increase risk of diseases that, you know, heart disease, osteoporosis and so forth. So a lot of women say, oh, I’m through it. But actually, when you talk to them, you say, well, what’s your sleep like? Do you get any muscle and joint pains? What are you having? Any urinary symptoms? You’ve got any libido? Is your skin changed, has your hair changed? Oh, yeah, yeah. But that’s because I’m 64 now. It’s part of age. So we often say to people there isn’t any evidence to show that HRT is harmful. They used to worry about older types of HRT, but the ones we prescribe are very safe. You can still have them when you’re older and then try it and see. And a lot of women say, well, I’ll try it for three months and see if I feel any better. And then they come back and go, wow, I’m sleeping better. My muscle and joint pains have gone. I can laugh and skip and cough without weeing. I can, you know, my skin and hair are better, my mental state is better. I thought it was just because I was getting older. But even women who don’t have many symptoms, we often give low doses too, because we know even low doses can help protect the bones. And we know that one in two women over the age of 50 will develop osteoporosis, a very common condition that none of us want. So if we’re taking something to reduce our risk just of osteoporosis, that would affect 50% of menopausal women. Well, that’s not a bad thing either. [00:27:09][112.4]

Raquela Mosquera: [00:27:11] No. [00:27:11][0.0]

Dr Louise Newson: [00:27:11] So yeah, so there’s lots of choice and I think that’s really important. But I’m really grateful for your time and really, really grateful that you’ve shared your story because it’s hard talking about how you’ve been feeling. And obviously Joe is a huge public figure and I’m really grateful for him and you for allowing us to have a bit of an insight of what it’s been like and sharing, because it doesn’t matter who you are, you still get to become menopausal and you can’t predict how it’s going to affect you. So before we finish, I’m really keen for just three tips. So for women that have listened to you, Rags, and thought, oh, right, yeah, I’m struggling, what can I do? She sounds like she’s in control. What three things would you say to women who are listening? [00:27:54][43.0]

Raquela Mosquera: [00:27:55] Okay, I’m going to have to put my glasses on and I hate putting my glasses on. Hate them. The first one is to educate yourself on the symptoms of the menopause. And when attending a doctor’s appointment, write down all your symptoms, including when they started and what can make the symptoms worse. [00:28:13][18.5]

Dr Louise Newson: [00:28:14] Very good. [00:28:15][0.3]

Raquela Mosquera: [00:28:17] Be a menopause warrior, as Davina McCall advocates, talk openly to friends and family and work colleagues about the symptoms and effects of the menopause to help reduce the stigma. [00:28:28][10.6]

Dr Louise Newson: [00:28:29] Yep. Very good. I love it. Yes. [00:28:32][3.0]

Raquela Mosquera: [00:28:33] And then three, over the years there has been a lot of scaremongering about HRT, but recent evidence says that the risk of HRT are very small and usually are outweighed by the risks. When you get symptoms such as a hot flushes, night sweats, mood swings, vaginal dryness, reduced sex drive, go to see the doctor, discuss it with your GP, and discuss what HRT therapy are best suited to you. But, you know, life on HRT has given me my life back, so don’t be scared of it, you know, explore it before you make that decision on whether it’s right for you or not. [00:29:12][39.5]

Dr Louise Newson: [00:29:13] Oh, amazing. And I love the way that you’ve done your homework. I’m very, very impressed. It’s very good. I’m really honestly so indebted to you, and it’s been wonderful and I’ve really enjoyed talking to you today. So thank you so much. [00:29:25][11.6]

Raquela Mosquera: [00:29:25] No, thank you, Louise. Thank you for having me on. And I hope that it will help someone. [00:29:29][3.5]

Dr Louise Newson: [00:29:29] It will help lots. So thank you. Thanks. [00:29:31][1.7]

Raquela Mosquera: [00:29:31] You’re welcome. [00:29:32][0.2]

Dr Louise Newson: [00:29:36] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk and you can download the free balance app on the App store or Google Play. [00:29:36][0.0]

ENDS

The post Confronting my menopause fears appeared first on Balance Menopause & Hormones.

At the hearing, her boss Jim Clark dismissed the remarks as ‘innocent’. Upholding Karen Farquharson’s claims of unfair dismissal and harassment, the panel, chaired by Employment Judge JM Hendry, said: ‘Jim Clark can best be described a blunt, self-made man and successful businessman. He no doubt has many admirable qualities but empathy for others is not among them… He expressed no sympathy for the claimant’s health problems.’

Here, Karen shares her story.

Content advisory: this article includes themes of mental health

Seven years ago, when I was 42, I began to experience perimenopausal symptoms – my skin was itching, I was tired and my periods were getting heavier. I started taking antihistamines and tried to sleep as much as I could. But in August 2020, there was a drastic change in my period. I started flooding and bleeding far more regularly – I was bleeding for longer than when I wasn’t bleeding. At first my doctor thought I had an ectopic pregnancy but I knew that wasn’t the case.

So they put me on the mini pill and I tried all sorts, but I was still experiencing bleeding, pain, night sweats, joint pain, pins and needles, brain fog and weight gain. The impact of my symptoms was life changing. I just never thought this kind of thing would happen, and neither did my husband. I brought books and made him read them as well so we could both understand what was going on.

Even though I’d worked for my company for 27 years, I was nervous about telling my employer. But I was upfront with them and explained the situation. They seemed to be fine about it, and I asked if I could work from home if needed – I worked an hour’s drive away and driving with symptoms was uncomfortable. I worked more with the younger director but I knew the older director didn’t like people taking time off work – he called people who needed time off ‘snowflakes’.

In January 2021 I was given HRT – oestrogen patches and progesterone. I continued to experience symptoms but at work they thought I was joking half the time, and I would make a joke out of it sometimes. But one time I was called up as a witness for a court case to do with my work and I told them I couldn’t do it as the stress would kill me – they thought it was hilarious. If I ever got overwhelmed at work, I’d shut myself in the toilet and have a good cry until I’d calm down. And any time I worked from home because I wasn’t feeling well, I had this terrible guilt. I would try and make up for it – I was putting myself under more and more pressure because I didn’t want them to think that I wasn’t capable. I’d work harder or longer to compensate.

I got my HRT upped in September 2022 and they referred me to the gynaecologist [I later learnt I have adenomyosis, which is where endometrial tissue grows in the muscular lining of the womb, causing heavy periods and pelvic pain]. I didn’t feel like I was getting anywhere with my symptoms with my local GP – they still wanted me to have a bleed, but I couldn’t cope with the bleeding anymore, I wanted it to stop – so I got a private consultation, which was a great help.

At work I had this nagging feeling that something just wasn’t sitting right with them, and I felt they thought I was a pain in the backside. But I couldn’t pinpoint it and I didn’t want them to think that I was being paranoid or making a fuss.

Things came to a head one Thursday afternoon in December. I had been working from home on the Tuesday and Wednesday because of heavy snow and I was experiencing heavy bleeding. When it was possible to travel, I came in and my boss Jim Clark said sarcastically, ‘Oh I see you’ve made it in.’ I explained about the snow and my bleeding but he gave me a disgusted look and walked away. I was upset and angry so went to see the other director, Jason Clark. A discussion took place between all three of us where my boss accused me of strolling in whenever it pleased me. He questioned how many days off sick I’d taken that year then said ‘menopause, menopause a’biddy f****** get’s it, just get on wi’ it, that’s your excuse for everything’. 

I burst into tears, I couldn’t believe it. I was angry and emotional and told them this was discrimination – they had no understanding of what I was going through. They had previously dismissed the menopause as ‘a’biddy has aches and pains’.   

I said I was going to get legal advice and I was asked to calm down. I had to get away from the situation so left. The next day I felt too upset and unwell to return to work and I expected to receive an apology but I heard nothing. I wrote a grievance letter and saw my GP, who signed me off work. My grievance letter was ignored and my remote access to the accounts system was cut off so I couldn’t work from home. I felt I had no choice but to resign.

I used an HR consultant to represent me rather than a solicitor and he was brilliant. He was very supportive and would speak to me at all hours. But I didn’t think that it would get this far, I thought they would settle out of court. Instead, it took six months to get my case to tribunal and I spent a whole week in court being cross examined.

The emotional impact has been huge. It’s the lowest I have ever felt. I didn’t want to be here a couple of months ago… I’d have conversations with my husband about not being here. I can’t see the actual word, but he was just devastated that I didn’t want to carry on. I rang the Samaritans at one point, but I really needed help with the whole process. I gave 27 years to my company, only to be treated like a piece of dirt. It devastated me.

Now that the verdict is in, I feel empowered that I’ve done it. I’ve never stood up for myself before, I’ve always been some sort of a doormat. I didn’t think I was anyone special, but there must have been something inside that kept me going. I am not going to be pushed around anymore, bullied or spoken to like rubbish and just accept it.

I hope that my case will help other people as well. For any woman going through this, I think they need to have a coach or somebody there to help them through it. Employment lawyers are taking on a lot of these cases but the women need to have coaching and support to go through it. I’ve now got a new job and thankfully my stress levels are much lower.

RELATED: menopause and employment law: where do you stand?

Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email jo@samaritans.org.

The post My story: menopause and taking my employer to tribunal appeared first on Balance Menopause & Hormones.

• Around 14 million working days a year in the UK are lost to menopause symptoms
• Employers have a duty to ensure the health, safety and welfare of their staff
• Discover how to talk about the menopause at work and get support

Women of menopausal age (45-54) make up 11% of all people in employment and 23% of all women in employment [1]. Many women can experience perimenopausal symptoms for years before their menopause, with three in 100 women going through the menopause before they are 40. It is perhaps then no surprise that women experiencing menopausal symptoms represent the fastest growing demographic in the UK workforce, with nearly eight out of ten being in work [2]. 

Yet research suggests a lack of awareness regarding the menopause, with the impact of discrimination resulting in vast numbers of women leaving the workforce. This is at a time when many of these women are at the height of their careers and should be reaping the rewards of their years of experience.

While the average age women in the UK experience the menopause is 51, retirement age is now 68. Early departure from the workplace is not only distressing for the women involved, but it has a huge impact on the UK economy, which is losing out on their skills.

In 2022, balance founder Dr Louise Newson conducted a survey for her book, The Definitive Guide to the Perimenopause & Menopause, of 3,800 perimenopausal and menopausal women about their experiences in the workplace. Significant findings included that 99% of respondents said their perimenopausal or menopausal symptoms had led to a negative impact on their careers; 59% had taken time off work due to their symptoms; 21% passed on the chance to go for a promotion they would otherwise have considered; 19% reduced their hours and 12% resigned.

While some women leave work because of the challenge of dealing with their symptoms at work, others feel unsupported or even discriminated against and are unaware of their rights.

RELATED: explore balance workplace resources

What does the law say?

The Advisory, Conciliation and Arbitration Service (Acas) advises employers that they should be aware of how the menopause relates to the law, including the:

• Equality Act 2010, which protects workers against discrimination
• Health and Safety at Work Act 1974, which says an employer must, where reasonably practical, ensure everyone’s health, safety and welfare at work

Unlike, say, age or sex, the menopause is not a specific protected characteristic under the Equality Act 2010, and there is debate over whether this should be the case. The Women and Equalities Committee’s report on menopause and the workplace recommended that menopause should be made a protected characteristic, meaning a woman could not be discriminated against because of her menopausal symptoms. However, in May 2023, the government rejected the recommendation – one of the reasons was the possible unintended consequence of creating new forms of discrimination, such as towards men suffering long-term medical conditions.

More recently, in February 2024, the Equality and Human Rights Commission (EHRC) released new guidance on menopause in the workplace, setting out employers’ legal obligations under the Equality Act 2010. The aim is to clarify the legal obligations for employers but also to provide practical tips on making reasonable adjustments for affected employees.

It is important to note that, contrary to some of the recent press coverage, the legal position regarding how certain provisions within the Equality Act relate to menopause-related challenges in the workplace has not been amended or added to by the EHRC and remains unchanged.

Is the menopause a disability?

As it stands, if an employee is treated unfavourably because of their menopause symptoms, this could be classed as discrimination under the category of age, sex or disability. Emma Hammond, a partner at gunnercooke LLP, specialises in employment law and advises women who have suffered discrimination in the workplace due to menopause related treatment. She says: ‘It sits quite uncomfortably to say that the menopause or menopause symptoms amount to a disability, but that’s one of the major starting points from a legal perspective under the Equality Act 2010. So, we look at the definition of disability, which is defined as a mental or physical impairment that lasts or is likely to last 12 months or the rest of the person’s life and has a substantial or adverse impact on their ability to carry out their day-to -day activities.

‘If a woman decides to sue her employer and take the tribunal route she may need to go through a preliminary hearing stage in order to establish that what they are suffering from meets the definition of “disability” under the legislation. Recently it was held at a preliminary hearing it could absolutely be the case that symptoms such as brain fog, insomnia and anxiety, could amount to a disability, as defined.’

RELATED: Podcast: workplace menopause advice from lawyer Emma Hammond

How else can the law help you?

‘Within the Equality Act we’re also looking at age (which only works in some circumstances) and at gender. Would a man be treated the same in the same scenario? Obviously, a man can’t go through the menopause per se so we look at the difference in treatment. But again, you have to be pretty creative because there isn’t yet a protected characteristic for the menopause so we have to make these things fit to your circumstances,’ says Emma.

‘We also have to remember that discrimination rights under the age, sex and disability arena kick in from day one, and are even present from the recruitment stage. So you don’t need a specific length of service, whereas the right not to be unfairly dismissed starts after two years’ service. I support women by explaining that they do have some level of legal protection but this is so hard to see and act upon when they are being mistreated and feel lost and vulnerable. Also under health and safety legislation, the employer has a duty of care and must create and maintain a healthy and safe working environment.’

The rise in tribunals

You may have seen employment tribunals relating to menopause making the news. The most relevant recent case is that of Maria Rooney, a social worker who took Leicester City Council to court, claiming constructive unfair dismissal, when she was forced out of her job due to menopausal symptoms back in 2019. 

This case went to full hearing in October 2003. It has made legal history and is the first ruling at employment appeal tribunal level to establish whether menopausal symptoms can amount to a disability. The burden of proof to show, first of all, that Maria was suffering from a disability (as defined in the legislation) is a significant hurdle to clear. Whilst Maria succeeded with this, the stress, anxiety and cost would have put off 99% of people affected by these issues.

The first employment tribunal related to the menopause was heard in 2012 – Ms Merchant brought the claim against her employer BT on the grounds of sex discrimination. After experiencing menopause symptoms that were impacting her performance at work, she was placed on performance management process, and was then dismissed without her manager considering a letter from her GP. Ms Merchant was successful in her claim, but some employers are still taking a similar approach.

‘Sadly, some employers seem to lean towards starting a performance management process when they see symptoms, particularly those such as brain fog, insomnia and anxiety,’ says Emma. ‘Fatigue can clearly affect performance as concentration is often impacted. The ladies who come to me for support have a tangible fear of losing their jobs as they feel they are being managed out. I have had cases where the occupational health report specifically states says that the symptoms that are being suffered are linked to the menopause, so that if the woman is then being treated less favourably you’re immediately looking at a red flag of discrimination taking place.’

So, what can you do?

Start a conversation

‘There are good legal reasons to be open your employer – the employer, from a discrimination perspective, could say, “well we didn’t know and therefore what we’ve done does not amount to discrimination”,’ says Emma.

‘But starting a conversation also allows the employer to seek advice and understand your position. Many do want to help but are unsure how to do so.’

However, Emma recognises that it can be daunting starting this conversation. ‘If you don’t feel that you can speak to a manager, maybe seek out somebody who might be a female of a similar age or stage in your life within the workplace, who you feel you can trust so you can start to open up the conversation.’

Keep a symptom diary

Emma recommends you keep a diary of your symptoms and how they impact your performance or your working day: ‘Don’t expect the employer to second guess what you need. If you can show them what’s been happening, a dialogue can begin about where support might come from.’

Keep a record

Emma also suggests making a note of any difficult conversations or comments. This could be done by sending a note to your personal email, so that it is timed and dated, which may be helpful if you need to later share with HR (or perhaps eventually seek legal support).

‘It may not be a formal grievance that you need to raise and this is rarely palatable unless you feel nothing more can be done. It may actually just be, “look, these things are happening to me, they’ve happened now for a few weeks, they’re making me feel very uncomfortable. I think we could do with a training programme or education internally to address this, along with some personal support etc.

‘Sometimes this opens up a conversation about working patterns and things can progress positively from here. I often provide training programmes for employers who absolutely want to do the right thing,’ says Emma.

Check the paperwork

Check if your company has a menopause policy and, if so, make sure you as an employee are doing what it requires from your side too. Obviously, having a policy is the bare minimum, it should be embedded and lived and breathed.  

What should an employer do?

Employers have a duty to ensure the health and safety of all their workers, and to identify issues that impact them, which includes the menopause. Working in a safe, healthy environment includes having access to toilets, water and ventilation.

The British Standards Institute (BSI) launched new standards for menstruation and menopause in the workplace [3]. The guide provides examples of workplace adjustments that can be made to improve the wellbeing at work of menopausal women.

Employers can launch their own menopause policy. The most important part of any policy is encouraging open conversations, so that any employees who are struggling feel able to raise their issues. Education workshops and training can also help harbour a culture of openness.

Employers also need to be prepared to take action – when open conversations have taken place, the onus is on the employer to consider what reasonable adjustments and support can be offered to help the employee with their performance. The EHRC menopause in the workplace guidance for employers can be found here.

References

1. Labour Force Survey Q2, 2021

2. Faculty of Occupational Medicine, Guidance on menopause and the workplace

3. British Standards Institution (2023), Menstruation, menstrual health and menopause in the workplace

The post Menopause and employment law: where do you stand? appeared first on Balance Menopause & Hormones.

On this week’s podcast, Dr Louise is joined by award-winning US broadcast journalist, podcast host and menopause campaigner Tamsen Fadal.

Tamsen describes how she didn’t recognise she was menopausal after suffering from hot flushes, brain fog and heart palpitations, as she believed she was still having periods. This prompted her to find out more and support other women along the way, including spreading awareness via the #MenopauseTok campaign on social media.

Dr Louise and Tamsen discuss the impact of menopause on careers, barriers to accessing treatment, the importance of being informed – and the growing voice of menopausal women on social media.

Here are Tamsen’s top three tips: 

1. Listen to yourself and your body and don’t miss signs that could be the perimenopause by putting them down to being busy or stressed.

2. Try and carve out time just for yourself, even when things are really busy.

3. Find your people: surround yourself with a community to support you through the perimenopause, menopause and beyond.

Follow Tamsen on Instagram @tamsenfadal and Tiktok @tamsenfadal.

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving, and always inspirational, personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast I’ve got someone with me who is from America. I’ve had a few people from America and this is someone who I’ve been watching from afar, really inspired by what she does. And she’s a well-known journalist over in America and getting known over here more as well. So her name is Tamsen Fadal and she’s got a bit of her own story. But she’s a person with a mission like a lot of us are, to really help as many people as possible who will listen and engage and move things forward for women. So welcome today to the studio.

Tamsen Fadal: [00:01:34] Thanks for having me.

Dr Louise Newson: [00:01:35] It’s really exciting. So tell me a bit about sort of you, why you’re in this space and what’s been going on.

Tamsen Fadal: [00:01:42] Yeah, it’s funny, I’ve had that question recently because I didn’t ever plan to get into this space. I’ve been a journalist for a long time. Over 20 years here in the US. I’ve written a number of books. I wrote them on relationships and dating because I was in that space for a little while. But mostly I’ve been a journalist, you know, covering the news of the day, covering stories that are happening here at home or globally. And it was a few years ago that I found myself on the bathroom floor in the middle of a hot flash with heart palpitations unlike anything I’ve ever experienced before. And not knowing what it was, I didn’t know it was a hot flash at the time. I just felt out of control. And I remember getting some help leaving the studio, not finishing the newscast the first time in 20 plus years. Having not done that, not gone back to set and thinking what in the world is going on? And, you know, I went on a mission to figure it out. And I went from one doctor to another, and I went to an endocrinologist and I went to a therapist. I went, you know, I was prescribed antidepressants. I had bloodwork done. They realised that my blood was in a range of what they call post-menopausal. And I thought, how is that even possible? I’ve had periods. But what I didn’t realise is that I didn’t know a lot about menopause or what was going on with me, and I had endometrial polyps. So I had been bleeding all along and didn’t know I had been missing real periods. So I ended up there and I realised I needed to do something about it because I was just feeling out of control, brain fog, and started to do a deep dive into this space. And what I didn’t know and then what other women didn’t know, and here’s where I am today.

Dr Louise Newson: [00:03:13] It’s so interesting, isn’t it, because I think so often we do get shaped by our own experiences. We have sort of something that’s maybe helped us. But I was actually saying to some of my friends who are also menopause specialists, last night a group of us went out and I was saying, it’s really weird, actually, seven years ago I was sitting in quite an eminent menopause specialist’s clinic in London, and I said to him, how do you know when someone’s actually perimenopausal? And he said, it’s really obvious, often it’s really obvious for that person. And I was there sitting actually perimenopausal myself, and I had no idea because sometimes when the symptoms come on very gradually, you can just blame life. And actually at the time I was developing a menopause website and it sounds weird seven years on, but seven years ago people really weren’t talking about the menopause. And I was a medical writer as well as a doctor. And I thought, I’m just going to write some really basic things. And I was looking at the website recently, I was showing a friend and it literally had what is the menopause, what is the perimenopause, what is HRT, and what is testosterone? Very basic information. And then as I started to see more patients, I realised that there was so much more that we needed to talk about, and it was quite incredible. But at the time, my brain was just not functioning or engaging very well. And I thought, oh, it’s just because I’m trying to fit in this writing as well as working, as well as having three children and trying to find all the excuses under the sun, why it might be happening without actually, and every night I’m writing saying brain fog, memory problems, irritability as I’m shouting to my husband and I still don’t piece it altogether. But the stories now obviously are far more prolific. People are realising. But there’s still a lot of medical gaslighting going on, actually, certainly in the UK, but I’m sure it is in the USA where I have a real problem and I suppose I’m more feminist the older I am, but it’s because women are not being listened to a lot of the time. They’re saying they’ve got all these symptoms and it’s almost like it’s in our head. How dare we think it’s related to our hormones? Or someone recently said to me, gosh, women just put everything down to the hormones. Well, why can’t we blame hormones for a lot of things? Because often it is related. What are Americans like? I mean, do you think American women are having much of a voice at the minute?

Tamsen Fadal: [00:05:30] You know what I think? I think that American women are learning slowly but surely. I think there are a number of thought leaders and doctors out there that are louder voices in this space, which is what, you know, obviously what we have needed. I think that there’s just still a lot of not only misinformation, but also a lot of doctors that don’t know. And I hear one woman after another come to me and said, my doctor said they don’t deal with hormones. And I said, What do you mean they don’t deal with hormones? They just don’t feel comfortable prescribing them. And so women are afraid. And if you’ve gone to a doctor since you were, whatever, 25 years old. Or 30 years old. And this has been your doctor. This has been your gynaecologist since the very beginning. And that person that you’ve trusted so long, doesn’t feel comfortable, tells you something. Most likely you’re going to listen and you’re not going to question that. And so I think that we’re putting women in, my goal anyway, and I think yours is as well, is to empower women to not be afraid to question and then question again. And then if they’re not getting answers that make sense to them or that are helping explain things a little bit better, to move on to another doctor. You know, I still think there’s a ton of misinformation out there. I’m grateful to so many people that are on social media that are trying to change the conversation, even if it’s through a mechanism that we’re not used to changing a conversation about medicine in, because that’s the only way that we’ve gotten this conversation. You and I would never be talking today if there were not some loud voices out there, right?

Dr Louise Newson: [00:06:50] Absolutely and I think the social media is a double-edged sword. But actually, I think it’s really, really useful because it’s very empowering. And if the information is accurate, it’s a way I can reach women globally that I could never have reached 20 years ago before social media. And actually it’s so important because so many people really do feel alone when it comes to the menopause. And I get a lot of direct messages and I can’t answer a lot of them. But when I read them, you know, people are really scared and they just don’t know where to turn to. And in fact, one of the doctors who works with me saw a lady yesterday in the clinic and 18 years she had been struggling and she’d actually become housebound and crippled with her anxiety. Her partner had left her as soon as her vaginal dryness was so bad he couldn’t have sex with her anymore. And she became absolutely uncontrollable, actually. And all she was eating was chocolate buttons because she found any textural food in her mouth was awful and her family had just deserted her and her whole life had become a shell. She just wasn’t functioning at all. And she was previously an actress. And you think, how can this happen in 2023? But somebody who’s intelligent, who’s English, who can speak English as their first language, not be able to access any help. And, you know, we see stories all the time. As you can imagine. We see about 4,000 women a month through our clinic. So when we meet every single one of the clinicians that work with me have horrendous stories that they hear, and they’re not just one or two stories. There’s lots. And I just feel like, why is it that it’s happening? But the good thing is the conversation is starting. There’s lots of people talking, but talking isn’t quite enough because once you’ve had that conversation and once you know something’s going on, it’s even worse almost. And I feel like, I feel sometimes quite embarrassed, Tamsen, with what I’ve done in the UK, but globally as well, because I’ve sort of lifted up this big stone almost. There’s lots underneath and I can’t put it back down. And women are now realising what’s going on and they’re saying, well, I’m not depressed, I don’t need antidepressants, I don’t need therapy, I don’t need painkillers, I don’t need blood pressure treatments, I don’t need sleeping tablets, I just need my own hormones. And then they can’t get them. And I know it’s very difficult because some doctors are really, really scared of HRT and they’re very scared of being sued. And, you know, they’re very scared of any risks. And obviously the whole thing over the last 20 years has been about breast cancer. And of course, women taking HRT are going to get breast cancer because women not taking HRT will get breast cancer. It’s very common. It affects one in seven women. But it doesn’t mean that everybody who is on HRT and gets breast cancer, the HRT has caused it, but it has this massive fear. And then doctors are thinking, I’m going to get sued because I have, you know, a patient’s developed breast cancer. But actually as patients and I’m one myself, then we can make decisions and we can choose can’t we? And I think this is where that choice for women has just eroded, really, hasn’t it?

Tamsen Fadal: [00:10:00] Yeah, it really has. You know, I talk a lot about breast cancer because I lost my mother to breast cancer at the age of 51. She was diagnosed at 44, went through a mastectomy, then another mastectomy, chemotherapy, radiation. I didn’t realise at the time because I just didn’t know what I didn’t know. I didn’t even realise until a few years ago that she had gone through, you know, a surgically induced menopause as a result or medically just menopause as a result. And when I look back at that, it makes me so sad. She had an estrogen-based breast cancer. I’ve always been very afraid of that. That was the dark cloud that’s loomed over my life for, I’m 52, you know, since she died. About 32 years, that has loomed over me as my biggest fear. And one that was in my mind when I found out that I was in menopause thinking like, gosh, what am I going to do? I’m going to have to suck it up and push through it because I’m not going to be able to go on HRT. And the first doctor I went to said, I’m not so comfortable prescribing that to you. The second doctor I went to, she said, well, try Lexapro, an antidepressant instead and see if that works for you to help get through some of the brain fog. And that didn’t work. That didn’t help the symptoms that were making me incapacitated to do my job, really, because I couldn’t even think straight. And then finally, I found two other doctors. But this is through a course of research and going and going and to expect women who are working a job and have kids that are taking care of a home and to now go and like, you know, doctor shop is not fair. And to have to question and question and question. And I really think that that’s where my voice comes into the space, because I want them to feel like they one, are heard, two, don’t have to have that fear and they can make the decision themselves so that they decide that’s what they want to do. Because that’s what’s very important. And they might decide not to do hormones. I’m not advocating hormones. I’m advocating you can have that option there. And if you decide that that’s what you want to do, you get to do it. And if you decide you don’t want to do it and you want to go a different way, as we know, there are different pharmaceuticals that are coming on the market every day that are available to help different symptoms. And you can go that way as well.

Dr Louise Newson: [00:11:55] Absolutely. I totally agree. I really feel very strongly that we can choose so many things in life and in medicine there should be a choice as well. You know, if I have someone sitting in front of me who’s been diagnosed with raised blood pressure, I will talk to them about the choice of treatment. Though some of them would have an ACE inhibitor, someone might have a calcium antagonist, some of them might have a water tablet, and we’d just go through everything with them. And if one doesn’t suit, you go to another. And that’s what we’ve always done in medicine. And to just say no straight off and ignoring any benefits, which is what we’ve done for far too long, I think is such a shame. And and certainly I think we should be thinking about, well, what are the risks of not taking HRT? So, you know, for you, for example, with your mother’s sad story, you might have an increased risk of breast cancer regardless, because of your family history. But it doesn’t mean that taking HRT will increase that risk further. But whether you’ve got a family history of breast cancer or not, you still have bones that are going to increase your risk of osteoporosis. You’ve still got a heart. And we know that women have an increased risk of heart disease and you’ve still got a brain. Women have an increased risk of dementia when they’re menopausal and so forth. And so a lot of women say to me, well, actually I’m more scared of heart disease than I am of breast cancer. So I would like to do everything I can to reduce my risk. That’s not unreasonable. Whereas other women will say to me every day, I’m going to worry about breast cancer, and every day it’s just my biggest fear. And if I was taking HRT, I would blame myself if ever something happened. Well, those women don’t have to take it. No one is forcing anyone to do anything. And I think this is where I feel that women are just sort of being sort of shoehorned or labelled all the same. And we’re all different. We all decide what type of exercise we do, what we eat or how we live our lives. And so whether we take hormones or not should be a choice, but it shouldn’t be a barn door no, which is what’s happening far too often. And I’m sure it’s the same in the US, but in the UK, it’s areas of deprivation, far lower prescribing, areas of ethnicity as well, far lower prescribing. So there’s even across the board there’s a real difference.

Tamsen Fadal: [00:14:03] And inability to afford them, which is, you know, is a big, big problem in the expense and whether or not you have the insurance and whether or not you’ve got a doctor even to be able to talk to about it. So all of those are things that have to be discussed, too. So when you say that past the conversation, what needs to happen? It has to happen on so many different levels, not just workplace, not just legislative, not just… there are so many different areas that have to be tackled. But I guess, you know, the one area that I feel comfortable in that I know well is to be able to push out information and to talk to as many people as possible and try to at least help guide people in a direction to as simple as trying to find a doctor. Right. That will listen to them, because some of them don’t have that. They don’t even know where to begin that, they don’t even know what’s going on with them in terms of the symptoms, in terms of the the different symptoms of what they’re dealing with. And I’m on social media a lot. And the women that I have heard from on there, as you know, the heartbreaking stories and the difference of stories, too, because everybody is so individual when they come about this and whether they have now gone through a divorce as a result of this or they’ve had to leave their job as a result of this, or they’re isolated like the patient that you were talking about, it’s not okay to have all those stories. The one thing I’m grateful for, though, is that we’re hearing those stories. So we know that there is a real problem. And they’re not just you know, there’s no way for us to talk about them or hear those. I feel like you’re right. Social media is a double-edged sword. But the fact that we’re able to communicate with somebody that is, you know, in another state, city, country across the world, to be able to hear and help makes me feel inspired.

Dr Louise Newson: [00:15:33] Oh, absolutely. And you mentioned workplace. I mean, we’ve done various surveys now looking at women, how they’re struggling with their jobs. And almost consistently we find that the figures say around 10% of women give up their jobs completely because of their symptoms. And it’s usually memory problems, fatigue and anxiety, actually. We did a study recently looking at NHS employees because about 40% of NHS employees are menopausal women, and around a third actually really wanted to reduce their hours and were not going for a promotion as well. And so lots of women, even when they’re going to work, they’re underperforming. They’re not doing as well because of the way that their brain is working. I was recently at a very high level meeting in the UK and it was about workplace and people were talking about the biggest breakthrough and I was thinking, great, we’re going to be talking about how we treat women. It was talking about uniforms, how there’s some new nurses’ uniform that’s thinner and about fans. And I just literally wanted to switch my camera off and cry because how is that going to help people’s brain work? And there’s so much sort of responsibility put on the employer. For the employer, they can signpost, they can learn, they can educate. But that’s not the same as enabling people to have treatment, isn’t it? It’s such a problem.

Tamsen Fadal: [00:16:59] No, it’s not at all. I mean, it’s like it’s the lower end of things and I’m appreciative for any conversation in the workplace. But, you know, it also has to have action, real action that can help somebody on a day-to-day basis or help somebody feel better or help somebody get up in the morning, help somebody feel empowered to go after that promotion. It has to start there.

Dr Louise Newson: [00:17:18] It is such a problem because there’s quite a lot over here about, you know, people working from home. Well, not everybody can work from home, they haven’t got the jobs that they can work from home. And why should we?

Tamsen Fadal: [00:17:27] I always hear the answer is a hybrid model. And I’m like, but not everybody can do a, I can’t do a hybrid model with the job I do. It’s just not possible.

Dr Louise Newson: [00:17:34] No, absolutely not. You know, and so I feel like menopausal women are often treated like second class citizens, really. And then people talk about this transition and say, well, it’s only going to last a few years, so let’s help these women transition through the menopause. I think well actually you can’t just have a different job and you shouldn’t have to wait? I don’t really understand why we have to reduce our hours, because then that reduces our pay, reduces income. But it’s also it’s not good for the economy globally either, if it means that, you know, women that have been trained up through organisations then suddenly have to withdraw. It costs, you know, companies a lot of money to lose working women.

Tamsen Fadal: [00:18:14] It also reduces confidence. And I think that that’s a really big deal. You know, and we have a lot of women that are the head of their household and women that are holding things together. And when you say to them, well, you’re not going to be able to do what you were able to do at that level anymore, that hits confidence in a very, very big way.

Dr Louise Newson: [00:18:29] Absolutely. So what’s been going on over in America that’s made a big difference to women, do you think, over the last few months or so?

Tamsen Fadal: [00:18:37] You know, I think more than anything else is the fact that there is finally some really vocal doctors out there that talk about it. I think the fact that women are hearing that there are other options out there and places for them to go to get information. There’s a lot of these telemedicine companies that are available. I think there are a few big companies that are talking about work policies. So women feel like, you know, if you’re spending so many hours at work right now. And if that’s a place you can go and maybe get some answers or help, I think that’s a good thing. There’s a lot more work to be done with regard to that. And of course, there’s a lot more work to be done with regard to being able to afford hormones, but before that, to be able to understand them. And I think that that’s where I try to come in to that is really understand and dispute that 2002 study or at least explain what that study was. It makes me sad that it’s been 20 years and we’re still talking about the results of that Women’s Health Initiative study that did such a disservice to women. I’m grateful for the doctors who were practicing before that study and that have some type of understanding of what the landscape was and what it looked like and where we need to get back to.

Dr Louise Newson: [00:19:40] I mean, it’s quite shocking, isn’t it, that one study can have such a big impact on so many people. And I can’t think of any other study in medicine actually that’s had such an impact on half the population. And even so, we’re still at half the prescribing. So before the WHO said in the UK, about 30% of menopausal women were given HRT and now it’s about 14%. It’s gone from 10 to 14%. So it’s nothing, is it?

Tamsen Fadal: [00:20:11] Well, and the other thing is, is those women, you know, then I think, you know, were probably not working as long as women are today, you know, and that’s the other thing. And I don’t have those numbers, but I’ve seen them in the past. But the fact is, is that we’re working well into our fifties, well into our sixties. So the reason we’re… I think the reason is because women are out there doing things in the workplace and seeing problems, are seeing an inability to be able to think or to concentrate or the anxiety that they have. And maybe that wasn’t happening 30 years ago to the extent it is right now, because we know what longevity looks like today. So, you know, when people say like, I wonder why we’re talking about it now, but we’re talking about it now because we’ve added now, you know, so many more years to our career and we’ve taken away something that helped women. So, you know, 30 years ago.

Dr Louise Newson: [00:20:56] Yeah, absolutely right. And the other thing is the incidence of early menopause. Menopause in younger women has really increased actually over the first five, ten years or so. We used to quote one in a hundred women under the age of 40. Recent studies have shown it’s more like 3% of women so three in 100.

Tamsen Fadal: [00:21:14] Why is that increase?

Dr Louise Newson: [00:21:16] Well, we don’t know, actually, for sure. But there are I mean, even if you look at some of the reasons why people’s ovaries fail, and sometimes it’s due to medical treatments, for example, if someone’s had a cancer, like a cervical cancer, maybe they might have had a hysterectomy, they might have had radiotherapy that affected the way the ovaries work. And the prognosis from lots of cancers is so much better than it used to be. All childhood cancers, leukaemias and lymphomas and so forth. And so the outlook is better so that a lot of these people are now living a lot longer lives. And then actually we’ve been doing quite a lot of work – women living with HIV because women living with HIV are more likely to have symptoms and less likely to receive treatment and also far more likely to have an earlier menopause. And that might be the relation of HIV itself, or it might be a side-effect of some of the drugs that these people take. But the outlook now for women living with HIV, their life expectancy is fantastic, whereas in the 70s and 80s they wouldn’t, a lot of them, even make the menopause age, you know. And so there’s more people living, like you say, for longer. But we also know the longer a woman is without her hormones, the greater the risk of diseases as well. And I really worry about younger women. We know that a lot of women in the US and the UK and other countries who are having a hysterectomy, having their ovaries removed, yet no one’s offering them replacement hormones. And so often in the clinic I hear people who’ve had their ovaries removed at a young age, you know, in their 30s. And when the surgeon will say, oh, let’s just see how you get on. And you can’t do that because hormones are biologically active in all our bodies. And there’s a reason they are there.

Tamsen Fadal: [00:22:57] That feeling of whatever it is becomes the norm, which is really sad. And people think they just have to live with it.

Dr Louise Newson: [00:23:03] Yeah, absolutely. And I feel that also there’s this sort of shame of almost giving into hormones or people feel that they have to suffer a certain amount of time, a certain length of time. And I think that’s when it’s important to be thinking about the health risks as well. And certainly a lot in medicine we treat to reduce risk of diseases. Obviously, that’s why we give blood pressure treatments or often statins, for example, to lower risk of heart disease. So we don’t wait for someone to get chest pain and angina. We try and reduce and prevent it, quite rightly so. And that’s exactly the same with hormones. You don’t have to have a certain list of symptoms or wait till one of the symptoms is so bad that you’re giving up your job. And we also know from evidence the earlier women are taking HRT, the better for their future health as well.

Tamsen Fadal: [00:23:53] So I find it so amazing when I think about the fact, you know, I’m assuming it’s the same in the UK, but you have a commercial on television for a prescription drug and then it gives you the big list of all the problems that could possibly happen. With regard to estrogen and progesterone hormones there’s one outstanding one that scares women for the most part, which is breast cancer. Yet that is the one thing that everybody is so frightened about versus all the other prescriptions that, you know, we probably take in a lifetime that have all these other warnings and outwardly is shown to cause that through tests. And we don’t even have the right tests here. So, you know that the testing and the studies that’s what I was saying earlier. There are so many different areas to cover. So I’m grateful that there are different voices out there. There are doctors voices out there that there are advocates voices out there, that there are real women that are talking about their experiences out there. And, you know, we’re seeing bit by bit different employers talking as well. So it’s not just a conversation, but it’s people hitting different areas of this because I think that’s the only way to tackle it. So in 20 years, we’re not in the same place again, just having the conversation.

Dr Louise Newson: [00:24:58] Yeah, for sure. And I think certainly I’ve got three teenage children, three daughters and they’re quite vocal, but they’re really vocal talking to others who are older as well. And just those conversations, sometimes it’s usually in the toilets where they overhear someone talking and then they say, oh, I don’t want to flex about my mum, but I think you should download her app, have you heard of balance? And they’re just and it’s just that starting that conversation, yes, it is brilliant because they all say they’re really more aware of PMS, PMDD. You know, I just think they’ll be on it so quickly that they’re not going to allow each other to suffer in the same way, you know, just the stories I hear of women who are finding sex so uncomfortable or they’ve got no libido at all, but they don’t talk to their partners because they feel so embarrassed, they feel so alone. They think it’s just them. Whereas I think the next generation, of course, they’ll be talking a lot more openly and then they can support each other in ways that perhaps we haven’t done over the last 20 years or so and only just doing now more virtually, like you say, through social media, but we need to have the conversations even closer. So it’s usually our friends or our relatives that will be persuading us to get help and treatment because that’s so important, isn’t it?

Tamsen Fadal: [00:26:12] I think so too. And you know, the other area that this is maybe down the line or maybe it just goes along with all of it is educating the men in our lives, too. It’s funny, my 11-year-old nephew asked his mom recently, they’re on Instagram at an early age. He said, what is aunt Tamsen talking about this menopause all the time? He’s 11. And she said, well, women go through hormonal changes just like you do because he’s, you know, he’s 11 turning 12. And then my 83-year-old father asked too, this menopause you’re talking about. I didn’t know you could go through it so early. And I said, Dad, I’m 52, it’s not early. I said, you know, it started before, you know what, 47, 48 years old. And he said, I knew nothing about this when your mom was going through breast cancer. And that made me so sad because I realise that this is something that women have lived with by themselves for a very, very long time. And so to hear on one end of the spectrum, an 11 year old, on the other end of the spectrum, an 83 year old man, I thought, okay, well, at least the word’s definitely getting out there somehow. People that are in our lives that might see things in us that we might not see in ourselves and might help us encourage us to seek help. And I think that’s important, too.

Dr Louise Newson: [00:27:16] Absolutely. So many partners, male and female partner, get really quite worried and they don’t know how to have or they don’t want to offend. And once the conversation starts they’re so relieved because they know it’s one or the other, especially if their relationship is affected or if it’s their parent. Oh, okay. There’s a reason. So once you’ve worked out the reason, then you can work out what to do.

Tamsen Fadal: [00:27:40] I couldn’t agree with you more. I’m so grateful for, you know, voices like yours that are willing to spend their time. I mean, I know when you’re seeing patients all the time and you’ve got so much going on, but you’re willing to spend your other time talking about this because I think that that’s the only way to educate and to help provide solutions to because somebody like me, I can’t necessarily provide solutions. I can provide guidance, but it’s encouraging to see that and it’s encouraging to be able to do it across the world, because I think that that’s the only way it’s going to happen faster.

Dr Louise Newson: [00:28:11] Absolutely. It’s really good. I mean, I’m so grateful for your time and I’m really grateful for all the work that you do. And I flick on to you on Instagram and see your lovely face imparting messages. And I think the more people hear from different people, the better as well. So it’s great to be able to join forces. So before we finish, I always ask for three take home tips. So I’d really like three things that you think women, wherever they are, whether they’re in the UK, USA. What are the three main things that you really want people to do to take this conversation further and make a difference?

Tamsen Fadal: [00:28:43] Yeah, absolutely. First, listen to yourself and listen to your body and don’t push things off and say it’s just anxiety because the kids or it’s just because I’m stressed out at work. Like really listen to yourself because I think that perimenopause is confusing. It’s a cloudy time, and it’s a time where we can make excuses for some of those symptoms. And that’s not always the case. Oftentimes, it’s exactly what it is as we’re going through this transition. So listen to that. Two, if there’s any way to find some quiet time on your calendar, I found that is critical for me. There’s a lot of noise out there. We’re all creating it. We’re all absorbing it. But I think that that quiet time is essential, especially in this period. And I think third is to find a community around you that will support you through this. And so if you don’t have the answers to something because we don’t all have the answers, maybe somebody in your life does. I mean, those are really my three takeaways that have helped grow me and make me feel confident into moving into this next chapter.

Dr Louise Newson: [00:29:36] Great. Love it. So thank you ever so much. We can all learn from that whether we’re menopausal or not, really good tips as well. Thanks ever so much for your time. It’s been great.

Tamsen Fadal: [00:29:46] Oh, it’s wonderful. Take care.

Dr Louise Newson: [00:29:52] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk. And you can download the free balance app on the App Store or Google Play.

END

The post Tamsen Fadal: Speaking out about the menopause appeared first on Balance Menopause & Hormones.

Podcaster, author and journalist Lorraine Candy returns to the podcast this week to talk about thriving in midlife and the importance of sharing menopause knowledge and spreading awareness.

Lorraine is co-host of the popular podcast series Postcards from Midlife, which often looks at the Generation X experience of the perimenopause and menopause. In this episode, she joins Dr Louise to discuss her new book What’s Wrong With Me? 101 Things Midlife Women Need to Know, which is a compelling and reassuring account of how to live a magnificent midlife. The book draws on many women’s experiences to look at the emotional side of midlife and how our identity as women can change during this time.

 Lorraine shares three reasons you should buy her new book:

1. It will make you laugh – which is always important.

2. It is packed full of expert advice that can support you to change your life in midlife.

3. Find out more about the emotional changes and impact of midlife, looking at how your identity can change in your 40s and 50s.

Click here for more details on Lorraine’s new book. You can access the Podcasts from Midlife podcast here and follow her on Twitter and Instagram.

Transcript

Dr Louise Newson: [00:00:09] Hello, I’m Dr Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the Menopause Charity and the menopause support app called balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. Today on the podcast, I’ve got someone back for the second time actually, Lorraine Candy, who I’ve known for a few years now, and the work she’s done vocally and behind the scenes to help more menopausal women be empowered with information has been very phenomenal and exciting. So welcome, Lorraine, today to the podcast.

Lorraine Candy: [00:01:05] Oh, it’s lovely to be back. I love talking to you about this because I think it’s always helpful, isn’t it, for people.

Dr Louise Newson: [00:01:10] Course it is. So you do your own podcast and I know when I’m on other people’s podcasts, it’s a bit weird being on the other side of the fence, almost, isn’t it?

Lorraine Candy: [00:01:18] It is, yeah, it is. But I am sort of on a book tour, so I’m kind of in that mode at the moment.

Dr Louise Newson: [00:01:25] Yes.

Lorraine Candy: [00:01:26] I mean, just don’t let me interview you. That’s the main thing.

Dr Louise Newson: [00:01:29] Yes. Well, I’ll talk about your book in a bit. Your new book that’s just come out, what’s Wrong With Me? But before that, you’ve not always been an author and a podcast person have you?

Lorraine Candy: [00:01:42] No.

Dr Louise Newson: [00:01:42] Just, I’m really keen to hear how you got into what you’re doing. And I know with lots of things, including myself, it’s your own experiences that shape what you do, and I think that’s probably a bit sexist, maybe, maybe more for women as well. Actually, I could not do the work I’m doing if I wasn’t a menopausal woman who struggled to get help. And you probably, I don’t think you could write your books if you never had children. Well, you might have done, but they wouldn’t be nearly as good. So tell me a bit about how you’ve come to doing what you do.

Lorraine Candy: [00:02:11] Well, just in context of my background. So I grew up in a very small village in Cornwall, went to a local comprehensive, always wanted to edit magazines and be a journalist, spent my life in the library, basically, the local library. I won a writing award when I was 16 and doing my GCSEs, about to do my A-levels, and that got me a little bit of work experience on the local paper. So I went and did some work experience over the summer on The Cornish Times, and I just thought, you know, I’m not academically gifted. What’s the point of doing A-levels? I might as well take this job and then I’ll be able to get on a paper in London. And I came up to London the following year when I was 17. So I then worked as a journalist and I worked on the Sun, The Times. I was features editor on The Times and the Daily Mirror and a newspaper called Today, and I kind of learnt my skills as a journalist then, and that’s where I learnt to write. But my main interest was women’s stories and, you know, telling women’s stories. And when I started I did a lot of stuff around, I interviewed the first woman who took her husband to court for marital rape. I interviewed one of the women whose imprisonment after she killed her husband after years of domestic violence, it was awful, Sara Thornton. And I interviewed her in prison and we did a campaign that changed laws. So all through the beginning of my journalism, it’s always been about women’s stories. And then I moved on to edit Cosmo and also Elle, where I stayed for 12 years and then Sunday Times Style. So throughout that whole time, my writing really has been very focused on women and obviously when you edit a magazine, you have a community of women around you who come with you and grow up with you. So I’ve had a huge community of Gen-X women basically, and when I hit perimenopause… well, two things happened when I hit my mid-40s and my children became teenagers, I thought, this is really unusual why are teenagers so awful and what can possibly be going on? I better find out. And obviously, you know, what is going on is their brain is being taken apart and put back together again. They are full of hormones and all sorts of things are happening. So I wrote a parenting book on why you shouldn’t be ambushed by this. And there are some very small, simple, easy ways of parenting that will make everyone’s life easier. Tried to make it funny. And at the same time, I was also going through what I found out was perimenopause. So I thought, I don’t understand why I’m ambushed by this when I’ve been writing, you know, probably specialising in health, mental health as a journalist. And I had not heard the term and I just couldn’t see how it could be fair of me not to put that into a book. And at the same time, I was chatting to a friend of mine, Trish Halpin, who edited Marie Claire, Red and InStyle, and we’d known each other 25 years and we were going through exactly the same thing, exchanging Whatsapps on our… Did we have a brain tumour? Perhaps we had dementia. Maybe these palpitations were to do with heart disease, maybe we had all these things, but neither of us knew that we were going through the perimenopause. So once we found that out, we thought, well, why don’t we do this new podcasting thing that everyone’s doing? Because it’s something to chat, that’s easier to chat about. And also I couldn’t, as I said to you at the time, I couldn’t get any stories in the papers about menopause and perimenopause, editors just didn’t want to read it. They were very against it. So we set up Postcards from Midlife because we thought it’s, you know, midlife is about more than just menopause and perimenopause. It’s really a hugely transformational stage of life. And there’s so much change. We’ll just talk to all the experts. And we sort of rang all our friends, kind of celebrities we dealt with. And women were desperate to come and talk about this stage of life. They’d never been asked about it. You know, we didn’t have to say, you’re going to have to talk about perimenopause and menopause. We said, can you come on and talk about, you know, getting into your 40s and 50s? And they said, brilliant. And we were getting so many new stories and we realised they just hadn’t been asked about this stage of life. Women were kind of invisible. So that’s kind of the context of where I sit now. Podcasting and authoring.

Dr Louise Newson: [00:05:57] It’s very interesting, isn’t it? And I mean, I never understood because I was never taught the psychological impact of menopause, but I was also never taught how hard it was to have teenage children. And you’re absolutely right, when it’s all happening together as women, this is a generalisation, of course, but certainly my personality is I blame myself if things aren’t right. I don’t look at others and think maybe it’s them, it’s like, well, my daughter’s shouting at me, that’s my fault, I’m a bad mother. Rather than actually there’s things going on with her.

Lorraine Candy: [00:06:27] I think that was the overwhelming thing, this shame. This is why the previous generation, I can only conclude, this is why the previous generation haven’t talked to us about it because they feel a bit ashamed. So you slightly lose your confidence and then you feel ashamed of the things that you’re going through. Have you looked after your parents well enough now they are beginning to get ill? Is the whole family getting on? Is, are you a good enough parent? You must not be because you’ve created this terrible person. But that’s just what teenagers are like.

Dr Louise Newson: [00:06:56] Well, I think so. And your book, Mum, What’s Wrong With You? was amazing because actually I remember you’ve got a thing about, it’s all about choosing your battles, isn’t it? You know, you were saying about piercings and tattoos and at the time I read it, my children only had the conventional two piercings and no tattoos. Moving forwards a few years, especially my older daughter’s got quite a few tattoos, and both of them have got certainly more than two piercings. And I’m actually really relaxed about it, and it’s probably partly thanks to you Lorraine, because I thought actually the bigger picture, does it matter? Their expressing themselves, it’s their choice. So I have to say to my 18 year old, I have no control over you. I hope I’ve given you morals and values that you can pull on, but it’s up to you what you do. Of course it is. And it’s having that ability, but you have to have a lot of mental strength to do that and you have to have a lot of ability to still be in control from afar. But it’s all mind games, a lot of this. But if your mind isn’t working properly, usually affected by not having hormones, it’s really difficult. Women then set themselves up to fail. And I think also this whole invisibility, some of you might have heard the podcast I’ve done with Joanne Harris, and how society wants people to be invisible. And I think what you’re doing and what I’m doing, what others are doing are allowing women to have a voice. And there’s all this thing, isn’t there? It’s very, even again, a generalisation, journalists are quite paternalistic. They’ll tell you what they think the audience want to hear. So I remember when we first met face to face, you were writing this article for the Sunday Times Style magazine, and you almost had to get it in in a different way.

Lorraine Candy: [00:08:32] I put it in the Trojan horse of the spa special.

Dr Louise Newson: [00:08:35] Yes. And we don’t want to upset our readers, but actually women are desperate to be unlocked and to have this platform where, you know, it’s almost that the celebrities don’t want to show that they’re being old. But actually others want to know how, even if you’ve got all the money and all the fame and all everything else, you can still struggle. And this is what’s helped you. And I think that’s with your podcast has really helped, isn’t it? You’re having quite high profile people having normal stories, which really helps, doesn’t it, when you’re a normal person with the same problems.

Lorraine Candy: [00:09:10] We all go through the same you know, we all go through some form of changes at this stage in life. We all lose our collagen and our muscle mass, and so we’re all experiencing it. But you do need role models culturally in order to see that it’s not something that’s happening to you alone. And actually, until the last five years, there have been no cultural role models. I mean, Joanne Harris’ book actually, because the protagonist is a menopausal woman, isn’t she? So they haven’t been in books. They haven’t been on TV. You know, we had Juliet Stevenson, the actress on the podcast, and she said that for ages she just couldn’t tell people her age, not because she didn’t want to, because she was grateful to be ageing and, you know, not be ill. The alternative is so awful to not ageing. But she said she couldn’t because it limited everything she would have done. And actually she said her last four roles, one of whom she’d won an award for in theatre, had been the best roles of her life and she’d done the most amazing work. And to take that away from women, as has been the case, you know, to only see older men able to marry younger women on screen. In the big blockbusters to only see Marvel heroes who are under 40, unless they’re male, is quite extraordinary. But now that is changing. I mean, it’s slightly slower than we would hope, but it is changing. And women are in better positions of power to change that. But they know what they’re talking about as well. So I think that’s the interesting thing. When you’ve got older women talking about menopause and perimenopause, that’s really, really helpful. And it also helps men shape the conversation as well. As we know this country is a patriarchy and the men are in the positions of power in most industries they are on the board level in a way that women aren’t, in much bigger numbers. So they need to know about it, so they need to see it as well.

Dr Louise Newson: [00:10:54] I think it’s so important and I think one of the things that’s certainly causing a lot of unrest certainly in the medical establishment with some of my work is because women patients are having information that they’ve never had before. So I was in a meeting this morning, actually, and someone was saying they really worry, these GPs – we’ve just done some research with balance how it can help the GP consultation – and it’s shown that it can really help and be very beneficial. But some of the GP’s are saying, well, we’re really worried that women are self-diagnosing and they might miss other diseases. So for example, if someone has palpitations, everybody should be referred to a cardiologist, have their heart checked before considering the menopause. Or everybody with memory problems should have a brain scan to make sure they’ve not got a brain tumour. And it’s like, no, hang on, let women decide actually, because a lot of women know when they’ve been given the information. And of course some people might have a brain tumour, of course some people might have heart problems, but we can still think about the menopause as well and we can still self-diagnose and we can still actually have treatment whether we need more investigations or not. And certainly for palpitations, if I referred everybody with palpitations to a cardiologist, the system would be flooded. But even if I did, just because some people obviously do still need to be referred, but they started treatment at the same time. Most people’s palpitations melt away, by the time they’ve got their appointment through. So we can work together. And I think with the menopause it’s always gone the other way that it’s sort of them and us and it’s causing this big divide actually with women sometimes, but also with with medical professionals because they see the menopause as a bit of a lifestyle problem. But actually we can work together so patients can, and women, can actually enable the conversation to get treatment earlier, but also look at their whole future health and lifestyle as well. And now it’s not just about do I just go and get a prescription, It’s actually where do I start my conversation to relook at my diet, my exercise, the way that I talk to my husband every night when he comes in from work, the way I manage my children, if they’re difficult and piecing all that together is actually a huge thing. And I think one of the things that with the podcast, with the work you’re doing is enabling people to have a bit of time for themselves, actually, isn’t it?

Lorraine Candy: [00:13:17] Well, so, you know, the thing I, with the new book, I interviewed lots and lots of women, obviously I interviewed you, around the more mental health aspects of it. So once you’ve got your HRT, there is still a lot going on in midlife. You know, it’s not as you say, it’s not just physical. And I just think women needed the language to know that. Actually, as one of the therapists we had, I talked to Julia Samuel, who said there is a softening that needs to occur. Gen-X women are very bad at it. We have a real endurance mindset. We have this do it all, have it all, you know, must be home, must be at work, must do this, must do that mindset generally. But we get to this stage and all women just need to soften slightly, be more vulnerable so they can ask for help because you really can’t do it on your own. And actually the help that you get is generally from other women. That kind of connection to other women in a similar situation. I’ve made an awful lot of new friends in midlife of women who are going through a similar thing. I do a lot of swimming, I meet them sort of by lakes and rivers and seas and things, and we have a shared identity and it’s really helpful that they have bits of knowledge I don’t have, but I only get that if I soften towards them and if I’m slightly more open and vulnerable. And I hadn’t really thought of that as part of the jigsaw. And I do really think it is part of the jigsaw because it’s not, you know, you’re not going from a to b in midlife. It’s so much more squiggly and you can’t see the road ahead. I interviewed an amazing woman for the book anonymously who shared a phenomenal story, and she was saying that she just for ages, you can see round the corner or you can see up ahead of you and then suddenly you just can’t see anything. You’re just hitting a wall and you don’t know what the next bit might be. You don’t know whether you’re going to be in the same marriage. You don’t know if you’re going to live in the same country. You suddenly become such a giant change and you have nothing to see ahead of you. So unless you soften and get more vulnerable, it’s going to be a little harder to navigate it.

Dr Louise Newson: [00:15:11] I think so. And it’s having the flexibility, isn’t it, because there’s so much more that’s out of your control or there certainly is in my life. You know, I think I’ve just sorted this out perfect. And then suddenly my daughter phones me and there’s a problem. All right. Okay. You go from one thing to another and you have to pivot quite quickly when you’ve got children and other issues.

Lorraine Candy: [00:15:32] You do, it just feels, and they’re not small problems. You know, when they were toddlers and you might have to go and pick them up from school because they had a rash, and these are…

Dr Louise Newson: [00:15:40] Oh, wasn’t that easy [laughs].

Lorraine Candy: [00:15:41] Massive things, you know, and people are dying as well around you. I mean, we lose people at this stage of life. So we may be dealing with grief for the first time. We are watching some of our friends leaving marriages. We are watching our friends being made redundant. And all of this is happening and it catches you unawares. And I don’t think we talk enough about it. And we we don’t want to portray it as a frightening, terrible time for women. We just want to say, you know, all these things may happen. So, you know, get your head around it, get the language around it, get the support you need, and then you can be in a better place. Because in in midlife, actually, I’m the most confident, happy, calmest, healthiest I’ve ever been. [00:16:20][38.9]

Dr Louise Newson: [00:16:21] And I think so. But I think you also have to be because you’re dealing with so much more than you were before. So your new book, What’s Wrong With Me, is very powerful and it does address so many more things, which I think having tools to cope with more because more is fired at us, as we’ve already said, is really useful, isn’t it? So why did you decide to write the book then, Lorraine?

Lorraine Candy: [00:16:43] Well, we’ve done, I think, 120 interviews or something of women and experts on the podcast and all that information was there. And I thought, I better share that. We should share that. And I didn’t want to do the kind of, you know, you’ve written the most brilliant medical helpful book on, you know, physically and mentally, what’s going on. And I just thought it would be worth just pulling stories together, other women’s stories together. So, you know, the main drive for me was I just didn’t want anyone to feel alone. And I think that’s the we know that’s the saddest, most lost, but, you know, you can be surrounded by family but still feel terribly alone in midlife. And I think we had spoken to so many women on the podcast, and we have a private Facebook group who told us really, really sad stories and they felt so lonely. And I thought, well, let’s just put it all together in a place so that there is, you know, you can dip in and dip out. And it’s a bit funny in places, but you’ll get this sense that it’s not you going mad and that you’re not alone, that there’s a massive army of women going through it with you, which, you know, it’s a little bit like childbirth, isn’t it? I always remember when I was breastfeeding in the middle of the night and at my wits end because it didn’t, for my first two, it didn’t really work very well. And I remember being up in the night thinking, at least I’m not on my own. I know millions of women are doing this across the world and there was so much information out there for me and I could join a baby group or I could go and meet a woman who’d had a baby on the same day that I had had the same problems with me. It was so accessible. But when I was waking up in the middle of the night, covered in sweat with night terrors, I thought I was going mad. I was completely on my own. I thought, this is yeah, you know, I have some form of psychosis. As it turns out, there’s an army of women waking up in the night with night terrors until they get their HRT. So, you know, we’re not alone. And I think that was my main thing for the book, that you don’t have to feel like you’re alone. There is a language out there that you can use, there is information out there and other women. Almost every woman over 40 is going through it with you. So that was the driver for me. I can’t say I enjoyed the process very much. I’m not good at writing books. I hate being trapped in a room for a long time. And I think the ladies at Swiss Cottage Library were quite glad to see the back of me after a while.

Dr Louise Newson: [00:18:54] So it’s no mean feat. Writing a book is it, it is hard. I don’t know if you, every time you reread a draft, you think, now I want to change it, I want to change it. And there’s always things that you can perfect and improve and wish you had done. And but then it’s here. You must be very proud of it.

Lorraine Candy: [00:19:09] I was really proud. We had the launch and a little party last night at Daunt’s books in Marylebone, and it’s a really lovely bookshop that I’ve spent a lot of time in over the years. It’s a little cult bookshop and to see your own book in the window is just quite a wonderful thing, especially for someone you know, because I was not academically great at school and there were not high hopes for me to get to university. So to actually think that maybe, you know, I never thought one day I’d be able to write a book and, you know, it’s here, it lives forever. You make a stamp on history, I’m part of a big conversation that women are having at the minute. So it was, I was actually really proud. I took one of my daughters, but she went halfway through because she said, I need to bounce, it’s boring in here, she said, But, you know, I think it’s so lovely for them to see that you don’t have, there is a different route to things in life as well that you don’t…. the jobs I’ve done haven’t been reliant on me having a degree or being uber-educated or, you know – it’s just being a journalist is being curious. And I feel I was curious enough to find out more from other women, put it all in a book, and now it lives. And the cover of the book, it really did pull midlife women together, so the cover of the book is designed by an illustrator from The New York Times. She’s Amrita Marino, she’s amazing. And I had to have a chat with her about it for her to design it. She’s a big colourful illustrator and then managed to get her to go and see a GP in New York about HRT. She won’t mind me saying she wanted to, she needed, there’s very little information in the States in the way that there is here. So I sort of feel like everywhere anyone involved, you know, my editor, Louise, who edited the first book with me, is a woman in her fifties as well. And, you know, we bonded over everything I talk about in the book. So it feels like it was put together by friends for friends. And I made friends doing it. So, you know, it feels like a very lovely thing to put out in the world.

Dr Louise Newson: [00:21:10] Yeah, it’s amazing, isn’t it? When I when my book came out, Yellow Kite’s my publisher, and I went and did a presentation to them about the menopause, and there were, I don’t know, 100 or so people in the room. And then they did it on Teams as well. And I thought everyone must know about it because it’s my book, they must have prepared, and still the questions asked and the tears in the audience, because it’s that realisation that it’s you, it’s always there. And it’s, I think, the more I work, the more I try and amplify my voice, but the more I realise there are lots of people that we’re not reaching.

Lorraine Candy: [00:21:43] Well, I spoke to a woman on Monday night. I did an event on Monday night with Christie Watson who wrote Quilt On Fire, which is about her midlife experience. She’s ten years younger. And a lady came up to me at the end. She said she works for a big city bank. How could I advise her to stop the men in her office making fun of her when she had hot flushes? And I thought, Oh, I’ve been talking about this now for, you know we, Trish and I, go and talk to corporations and I said, that is still happening? She said, oh yeah, well, they’ll open a window and say, oh, we’re doing this for so-and-so because she’s, look at her, she’s flushing away over there. She said, they mock me and make fun of me. And she said, they do it in a kind of as if they’re being friendly and including me. In their minds, she said, they think they’re being helpful talking about the menopause. And it’s really unkind. And I think it’s just…they’re not being helpful, but they’re not being malicious. They’re being ignorant. And as you said, to still be hearing that from women, you know, for years we’ve been going around talking about it. I was quite surprised that, you know, just two days ago someone said, the men in my office are making fun of me for having hot flushes. What do I say to them? I mean, you know it’s not good.

Dr Louise Newson: [00:22:48] And it happens all the time, doesn’t it? You know, the NICE menopause guidance came out seven years ago, you know. Yesterday, I saw someone in the clinic the who told me their GP said, you’ve just got to get through it. There isn’t any treatment. So the impact that it’s having is still we’ve got to amplify, and I think, you know, the work that people are doing in different ways is really important, but it’s allowing people to have what’s right for them. I think now it’s become so toxic in some areas that it’s always like, well, all Louise does is push HRT. Well, actually, no, I’m not. I’m just allowing women to have a choice. And that’s really important. And it’s the same with, you know, your work, the books, everything is. You can choose to read the book. You can choose to listen to any podcast. We’re not ramming it down people’s throats. But actually what we are realising is that we’re, it’s like picking up a stone and seeing everything underneath and then you pick up more and more and you realise that we’re, we’re just opening something that’s not been allowed to be open before and it’s actually very liberating, but I spend time feeling I’m quite naughty doing what I’m doing, but it’s quite liberating as well for those people that we can reach. And last weekend, you very kindly invited me to be part of this most amazing conference. Well, conference? Not really a conference, an event.

Lorraine Candy: [00:24:01] Festival I think we called it in the end.

Dr Louise Newson: [00:24:03] Festival, it was a festival. Which was really interesting to be there witnessing. Obviously, you had, what, 80 speakers. I mean, this is your first event.

Lorraine Candy: [00:24:13] We had 95 speakers, yeah. The first big midlife event for midlife women. [00:24:18][5.1]

Dr Louise Newson: [00:24:18] Yeah. So most people, when they do their first event, they wouldn’t call it a festival at first and it will be something quite small, that you do. But you just suddenly decided to do like the biggest event ever. So 95 speakers. How many people came? About 2,000?

Lorraine Candy: [00:24:34] We’re still doing a what they call a mop up on it this week, more than 2,000, I think. Yeah. So it was a ticketed thing with, you know, different rooms and, you know, we kind of hoped that women would want to go to everything and it was hard to programme it. But, you know, we would have a room full of 300, 400 people when we were interviewing. But the other rooms were careers, parenting, and there’s so much thirst out there for knowledge about this stage of life and people just aren’t talking about it. They tend to talk about it in terms of career or the crisis that people go through. But it isn’t really a crisis, is it? It’s an opportunity. And it’s good to know everything.

Dr Louise Newson: [00:25:12] Yeah. And I felt that there was this opportunity because there was this opportunity to do a bit of shopping. I was looking at the people doing face massages and I thought I would love to be there, but so many people kept recognising me I just had to keep going, hiding. But it was a real joyous occasion actually. And I felt that sometimes you go to these events and you’re all in your own little cocoon and you’re doing your own thing, but everyone was looking around and smiling and sharing and you know, it was as if they were friends coming together. And that’s the community that you and Trish have magically created. And you must have been so proud of how it went, because it really was spectacular.

Lorraine Candy: [00:25:49] We were immensely proud, actually, because almost everyone we talked to was very tearful by the end of the conversation, they were tearful because they, you know, if we hadn’t listened to you, we wouldn’t have seen our GPs. We wouldn’t be on HRT. We had a woman who said she would have left her, I mean, you’ve heard these stories again and again. I would have left my marriage. I would have left my job. We met two firefighters, female firefighters who came to find us to tell us that I think its Staffordshire Fire Service had paid for them to go to the festival because they wanted to get some information on how to talk to women about what they were going…and they wanted these two members of the team to be experts on it. So could they go and get…and I thought that is kind of incredibly amazing, actually, that, you know, this has become part of the conversation in a very practical way. And we had, we met some women from the Facebook group as well, actually, who are very interactive. And we have some experts on the group who are tagged and they help out where they can. And they were all saying the same things. We’ve come with our friends. This is just so lovely. We had a woman come from Norway who came on her own and she’d put on the Facebook group, please will someone come and chat to me because I’ll sit in the cafe and I’ve come all this way on my own. It’s my first holiday that I’ve had on my own, but I’ve been through a horrific menopause. I’d quite like to meet other women and honestly, to see them all back up around her and say, Yeah, I will meet you at 10 o’ clock, you can come to this talk with me. It was a real sort of gathering of stylish, like-minded Gen-X, mostly Gen X, I thought there were quite a few younger women actually, women who just really wanted to support each other, get information and just get on with living their best lives. It felt really powerful, but also very teary. And I’m sure you, you had the balance team there, and I know when I talked to them, they said they’d had lots of women in tears about what was going on and how they were dealing with.

Dr Louise Newson: [00:27:35] Well, yeah, especially when we did the, you were interviewing me, and then afterwards we both said, go to the balance lounge. And I had a couple of doctors there and they were completely swamped. But it’s a two way thing. I think there’s a real mixture. There’s those women who are so grateful, and I hear it a lot from women with the utmost respect, saying, you know, you’ve saved my life, you’ve saved my marriage, you’ve saved my job, and not, some of them are patients, but a lot of them it’s just because they’ve got the realisation and they’ve gone and got the treatment they want. But then there’s, there’s others who you can tell by looking at them they are absolutely, almost distraught because they’re realising what’s happened to them. It’s that lightbulb moment and it’s that fear and panic and desperation. How am I going to get help? I can’t get help. And I, it’s almost like a form of torture, that is happening for some women because they they know what’s going on, they really know what treatment they want and they can’t get it. And those are the people that are still there. And obviously a lot of the work we’re doing is trying to help give them a voice, give them confidence so they’re not alone so they can become better advocates, so they can go see the right healthcare professional to get the treatment that they want.

Lorraine Candy: [00:28:44] Yeah, I mean, I think that’s the key. You can say to you, you need HRT or you need to do this, that whatever your lifestyle changes, but you’ve still got to find the right doctor. You’ve got to take someone with you. You’ve got to take in a list of your symptoms because the chances are you’re not going to get the right dose or the right information. It’s a shame. I know most GPs are really trying their hardest, but there’s a whole chunk of GP’s who are not trying their hardest. You’ve got to be strong enough to say, I don’t want antidepressants, you’ve really got to know. And we know for years, don’t we, that women have gone in to have things like smear tests and other things that are phenomenally painful and we’ve just put up with that. We’ve been told that’s how women should be treated. So I think you have to be quite brave. You’ve then got to navigate getting your prescription and only paying for it once. You’ve got to get that all sorted as well. You’ve got to navigate going back after three months, you’ve got to… it’s harder than just getting the help. We and you can see that sort of confusion and desperation in people’s faces, can’t you, sometimes when they say, I just don’t know what to do. And then, you know, they’ve got to find out about testosterone, then they’ve got to find out about the shortages and where they can and cannot get things. So it still feels like a bit of an upward battle. While we know the words and the language and the information we’re still struggling to get it, I think. I spoke to a woman on Monday night at an event, and when I explained why that misleading survey 21 years ago, her mouth just dropped open and she said, I can’t, I can’t believe that. What you mean, I could have been – she was in her 70s – and she said so I could have taken HRT? So I would have been okay? I went through the most awful time and I could have been. I said, yeah, you, you could, you could. And it’s terrible, isn’t it?

Dr Louise Newson: [00:30:26] It is awful. It’s absolute.So we need to change it for not just for our generation, but for future generations as well. So very grateful for your time today. And before you go, three take home tips, of course. So I’d just like three reasons why people listening should go and buy your book.

Lorraine Candy: [00:30:43] Right. Well, the first reason, it will make you laugh, which I think is like the main thing we need to, you know, because we do tend to humour in midlife. The second reason is if there’s an expert, a leading expert, I’ve interviewed them, so the information is there, so the language is there for you to use if you want to change your life. And a third reason is this book is about the emotional side of midlife. So you’ll get the practical information, but you’ll also get what’s going on with you inside. And it’s about forming your own identity. And we don’t talk about that enough. But the identity of women as they change as they go through this very powerful part of life is really important and you don’t want to get it wrong, you don’t want to make mistakes. And you will read stories of other women who’ve gone through it. So you’ll be able to see if what they experience will be helpful to you. I hope that helps.

Dr Louise Newson: [00:31:34] Very good. So it is available on Amazon. All good bookshops, including Daunt’s, my favourite bookshop in the world. So thanks ever so much. And keep going with your work, you and Trish. It’s brilliant. Phenomenal duo. So thanks very much, Lorraine.

Lorraine Candy: [00:31:44] Thank you, Louise. Thank you for leading the revolution.

Dr Louise Newson: [00:31:47] Thank you. For more information about the perimenopause and menopause, please visit my website www.balance-menopause.com. Or you can download the free balance app, which is available to download from the App Store or from Google Play.

END

The post Lorraine Candy: how to make your midlife magnificent appeared first on Balance Menopause & Hormones.

This episode looks at how hormone changes impact women in the workplace and in their personal lives – and why do many women put their own needs last?

Dr Louise is joined by Dr Claire Kaye, an executive career coach and former GP specialising in perimenopause and menopause in the workplace. Dr Claire explains how career coaching can help bring about clarity and focus, particularly when you’re dealing with physical and psychological symptoms during the perimenopause and menopause.

And both Dr Claire and Dr Louise offer advice on how to navigate these changes and overcome negative emotions to prioritise your own health and wellbeing.

Dr Claire’s top three tips for building self-esteem:

1. Recognise what it is that you’re feeling, take a few minutes to work out what it is that’s an issue for you at the time and label it
2. Ask yourself ‘what might help here?’ or ‘who might help here?’
3. Pick one really simple thing that will help and feels really comfortable: and do it.

You can follow Dr Claire on Instagram @drclairekayecoaching, LinkedIn @drclairekaye or visit her website here.

Transcript

Dr Louise Newson: [00:00:09] Hello, I’m Dr Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of the Menopause Charity and the menopause support app called balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. So today on the podcast, I want to welcome you Dr Claire Kaye, who I’ve been emailing for a while and like many of my guests, have never met in real life, but I’m meeting on the screen for the first time today. And like me, she’s a GP, but like me, she’s not a GP anymore. So I’m going to hear a bit about what she does and let’s see where the conversation goes. So. Hi, Claire, Welcome today.

Dr Claire Kaye: [00:01:07] Hi, thanks for having me.

Dr Louise Newson: [00:01:09] So you trained as a general practitioner?

Dr Claire Kaye: [00:01:11] Yes. So I was a doctor for about nearly 20 years and I was a GP and I did, as you would imagine, lots of women’s health and I did also lots of mental health. But I particularly had a special interest as well around frailty. So a lot of what I was doing was talking to people and spending time with people. And I really found that after a period of time that I was starting to develop this sort of sense of really enjoying the consultation and spending time with people. And I realised that actually that for me was one of the big things I got a lot of enjoyment, motivation from. So I gave up clinical medicine about five years ago, maybe a bit more, and I became a qualified executive career coach and I specialise in career development and also perimenopause and menopause in the workplace. So helping women to thrive in the workplace during that period in their life.

Dr Louise Newson: [00:02:04] It’s really interesting, isn’t it? And I don’t know about you. I’m sure I’m older than you, but when I was at medical school in the eighties and nineties, I didn’t get any training about the consultation. It was all well, the preclinical obviously was about the pathology, the biochemistry, the physiology, and then it was all about disease and pattern recognition and trying to work out what the disease process was. And we never really got taufght much about how to talk to patients. And you get on this conveyor belt sometimes and you think about the patient as a disease rather than the person who has a disease that’s affecting them. And each disease affects people in different ways. Did you get much training when you were younger?

Dr Claire Kaye: [00:02:46] Well, I was really lucky because when I was a GP trainee and I think actually this is probably shaped the bulk of my career, I had a trainer who had been trained herself by John Launer from the Maudsley [Hospital], and he had basically created this consultation model, which is like a way of talking to people, which basically puts people in their story. So rather than just being somebody’s cough or somebody’s sore throat, you would be looking at the whole person to try and get to know them, but also to understand what that meant to them having a cough or a sore throat and the implications of that. So from a very early stage in my career, I was really learning to talk to people in a different way, which I think, as you say, is quite unusual. And that for me just gave me huge amounts of satisfaction and joy.

Dr Louise Newson: [00:03:30] It’s really interesting, isn’t it? So I because I did hospital medicine for many years before changing into general practice, I sort of got into my ways, which is a bad thing to do. And then I had a very inspirational trainer like it sounds you did, John Sanders, who was just brilliant, but he made me play with a consultation. And you know, for example, if you see someone with a sore throat, it’s quite, oh right they either need antibiotics or they don’t. And I remember once there was this young lad who came one day and he had a sore throat and I thought, Oh come on, you know, what are you doing coming to see me? But I thought, no, I’ve got to listen to John. So I just pushed the consultation round or changed it and said, Oh, could you just let me know why have you come today? And I thought he might say, Oh, because the only time I could make an appointment. But then he started to look down, no eye contact, and said, It’s because my mother is in intensive care. And I’ve been told that if it’s a bacterial infection, I can’t see her and I really want to see her because she’s so poorly. And I just thought, Oh my goodness me, Louise, if you hadn’t have asked that question, you could have just dismissed him. And it’s the more you probe in the right way, the more you get back as well from people. And I think one of the things medicine does do is give you confidence to ask maybe quite awkward questions that you maybe wouldn’t. And I sometimes get in trouble with my friends because I’m quite direct and I will ask questions. But, you know, I think not to be scared to ask and to change a consultation. I think what I really enjoyed in general practice was to be able to play with the consultations and if you’ve got more energy, you can really do it and you can really, really chat. And then you get to know people in a different level and then they open up to you more. And then, you know, I’ve had so many women who have been scared because they’ve had some irregular bleeding and it would be very easy to just fill out that form and get them sent off. But then when you say, well, why are you worried? Well, my granny and my mother had ovarian cancer. Well, sometimes they’ll tell you something completely different, and it’s a reason for them just coming in to see you. And the bleeding is actually nothing of any consequence when you’ve taken a proper medical history, but you realise they’re more worried about something else. And it’s a real. privilege, isn’t it, when you can talk to people in the right way?

Dr Claire Kaye: [00:05:47] Yeah, definitely. And it’s really interesting what you’re saying about asking the right questions, and that’s very true. But I think it’s also about listening to the answer. And that’s, I think, very much the space that I sit in. And it’s always that sense of listening is really powerful for both parties. And I know when I was GPing and I sometimes timed myself is how long I didn’t speak for at all at the beginning of the consultation. And if you imagine somebody is there for, you know, 10 minutes, sometimes I wouldn’t speak at all for five, but literally nothing except for nodding and smiling or, you know, listening with my nonverbal cues. And that power of, as you say, and how the experience that you had with that boy and with women coming in about that bleeding, etc., that’s when you get to the nub of the issue. And sometimes it’s the first time that that person has even realised that that’s what’s going on for them. They know they need to have a conversation about their throat, about their bleeding, but they don’t realise what it means and the impact for them. And sometimes that, just that space, that safe space to talk and to be open is really powerful. And I suppose that’s really what happens in the coaching room as well. And I think that to me feels very important. You know, we were talking about this before, but the sense of listening and how I genuinely feel that most people have never truly been listened to for a prolonged period of time. And that makes me sad because the power of being heard is remarkable.

Dr Louise Newson: [00:07:16] It’s amazing, isn’t it? And I think it’s become less as not just as people have become older, but I think society has changed as well, we’re so much more fast paced. When I read statistics of how few people sit around a table and eat their meals together, or when I speak to patients who I see who have really struggling with their perimenopause or menopause and with their intimate relationship, and I say, Have you spoken to your partner? Oh, gosh, no, no, he wouldn’t understand. But you’ve told me you’ve been married for 25 years… yeah I know but he’s my best friend no, no, no I can’t tell him. I can’t tell him anything. And you think gosh what do these people do? And I’m very, very fortunate because I’m very close to my husband. And my mum actually as well and I share a lot. But I’m also very good at reflecting and thinking in my mind. But if you don’t talk, you don’t realise what’s significant and what is insignificant or what’s important or what’s common as well, I think, isn’t it sometimes?

Dr Claire Kaye: [00:08:13] But I think talking can feel scary for people in the sense of they’re worried that they’re burdening somebody or they’re worried that they’re going to be judged or that they’re going to be seen in a different way, or that perhaps what they’re saying is a bit weird. And actually that can stop the talking process for a lot of people. But again, I think whether it’s in the coaching room or the GP room or, you know, any sense where you’ve got that space, where you’ve got a non-judgmental ear, where you are literally going to be heard, and it’s almost like you’ve got a metaphorical hand holding yours in the sense of just there’s no judgement here, there’s just support and advocacy. That’s a space that’s very precious. And I mean, I know when I first had coaching, I kind of found it. I mean, it literally changed my life and I’ve never been happier and I’m very grateful to it. And it was that space just to open my mouth and to be able to speak and to be heard, but then to realise I had all the solutions, I just didn’t realise I did. And that sense of empowerment that came with that was hugely, it was liberating and such a relief. But I probably would never have got that if I’d said to a friend, can we talk about it because I don’t know about you, but there’s always the advice monster. You know, someone says something, they get, oh, oh yeah, but I’ve got the answer. You should do this and you should do that. Yeah. And that’s what’s different in my world, is that there’s a good coach anyway, will never give you the answer. Which sounds really counterintuitive.

Dr Louise Newson: [00:09:39] Yes. Which can be quite frustrating. And yeah, I have had a little bit of coaching not just for me, but for the business as well, because obviously the business has really expanded. And even actually when I do yoga, one of the yoga instructors says everything that you need is here within you. And when I first heard that, I thought, Oh, that’s silly. And then actually the more I do yoga and listen to this instructor and I think actually that’s right. But then having, like you say, the coaching that I’ve had, like I’ve only had a little bit I always want the answers, but actually the answers that I get told often aren’t the answers I want to hear. So isn’t it better to work out your self is so important, isn’t it?

Dr Claire Kaye: [00:10:20] Yeah. I mean, I always talk about coaching like noise. So basically when somebody is feeling stuck or lost or unsure or not sure how to move forwards or don’t know how to optimise the situation or just that sense of like unsettledness and you don’t know what to do and you don’t know where to go, but you can’t really find the answers. There’s all these things that go around in your head and actually it feels really noisy in your head. Like on Tuesday, you wake up, you think I’m going to do this, and Wednesday you think no, no I’m going to do that. And it’s really difficult to know the right path. And then if you compound that with the external noise that goes on from friends and relatives and colleagues going, oh, but I love you and I think you should do this, and I know you and you should do that. And it can feel very confusing. And so you have this internal noise and then this external noise, and it’s really hard to know what the right path is. So what lots of people do is they find somebody that they kind of trust and love and go, I’m going to do it their way or what they suggested because they know me and they love me. So that’s probably good. And actually it can feel quite uncomfortable and it’s often the wrong path. And what coaching does is it gets rid of all the noise and it gives you this sense of clarity and focus and direction because it helps you work out what you want and how to get it and in a way that feels comfortable to you. So it’s this, again, this sense of often the first time that people have had, particularly women, have had this opportunity to work out what they want, not what they think they should want or they feel obliged to want or guilty if they want it, but actually what they genuinely want. And that might be something massive or something really tiny and it doesn’t matter, but it’s that sense of finding that and then working out really easy, simple steps that feel manageable to get there. And just having somebody to metaphorically hold your hand and ask the right questions sort of push you and to hold you. And as you said with your yoga teacher, it can feel if somebody says, oh, you’ve got all the answers within that can feel, particularly when you’re feeling stuck, an overwhelming statement. It’s a true statement, but it can feel overwhelming. But with somebody that knows what they’re doing, it can actually be just done very gently that you don’t even realise it is happening and actually suddenly think, Oh, I actually don’t want to be on this treadmill, or actually I want to be where I am on this career path or this life that I’m in. But I’d like to try something else, but I’d like to try in a really safe, easy way first, and then I might build on it or I might not. I just going to see, and that sense of permission is really an amazing thing that happens because you start not because the coach does it, but because you’re starting to believe in yourself a little bit, that your thoughts and points of view and your values actually matter, which they do for everyone.

Dr Louise Newson: [00:13:03] Absolutely. It’s so important. But isn’t it interesting that, you know, you’re saying that it’s more women and you’re seeing more women, And why is it that you think that it’s more women that need to have somebody to talk to? Do you think it’s partly because as a woman, we do take more responsibilities. Maybe we are more caring and nurturing. This is a generalisation, of course, but for a lot of women they do have this. And we’re always at the bottom of the pile as well, because certainly even just in my small family, I’m only as happy as my least happy child. And I’ve got three of them. But actually I know if I’m in a bad mood, my whole family, just seem to not be happy. Whereas if my husband’s in a bad mood, he’ll just take himself off a cycle ride and it doesn’t really impact the family. But then sometimes we maybe do women feel more guilt? Do we feel bad if we’re burdening and talking about how we feel? Or are we, do we find it more difficult to open up?

Dr Claire Kaye: [00:14:01] Well, I think we are generalising. I think we should just say that, first of all. But I think that from my experience with the women that I see, I would say, and from my own experiences, I think a lot of what you’re saying is absolutely right. I think there is a sense of this guilt and love and wanting to be everything for everyone. And that feels like we have to be at the bottom of the pile. But I think the biggest thing I see and see in women particularly is this negative self-talk. You know, everybody has self-talk, this voice in our heads. And for a lot of women it tends to be very negative. And for a lot of women, the negative self-talk tends to be very loud. So it’s this sense of I’m not a good mum unless I do, or I’m going to make this really nice meal because that’s my way of showing love, or I’m going to work really hard and model, you know, being really successful at work. And then if things don’t go so well, it’s not only you’re not doing well at work, but you’re being a poor mum and you’re not supporting the family. And this voice gets very loud. And I think women’s confidence, women’s negative self-talk, women’s sense of disempowerment is very challenging and gets particularly bad during the perimenopause and the menopause time. And that’s also a point in their lives when they often are sandwiched in this sort of, you know, having maybe if they’ve got families, slightly older children, where the needs are even bigger than younger children, I think, and, you know, older relatives that they’re caring for, plus, you know, being often the peak of their career. And it’s this sort of overwhelming burden almost. They have to put themselves at the bottom of the pile. And that’s where I would say actually that’s where people sit. But it doesn’t have to be like that. And it’s not selfish to claim a bit back. It doesn’t mean that you have to take away from anything or anyone by starting to see what you can do for you in the sense of support and wellbeing, but also building your confidence and knowing that you have value and that you matter and that doesn’t overtake everything else. But it just means that you’re not right at the bottom. It just means that you’re in the pecking order somewhere. So I think it’s incredibly complex why women feel like that, but it is incredibly important to try and address.

Dr Louise Newson: [00:16:12] Yeah, it is important, isn’t it? Because I’ve become wrongly or rightly more selfish as I’ve gotten older and busier. So, for example, if I don’t do yoga regularly, I just feel less focused. I’ve got less physical energy, but I’ve got less mental energy as well. So actually taking some time out to do yoga when I could be playing a game with one of my children or going for a walk or phoning a friend actually is a really good investment. But it’s taken me quite a long time to realise that I have to do that or making sure that I take my lunch to work that I’ve made before, because if I don’t and I buy something, I know it will trigger a migraine. So I have to have a bit of time in the evening to cook, or I usually batch cook anyway. But I still, you know, making sure that I’m looking after myself. It’s that whole mask, isn’t it, in the aeroplane. And it takes quite a long time to realise that actually if I’m healthier and better and physically and mentally stronger, I can actually do a better job looking after everyone else. But it seems so obvious when I say it, but it has taken me 52 years to realise actually you can’t just put yourself at the bottom the whole time.

Dr Claire Kaye: [00:17:20] No, exactly. And I always think about that as if you’re your car and if you’re trying to drive your car from A to B, whether that’s looking after your children in the workplace, doing whatever it is, then in order to get from A to B, you have to have fuel in the tank and you can fill up with little bits like maybe it’s yoga once a week or maybe it’s, you know, eating healthily every day, or maybe it’s trying to, you know, prioritise your sleep or these little things are hugely important or it might be something bigger where you start to think, actually, I need to fill up my tank properly this time. It maybe actually the thing that’s depleting me is, for example, my work and actually it doesn’t fit with my value system or it doesn’t make me feel joy. Is there something else? Maybe there is, maybe there isn’t. But maybe that piece of work, it feels like more of a bigger fill up, if you like, of fuel and that sense of that we think that particularly as women that we can get from A to B with no fuel and do it with a smile on our face is impossible. It isn’t. Your car doesn’t work unless you fill it up and it’s working out what you need to fill up the tank. And for some people that small things regularly. For some people it is small things every so often and other people it’s big things, but it’s knowing what your fuel is, is vital. Like you’re saying, you know, you know that if you take some food to work, that’s a much better prospect for you for the whole day and probably the whole week. And it kind of takes since that concept of that is really well known about being in flow, that sense of being in the zone. So I suspect when you’re doing your yoga, you’re very much in the zone of your yoga. So there’s that moment there that, you know, your 40 minutes or your hour that you’re doing it that will be incredibly fulfilling and calming, etc. and good for your body. But I suspect for you and for other people, it drip feeds into the rest of your week. You feel more vibrant, more fulfilled, like more able to cope with things. And that sense of being in flow. There’s loads of evidence that that drip feeds into all the other bits of your life. So working out what fills you up, makes you feel good and puts you in the zone. Whether that’s cooking something creative, taking the dog on a walk. It doesn’t matter what it is, but doing more of it is really valuable to help combat that lack of self-confidence, negative self-talk, feeling depleted is just a really valuable tool. And I think you’re right. Saying that it often takes us a long time in our lifetimes to work that out. So if there’s someone younger coming along who’s listening to this, that would be amazing because maybe they could start perhaps younger than you and I did.

Dr Louise Newson: [00:19:52] Yep. And also, it’s not just age, is it? You throw low hormones into the mix. So perimenopause or menopause, one of the very common symptoms is reduced self-esteem, feelings of low self-worth, and often psychological symptoms we know are far more common than the physical symptoms. The power of hormones in our brains is really important, but there’s so many women who are charging ahead in their career feeling great top of the game, and then hits them like a bus. And I’ve spoken to a lot of people in organisations who said, Oh, I thought it was my career promotion or my changing job that made me feel like this. But now talking to you, I realised that it all happened at the time that my periods changed or I had a hysterectomy or whatever, and then they realise. But people are really struggling and a lot of women I’ve spoken have said, well, of course now I’m menopausal. I can only expect work part time. I can only expect to have a lower paid job because of my hormones. And, you know, society has changed. And I think that is quite right for a lot of women. I would not be working as a doctor if I didn’t have hormones on board because I was really struggling with everything. Some people are fine, but it seems a shame that we need to put these menopausal women in a box. And we’ve heard a lot with policies and various things that, well, let’s just help them by, you know, reducing their hours or changing the air conditioning or whatever. But actually, that’s helping. Well, that’s not helping. Sorry. That’s actually stripping them of some of their identity as well. And I find that’s really difficult. And for every woman, choice about treatment is very individualised. We’re not going to talk about that now, but it is about the ability of women being the best version of themselves when they’re perimenopausal or menopausal. And it’s having those tools to not feel that they’re failing in workplace because actually, for a lot of us, work identifies who we are, doesn’t it?

Dr Claire Kaye: [00:21:52] Yeah, definitely. And I think a lot of women describe it and I would put myself in this category as well. It’s almost like you lose your mojo. It’s that sense of, you know, oh gosh, I’m getting really worried about this now. I don’t know how to make a decision, so I’m obviously not good anymore or I couldn’t go for that promotion because I’m really, you know, sometimes I forget things in meetings. So obviously I’m seen as not very good anymore. That sort of negative conversation that goes on in your brain. And it’s a self-fulfilling prophecy because, you know, if you’re not sleeping well, because you’re going through the perimenopause and that may be from night sweats or maybe just insomnia, or maybe you’ve got more anxiety, which is making you have sleep problems, and then you go into work and you’re having problems with decision making anyway. But we all know that when you’re tired, it’s even harder. And it’s just this ever decreasing cycle that makes women feel like they can’t do and are useless and rubbish. And actually that’s just wrong. It is just wrong because women are just as good as they were, if not better than they were five years ago. It’s just about ensuring that the infrastructure’s in place and the choice and the control and the sense of being able to move forwards and not being put on the scrap heap because, as you say, something has changed in their body, which has affected every bit of their body. And as you say, a fan is not going to fix it, but there are things that we can do. For me, a lot of it is around understanding all the amazing resources that are out there, getting a sense of control, working out what you want, having the permission to, you know, really take steps forwards in whichever way forwards is for you. All of that is so important. And that sense of being heard and listened to and not thought of as rubbish or invisible or this sense of useless because it’s very damaging to the individual, to the families, to the communities, and also to us as a whole entire nation. Because let’s face it, what is it? Something like 13 million women in the UK are perimenopausal or menopausal at this present time. That’s huge. So we have to see it differently. We have to see it as retaining, supporting, but more educating and just allowing people to get back to themselves and feel like themselves again in whatever way they need to do it. Whether that’s medication, through lifestyle, through other resources, through a coaching, through CBT, it doesn’t matter what it is, but as long as women choose that path that feels comfortable for them and works for them, but having that confidence to do that.

Dr Louise Newson: [00:24:22] Is so important. Is it? Especially when you look at the number of women who are leaving the workplace totally or reducing their hours? And we know more and more there’s all these movements to try and increase, you know, people having their jobs over the age of 50 or whatever. And there’s very little about how to really focus just on perimenopause and menopausal women. And I feel that it’s so important that they’re identified and individualised as well, because some of the conversation is being led by people who really haven’t suffered at all and don’t understand what it might be like to be menopausal and other people who don’t really want to understand, maybe, but it is very different. You know, I get bad migraines. And one of the things that got worse for me was my migraines. And I can’t work when I have migraines because I can’t think, I can’t speak. I sleep, I slur my words, I sound dreadful. You know, no one wants to come to see a doctor who can’t think and is slurring their words. But actually having the education that those migraines could have been made worse because maybe if I don’t eat lunch, as I’ve said, I’ll get a migraine. But also it could be oh Louise are you’re eating well? Or Louise could it be related to your hormones? Or, Louise, are you stressed or is there something else we can do? Doesn’t matter what’s causing my migraines. But wouldn’t it be lovely for somebody in the workplace to be able to look at it in a very holistic way and give me, like you say, the education, and then I can decide, well, do I want to take medication or could it be the fact that I’m stressed at home, or could it be the fact that I’m perimenopausal, or could it be the fact that I’m not in the right job? I don’t know. That’s for me to understand. But it’s making sure that I am allowed to have all that information and then make the decision, rather than being sort of forced into one corner, made to feel that I have this chronic disability that means I can’t go on in my career, which I think is happening for some women. And then that really is stripping them of who they are and what they’ve always wanted to become. And then if they’ve got reduced self esteem, they’re going to feel more of a failure as well, which this downward spiral. And that’s happened to women for centuries actually. And it’s not improving for some people, which is such a shame.

Dr Claire Kaye: [00:26:42] Yeah, I totally agree. But you know what? I find just so rewarding in what I do is that I see women in that situation all the time, literally every day, and see the power of the right questions. Like you were saying right at the very beginning of this and through lessening and through allowing them to rediscover who they are. Most women don’t have a clue what they like, what they’re good at, what they could bring to the conversation. They honestly have no idea. And just even starting there and working out what they stand for and their values and their purpose starts to rebuild the sense of self. And what I see is a massive change from some people feeling like they can’t, that they should leave work, that they are useless, that they are adding nothing, to actually starting to see their value and where their voice sits and what they bring and how that helps both others and themselves. And actually, I suppose my biggest message is that it doesn’t have to be this way. And I think that’s probably what I hear from you. And it doesn’t have to be this way. And there’s so many things out there that can help women through your messages. Through my messages. You know, there’s millions of resources out there, and I think it’s just about choosing the one that works for you, whether it is HRT, whether it’s coaching, whether it’s a combination of both, whether it’s communication, whether it’s education, whether it doesn’t really matter what it is. But finding out what’s right for you and it doesn’t have to be that you are on the scrap heap, it shouldn’t be that it’s wrong. And I suppose I would encourage every person just to sort of take a step back and just ask themselves a few questions like, you know, what does good look like for me? Who and what might help me? What are the first steps? Where would I feel comfortable starting with this? And just even those little conversations that you start to have ease of self, A little bit of self coaching is really powerful and I’m a massive advocate for self coaching, which I could talk all day about by I won’t today but you know, if anyone’s interested, then just contact me.

Dr Louise Newson: [00:28:46] Yeah, absolutely. And we’ll put your contact details in the notes. But another day obviously I’ll bring you back to just talk about self coaching. But it’s so important because there’s so much we can do from within, but often we can’t always unlock it. So it’s been really great talking to you, Claire, and very inspirational. But before you go, I wouldn’t mind three tips. So for people that have heard this and do feel that they’re not getting forward or they’re not being listened to or the word coaching can be a bit scary, what are the three things that really, in your experience, help with self esteem to start helping people get into the right zone, to go in the right direction to improve their house?

Dr Claire Kaye: [00:29:30] I think the first thing is to recognise what it is that you’re feeling. So just taking a few seconds, it doesn’t have to be a big piece of work that you do, but a few minutes to work out what it is for you at that particular time is really an issue and almost label them. So whether it’s, you know, anxiety, whether it’s feeling low, whether it’s…whatever it is, but label it so you can start to realise what’s going on, first of all. And then ask yourself, well, what might help here or who might help? So it might be that you want to educate yourself more like, you know, going on to, if you feel that it’s perimenopause, maybe you want to go pnto your app, which I love, and you know, that sort of thing, or it might be actually, I need some extra support. Maybe I’ll start speaking to a friend. Maybe I need to have somebody to help me with this. So that sort of sense of, you know, what’s going on with me, what or who might help me to begin with. And then just once you’ve written out a whole load of options of what you could do, just pick one really simple thing that feels really comfortable that you could do tomorrow and do it. You might be sending one email, it might be having one app, it might be contacting one person, but just do it. And once you start this process and you just do tiny little things that feel manageable. You’ll start to rebuild that sense of who you are and what you need and how to move forwards.

Dr Louise Newson: [00:30:52] Great advice. I’m going to start thinking about what I’m going to do tomorrow. That’s really useful. And thanks so much for your time today, Claire. It’s been great. Thank you.

Dr Claire Kaye: [00:31:01] Thanks so much for having me.

Dr Louise Newson: [00:31:05] For more information about the perimenopause and menopause, please visit my website. www.balance-menopause.com. Or you can download the free balance app, which is available to download from the App Store or from Google Play.

END

The post How to thrive at work during the menopause appeared first on Balance Menopause & Hormones.

Emma Hammond is a lawyer with gunnercooke LLP specialising in employment law. Often assuming the role of Investigating or Grievance Officer, Emma leads enquiries into complex bullying, harassment and discrimination complaints for individuals and organisations. Emma has an interest in mental health and its impact on the workplace and she incorporates as much pro bono work into her practice as possible, specialising in advising women who have suffered discrimination due to the menopause.

In this episode, Emma chats to Dr Louise Newson about the effects of the menopause at work, the intricacies of legal protections for women suffering professionally because of menopausal symptoms, and they discuss some positive examples of working in a menopause confident organisation.

Read more about Emma Hammond here.

Episode transcript:

Dr Louise Newson [00:00:09] Hello, I’m Dr Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of the Menopause charity and the menopause support app called Balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. On the podcast today, we’re going to talk about something that is very, very common, actually, about the effects of menopause and perimenopause in the workplace. So I’ve got with me Emma Hammond, who I’ve known for a little while now, actually, who’s a lawyer and doing a huge amount of work in this area. So welcome, Emma, today.

Emma Hammond [00:01:03] Thank you Louise.

Dr Louise Newson [00:01:04] So, a few years ago, if I’d met you maybe ten, 15 years ago, how different is your job now to how it would have been 15 years ago? And if I’d said to you the word menopause, what would it have conjured up 15 years ago?

Emma Hammond [00:01:18] That’s a really good question. So 15 years ago, let me do the maths… I was 37, so I knew about the menopause from my mum. I knew that she started around the age of 50 by fainting in the office.

Dr Louise Newson [00:01:32] Gosh.

Emma Hammond [00:01:32] That was her first indication. And I was asking questions then around when it happened to her to think when it might happen to me. I’d only had my first child at 36, so was very much in the new mum phase rather than thinking about what hormones may do to me regarding the perimenopause. But work wise, absolutely nothing happening that gave me an indication that women were experiencing issues in the workplace around menopause and perhaps being treated differently.

Dr Louise Newson [00:02:01] Yeah, which is interesting because if I’d met you, I would have been in a similar age. We’re very similar ages. So in my late thirties, I didn’t even know – I didn’t really think about symptoms. And the only symptoms I was really taught about was about hot flushes and sweats. But it’s more about night sweats. So I think well, that’s night time symptoms, actually. So I hadn’t really thought about it either. It’s quite something, isn’t it? And I think now it is spoken about more, which is great, but there are still, and I’ve read a lot of journalists saying, oh, women just need to sort themselves out. They just need to… they need to stop complaining. Are we going to be looking after people now who’ve got ginger hair or people who have got other, you know, problems for goodness’ sake? It happens to all. It’s just a natural transition. And then I also speak to other women who say, “well, I’m menopausal now, so I can’t go for job promotion or I need to move differently in my career, I need to reduce my hours. And that’s fine because I’m menopausal.” It’s all a bit wrong.

Emma Hammond [00:03:02] It is. And I think what I found – so when I joined gunnercooke, my working life has changed significantly in the last six years. And in fact, I joined this firm to assist myself in managing my menopause and my migraines, particularly, something I knew about.  And so kind of my own journey has led to me looking into how I can help others because typically, working as a lawyer in a private practice environment is pretty tough. And lots of women I know stopped fee earning because they couldn’t balance it with being a mother and latterly being a carer perhaps, and also managing menopause. So all those things have led to a gender imbalance at partner level. And it was something I was asking myself so can I continue to fee earn with all the demands I’ve got at home. And so an opportunity came up in gunnercooke. And just to explain a little bit about the firm because it does impact on how I work now in the menopause arena as well. The idea is it’s very philanthropic in its set up and we’re all encouraged as lawyers to give back. So I’ll talk about that again in a minute in relation to the menopause, but particularly the set up is like a barrister’s chambers. So we’re very much encouraged to be business people as well as lawyers. We fee earn in such a way that it’s fee sharing with the firm. We manage our own business without chargeable targets. So when you then look at the gender balance, I find it fascinating, we’ve now got 300 partners and we’re almost 50/50 split. That’s almost unheard of in a law firm. And it goes to show that what women need is flexibility and ownership over their own businesses to be able to work how they want and how they need. So I’ve had various challenges, one of which was when my eldest son was diagnosed as epileptic and I had to take some time off work and the firm was incredible in just allowing other colleagues to take my work off me and for me to concentrate on his health. No sickness absence obviously, because I work for myself. But the wellbeing support was phenomenal and that’s now translated into the menopause, into all of the women that we have in our workplace, many of whom are 40 plus, a lot are managing all of these things within a fantastically thriving practice, which is how it should be. And it’s so refreshing to see that I can do the job I love in a way that works with my health. And there’s no shame in it. In fact, one time I had some bereavements in the family and the owner of the business and co-founder actively rang me to find out that I was okay, because they heard about it through other colleagues and said, “you’re working too hard, what can we do to help you?” Now that again, it probably happens in some law firms in traditional law firms, but I think it’s pretty unusual. And so there’s a fantastic kind of collegiate atmosphere which encourages people to create a life around the law rather than the law dictating the life that you lead.

Dr Louise Newson [00:06:01] That’s so incredible and actually very unusual for professions or any careers, actually. And I have got three children and people know my husband’s a surgeon and I don’t rely on him. I’ve never relied on him for childcare, but I don’t have my family close. So it’s always been really difficult. And I’ve actually always, up until now, chosen to work part time because I can be there. I can go to Harvest Festivals , I could pick the children up from school, which is great. But then in the holidays I needed to be part time. So it was just easier and cheaper actually, because it’s very expensive, isn’t it, when you’ve got more than one, especially more than one child, looking at childcare. But then I’ve always wanted to work longer in the term less in the holidays. And then, you know, if I have migraines and I can’t go to work, I’m very happy to put that time back. I think flexibility in an organization, actually you get so much more out of your staff because if I go to work with a migraine, I might as well just not bother because I can’t speak. I slur my words, I can’t think, well, you know, you have migraines as well, whereas if I have to go off sick, I feel like I’m a real failure. Then I know I’m putting on my colleagues and it has such a ripple effect. But this isn’t just about for women actually, is it? This is for men as well. Having a flexible workforce is really important ‘cause we’ve all got challenges either they’re personal or family or other things. And there are times aren’t there, where flexibility is key to keep people working.

Emma Hammond [00:07:27] That’s it. And I think that was recognised in the set up of this firm. Darryl Cooke, who founded the firm, he was committed to trying to move to a place where he was so disheartened by how many unhappy lawyers he was meeting. He wanted to create a firm where lawyers were literally just very simply happier with what they were doing with their lives, with their work. And to that end, on the philanthropic point that I mentioned earlier, he’s hugely encouraging on us all giving back. We have Inspire, which is a part of our business which is linked to charities. We help lots and lots of charities and all of our lawyers who want to assist with these charities are put in for free. So again, pro-bono element to the work so that we can help the charities thrive. And that’s kind of led me to my menopause work because historically I did a lot of work in the mental health arena, I was on the steering group of Leeds Mind, part of the Mind charity and I helped to set up conferences in the city around the benefits of working for mental health. And I did that for the tenure of four years, that was the typical period. And then thought what else can I do? And I was a school governor at my son’s school for a while, but it wasn’t giving me what I needed in relation to the kind of employment law aspect all the time… well, there’s some of it touched on that. And then I came to helping people with menopause discrimination issues at work, quite by chance, really. It was almost at the same time I started my own menopause journey, a couple of people were referred to me and in fact a couple of queries through you as well, and suddenly thought, hang on a minute, this works well given that the Leeds Mind work has dried up and it fits with what I’m going through, so I can very much empathise with these issues and of course at the time, I think you and I discussed the tribunals were starting to come through linked to menopause. I’d never seen that in my career before until about what must be some five, six years ago now. And it showed that obviously women are starting to break down that last taboo – with mental health I think being the one beforehand, particularly in the workplace – and realise they have rights and start to take advice. So it was then that I began to be committed to opening up that as my pro-bono practice and talking about it a little bit more, gaining momentum. And so that’s where I’ve got to today and it’s been fascinating to kind of follow that journey to help people through. And I know you’ve seen some of the commentary of how that changed people’s lives and it’s a wonderful thing to be able to be involved in although still very sad that people are experiencing this. But again, with all the other workplace challenges and all the challenges around managing menopause, kind of not surprising.

Dr Louise Newson [00:10:15] Yes, and talking earlier about how ignorant I was in the true sense of the word, not knowing about the menopause and the impact on workplace, about seven years ago, I did a year’s work, very privileged, working with West Midlands Police, second largest police force. And I went there and they really thought that I would be going to help them with their policies and their sort of HR really, and to help them with reduced hours and flexible working, whatever. Well, I’m not that sort of person. I’m a clinician, as you know. So I said to them, “look, all I can do is talk to you about the menopause, what it is, what it means, what the symptoms are, what the treatments are, how to look after yourself.” And I went to the first meeting, and there were lovely, lovely people there, but they were telling me how they were looking forward to retiring age 50, how they couldn’t take their grandchildren to the park because their joints were so stiff, they couldn’t put them on the swings. How they were going home and just collapsing on the sofa, how they couldn’t go and work on the beat anymore because walking was really difficult. So they would just, had a sedentary office job, they had put on weight. They were feeling really tired. Their brain wasn’t working. We did this big survey and we found that the top three symptoms affecting people in the workplace were anxiety, memory problems and fatigue. Yet most of them, 78%, when directly questioned, didn’t know that those symptoms could be related to their menopause, yet they were menopausal women. And okay, seven years ago we weren’t talking as much about the menopause then and also the majority of them had been signed off work when they had had time off work, they’d been signed off with depression, anxiety, migraines, never a mention of the word menopause, even if they’d gone to their healthcare practitioner saying, you know, “I think it’s the menopause”. So they were there saying, “well this is my bag”, “this is me”. And I just thought, goodness, this is awful. I had no idea, no idea what was going on. And so then now it’s almost gone the other way, because I think a lot of organisations are writing policies, they’re giving this ‘assisted workplace’ or they’re reducing hours, which in my mind means reduced pay, but that’s actually not always that helpful either. So tell me about some of the people that you’ve seen and helped Emma?

Emma Hammond [00:12:33] Yeah. So, one of the biggest kind of negative reactions I’m seeing from employers is that they seem to lean towards performance management when they see symptoms, particularly like brain fog. Fatigue clearly affects performance concentration, insomnia and anxiety. All the things you just mentioned are classically for people, particularly working in professional jobs, sedentary desk based jobs where concentration is key for long periods of time. The ladies come to me with very much fear factor over losing their job and saying to me “I’m being performance managed”. But in particularly one recent case, “I’ve owned up, I’ve got early menopause because of some health issues” – so this particular lady was in her thirties – “and I’ve had an occupational health report which says, Yes, this is to do with menopause. I need a specific temporary change to my working conditions as set out in the Occupational Health report”, for example, some homeworking all the stuff we’ve been doing in Covid anyway, that should have been quite easy to put in place, simply as a reasonable adjustment because this lady actually was disabled as defined in the Equality Act at the time anyway for a different reason. And that this would have simply been in place until their GP and the occupational health team combined said the HRT was kicking in and things were improving. It was a very open dialogue and there was a hope that in being honest this particular individual could have sought the right level of support. But instead of that, shockingly, the employer decided to put the person on a performance management programme. Quite a tough one, which logically, when you see that the report says that the symptoms are linked to menopause, you’re immediately looking at a red flag of discrimination.

Dr Louise Newson [00:14:29] Yes.

Emma Hammond [00:14:29] And at that point, she came to me and in fact, the sickness absence was precipitated by the performance management programme, as you can expect. And we carried on talking, and I do a lot of ghostwriting. So my presence often is very much hidden. I’m very conscious that if people who are having trouble at work, suddenly have a lawyer pop up, whether I’m writing or whether I’m contacting the employer, it can often be absolutely the wrong thing for the lady in question to be seen to be taking advice, even though it’s their prerogative. So I’m always very sensitive to how I can help. And again, as I say, I won’t charge for this work, but I will work very carefully so as they’re getting the best value for my time, of my time. So I’ll mirror the person’s style if I write for them, give them scripts for meetings, that kind of thing, and very much stay in the background to try and give them the power to feel they own their own process as well.

Dr Louise Newson [00:15:27] And that’s really important. I mean, I know a few of the ladies who you’ve helped. It’s been very transformational and it’s also it’s giving them a voice. And as you know, a lot of people when they’re perimenopausal, their memory goes, their concentration goes, their actual self esteem can reduce as well. So you turn into this often person who’s just a bit of a shell, and then if someone’s telling you something, even if it doesn’t feel right, it’s very hard then to do a counterargument. So to have this clear voice of reason and you’re really working as their legal advocate, aren’t you, to sort of help empower them and shape discussions. But I think, also I’m not aware of any negative feedback because I think it’s actually really helpful for the employer as well to know where the person’s coming from, because it can be very hard for HR departments or occupational health departments to know sometimes how best to help. And I think in the past, that whole thing of ‘out of sight, out of mind’ is a quick thing, isn’t it? And it’s not good. You know, I employ many, many women in my organisation and quite a few of them are menopausal. I want them to come to work the best version of themselves because selfishly, I want to get the best out of them.

Emma Hammond [00:16:43] Of course.

Dr Louise Newson [00:16:43] But until we know what’s going on, you can’t help them. But having that legal voice, because there’s something about lawyers that can make things so straight and black and white. And that’s what you need when you’ve got this monkey noise, monkey chatter in your brain and you’re menopausal and you don’t know what you’re entitled to, I think that’s the other thing that’s really important, isn’t it?

Emma Hammond [00:17:06] Well, I think that’s right on the entitlement point, what I try and do is set out the individual’s rights. And we talk about that obviously behind the scene and I simplify that as best as I can. And the challenge, of course, just talking about the law for a minute, because it’s certainly a hot topic as to whether or not the Equality Act goes far enough. And the Women and Equalities Committee presently are looking at making menopause a protected characteristic. And that seems to have stalled with all of the governmental challenges at the moment. Clearly, unfortunately, it’s gone down their list, which is a shame. But the campaign continues. And I think the issue is we have to be very creative as lawyers for the claimants or for individuals pushing these issues and having these problems, because there isn’t a one size fits all and because there’s no protected characteristics as per sort of age or gender, we have to say, okay, so what are we looking at? And it sits quite uncomfortably to say menopause or the menopause symptoms are a disability, but that’s one of the major starting points. So we look at the definition of disability in the Equality Act, which is a mental or physical impairment that lasts or is likely to last 12 months or the rest of the person’s life, and has a substantial or adverse impact on their ability to carry out their day to day activities. So we break that down. But of course, you well know with your clinician’s head on that the symptoms fluctuate. So if an occupational health doctor or specialist is to look at an employee’s symptoms at one particular point in time, they may well say “well, although I’m not a judge and I can’t actually decide whether there’s a disability here, I don’t think there is because the symptoms aren’t severe enough, even though that lady is absolutely struggling to get out of bed and get to work. So it becomes almost too academic in its analysis. And of course, I will always argue that my client is disabled because I need to to maximise their position, because often the relationship’s broken down and I have to negotiate a deal. So I will do that analysis and as best as I can establish that disability. But ultimately, the only body that can do that is a tribunal. So in tribunal speak, we find the challenge for women in that place and I’ve looked at various cases where the stages that the lady has to go through are so arduous. They have to say they’re disabled if they’re pushing to claim, and then they have to go through a preliminary hearing to establish that disability, with their employer arguing that they can’t possibly be disabled and going through the law when obviously even attending that hearing when they’re in that space, is incredibly difficult. And they’ve got to face criticism over “well actually maybe, you were just not good at your job, it wasn’t these symptoms at all”. And all this horrible stuff that you have to go through. And recently a female judge said at a preliminary hearing that she could absolutely see that all of the symptoms you cited at the beginning of this session, such as brain fog, insomnia, anxiety, could amount to a disability. So we are getting somewhere. But of course, that’s the first hurdle. The next point is the main hearing. So there’s mostly – and I haven’t gone to tribunal in any of my cases yet because really the best solution for the employer and the employee is to either get them back to work and sort a dialogue and some mediation and start to move forward with reasonable adjustments or to settle unfortunately and accept that a new start is required for both parties, because we know that tribunals are incredibly stressful and quite destructive and not good for our party, you know. So we’re looking at Disability and the Equality Act, but then within that we’re looking at age. Of course, that only works in some circumstances and we’re also looking at gender. Would a man be treated the same in the same scenario? And obviously a man can’t go through  the menopause. So we look at the difference in treatment there as well. But again, you can see how you have to be pretty creative because there isn’t a protected characteristic to make these things fit to your circumstances. And that’s again, if I’m speaking to somebody who’s already struggling, that’s a heck of a task to do together.

Dr Louise Newson [00:21:21] It’s absolutely huge. And I heard and I don’t know whether you have as well Emma, that quite a few people say, “well, don’t you think the menopausal women will just use the menopause as an excuse because they’re underperforming at work?” Now, I obviously hold women in high esteem. I hold everybody in high esteem really and I want to believe people and I have not met a menopausal woman who does not want to feel better, you know. I think one of the problems and the frustrations for me is knowing that there’s so many people struggling in the workplace who are unable to access evidence-based treatment, so they’re struggling needlessly. And that really horrifies me. And a lot of the work we’re doing in the clinic to try and reduce costs to make things even easier to access evidence-based treatment is really crucial. We’re sort of cranking it up this year, but I don’t think anybody uses their symptoms – no one wants to have anxiety. No one wants to struggle with their memory. No one wants to have joint pain. No one wants to come into work saying, “I’m menopausal, give me some extra help”. Is that your experience as well?

Emma Hammond [00:22:22] It is, and nobody wants a pay cut either do they?

Dr Louise Newson [00:22:24] No, absolutely not.

Emma Hammond [00:22:25] You know, everybody wants to be the best they can be, certainly that’s what I’ve seen. And of course, going back to the lady that I helped who was very honest and open and obtained the occupational health report when she was struggling, legally, it’s very important that people are open with their employer because actually the employer, from a discrimination perspective, could say, “well we didn’t know and therefore it’s not discrimination”, there needs to be knowledge. And so that dialogue is important. And if we can empower women to speak up, I know it’s very difficult, but a lot of my clients, I work with a lot of businesses as well obviously around this, and there’s some fantastic businesses out there. Yorkshire Water is one of them. They’ve had a menopause policy in place way before it was a thing and I’ve been talking to them recently about helping them with some internal training. They’ve got a menopause taskforce. They’re very much ahead of – they were ahead particularly of where we were years ago – but even now they’re doing brilliant work. And so where you’ve got employers that are having that conversation, there’s an openness already and there’s a willingness for people who are struggling and coming through the ranks will feel, well it’s not embarrassing or difficult for me to raise this because it’s accepted and I know I’ll get support. So already a barrier has been broken down before we’ve started and you’re expecting to be supported, which is great. And I think more of my clients, my longstanding clients who I would help with other employment challenges, are coming to me because they’ve seen the work that I’ve been doing, also with menopause mandate and the campaign around that, to actually ask me for help and ask me to speak at events. So what is great is that employers are actually wanting to help people. They’re wanting to help their workforce and get the best out of them. And also they’re wanting to educate the male members of staff as they should, because they’ll be either managers or they’ll have partners or wives, people they want to help in their own lives. So all of that is very encouraging. But I think we just need to establish a situation where it’s not frowned upon to admit that you’re struggling. And in fact, one of my very close friends who came to the rally in Parliament with me in October, said, she’s similar age to me, it was interesting because when she speaks to her male boss, he has no trouble saying, “Oh, I’m feeling a bit rough today. I got a few symptoms” from a, I don’t know, kind of cold or flu or whatever it might be. “I’m not going to be on my best form today, so bear with me”. And that’s not linked, obviously, to any life stage or any hormonal issues. Typically, it’s just ‘not on my best form’, ‘not feeling great’. And she had a kind of a light bulb moment with that and thought, It’s funny, isn’t it? How because it’s not linked to anything that may be taboo or may be linked to a life stage, it might be easier for a man to admit that they’re not on best form. But because when you reach a certain age, the kind of symptoms that you’re talking about: off colour, losing concentration, had a bad night’s sleep, are naturally now  – particularly as we’re talking about it – thought to be linked to the menopause. Women are more likely to just grit their teeth and not tell anybody and not feel they can open up to perhaps that male manager because they might be worried about their future or their promotion or how they’re regarded in the workplace. And I think that’s one of the issues that still needs to be addressed because there is that fear that some employers, such as the ones I have sometimes faced, will still think that because they’re facing their own challenges with their own numbers and their bosses coming down on them, that their natural place to go to is performance management because they can’t see that there’s any other solution. 

Dr Louise Newson [00:26:13] Yeah. And I think it’s so important is this labelling and the, like you say, the taboo that people misunderstand the menopause and they’re almost scared because they don’t understand it. So we know for example, back pain is a very common reason for taking time off work. Now if I had time off for back pain, I wouldn’t have to go and have an MRI scan. I wouldn’t have to go and see the top back specialist to get a diagnosis. I would be believed and I would have the time off that I needed. I might be able to get some physio through my work scheme or I might be able to see somebody through my work scheme. And it’s just done. It’s one of those things and we know back pain is very common, you know, migraines, for example, I wouldn’t have to have a brain scan. I could just go and get help.

Emma Hammond [00:26:53] Yeah.

Dr Louise Newson [00:26:53] Something about the menopause. It’s like, ‘oh, hormones, women. Oh my goodness. How long is it going to last?’ Let’s make you feel really awkward and uncomfortable. And ‘how am I going to ask the right questions? How am I not going to upset her?’ And men, ‘do we really need to know about it’ or ‘I’m too young to think about the menopause’ or ‘it’s really uncomfortable’. And I think all these barriers have got to be just gone. So it is just a normal conversation. But actually above that, I really feel that employers should be saying, “well, how are you getting help? Have you seen a specialist”, or “have you seen a doctor or nurse?” And “perhaps you could, you know, invest in some time, have some time off” or whatever, and get the right treatment as well, Because investing in them now, it’s like if I had back pain, I wouldn’t want to have back pain every day. I’d want to hit it with some anti-inflammatories or painkillers or physio or whatever I needed, and then I could get back to work. And I think it’s the same with menopause. It’s almost seen as like, ‘it’s just a transition, let’s just wait for the women to be better and then they can carry on their jobs’ when actually for many women the symptoms can last for years or decades. We can’t do that. As women every day, we want it to be the best day of our lives. So there’s so much we need to get better, isn’t there?

Emma Hammond [00:28:06] Oh, there really is. And I think when you look at the stats of the amount of women leaving the workforce…

Dr Louise Newson [00:28:10] Very scary.

Emma Hammond [00:28:13] Particularly, you know, post-Covid, the value that that sort of 45 to 60 adds to the workforce and the workplace and the economy, particularly at the moment, it’s significant. And the value that you get from work, you know, as I said with the Leeds Mind work I did, the value we looked into as to what work does for you on a positive basis, particularly again when women who have been mothers are seeing that empty nest syndrome, they’re maybe caring for elderly parents, their value, even if they can only manage a part-time working life for the latter years, is so significant in what they can get from it and give back, it’s such a shame to waste it. It’s awful. And I think if we can give people that voice, both the employers and the employees, there’s some fabulous employers as I say, who are absolutely committed to helping, but they just need the support and they need the knowledge and they need to feel that that level of, as you say, taboo and embarrassment is now disappearing, as it absolutely has done for mental health. Why can’t it do that now for the menopause? It’s the last taboo, really, isn’t it?

Dr Louise Newson [00:29:19] Totally is. So the work you’re doing is incredible. We need more of you. We need more of gunnercookes in the world as well because you know, the setup of the organization is amazing, the work you’re doing is incredible. So I want to thank you very much. But just before we finish, I’d really like three take home tips. Three things that you think somebody who’s listening to this and might be struggling in the workplace, three things that you think they could do to help their employer actually to get the most out of them as an individual.

Emma Hammond [00:29:53] Okay. So I guess the first one is about getting yourself to a place where you feel you can speak up. Now, you may need help behind the scenes from either your GP or if you’re seeing somebody, a counsellor or a close family friend or family member to give you that confidence because you’re probably at a low place anyway. Speaking to your employer is maybe the last thing you feel like doing depending on their setup. And if you don’t feel you can speak to a manager, maybe seek out somebody who might be a female of a similar age or stage in your life within the workplace, who you feel you can trust so you can start to open up the conversation to. They could be your advocate, even if there isn’t a menopause sort of programme in place where those people are identified as menopause champions. Find somebody yourself and start that conversation, even if it’s only over a very sort of relaxed coffee, to open up to them and see how that conversation feels on an informal level to maybe then try and take it to a formal level if you are struggling. Because, as I say, openness not only helps the employer to understand what they might be able to do to help you, but legally it’s incredibly important because then we’re looking at fitting your symptoms within the Equality Act to gain you that support. And of course, the important thing to remember that I haven’t yet mentioned, is that discrimination rights under the age, sex and disability arena kick in from day one, even from a recruitment stage in fact, they’re in place. So you don’t need service, whereas clearly unfair dismissal is two years service. And so you need to remember that you are protected. And of course, under health and safety legislation as well, from a duty of care perspective, the employer is under a duty to create a healthy and safe working environment. So all of those things need to be remembered when you’re feeling lost, unsupported and unprotected. You do actually have some protections from early doors. So that’s the first thing. I think the other thing to do, which is more of a personal move that you can make but actually does help your employer as well, is where you’re having difficult moments, difficult conversations with people, difficult days, keep a diary.

Dr Louise Newson [00:32:08] Yeah.

Emma Hammond [00:32:09] Keep a diary of your symptoms and keep a diary of those symptoms and how they impact your performance or your working day. And when they do impact it, you may have had a terrible night with night sweats. What does that next day look like? And what if you had a magic wand? What would you do to waive that and say, okay, for me to survive today after that terrible night, what do I need my day to look like at work? It may be extra breaks, it may be working from home, depends on how your job is set up. It may be different uniform. All those things we’ve looked at before and employers are presently looking at are important because again, you can be your own advocate. Don’t expect the employer to second guess what you need. Try and open up and really be creative in that. Think about things that nobody would have thought about in your job before. I think there should be no barriers to this. It’s all up for debate. And on top of that, the third point, which is very much a self-protective step, but again, if things get a bit more dicey, would be helpful, selfishly to me as my line to the employer, is to send yourself emails. So most people have a Gmail, Hotmail address where those difficult moments happen, particularly perhaps difficult conversations with managers or where a colleague may say something that’s hurtful that they don’t even realise is hurtful because it’s linked to the menopause or menopause symptoms, is on that day if you can, go home or privately send yourself an email with a file note, a diary entry of what was said and what was done, what happened, because that’s timed and dated with it being electronic. So it’s very hard for somebody to say, ‘oh, you made that up weeks afterwards’, etc. And it’s good for you to then be able to go back and track. Okay, so if I do need to seek advice, these are the things I need to tell or if I need to speak to HR, this is my record and it may not be a formal grievance that you need to raise. It may just be, “look, these things are happening they’ve happened now for a few weeks, they’re making me feel very uncomfortable. I think we could do with a training programme or education internally. Please, can you help me?” It can be that level. Obviously, I only get involved when things get much more frenetic and stressful. But equally all those things are quite practical steps that I think everybody could take.

Dr Louise Newson [00:34:29] Really great advice, very sensible and actually easy when it’s broken down. So thank you ever so much Emma, for your time today and keep doing this work. It’s brilliant. Thank you.

Emma Hammond [00:34:39] Thanks, Louise.

Dr Louise Newson [00:34:42] For more information about the perimenopause and menopause, please visit my website balance-menopause.com. Or you can download the free Balance app, which is available to download from the App Store or from Google Play.

END.

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