Advice for Partners and Future Health

Hello and massive welcome to Happy Place with me, Fern Cotton This is the show that empowers you with knowledge so you can make the decisions that are right for you. Today, I'm chatting to Louise Newson If we're getting any symptoms, the first thing as women we should do is think, right Could it be my hormones and could topping up my hormones in a very natural way help They affect every cell in our body, so that means every organ. so you could literally list going from your head down, literally obviously so many functions in the brain. Palpitation is very common. Muscle and joint pains really, really common. A lot of people in their forties get diagnosed with irritable bowel syndrome, weak bladder, all of that can be related to hormones as well, restless legs You know, so many women are having these symptoms are just putting up with them. Hey, how are you all? I hope you are well.ook, this is a chat that I've needed to have for a very long time. Hands up any women that are listening right now that are of a certain age that have got their heads buried firmly in the sand when it comes to perimenopause and menopause because that is me I am in complete denial. Whenever anyone mentions a menopause or permimenopause, I just think, Ohh my God, stop talking about it I can't think about it, I don't wna think about it. And mainly that's because I've been so confused as to what the solutions are And it shouldn't even be a solution. It should be like how do I cope with this? What can I marry with everything else that I'm doing in my life to feel okay? So I needed to face up to this whole subject, head on and get stuck into it. and what better person to do that with than the brilliant Louise. So Louise is a GP, author, campaigner and the menopause specialist in the UK. She's the founder of the Newson Health Menopause Clinics and Balance menopause app. and her latest book, The Power of Hormones is an absolutely vital read because there's so much in there that gives women the understanding of our own bodies that's been withheld for far too long. This chat could have gone on for weeks, but we managed to really crack on and condense it into a listenable amount of time, and we cover subjects like the power of believing in women's experiences of their bodies. So basically going to the GP and properly being listened to. We also look at understanding the history of the pill. Maybe if you were again a similar age to me, back in the day, like in the nineties, the early nyies, you popped that contraceptive pill without giving it a thought as to what was in it, what the side effects might be We talk about what hormones do in the body and the brain, the perimenopause symptoms to look out for. and debunking the fear around taking hormone replacement therapy. That for me is the big part of this conversation because that's been the bit that has been keeping my head buried in the sand. So I really needed to Ask all the questions, like just to give you a bit of behind the scenes. I do a lot of research for these conversations, I read books, I read news articles, I watch YouTube clips, I listen to podcast episodes. I did all of that with this one. but when I got to sit in front of Louise, I basically freestyled and just asked her all the questions that I have previously felt I mean, too embarrassed to ask anybody, like what happens when you go to the doctor to talk about menopause symptoms? L that basic. So if you're with me on that, this is the chat for you What makes a leader worth following? What should you really care about in your job as technology is changing so quickly? Is it just gonna be about machines talking to other machines? I mean, should you quit your job and start something on your own? What would that take? What does success and risk look like when we're all at the starting gate together? These are the questions we answer each week on lead human Myers and Tim Spangler. Join us each week and subscribe at your favorite podcast platform and YouTube We'll tell stories We'll hear from some of the best and we'll try to figure this out together Right, here we go. this is the show Louise, I'm so thrilled to have you. I'm very excited to be here in this lovely love. I've been to sit all day and straight your chairs. wanteductile chairs. they' very. I like to fiddle with, you know textures and a pen and Miss Fidget, so I thought, yeah, these chairs are nice. Very nice. Comforting. You're very calm. much to talk about today. It is unbelievable. Now, of course, you are the doctor known for kickstarting the menopause You're robing your eyes the menopause revolution, but my God, did we need it and do we still need it? And it seems like Many women out there are really on board with having this conversation now and learning and being open minded, but is the medical world ready for this job? It's not. I'm really proud of being a doctor, really proud. No one in my family has been a medical doctor and I wanted to be a doctor since I was four. So you know it's something I feel very, very privileged to be a doctor And I went into medicine to help everybody. I've worked in some really deprived areas, including in prisons, and I never judge my patients because they all have problems but what I learn really young as a doctor is to listen and believe your patients and put them in the center of your consultations, which is what I do every day. The biggest agenda with all of this and I've written a chapter about it in my book actually, is women not being listened to and not being believed and that is something that I'm really, really sad about. So we can talk about whether doctors are educated about hormones or not. which is a problem. But for me, the biggest problem is the stories that I hear every day for women not being listened to, not being believed, not being taken seriously. And in my clinic, you know, when I see new patients Before I finish the consultation, they thanked me. That's before they've used any hormones, before they've had any treatment, because I've believed them and listened to them. And the stories that I hear, the way other doctors have spoken to them. It just fills me with horror because as a doctor I don't know everything But I could say to you, phone, I'm not really sure what's going on. Let me just have a little think or let's do some tests or I'm going to talk to a colleague. and you probably feel quite reassured. But if I cross my arms and say I think it's all in your head You will feel awful. Yeah. And you know I've got a small family and my middle daughter had sepsis a few years ago. and Martha's Lw wasn't a thing then, but I had to demand for her to stay into hospital. And I'm sure I saved her life that night. But I've got a lot of bulls and I've got medical knowledge, but I realize how vulnerable patients are And this is the bigger conversation really about womenal care, health of women, all of that it's just that side of it really arates me. Well, I bet because you know, we all know and we've touched on this in other episodes before to a degree that we know that women's health is not taken seriously when it comes to, you know, and if you think Women, young girls, start their period, could be as young as eleven and then have to deal with You know, fluctuating hormone levels and everything that comes with having a period of menstrual cycle, pregnancy, perimenopause, menopause until we're you know forties, fifties. That's a big section of our lives that isn't really being taken seriously. So I'm sure that plays into a large part of it. Also, I'm imagining doctors being time poor that you get these like five minute segments with you I don't think that's It doesn't take long to be kind to people. You know I've been a GP for many years, ten minute consultations and actually on a Monday morning we used to do five minutute, I can't believe we did it, just to try and get through some of the emergencies for the day. But you can really learn a lot in a short space of time if you listen, but also if you educate people. So as you hopefully know, I've worked really hard the last ten years to try and educate women so they can make choices themselves. So what I feel almost guilty for now is that women are educated like you say. So they might have know downloaded balance, got the symptom questionnaire, printed it off and say to their doctor because it's always one problem one consultation I think it's my hormones because I've got this this, this, this, this symptom. They're really empowered. So as a doctor who's educated, it's really easy because you go, right, I'm thinking hormones now. I'm not thinking palpitation's heart problem or joint pain's rheumatological problem. It's easy. The patient's giving you the diagnosis really But then it's still people aren't joining the dots. and that's what's really difficult. So it doesn't take long. know If you came to me saying, Oh I'm a bit tired and I'm crying a lot and I've got joint p, that's going to take me ten minutes to listen to your symptoms. But if prepared, you've got everything on a tick box and you're saying, Dr. Newson, these are my symptoms. I would now like to talk to you about whether I can take hormones, I've got nine and a half minutes to talk to you about hormones in long time. So it's really for the patient taking back control to say I've got a feeling as to what's up rather than, oh my God, I don't know what's going on with me, but I'm really struggling. I think the ripple effects of women not being informed previously, but also as you say the medical world not catching up with this conversation. as many women and me have got their head buried in the sand. So in many ways, I'm the perfect person to interview today N only about your new book, which I raced through because I was just like I need this book right now. the power hormones will'll put all the details in the podcast copy, but I am that typical mid forties woman who is totally and utterly in denial My head in the sand. I don't know. I think because I have found the conversation around perimenopause and menopause Owhelming at times and you're fed so many different pieces of advice And also people like to regurgitate their own narrative to. whichich then you know, you could start thinking, Oh, maybe I should go and talk to someone about this or should I start hormones? Th then someone else says, definitely don't because of this or the fear mongering comes in. I am that person right now who is still slightly head in the sand and Ive got certain symptoms, my periods are certainly getting closer together. so the cycle is shorter. The periods can be shorter, but I can get a bad headache on day one and a heavy period on day one and then it's kind of very light after that. So I know that there's changes. I know there's stuff going on but I'm doing nothing about it. And I reckon there's a large portion of my listeners of my age who because they're confused. They're confused. I hate my Instagram. I mean, I love it and I hate it. Whenever I go on it there's all this stuff. likeike, o my go, what do I believe? Who do I trust? It's just awful. But can I ask you a question if you If you had like low iron, would you take an iron tablet? Yeah And if you had an underactive thyroid glamp making you really tired wouldould you take the rocks in? Yeah. ye. So it's interesting, isn't it? because You know, that's why in the book, I've written that I hate the word menopause, perimenopause, you know, PMS, PMDD. they're just labels for women. But if I said to you, I've done a blood test for and you've got low I mean I have', by the way, just for your listeners, but you know but you've got low testosterone and that's why you're feeling more tired, you're having headaches, or whatever. wouldould you like to try testosterone? Just for a short time, seeee if it's going to help your symptoms. Yes. It makes the conversation then really easy. Exactly.ess What we need to do first is debunk some of the myths perhaps, All the fears that women have. So you say in your book, only fifteen percent of women in England or the UK are currently getting hormone therapy, the lowest in years now, isn't it? More likely because of these fears. One of the big ones being a story that we've seen in the news Circulating, it goes, it comes back around the link between taking hormones and breast cancer. This is a big subject to dive into straight off the bat. I think it's the one that we need to really important. So I think before we answer that, we need to remember what hormones are because so many people think hormones are something we prescribe They're not something we produce ourselves. Yes. So we produce dozens of hormones. They're just chemical messengers that go into our bloodstream, made in different organs in our body. they all have defined actions, but they're really important for our cells, our organs to work properly. So the hormones we're talking about are only progesterone Eestrogen, but I really talk about estrodol because that's the best form of estrogen and testosterone. to keep it really simple But when I prescribe Hormones or HRT looads of different types. So there's the ones that I prescribe day in day out which are the same structure as estrodle, progesterone and testosterone because they've got their own chemical structure. So they are the body identical natural hormones. you're replacing light with light. When HRT was first made, and that's where you've got that whole history of HLT in the book It was made synthetically because one of the problems, which isn't really a problem, but when they made it more naturally, you could buy it over the counter. But the pharmaceutical companies wanted to clearly make money. They worked with gynecologists and scientists and they made it synthetic version So they change the chemical structure. Now even if you don't know much about chemistry, most people know that water is H two O. two hydrogens with one oxygen atom If you add one more oxygen and make H two O two, it's hydrogen peroxide, it's bleach. So just to highlight to you a small change in a car structure. can make a huge difference of properties. So they change the chemical structure so it's like estrogen, like progesterone and even they've made lots of synthetic testosterones, it's like testosterone But it's not. Does doesn't we workar the same in the body So you know quite simply that putting something that's a chemical in your body is not going to have the same biological effects. No It's not going to bind to that receptor and unlock those lovely beautiful cascades. You know even Lizelle talking about mitochondrial function, I love mitochondria. We need they're the powerhouse of all ourselellves We've got receptors for estrogone progesterone and testosterone on our mitochondria, not for synthetic estrogen, not for synthetic progestteres, not for synthetic testosterone So once you know that, that's really important because All the risks with HRT, including that big terrible study, came out in two thousand two was using synthetic hormones So you can almost discard it. O than the hormones they used are still similar to hormones in contraception. So it brings a whole new like complexity and that's what I do tease out in my book as well. The whole history of contraception because they're not hormones. they're synthetic. I took that without even thinking back. Yeah. I was like, I'll take whatever pail you've got, give it to me. I had did No research. So it's weird that there's so much more focus on Well this is what I find out I wish I'd written this book ten years ago really because twenty years ago, I was the same as you. I took the pill. I didn't actually know. No one taught me at medical school that it wasn't a hormone. It was only because I'm very scientific evidence based. I've had a lot of blue sky thinking as a doctor because I've worked as a medical writer for so long and an educator that I sort of sat down and just thought, what is the difference? that they're all called different. they can't be the same. And then once you understand them and you understand how they work different in the body. it's suddenly this big wake up call and think, hang on They're not hormoonons. We need to be really clear with our language. and women are being Misguided, but so are doctors because the doctors that are scared of HRT merily prescribing synthetic contraception for twelve year olds with acne. Yeah. And I'm like hang on, we don't know we know that all synthetic hormones have a small risk of clot and heart attacks and stroke and cancers. We know that they probably get into the DNA. so whatever goes on might be transmitted to other generations and we've known that with other types of synthetic hormones No one's really looking at that. They're still trying to like stop women from having natural hormones, which improve symptoms but also improve our future health. Is there such a thing as a contraceptive pill that isn't here? wouldn't that be nice So there is and there isn't. So there's one called Zoi Zo ELY, which contains esodol, not ethanol Eestodol Now we've known since nineteen seventy nine, the World Health Organization put out a report to show that ethanoladol is carcinogenic or causes cancer Every combined oral contraceptive bar one contains ethanolodiole All of them contain a synthetic progesterone. Right But what's ironic is that when contraception came to market, it was just for periods, they didn't even test it properly as a contraception. Then they changed the marketing after a year because it was going so well and women weren't having periods. they thought, oh, it's probably fine for contraception. So sales doubled. But they never did testing of the contraception on the bones, the brain, the heart, on our other organs. All the testing was done on the womb N lot of it was done in the war actually as well in concentration camps. It's mind blowing when you read the history. God. Yeah. I think because we were fed at a young age, the fear of getting pregnant tege was so huge. you're like, I'll do anything anything Precisely we were taught at medical school. You know, you have to worry about the risks of unwanted pregnancies and backstreet abortions and all of that. And I'm not coming on to here to say that we can't use contraception. It's like I sort of explain to people sometimes who don't understand like the difference between having roast chicken and chicken flavour crisps. L chicken flavour crisps do not contain chicken They might taste like chicken. It doesn't mean you can't eat cris, but you just need to know they're probably not the healthiest thing to have Yeah. Do see what I mean? And it's the same if it's the only option for you, then absolutely. But you've just got to know there are small risks associated with all these synthetic hormones. I mean Zoly, like I say, the Eterial contains which is better. people top up with other hormones as well. so someone might have a marina coil here, which is a synthetic hormone It can block the ovaries working, so it can lower estrdile progesterone testosterone. So then some people take those hormones as well which will improve their symptoms and future health too. The thing that grs the most, I guess is that all of this is on women and young girls. know notot only do we have no choice, if we're looking first and foremost at the contraceptive pill.K, we've got no choice. We're like, I guess I'll take the synthetic one, but there's a not much research seemingly into let's look at a natural alternative, but equally nothing on the boy slash man. No Well this is why peopleization. Men has never really taken off. if you say to a man Right, I'm going to give you a synthetic hormone that's likeom, but not. It will reduce your fertility but it will probably block your hormone receptors in your brain. It might make you feel low and flat. It will increase your risk of clot and cancer and heart attacks Quite rightly they'll say no and actually to get a drug to market now. is a lot harder Perfect because we've got more stringent rules, we have to do more studies. In the sixties, there was no ethical consent. They had no proper studies. And in fact, when you do read some of the studies, a lot of them, they disregarded some of the risks and the problems because they said we can't prove it's a direct cause. So they had no real idea what they were doing But these drugs were pushed by the pharmaceutical companies. Once it's got licensed, you don't have to do the same stringent studies. So I do wonder appeill was being or the contraception were brought to market now in twenty twenty six Would it get over the line And I can't answer that question, but you know, it's just trying it out there craz. I mean it's a mindfield that I'm happy to dig into and like really dissect it and get into It is so, so important for women. I think because so many women and young girls, even if they I wasn't cognizant of it as a young person, but We feel so out of control in terms of what our options are. I think that's why my head's been in the sand. So let's move on now to looking at you know, women of my agege will be a large portion of my audience will be women who will be perhaps thinking about this or Women slightly younger are thinking, I should start to prepare for what that looks like down the line. When you go to your GP thinking, yeah, I probably have got some symptoms here that are alluding to you know, hormonal changes in my body, are you automatically offered the synthetic HRT initially? Is that how it works? It really varies.ight It there's a big move to change into the body identical hormones. ten years ago, it was very much one size fits all and it was usually the synthetic hormones. So there is a choice and offten people say the patches, the gel, if the patches are just the pure Eadial, and it will stay on them it ass a bit like food. If you look at the ingredients, say. If it says Erad, that's fine. The tablets, micronized progesterone, usually use progesterone in the UK. and then sometimes we give it as pzaries or suppositories. pure progesterone Testosterone in the creamor gel is testosterone. It's not one of the synthetic hormones. But it's important to know because it's not just perimenopause or menopause. So many women have PMS ninety five percent probably of us have PMS. PMDD, premstal dysphoric disorder is a more severe form. Postnatal depression affects eighty five thousand women a year in the UK, and it's all due to hormonal changes, and some women are more sensitive than others to these hormonal changes And these hormones, as you know, are made in our brain. And I'm more concerned about the effect on our brains than anything else Yeah because mental health we know is in a crisis. And we know that more women And children actually, are prescribed antidepressants than they are hormones. But they're misdiagnosed as having. And know we had Kally Beaton on here, a comedian who's writting a brilliant book about the changes in midlife and one of the big cups for her where she went to the doctor and they said, you've got bipolar. and she was prescribed a ton of medication and then she realized she was going through the menopause and it hadn't even been on the doctor's radar toiz her. I mean, you know, I'm doing my theatre tour at the moment and I've called it breaking the cycle the power of hormones because people are locked in this cycle of mental health. Once you get diagnosed, Usually with a mental health condition. That's it. You're on this trajectory with antidepressants, antipsychotics, lithium. I've seen people that have had ketamine infusions, eight thousand pound ketamine infusions, forty five year old woman, no one asked about her hormones. No one thought about her hormones. And this is really scary because we know and we've known for decades the importance of hormones in our brain improve our mental health. And actually sixty years ago, doctors were giving natural hormones for postnatal depression, postnatal psychosis, PMDD, natural progesterone. It's not rocket science. No. And women improves. You know, we've got all these other chemicals that people have been given whether it's synthetic hormones or whether it's antidepressants, antip psychotics. And very few people are thinking about hormones and it doesn't make sense Howdy, Howdy Hoe and welcome to Fantasy Fan Fellas. I'm Hayden, producer of the Fantasy Fan Girls podcast and your resident lover of all things Sanderson. And I'm Stehven, your bookish internet goofball, but you can call me the Smash Daddy. And we are currently deep diving Brandon Sanderson's fantasy epic Missborn. But here's the catch. Stehven here has not read Missborn before. That's right, Hey, Hey. So each week, you'll get my unfiltered raw reactions to every single chapter And along the way we'll do character deep dives, magic explainers, and Stephven will even try to guess what's next. Spoiler alert, he'll be wrong. News Flash, I'm never wrong. Episodes come out every Wednesday and you can find fantasy fan feellllowas wherever you get your podcasts. If we like know very little about hormones Yeah, what are our hormones impacting physically mental? What are they doing? So they affect every cell in our body. So that means every organ. so you could literally list, you know, going from your head down, literally, obviously so many functions in the brain, so that's why memory problems, anxiety, low mood concentration, sleep problems related to hormones changing in the brain eyes, dry eyes, mouth, burning mouth, sore mouth, teeth changes, even smell changes, you know, just going down the body Palpitations is very common. breathing changes can occur. asthma increases without hormones, for example, coughing extracted sleep outnea where people have breathing at night Muscle and joint pains really, really common. alsoso gastrointterstinal symptoms. a lot of people in their forties get diagnosed with irritable bowel syndrome. A lot of that's related to our hormones. W. Our hormones affect our gut microbiome in a positive way. so if we don't have them Bloating, heartburn, indingigestion, very common symptoms, constipation, all of that can occur. It's basically everything. It'schically everything. Every urinary symptoms, really common, UTIs, incontinence, you know, weeat bladder, all of that can be related to hormones as well, restless legs. I mean, we've got a symptom questionnaire that we use for all our patients, but it's also in balance the app And it's got over eighty symptoms because I extended it, well, you did use one that had twenty one symptoms, but I extended it a year or so ago because I find it really useful as a doctor so I can eyeball all those symptoms. But also patients do and women because they look and go, I didn't realise. I didn't realize my hair changes, my skin changes. all of this could be related. And that's really important because often You know, when you ask women, they're quite intuitive. Oh yeah And if the symptoms are similar to maybe how they've had those days before their periods, they're more likely to be tuned in and go, you know what? I think there's some hormonal change. And it's just the suffering. You know, so many women are having these symptoms are just putting up with them. E PMS, for example, you know my daughter has My oldest daughter has PMDD and she's had a really difficult time and thankfully she's so much better because she takes natural hormones, but she's had some very, very dark times. She said to me, but I mean, it's just not those three days that I feel awful, the rest of the month I'm dreading those days coming. Yes. She's a trombonus. So she said, what happens if I'm doing an audition or'm you know, I'm playing in a concert I can't function, she said, But the rest of the days, when I'm feeling great I just think sly I can't feel this bad. It must be You know, it can't because it's so black and white and then it comes and I'm just like in this hole. And I see that so much of my patients and I see a lot of her friends as patients now. and a lot of them are great, really clever musicians, they're quite neurodivergent. A a lot going on. a lot of them have had very difficult upbringings. so they've always been blamed for their trauma, their past or whatever I give them often just some natural progesterone for a few days when their mood dips of the cycle. And one of them said to me other day, Louise, I' just like to thank you because you've transformed my life. Are you sure it's legal to feel this good every day of the month? And it really made me think th fir because Yes, we should feel good every day in the month. L C you imagine saying to a man, like once a month, you're going to have a duve day. You're probably get a bit shit, You won't want to go to work. You' you're going be paranoid that you're be I'm constantly like, can I wear that outfit at that time of the month? I'm going to be checking the whole time. paranoia dont worry. Can I get to a loo quickly if I'm out in publicly. And then there's all this about you should change your exercise. So there's a few days before your month when you' Hormones are low, you could just like not do so much cardio and you should rest. and it's like, hang on, stop it. If we're getting any symptoms, the first thing as women we should do is think, right, could it be my hormones and could topping up my hormones in a very natural way help Because evolutionary, we have to remember we are designed to have hormones in our body. And you know in the Victorian times, we were pregnant more than we weren't. You know lots of pregnancies, really high levels of hormones actually in our body. but the average age of menopause was about fifty seven, the average age of death was fifty nine But we have to be thinking, actually, these hormones are really beneficial for our day to day functioning, but our future health. So women who don't take hormones have a higher risk of inflammatory diseases, heart disease, osteoporosis, diabetes, dementia, autoimmune diseases, multiple sclosis, all those diseases of the increases we age increase without hormones And studies have even shown women with PMDD because they have half of their cycle or a weaker cycle. So you know a good chunk of their time without hormones, they have an increased risk of future diseases. So we have to sort of spin it on its head a bit and think What are the risks of we not having hormones rather than what are the risks? Because taking natural body identical hormones, how do they have risks when they're our own hormones? So is there any risk of, say the big one that we keep getting fed in the pressed breast cancer? Is there any risk of that with the body ident? So when we look at the study, that scary study. There were two groups of people, there were people that they only gave estrogen to, and that was the pregnant horse's urine. So it was a bit different to what we prescribed now, but it had estrogen in it.. But there was also the people that had estrogen with a synthetic progesrogen called magoxypgesterone acetate, which is still used in contraception now. The risk of breast cancer was small, wasn't statistically significant, was only in the arm of the study that had the synthetic progestergen. Right. The ones who had estrogen had about a forty four percent lower incidence of breast cancer. So there's no evidence anywhere in the studies that estrogen causes breast cancer which is really important for people to know. So if you were to go to the doctor and they And they took their symptoms seriously. and they said, right, we're going to prescribe you HRT. but it was the synthetic version. Do you have the autonomy? Yeah actually GP say I want body identical. Yeah. Firstly, but body identical is actually depends on on the region, but it's similar price or slightly cheaper than the synthetic. So they can't use cost as a thing The guidelines that I think are the most important are shared decision making guidelines, which is for any condition. So if I'm your doctor and you come to me and say, I really don't want to take iron and I've got low iron and I'll say to you your welfare, and you've got the risk that you're going to be more tired. and you know you've got this low iron and unless you eat differently or take an on subance, it's going to carry on You might say, Well, that's fine, I want to carry on like that. You are allowed to be involved in that consultation and share the decision, even if your decision isn't what I would recommend as a doctor. So this is what's really important that people know and it's really that's why it's so sad that people do go to their doctors and say I would really like to try hormones. I would like to try testosterone and then met with this no. I met somebody at the theatre a couple of days ago. She said to me, she felt so prepared for a consultation. She printed off some information from Balance app. She had the questionnaire, she went to her doctor and her doctor said This information is wrong and Dr. Louise Newson, you don't trust stood up and marched her out of the consultation room. So she was crying and said I've just given up now. I'm sixty two. There's no point me even trying to go back to another doctor She might have twenty thirty years of her life without hormones putting her life at risk and she wanted to try them This is where I just in my head, I get so sad because these stories all the time. And you know, not only are you trying to get this information out there and debunk you know myths that are putting women off getting the help that they need You genuinely want to help women, want to stop the suffering of women in general. You personally have had a lot of backlash. You had to And I can't even imagine how that's felt. When you're passionate about something and you've spent your life's work is studying this, to be constantly pushing against that must be personally. I mean, you know, you've got children. It's not just me. it has had a big impact on my whole family, you know As a mum, you're the strong person get all the everything together For them to see me broken last year is really hard. really difficult, but you know, I've got three daughters and they won't let me stop working. They're like, you get back out there because every day you're helping these women, these women who have suuicidal thoughts. you know, one in six of our patients have suicidal thoughts You know, I've funded a PhD student in suicide prevention and we've got some amazing results. You know, a lot of people they can't they've got anywhere else to go to But last year I was close to having to close my clinic because of the financial impact that Panorama did to me And it's like if that goes, balance that goes, my podcast goes, everything goes. But also You know, I went into medicine to do the best and I've not done anything wrong. There are loads of doctors out there that have done things wrong and you know, they should be sanctioned but often they get off So I feel So strongly because I'm very fortunate. I'm on hormones and I know who to go to, I'll be pleased to know to get good advice. You know, when I was doing some voluntary work in prisons, these women have no voice and no one's prescribing them hormones. You know, I said to the prison doctor, do you ever prescribe testosterone in the prison No, why would we do that? Women don't need a libido in prison I suppose in a same sex relationship, but you don't always need a man and a penis to have a libido. I mean the colour just drained from her face and then obviously they reported me for even going into the prisons and educating women. and this is where I feel like sad because I'm not here saying you have to take hormones, but you have to know. You have to know the benefits, you have to know the risks of not having them, and it's about choice. And my role is really as an educator. reallyally you know, people come to my clinic because they've decided they want hormones and they want the right dose and type for them My work is so much bigger than the clinic. It is just allowing people to have this knowledge that has sort of been hidden from us for so long. and I've spent a lot of time you know thinking and reflecting and I'm very evidence based. you know I think there's about thirty pages of references in my book because I'm very clear that I am telling a story. People keep calling me controversial. I'm like, well, I'm not inventing a new drug. you think just because you're wanting to bust the myths? Yeah, I think so. I think sometimes the truth hurts and it's uncomfortable' I didn't say I'm happy because I'm not happy but I wouldn't say like I don't mind admitting to you, F that I was that doctor that used to give contraception for heavy periods. I was the doctor that used to give forty five year old women antidepressants because I didn't know about the effect of hormones. I was that doctor who, you know gave biolog agents to people with rheumatological problems, because I didn't know there was an option. I didn't ask the right questions And I've done a lot of hospital medicine and I look back and I think All these women I saw All those women that we were admitting with all these different conditions and I never thought about it But you know, it's like anything in life you learn And then you say, okay, I'm going to change my practice, but it's this resistance for others to learn. is harming women. and that's really sad. And what is that why you've been occasionally called controversial or you've had shit thrown your ways because you want to do things differently and the medical world is a bit stuck in time. I think there's this and I've written about it in the book. I mean, medicine is very patriarchal. Yeah. My husband's a surgeon Obviously, you know, I courty to him every morning. I don't, but you know. there is mutual respect. But there is this thing that in medicine, there's the surgeons, and there's the physicians and then the GPs really at the bottom, which I really challenge because, you know, I was doing hospital medicine. I only went into general practice so I could see my children and go part time and help you bring them up really. But I've always worked as a medical writer. I've written books on evidence based medicine. I've got pathology degree, science degrees. so you know I am clever, but I'm very inquisitive. I like to know like But why? but why? you know, I'm one of those people. But in medicine, you often learn from your peers. So you learn from your senior doctor. and if they tell you something and it's in a guideline, then you do it. and we're quite robotic Because I've written and summarized guidelines for the Royal College of GPs, I worked for them for twenty years I'm used to like looking at the guidelines, looking at all the references that have been used the studies, looking at who's written them, what conflicts they might have, which farmer involvement they've had, for example, and then summarising them properly for people. Lots of people don't have the luxury of that time And I think what's happened is in the past Menopause hormones has sort of been owned by gynecologists, if you like. I'm not a gynecologist So some gynecologists have got quite rattled. and I know that because I've had a subject access request. I've got three hundred and fifty pages of emails that they've written about me I' really frustrated that I'm doing a work unconventional ways as well, because women in the past, like Katrina Dalton, who prescribed a lot of progesterone for women with MDD and postnatal depression was really slated as well because she was only a GP. and she could reach her patients But you know what it's like with the podcasts, with social media, you can reach people that you're never going to make money from. You're never going to know, but you're empowering them And that's what I think a lot of them haven't liked the way that I've gone about things, but also and they have told me because inverted commas I'm only a GP. and I find that really, really frustrating. and it's sad because it's other colleagues. like we've all got plenty of work to do. and patients can choose. We can agree to disagree, but not do it to the extent that you make Panorama documentary about me and try and ruin me professionally and personally. Yeah. mean Horrific for you. horrific, but also like you say for all the women that you desperately want to help. And you say in the book want menopause pro menopause to just be seen as a gynecological issue because as you stated a moment ago, it's affecting literally every part of us physically and mentally. and maybe we're being reductive in terms of conversation It's just the reproductive part of women's bodies and that's it. Whereas we know it's not that.' But it's just stupid, isn't it, really? too think that women are just their periods of fertility. doesn't make any sense to me. And even the testosterone conversation You know, some people, you just look in the media and all these experts are saying We so scared, there's over prescribing of testosterone, it's getting out of control. Somebody, a doctor even wrote that it was abusive. the amount of women who are being prescribed testosterone in private clinics. She didn't kindly mention my name, but I'm sure that's where she was pointing a finger at. Now if you work out the stats It's about zero point eight two percent. So less than one percent of women are being prescribed testosterone That isn't out of control. What is out of control are all the drugs that people are being prescribed instead of testosterone? And we've published some data that women who were on testosterone as well as progesterone and esodile We can reduce their antidepressants, their antipsychotics, their're painkillers, they're gabapentin, they're progabolin. You know those drugs I would lose sleep about prescribing for my patients, I don't lose leep about prescribing natural hormones to patients who feel better. You say that testosterone is the most misunderstood hormone. Why is that Well, look at the name, test. It's come from the testicles. We don't have testicles. So that's really confusing Yeah. And then what happened is you know the history of it, once they discovered testosterone, they made synthetic testosterones, went to market and then athletes got hold of it. So then they were pumping themselves with synthetic testosterone. so then they have this weird body shape, they know it's associated with heart disease, other problems And so that's why it's a banned substance. Even in sport, women are not allowed any form of testosterone, which is crazy. But we prescribe the same chemical structure. as our own testosterone And testosterone is made in our ovaries, our adrenal glands, but also in our brains as well And so it's the most biologically active hormone we have Testosterone starts to decline in our late twenties, early thirties. So it's not a menopause related to women.' not men women. but it's not men. It's later. usually in the forties and fifties. Yeah, but it's a problem for men too. and men struggle to get testosterone. But women especially and then when you look at the guidelines, they say it's if women have reduced sexual desire. And then some menopause societies say women have to have this ridiculous disorder called hypoactive sexual D disorder, which is HSDD for short. If you look at one of the criteria, it says that women have to be severely psychologically distressed with their reduced libido for at least six months.. So like can you? I mean been suffering of course. So if you've been suffering for five and a half months, I'd have to say no sorry phone and come back in two weeks. L it's just sory, it's just bullshit. It's just ridiculous. but also Why does someone think that Lbido is just like an The testosterone is just a tiny bit of our libido part of our brain when it affects every cell in our body. And we've known since the nineteen forties that testosterone helps with wellbeing, it helps with mood. They used to give it to people with period problems as a menopause treatment in the forties That's like years ago. So we've gone backs. We've completely gone backwards. Yeah. Going back to something you said a moment ago, something just sparked in my head. If you are a woman who has an inkling that You know, your hormones are changing, but you are on anti anxiety medication, antidepressants, etcetera. Can you take hormones the same way? Yeah, there's nothing that will interfere with natural hormones because that's what they are. If you sa this me, lots of people told someone contacted the clinic the other day and said, Oh, I've had a meningioma. I've been told I can never have hormones. So meningioma is benign brain tumor. It's like, well, of course you can. You know, there's very few conditions that you absolutely can't have natural hormones because that's what they are. The synthetic hormones very different. Okay, so that's a really good thing to clear up because I think again, some people are completely put off because someone has once said it to them abolutely. L lots of people are told if they've got a family history of any cancer, they can't take hormones. Someone last night because they do a live Q and A in the show as well said that one of their family members had a clot. they're worried about the clot risk. There's no clot risk in progesterone estrdol or testosterone So just because you've been told something, the chances are it's not right There's also a terrifying fact in your book. You say that the suicide rates for women are the highest since nineteen ninety four in the age bracket forty to fifty nine, which as we know, it's quite clearly the hormonal change, perimenopause, menopause era of a woman's life. but there is littleittle if any correlation to hormones when we look at how the medical world are viewing those really scary, very real suicide rates. How do you feel about that? It's terrible. It's one of the reasons that I work as hard as I do because I worry I really worry about suicides, mental health We know that about eighty four percent of women with PMDD have suicidal thoughts. I mean, that's huge. But like you say, Suicide rate has increased in these women. And of course, there's lots of reasons why people might want to harm and end their lives, but we can't keep ignoring the role of hormones because we've known for many, many years that hormones can improve mental health, reduce suicidal thoughts You we've just published data to show that ninety two percent of women with suicidal thoughts reduce their suicidal thoughts when they're prescribed progesterone, estradol and testosterone ninety two percent reduction I've already said one in six of our patients come to our clinic with suicidal thoughts Like, why wasn't that in the front page of the papers I don't know, and I might be wrong I'm sure your listeners will tell me. I don't know of any psychiatric drug that will reduce suicidality by ninety two percent that doesn't have long term effects And you know I rose a training module for the Royal College of GPs a few years ago And it took me a few years to get it over the line because I kept pushing back on the data and saying we don't have enough evidence. I said you do? There's this, is this, is this. Anyway, got it over the line. I actually paid my money so it was free access for psychiatrists. And I got aprized because it was the most downloaded course. Lots of psychiatrists learnnt. For the first time about the role of hormones in the brain, some of them started prescribing hormones to see, seeing the transformation effects And then a few weeks ago someone from the British Menopuse Society contacted them to say that I overve exaggerated the effects of hormones and they've taken the course down. What? And I've given them more evidence now because we've published since you the course came out And they said it's under review at the minute And I told them that I would, if you don't tell me what's going on, I'll tell people in the theatre all, so I have done. because I'm really sad. and they said, you know, I know they've had complaints from psychiatrists about it And it's just it's harming women I'm not saying that all mental health can be cured by hormones. I'm not saying all suicides can be reduced by hormones, but I am saying and I've seen it time and time again, you know, I've saved lives from women who are on hormones and they've tried everything else, you know with in theat where I'm going with a guy Jay who's twenty six and his mother had thirty years of being in a psychiatric hospital she had First mood chang was after a termination of pregnancy. She had postnatal psychosis three times. She had PMDD. Her mood worsened when she tried contraception Then she was perim menopause and he just reached out to me on Instagram eighteen months ago. And I managed to persuade the psychiatrist to prescribe for her. Now Ive prescribeed Full h The GP won't have anything to do with her, Do doesn't won't prescribe hormones, yet they'll prescribe the lithium, the ciopene antidepressant for her. She's had electroconvulsive therapy over the years. Nothing has transformed her life like hormones. It's there in black you know what I mean? But I've seen it so often. And like I said, I didn't know it when I did psychiatry training. I didn't know it as a GP But you learn, you know, I've learned from scientific evidence, which is there when you look for it and basic physiology. that's why in the book it was so important to write about the basics of how hormones work. so others can work it out for themselves. But then I've got a wealth of clinical experience. You know, we see so many women in our clinics constantly, you know writing up our data, sharing with other people We just have to we have to join the dots because the suffering is palpable, not just in the UK, but globally. Well, of course. women out there feel like there's something up and they've done nothing wr it M. Yeah What would your one bit of advice be? I would say download balance, get information that's right for you, ignnore the noise. It's like having children. everyone will tell you things. You've got to do what's right for you. 've got to make sure that the decision is right for you And no decision is irreversible as well. So but I would also seek out someone who really understands hormones, have a really good conversation about it, but also trying to have that mind shift about Is it right for not just me but my family, my friends, my colleagues, if I keep ignoring it and not having hormones. And often I say to people who bit like you're going notot really sure. I'll often say lookook, I'll rebalance your hormones in a physiological way. You've got to wait three to six months for them to have an effect And then decide. If you don't want to carry on, I'm not coming around to your house and putting them on for you every day, then you stop. but then you can decide. And it's really hard because also when you don't have hormones, your brain doesn't function properly. you often overthink and catastrophize and think about things that really you shouldn't worry about. Yeah, that's me. Yeah, there you go. That's me. obviously Many people out there will be in a heterosexual partnership and their partner will not have a fucking clue about any of this. will have checked out this conversation weirdly seems to actually determine completely or they just think, o God Time of the month, hormones, all the usual stuff that we're fed. But if you're in a loving partnership, of course, you know, it's a two way street. You want to support each other. If one person' struggling, the man or the woman, then you want to be there for each other. So I believe that men should be fully integrated conversation. Absolutely. One thing do you think all men out there should understand about Penopauses menopause. This should probably be listen to my podcast for Joe Warner because that's a man talking about, you know, from a man's experience They should know that hormones affect women, but we can do something about it. So I really feel that men partners, whether it's heterosexual or same sex relationship They should be an advocate for that person because you know, when you're with yourself twenty four seven, it's really hard. you can always sort of make excuses for how you're feeling. If you notice that your partner's changing mentally, physically, it doesn't matter. You should, rather than just normalizing it, say look, I'm going to read this book I'm going to listen to podcasts. I'm going to work out, let's try and work together. and let's go to find a doctor who can you know give you or talk to you about having treatment so you'll feel better. And so many partners come to the consultations with us and it's really important. lovely. It's so lovely. It's really lovely because You know, they they really care. it's not just because they want to have sex again. if they really care. you know, divorce rates increases It's it's quite Aful but we need to. and you know, I only suffered symptoms for about six months and my lovely husband really didn't join the dos at all And I didn't because I thought I'm just working too hard. I'm just like I've got three children. I can't cope with my work. the people at work weren't very nice to me and everything was just and it was really it was actually my My daughter who's now twenty one, she was about twelve And she just said to me one day, Mommy, you are so cross and irritable. I just wish you'd have your period and your mood might improve. And then I suddenly went, Ohophia I haven't had a period for about six months, that's why I've got all these symptoms. But it took her and she obviously my children are very well educated about hormones now, but then she didn't know. She was just using common sense because she knew her friends, their mood improved when they got their periods So we can't be normalizing it. And that's why I feel really sad. So many people are like, let me hold your hand and talk to you while you're having these symptoms. And people also think it's some transition that we go through. And there are all these people on Instagram saying, you know, it's a phase of our lives. It's not a phase in our lives. The low hormones last forever And we have to wake up to the fact as women We're less healthy the last ten years of our life At the age of sixty, most women are on six, seven medications, they're on antidepressants, blood pressure treatments, statins, painkillers. You know why? But whereas if they're on natural body identical hormones, they won't be needing all these medications. So we're sort of investing in our future health as well with hormones. And also all of those other medications you've just mentionedar far less about the side effects of those. Hear me. Some of those, and I've been on antidepressants, I couldn't tell you what the side effects are. I didn't look into it. No. I just was desperate and was like, I'll take them. Whereas with this one, you could live under a rock and still have heard the breast. This is the thing. So you know, antidepressants have a risk of early death. Dmentia, osteoporosis Yeah. I didn't know. So who tells people that no one because theyre just pushed out like smarties. I read the other day that one in seven children in the US are taking antidepressants Like it it's awful Yeahet, you just mentioned the word HLT and everyone going everyone cancer cancer cancer Contraception, know that's where I feel like it's a double standard really. But no one really talks about the benefits. And in fact, it was amazing because I'm sure you know the FDA in the US did this big announcement last year that they were removing the black box warning of estrogen. So you've got doctor Marty Mcari, who's the FDA health commommissioner who says that he estimates fifty million women have been harmed by not having hormones Like that's a big thing for the government to state that So that's probably an underestimation And that he was saying they have been harmed, they want to change it But it's still every day because you've already said for fifteen percent of women And that's fifteen percent of On average, in areas of deprivation, it's as low as two percent of women who have hormonal changes are taking hormones. So the harm of not having those hormones is happening every single day I feel like I need to go consolidate that process everything that you've just told me in the best possible way. because this is a conversation that I've wanted to have for so long. You know, since probably since I hit forty where I was like, well, yeah, things are changing. I'm noticing things. I've just been like head in the sand, head in the sand So I am so grateful for your time for reading the book. I mean, we've literally skimmed the surface of a very big conversation. so I would urge everybody to just read the book, Listen to your podcast, do the research if they want to get more information on this, to make the right decisions so we can all feel as empowered as possible to walk down a path that feels right for us rather than be so bombarded that we bury our heads in the sand, pretend it's not happening, or deny ourselves of help that is available. Before we wrap things up, I want to first of all ask you a bit of a careful question that's not related to menopause at all, but we're making a playlist at happappy Place of songs that make us feel great. and I wonder if there's one song that make puts Pepp in your st. Well I've been doing a bit of a warm up song like for the theatre tour just because I don't want my voice to go. I've got so many tours left to do. shows left to do. So I really like My lifeife by Billy Joel. Oh, I love that s. Yeah, because it's a bit of an FU to other people. like just leave me alone. It's my life and my children sort of for me last year when I was having some dark times because of the stuff that's going on. And I just it makes me just feel good actually. and a bit stronger, which I think is great. We all need that. I love that. And where Louise is your happy place? O my yoga mat. Yeah. Yeah. I do yoga most mornings and have I do a Stanger yoga And my teacher is now sevenenty, James Pritcher, He's amazing. I've known for twenty three years. And so my yogaat if I'm allowed to think with James because his voice, he's just so calm and it's just like I mean you do yoga, don't you? I've never done Ahanger. I've never never tried it even. It'. Well it's the whole primary series it's just's a whole every breath is a movement, It's a lovely flow. It's really lovely. It takes about an hour and fifteen minutes to do properly. But I do it with him every week It's a bit difficult with the allour That's really p. And I just love doing headstands. It's like I love a headstand. I just love it. And it's one of I think I also do it because I know like a lot of these people that really hate me can't do them and I like it's just's of a p thing as well. But I do like it. And I'ort thing I don't keep doing the most mornings O day I'm not gonna be able to enough. I want to be like a sevententy year old woman doing headsts.e too. I' be forever. I also think turning yourself upside down once a day is a really good thing. I do handstands up against the kitchen cs every day. And there's something about it. It is just like I needed to do that. know Oh it's great. I love all that blood going to your brain. It's briiant Well at Dr. Louise, what an absolute pleasure to have you on. It's been a chat that I really needed to have, so thank you so much. Thanks for inviting me. God, thank you, Louise. My main emotion coming off the back of that is relief because as I said at the start