Advisory: this podcast contains themes of mental health and suicide. In this episode, Jo shares a moving account of her menopause experience before finding the right treatment for her. Struggling with numerous symptoms including vertigo, dry mouth and eyes, joint pain and vaginal dryness, Jo went from not visiting her GP for six years to monthly appointments. After being prescribed a cocktail of medication and spending thousands of pounds on dental treatment to no avail, Jo felt she was never going to get better. She talks to Dr Louise about the effect of low hormones, and the transformative impact finding the right dose and type of HRT had on her mental and physical health. Jo’s three top tips: Download a period tracker, such as the balance menopause support app, to track your periods. This will help you notice any changes and identify any patterns of other symptoms occurring. Educate yourself: try to read as much as possible about the menopause so that you can understand what's happening with your body. Reach out to friends: by being honest and saying how you're feeling, you can help others to open up too.

In this episode, Dr Louise is joined by Kat Keogh to talk about Dr Louise’s new book, The Definitive Guide to the Perimenopause and Menopause. Packed with advice and information from leading experts, it is the definitive, accessible and evidence-based guide to help you navigate your perimenopause and menopause. It covers key facts about hormones, family histories, the complete guide to HRT, libidos, mental and physical health, how menopause affects careers and relationships and so much more. Kat, who works at Newson Health, shares her top three reasons to buy The Definitive Guide to the Perimenopause and Menopause: It gives clear, practical advice on talking about the menopause with your children. If you’re starting, at any age, to feel like your hormones are off balance, buy this book to find out everything you need to know about the role of hormones in your health and how to manage that. If you’re struggling and alone with the perimenopause or menopause, turn to this book for reassurance, support, knowledge and to be empowered. Order your copy here

Dr Walter Rocca is a neurologist from the Mayo Clinic in Minnesota, USA, where he studies common neurological diseases as well as the aging processes between men and women. He has a particular focus on estrogen and the effects of menopause on health risks. In this episode, Dr Rocca explains how sex hormones have a much greater role in many of the body’s functions than simply regulating the menstrual cycle and reproduction. He explains why it’s so important to treat women with hormone replacement after bilateral oophorectomy with or without hysterectomy or early menopause, especially younger women. Dr Rocca’s three take home messages: The ovaries are a tremendously important organ for healthy functioning of our heart, brain, bones, kidneys, lungs and more. For healthcare professionals: be very careful when thinking about removing the ovaries and/or the uterus, unless there is a very clear clinical indication. The longer-term harmful effects of these surgeries are greater than the apparent short-term benefit to symptoms. If a woman has a high genetic risk of ovarian cancer (>40% risk level), removal of the ovaries is appropriate, but she should be given estrogen therapy afterwards as the risk associated with this treatment is very low (including for BRCA carriers). If a natural menopause occurs early or prematurely, these women should also be offered estrogen therapy, unless there is a specific counterindication. More about Dr Walter Rocca

Dr Namugga Martha Monicah is one of four female urologists in Uganda. She recently completed the Fellowship of the College of Surgeons (FCS) exam at the College of Surgeons East and Central and Southern Africa (COSECSA) exams, finishing top of her class. She was supported with a sponsorship from Newson Health. This episode of the podcast, released on the eve of International Women’s Day which this year centres around equity for all, looks at women’s health and access to care in Africa. Dr Monicah tells Dr Louise Newson about the barriers to women’s health in Africa, the shame surrounding it and the international support making a difference. She also addresses the stigma around the menopause and the need to move past a ‘suffer in silence’ approach. Guest’s three tips: Anyone in the world who listens to the podcast, know that there is somewhere where menopause doesn’t have to be taken on humbly and that something can be done to improve your quality of life. To the African girl child, know that despite all the challenges, the hurdles, you can still do it, you can still emerge victorious. In whatever small way, any individual can do something to improve the life of another. For more about Dr Namugga Martha Monciah, visit https://www.baus.org.uk/professionals/urolink/urolink_home.aspx.

Dorothy Byrne returns to the podcast this week to discuss her previous role as former Head of News and Current Affairs for Channel 4 television and the commissioning of and reaction to the menopause documentaries. She also updates us on her new role as president of Murray Edwards College, Cambridge University – one of only two higher education institutions in the UK for women only – and how she hopes to inspire young women especially in the fields of medicine and science. During the conversation, Dorothy shares some of her experiences of how a menopausal lack of sleep affected her at work, why she continues to take HRT in her 70s, and the ongoing systemic gender discrimination in medicine and the workplace. Dorothy’s advice to women who are struggling to get menopause treatment: Go to your doctor and ask for accurate, up to date information about HRT, and if they are not able to provide this, ask to see another doctor Don't think you just have to put up with your symptoms Don't be embarrassed by anything related to the menopause. If something’s going on ‘down below’, find out what the cause of it is, it may well be the menopause and there are effective treatments available.

Nina McGowan is a visual artist and Bikram yoga practitioner from Ireland who discovered freediving while on holiday in Egypt when she was in her mid-forties. Shortly after she turned 50, Nina secured a world record dive of 43 metres that involved holding her breath for 2 minutes and ten seconds. In this episode, Nina explains how her yoga practice helps her free diving and she outlines the benefits of eating well, sleeping well and clearing your mind to focus on your breath. Nina also shares some of her own personal experience with her hormone journey and seeking out the right support. Nina’s three priorities for a positive lifestyle change: Prioritise your sleep and protect that space Make any diet changes slowly and one at a time Have faith in yourself to take a step into the unknown and a bridge will appear across the chasm. Follow Nina on Instagram

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.

Breast cancer specialist, Dr Tony Branson returns to the Dr Louise Newson podcast two years since his first appearance. Tony is a Consultant Clinical Oncologist at the Northern Centre for Cancer Care, based at the Freeman Hospital in Newcastle upon Tyne. In this episode the experts discuss the current situations women can find themselves in when having treatments for breast cancer and experiencing the onset of menopausal symptoms. Tony supports the women he sees through some challenging decisions around managing the risk of cancer recurrence while for some, treating menopausal symptoms with HRT to improve the quality of their lives.

Two important issues for women come together in this episode of the Dr Louise Newson Podcast featuring guest Joeli Brearley. Joeli founded the charity Pregnant Then Screwed after she was fired from her job the day after telling her employers she was pregnant. Joeli wanted to create a space for others to share their stories of discrimination at work, which quickly grew into Pregnant Then Screwed, a charity dedicated to ending the motherhood penalty and campaigning for change. Joeli shares a personal story of her own changing hormones in her late 30s; she recounts her struggle to be listened to by healthcare professionals and to find the right treatment for her symptoms that were exacerbated by progesterone intolerance. Joeli’s three tips for women who think they might be perimenopausal: Talk to other women, it’s a great way to find out really useful information Keep going and don’t give up. Trust in yourself and how you know you’re feeling. Keep pushing for what you feel you need. If you don’t feel well and feel like you’re going mad after having the Mirena coil fitted, tell your healthcare professional. You could have a sensitivity to the progestogen in it and there may be a better alternative method for you. For more about Joeli’s work and her books, visit pregnantthenscrewed.com Follow Pregnant Then Screwed on Instagram or Twitter.

Dr Louise Oliver, a GP and functional breathing practitioner and therapeutic life coach, joins Dr Louise Newson as a guest on the podcast this week. Louise Oliver has had a special interest in women’s health and menopause for many years and now incorporates her skills as a functional breathing practitioner to raise awareness of how breathing is altered by hormones, how this can lead to symptoms of inefficient breathing and how to improve the connection between our brain, body and breath. Louise’s three tips to breathe more efficiently: Be aware that your hormones affect the way you breathe and how you breathe affects your health and wellbeing. Learn more about breathing. The book ‘Breath’ by James Nestor and all Patrick McKeown books and podcasts are excellent. Assess your breathing efficiency by observing your breathing at different times over the next week and see whether it matches the description of effective breathing as discussed. Improve your breathing efficiency by learning the techniques and dedicating some time over a number of weeks and months to adjust your breathing style until it becomes more natural for you. For more about Dr Louise Oliver, visit her website. The video link mentioned in the episode from Mr Vik Veer, ENT consultant, to improve snoring and sleep apnoea can be found here. Louise is on Instagram as @drlouiseolivertlc and on Facebook here.

Dr Marianne Tinkler is a respiratory consultant from Swindon. In March 2020, Marianne contracted Covid-19 and had to take a month off work with a severe cough and extreme fatigue. She returned to frontline work on the wards at the height of the pandemic but found it difficult due to ongoing symptoms of tiredness, breathlessness, a racing heart rate and significant brain fog. Later that year, when long COVID became more recognised and Marianne was continuing to experience severe symptoms, she was encouraged to take an extended break from work, and this gave her time to reflect on her hormonal journey as well as learning how to navigate life with long COVID. In this episode, the experts discuss the relationship between long COVID and the perimenopause/ menopause, the barriers to accessing treatment and some of the benefits of diet, movement and HRT for those suffering with long COVID. Marianne’s advice if you have long COVID: Pace yourself carefully and don't ‘push through’. Track your symptoms on the balance app and consider HRT if you think some of your symptoms may be due to perimenopause or menopause – even if you think you’re ‘too young’. Look at your diet and activity levels and eat foods that are good for your gut microbiome. Try and get outside every day, even if your energy levels will only allow you to sit on a bench.

Mr Osama Naji is a consultant gynaecologist at Guy’s and St Thomas’ hospital in London and he leads the busy department of women’s cancer diagnostics at Guy’s Cancer Centre. Mr Naji specialises in early detection of pre-cancerous conditions and is an international expert in advanced gynaecological scanning, contributing significantly to scientific research in women’s gynaecological health. In this episode, the experts discuss the complexity and influence of the menstrual cycle, bleeding on HRT and when it should be investigated further, and the safety of HRT with regard to gynaecological cancers. Mr Naji’s three take home messages are: The workforce of women is needed now more than ever, therefore we must invest in women’s health and wellbeing and paramount to this is education about HRT. Endometrial cancer is on the rise but can usually be detected at an early stage and treated very effectively through raising awareness, identifying the causes, managing risk factors and engaging and empowering the patient. HRT is the very last item on the list of risk factors for endometrial cancer, therefore believe and trust the patient on whether the bleeding is abnormal for them and work through the management process using a shared decision-making approach. For more information on Mr Osama Naji, visit www.rylonclinic.com

GP and menopause specialist, Dr Sarah Ball, makes a record fifth appearance on the podcast this week to discuss her work exploring experiences of menopause care in women who have had breast cancer. The experts discuss findings from a recent survey carried out by Sarah and the Newson Health team to highlight how things have improved in recent years and identify some of the ongoing needs. You can read more about Sarah’s survey and other recent menopause research carried out by Newson Health here. Follow Dr Sarah Ball on social media on Instagram and Twitter. View the breast cancer booklet here.

Clinical Director of Newson Health, Dr Rebecca Lewis, returns to the podcast this week for a special end of year episode with Dr Louise Newson. The business partners and friends reflect on some of the positives over the last 12 months and discuss the continued challenges in trying to help more women with their experience of perimenopause and menopause. Rebecca’s three hopes for 2023: Testosterone needs to be licensed for women (and not just for low libido) Treatment for significant and severe menopausal symptoms in the workplace to help keep women in work Education about the perimenopause and menopause reaching out to other medical specialties so more healthcare professionals understand how it affects the patients they see. Follow Rebecca on Instagram at @dr.rebecca.lewis

Professor Chris Harding is a Consultant Urologist working at the Freeman Hospital in Newcastle upon Tyne and at Newcastle University. He has a particular interest in bladder dysfunction, continence and urinary tract infections (UTIs). In recent years, his research has focused on non-antibiotic treatments for recurrent UTIs and developing targeted treatments for specific patient groups. In this episode, Professor Chris talks to Dr Louise about the challenges of diagnosing UTIs accurately, the severe impact recurrent UTIs can have on your life, how antibiotics can be used appropriately, and how to prevent UTIs occurring. The experts share some of their plans to study the effects of systemic HRT and vaginal hormone treatments on UTIs in women. Chris’s advice if you have recurrent UTIs: You don’t need to put up with UTIs in the perimenopause and menopause; there are many proven treatments available Acknowledge that current tests for UTIs are not 100% accurate. If you think you have a UTI, you probably have, even if your test was negative - the diagnosis can always be questioned Discuss with your doctor how you can prevent infections if you have had 2 episodes within 6 months, or 3 within a year Hormone replacement, particularly vaginal treatments, are significantly protective and preventative against UTIs. Follow Prof Chris Harding on social media at @chrisharding123

This episode contains reference to suicide Professor Jayashri Kulkarni is a psychiatrist working in Melbourne, Australia, specialising in women’s mental health and researching the role of estradiol in mental illnesses such as schizophrenia and depression. She founded and directs the Monash Alfred Psychiatry Research Centre, a large clinical research group in Melbourne. In 2022, Professor Kulkarni launched and directs HER Centre Australia – a Monash University Centre delivering Health, Education and Research in women’s mental health - dedicated to improving the quality of care for women with mental illnesses by developing specific treatments tailored to suit women’s needs. In this episode, the experts discuss the different ways estradiol influences brain health and function, what this means for healthy brain aging and longevity, and they share some of their experiences when helping women with mental health changes during the perimenopause and menopause. Prof. Kulkarni’s tips for women experiencing mental health changes: Trust your instinct – you know you best. If you think it might be hormones, help is available. Look at your background history. If you had premenstrual mood changes or postnatal depression in the past, this may mean you are particularly sensitive to hormonal changes. Early life trauma (e.g. neglect or emotional/physical/sexual abuse) can disrupt hormone signals and brain chemistry and this may make you more vulnerable to mental illness. Whatever your past history, there is help available in the form of HRT. See your local healthcare provider or a menopause specialist if needed. You can find the Meno-D questionnaire here. This tool identifies the specific mood changes that are more typically present in perimenopause and menopause related depression. For more information on Professor Kulkarni’s work and research, visit www.maprc.org.au

Dr Samantha Newman is a British doctor working in Hawkes Bay, New Zealand. After training in obstetrics and gynaecology, a moving encounter with a patient led her to re-train as a GP and develop an interest in supporting women’s health and wellbeing. Samantha’s clinic, FemaleGP, was established in 2016 to improve access to focused healthcare for women including gynaecological and sexual health and treatments for perimenopause and menopause. In this episode, the experts discuss shared decision making with their patients, symptom improvements with HRT, and supporting women to ‘listen’ to their hormones. Samantha also shares some of her experiences working with women from the Māori community and culture. Dr Samantha’s three tips: See your hormones as a journey and not as separate, distinct phases of life. Find support along the way – wherever in the journey you find yourself. For healthcare providers: see your patients as a whole person and as part of their families and find out their true thoughts and desires. Be honest with your patients and encourage them to be honest with you. If they haven’t taken your advice, revisit things and find out what didn’t align with their values rather than viewing it as a negative. For more information about Samantha’s work, visit www.femalegp.co.nz Follow Samantha on social media at https://www.facebook.com/FemaleGP and https://www.linkedin.com/in/samantha-newman-34223b230

Dr Laurena Law is a general practitioner working in Hong Kong who has a special interest in nutrition and lifestyle medicine to improve healthy aging and prevent chronic illness. When Laurena gained personal experience of perimenopause and saw the impact it was having on her own life, she decided to learn more about hormone health and evidence-based treatments for the menopause so she could help herself and her patients. In this episode, Louise and Laurena discuss cultural differences and similarities between British and Chinese approaches to menopause from both an individual and healthcare perspective. Laurena emphasises the importance of educating women so they know how to recognise their perimenopause or menopause and to empower them to make their own health needs a priority. She educates healthcare professionals in Hong Kong and further afield to ask women the right questions in consultations and to know how to prescribe body identical HRT. Dr Laurena’s three tips for women: Complete a menopause symptom questionnaire and repeat it every few months. This can form the basis of a conversation with your healthcare provider Find a healthcare provider that is educated and updated in menopause care Find a support group of women also going through the menopause to talk about the problems and challenges you’re going through – you’re not alone.

GP and menopause specialist, Dr Sarah Glynne, joins Dr Louise Newson on the podcast this week to discuss menopause care after breast cancer. The experts share more about the breast cancer steering group established as part of the Newson Health Menopause Society that is working towards producing a consensus statement to support clinicians and improve the quality of life for menopausal women who have had breast cancer. Dr Sarah Glynne discusses the importance of individualising the risk-benefit ratio for every woman when making decisions around treating the cancer and weighing this up with treating menopausal symptoms. Sarah emphasises the importance of talking through the implications of each of these considerations using a shared decision making process. Sarah’s three tips for women after breast cancer: Understand the risks and benefits of the drugs used to treat your breast cancer and what this means for you personally. Ask your oncologist for more information about your own breast cancer, if you are not sure. You can then use the PREDICT tool online for understanding more about your own cancer risks and what additional benefits any treatments may offer. Read about non-hormonal options to help your menopause symptoms and cancer recovery such as diet, yoga, or acupuncture. Try various approaches to find the ones that may bring some benefit to you. Vaginal moisturisers and lubricants may also help and these do not contain hormones, and there are other medications your GP may be able to prescribe for some of your symptoms such as hot flushes. If your menopause symptoms are severe and your quality of life is suffering, ask your clinician to explain the risks for you regarding your cancer prognosis if you decide to take HRT, versus the risks to your quality of life and long-term health if you choose not to take HRT. If you have genitourinary symptoms of soreness and dryness, vaginal hormones are very safe for improving these symptoms. Read information on the balance website and the book ‘Oestrogen Matters’ by Avrum Bluming, and make a choice that is right for you through discussion with your clinician using a shared decision making process.

In this episode, Sam shares her moving account of the journey she has been on for the last five years when, after a miscarriage and losing her father, things started to unravel and her mental health suffered. A difficult few years followed spent navigating depression, trialling several antidepressants and anti-anxiety medications, and seeking help from psychiatrists to try and understand what was going on. At the time, Sam believed she was years away from becoming menopausal and through her own research sought treatment privately in the form of ketamine due to her desperation to feel better and function again. Through learning more about hormones and their effects on the brain and mental health, Sam has recently begun to take HRT and feels she has started on a more positive path to health and stability. Sam’s three tips for those struggling with mental health: Try and be assessed by a menopause specialist before accepting a diagnosis, medication or treatment from a psychiatrist – it may save you a lot of unnecessary suffering. If you do start taking HRT, be patient. It can take time and the dose and type may need tweaking before you feel the beneficial effects. Become as well informed as you can about your hormones and the menopause from good sources online. And talk to other women – you’re not alone.