Dr Mary Claire Haver: on a mission to demystify menopause

In this week’s podcast Dr Louise is joined by Dr Mary Claire Haver, an obstetrics and gynaecology doctor and a menopause specialist in the US. Dr Louise and Dr Mary Claire discuss the challenges of ensuring all women have access to evidence-based information and treatment, and their hopes for change.

Dr Mary Claire shares her three tips to help menopausal women improve their health:

1. Really focus on your nutrition. Make sure you’re getting adequate fibre in your diet every day. Fibre-rich goods are good for you gut microbiome, help you stay full for longer, and are good sources of vitamins, minerals and nutrients.
2. Limit added sugars – those that are added in cooking and processing – to less than 25g per day. Women who do that consistently have less visceral fat. Visceral fat is tied to increased risk of chronic inflammatory diseases.
3. Don’t just focus on cardio for your movement. You really need to keep your muscles strong so at least two days a week pick up some weights. Multiple studies in menopausal women show much better outcomes for osteoporosis with resistance training.

You can follow Dr Mary Claire on Instagram at @drmaryclaire

Click here to find out more about Newson Health

Pre-order the revised and updated paperback edition of Dr Louise’s Sunday Times bestseller The Definitive Guide to the Perimenopause and Menopause here

References to studies discussed in this week’s episode

J Gen Intern Med 2006; 21:363–6

J Gen Intern Med 2004;19:791–804

Am J Med 2009;122:1016 – 22

JAMA 2004; 291:2243 – 52

Int J Cardiol 2010;138:25 – 31

Urology 2024; Jan 29:S0090-4295(24)00006-2

Transcript

Dr Louise: [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. So today on my podcast, I’ve got another clinician who is in US and really excited actually, I’ve been stalking her for a while. We’ve been sharing each other’s posts sometimes, and it’s great because we think the same in the way that we work, the way we practice, and the way that we educate people globally as well. So she’s quite well known, getting more well known. Dr Mary Claire Haver and she is an obs gynae person, OB-GYN in the US. And she’s also got qualification in nutrition as well. And she’s, like me really, on a mission to demystify and simplify the noise that’s been going on over the last couple of decades. Would that be fair to say, Mary Claire? [00:01:44][93.2]

Dr Mary Claire: [00:01:44] Absolutely. Removing the shrouds of secrecy and shame and misinformation around the menopause. [00:01:50][6.4]

Dr Louise: [00:01:52] Yeah, it’s really interesting, actually. So about, well, eight years ago now when the International Menopause Society produced their guidance and NICE over in the UK, produced their menopause guidance. I went to an International Menopause Society conference, and all these people were talking about menopause and the health risks and the problems and how safe HRT is. And I sat in this auditorium thinking, what can I do? How can I help women? Like, I’m only seeing 20, 30 women a day. I was a GP then and I was busy and I thought, I’m never going to make a big difference, so what can I do? And I thought, right, I’m going to play with media and social media because technology is the only way we can reach people. And so since then, I’ve just been posting and I’ve been educating people because I’ve been a medical writer for many years as well. And it’s been really empowering, but it’s a really incredible space that, you know, 30 years ago we couldn’t have educated in this way. [00:02:48][56.6]

Dr Mary Claire: [00:02:49] No. I am shocked about my own growth on social media. You know, I knew I was a good communicator. I knew I could talk to patients in a way, and breaking down complicated medical information into something a layperson without my background and training can understand. I’ve done it for years, you know, talking about risk, benefits of medications and surgeries, etc in my practice. And then learning how to translate those skills onto social media has been such a wonderful kind of surprise for me. And it’s just the feedback that I’m getting from my followers about, you’ve changed my life. You gave me tools to advocate for myself. You’ve given me hope. You know, I thought I was crazy, I was gaslit, I was dismissed, and now I feel like I have, you know, a set of skills that I didn’t have before that I can take to make my health better moving forward. And that, to me is everything. [00:03:43][54.8]

Dr Louise: [00:03:44] It’s incredible, isn’t it? Because I’m sure you, like me, went to medical school because we wanted to help people feel better, but also we wanted to reduce the risk of diseases. And there’s very little in medicine where you can really do that. You know, I have diabetes clinics, I’ve run asthma clinics, and it’s still quite difficult because people don’t get completely well or they’re not taking their medication properly, or they get side effects, their medication or whatever, whereas my menopause clinic is just transformational medicine. But actually, to hear the stories where people that you don’t know, you’re never going to meet, so you’re never going to make any money from them, it’s not a commercial situation. Those are the people where, you know, people say to me, thank you. You’ve got my life back, my family back, my job back. I can’t thank you enough. It’s amazing. But it’s also really frustrating. You know, we’ve always been told, well, it’s flushes, sweats. It’s just something that happens. And then I go to lectures and people say, well, the symptoms only last 5 to 10 years. Only! Right, I don’t understand. Do you let people suffer? It doesn’t really make sense. And then when I sort of explain to people how important our hormones are biologically, how they help with mitochondrial function, how they reduce oxidative stress, how they’re anti-inflammatory, how they work in our brain, and our brain produces these hormones. You can see the gyneacologist going, what’s she talking about? The menopause is just about a few symptoms. And so when there’s this big debate about medicalising the menopause with HRT and it should be a natural transition, I find it quite difficult to think that women, the majority of women globally are being refused this evidence-based treatment or not allowed to have it or don’t know it’s available. There’s obviously different reasons why people don’t take it. [00:05:32][107.9]

Dr Mary Claire: [00:05:32] Right. [00:05:32][0.0]

Dr Louise: [00:05:33] But it’s not usually because women don’t want it. It’s just they can’t access it. [00:05:36][3.4]

Dr Mary Claire: [00:05:37] They can’t. Yeah, there’s definitely barriers to access in the US. You know, if you’re fortunate enough to have traditional medical insurance, you know, we have a huge percentage of our population that does not have access to what would make it easier for most people. But even if you do have it, you walk into your clinician’s office and there is barrier after barrier after barrier, and probably one of the biggest barriers is just lack of education and training around menopause and, you know, not only symptom relief but the potential preventative aspects of hormone therapy and those are just being completely dismissed and ignored. [00:06:16][39.0]

Dr Louise: [00:06:17] And why do you think they are being dismissed and ignored? Because there’s good evidence and it makes sense as well. So it’s really important when you look at studies we don’t interpret them in isolation because obviously you can skew data. You can have different trial population that don’t translate to real world data. But actually we know our hormones are very anti-inflammatory. So when we think about heart disease risk reduction, we know oestradiol is anti-inflammatory on the endothelium, it helps relax the blood vessels. It helps lower blood pressure. It helps the way our kidneys work. So all that fluid balance and everything else as well. And we know it reduces atheroma and reduces cholesterol. So it makes sense that when people have HRT it lowers their risk of heart disease. And we’ve got studies that show that. But I know like over in the US and over here that a lot of the societies will say there isn’t enough evidence so then people then get scared. But actually there’s better evidence that giving HRT for primary prevention of heart disease than there is compared to a statin or a blood pressure lowering drug. But even so there’s still this antagonism saying no there isn’t, no there isn’t. And I don’t understand why we have to try and not have this professional curiosity and look at the data and look at the common sense as well. [00:07:30][73.2]

Dr Mary Claire: [00:07:30] I think it makes it harder. There’s so many, you know, boxes to check and a lot of doctors across the world kind of stop learning once they get out of their training programs, and they kind of stick by what they learned in school and maybe pick up a few things over time. But at least in like the OB-GYN literature for our continuing medical education, for my board certification, there’s rarely a menopause focused article. Last year they did present the American Heart Association article that came out in 2020 looking at the menopause transition and risk of heart disease. And just a week ago AHA, American Heart Association, in circulation again just presented more data. Really really fascinating. But by and large it just seems like that information is not being picked up and disseminated. I think honestly, Dr Newson, we are a generation away from a woman being able to walk into her healthcare provider’s office and getting an informed conversation about menopause. [00:08:35][64.2]

Dr Louise: [00:08:36] Yeah. I think the times are changing. I mean, on Wednesday I was chairing a women’s health education event and there were thousands of doctors there because there were lots and lots of other things going on. There was heart disease and various other streams, but it was the first time they’ve had a menopause education sort of tent, if you like, lecture theatre and the organisers, I did try and warn them that it would be busy, but they literally couldn’t fit everyone in the lecture theatre, and it was like the first day of the sales. There were so many people wanting to know, which is wonderful. Like a few years ago, no one. The tent would have been empty, no one would have been interested. And there are some fantastic healthcare professionals who have this curiosity, who are undecided. But also a lot of them say to me gosh, since I’ve been prescribing HRT, the women aren’t coming back every week. They’re not having all these symptoms. They’re able to reduce their blood pressure treatment, they’re coming off their antidepressants. And this really is amazing. And in medicine, when you learn and you do something, then you learn more and then you apply it and hopefully teach your colleagues. So this ripple effect is definitely happening. But there are still certain doctors and clinicians, not just doctors, who are very resistant to change. And it’s really difficult making a change, isn’t it? [00:09:50][73.2]

Dr Mary Claire: [00:09:50] It is, you know, and it’s like you say, it’s the doctors who are approaching new data with curiosity. And those are hard to find, I think, because in both of our healthcare systems, doctors are overwhelmed. You know, the burden of so many patients to see in a day in order to pay your bill, you know, reimbursements are going down in the United States. You’re having to do more ancillary care, and it takes a long time to take a woman with 19 symptoms and tease out all of the important information to determine, is this really perimenopause or is this hypothyroidism? Is it both? Is it autoimmune disease? Is it, you know, primary hypertension? And without that good baseline of training and knowing how to recognise these things, it’s just hard. And you know we have a long way to go. You know I think this is not just an OB-GYN thing. You’re a GP. This is an-all medicine thing. This is all specialties need to include menopause, like female healthcare, I don’t want to call it menopause. This is women’s health. [00:10:54][63.4]

Dr Louise: [00:10:54] I totally agree. And it’s actually, I was thinking the other day it’s more like health of women rather than women’s health. And there is a subtle difference that when we say women’s health, it’s always about contraception, it’s about fertility, it’s about periods. And I don’t want to be defined by my fertility status or whether I have periods or not, I’m 53, like, forget it. But actually, I don’t even want to be called menopausal. I just want really good health. And so when you talk about health of women, then you’re including cardiovascular health. You’re including brain health, you’re including… And I think that’s where we’ve got to put the change. And I don’t want to see myself as a menopause specialist, because I actually see a lot of perimenopausal women or lots of women with PMS and PMDD. So it’s the hormonal changes, but it’s not, like you say, there’s so many other hormones as well. We just, there’s just this block when it comes to these three hormones that we all need and men need too of course. [00:11:51][56.8]

Dr Mary Claire: [00:11:52] I’m writing that down. The health of women. I love that so much. I think that is the change that needs to happen. And I talk a lot about this on social is, you know, and I’m stealing the phrase from Doctor Stacy Sims, who’s an exercise physiologist who looks at muscle strength training and health in regards to females, very different than males. And she says over and over again, we are not little men. [00:12:18][25.7]

Dr Louise: [00:12:18] Yeah, absolutely. [00:12:18][0.4]

Dr Mary Claire: [00:12:19] There’s a lot of historical context around medicine that a lot of the tests, the drugs, the pharmacology were done on the average 30-year-old white male and all of that you know, data gets extrapolated to other cultures, other races and other genders. And that’s just not how we work, you know? And then when you layer on oestrogen deprivation and hormones and the fluctuations in our cycles premenopausal and then the loss of them post-menopausal, we’re very different medical beings. And for the health of women, I think we need half of all of the research budgets. Half. [00:12:54][35.3]

Dr Louise: [00:12:55] Yeah, absolutely. I totally agree because otherwise it gets fragmented. There’s a little budget for women’s health and then it gets fragmented. Quite rightly. [00:13:03][7.9]

Dr Mary Claire: [00:13:03] Yeah. [00:13:03][0.0]

Dr Louise: [00:13:03] Conditions like endometriosis and fertility which is really important. But you know when I speak to cardiologists and say do you prescribe hormone replacement therapy? Oh no. But do you see women with palpitations? Oh, yeah. Lots of women in their 40s and 50s. Would you ever give it? Oh and then psychiatrists. No, no no we don’t. But then they and that doesn’t help. And then so many people say to me, do you know what? We’re so bored of listening to the menopause. It’s gone on for so long. And then when I say, actually, only 14% of women in the UK who are menopausal take HRT, it’s a real shock. But you know, you’re going to shock the audience by saying, how many, what’s the percentage of women in the US? [00:13:45][41.3]

Dr Mary Claire: [00:13:45] It’s four. [00:13:45][0.2]

Dr Louise: [00:13:46] 4%. [00:13:46][0.0]

Dr Mary Claire: [00:13:46] 4. [00:13:46][0.0]

Dr Louise: [00:13:46] And pre-WHI, it was about 30%, wasn’t it? [00:13:52][5.8]

Dr Mary Claire: [00:13:53] Here it was about 40. [00:13:53][0.7]

Dr Louise: [00:13:56] 40. So 40%. And it was on the increase wasn’t. So this was before the study that was the biggest car crash for women’s health. And actually the study, even when you look at it in the worst eyes it’s not that bad a study. It still shows benefits of hormone replacement therapy. [00:14:10][14.1]

Dr Mary Claire: [00:14:11] Right. And it showed wonderful like information on protein intake and frailty. And I mean there’s good information that came from it. [00:14:17][6.0]

Dr Louise: [00:14:17] Yeah it was a good study. And now we’ve just nail in the coffin for HRT and from 40 to 4%. And I know your heart disease figures rates have really increased. And of course it’s not just hormones. You know, nutrition has got worse, obesity has got worse. But actually, I don’t know about you, but it’s really hard to have as good nutrition and as good exercise when you’re menopausal and really struggling with symptoms. It’s difficult isn’t it? [00:14:46][29.0]

Dr Mary Claire: [00:14:46] Yes, definitely. The mental health load is just incredible. And you know, why aren’t the psychiatrists recommending hormone therapy? Why aren’t the cardiologists? The neuro scientists think you should be doing it. You know the PhDs think you should be. [00:15:00][13.6]

Dr Louise: [00:15:01] Course they do. [00:15:01][0.3]

Dr Mary Claire: [00:15:02] The, you know, people in the labs who are writing these articles and doing the research are really pro HRT, but it’s just not translating to the rest of the medical subspecialties. Orthopaedic surgeons should be recommending it routinely for musculoskeletal syndrome of menopause and osteoporosis prevention. [00:15:22][20.3]

Dr Louise: [00:15:23] Yes. And it’s licensed in the UK. It certainly licensed as a treatment for osteoporosis, so anyone who has an osteoporotic fragility fracture should be thinking about having HRT. And certainly rheumatologists, you know, the people with muscle and joint pains and the urologists. I’ve done some training with the British Association of Urological Surgeons. [00:15:41][17.6]

Dr Mary Claire: [00:15:41] They’re better about vaginal oestrogen. [00:15:42][1.4]

Dr Louise: [00:15:43] They are a lot better with vaginal oestrogens. Absolutely. But then we’ve got Intrarosa and which obviously helps with testosterone, but they don’t prescribe systemic hormones. And as good as vaginal hormones are, they just don’t get absorbed systemically. That’s why they’re good, obviously, for women who’ve had breast cancer as well. But a lot of women still have urinary symptoms because they need systemic hormones. But there’s still a bit oh not sure Louise, not really sure. But they prescribe other drugs. They prescribe drugs for overactive bladder which have all sorts of side effects. They prescribe anti-muscarinics, which increase risk of dementia and probably heart disease as well. So it’s how do we get that shift where those people can be confident. And I know there’s a real scare of litigation isn’t there, in the US and here? [00:16:30][46.9]

Dr Mary Claire: [00:16:30] Yes, for us, there’s a huge scare of litigation. There was a paper, a follower sent to me, and it was a full sheet, completely typed, of a consent for hormone therapy. Like before they would, the physician’s practice would give them the prescription, they had to sign this paper. And it was basically all four of the findings that have been rescinded from the WHI. And the only benefits listed were relief of hot flashes and osteoporosis prevention. That was it, you know, and the patient was like, can you believe this? And I’m like, this is rescinded data, rescinded. You know, I can show you the studies where these were rescinded points on the risk of breast cancer and, you know, all the things, but it is just it was the original viral, you know. [00:17:17][47.4]

Dr Louise: [00:17:18] But it’s very difficult isn’t it, you know, I, actually, it’s awful, last night, I was feeling a bit overwhelmed with life and tired and a bit emotional. And then this morning I was in the shower and I thought, oh, haven’t I took my patches off and I forgot to put them back on. So I’d had like 15 hours without any oestrogen. And now, of course, I’ll still have some, but as you know, it declines quite quickly without. So I opened a new packet of my patches and I always put it in recycling because in that box is this MHRA risk of death, risk of breast cancer, risk of heart disease. And it’s so wrong because actually it’s linked to our prescribing as well. I don’t know what it’s like in the US, but if I prescribe patch comes up with a warning of risk of breast cancer, which increases after a year. And so then I’m thinking well no wonder doctors don’t prescribe it, no wonder women are scared because they go home and read this horrific insert. And your FDA is the same and so why is it that it’s so hard for women who want it to get HRT, but it’s so easy for men who wanted to get Viagra, for example, which has more risks, actually, for a lot of people than when I’m just talking about transdermal oestradiol. It doesn’t seem fair. [00:18:29][71.0]

Dr Mary Claire: [00:18:30] It doesn’t. And I think it’s kind of the built-in misogyny in medicine and paternalism. And, you know, just it’s a stark example of how men, you know, males are treated medically versus how females are treated medically. And where did informed consent go? Where did shared decision making go? Doctors feel like they are in control of a woman’s health, and we’re not seeing the same amount of shared decision making. You know, women aren’t given the option. [00:19:06][35.6]

Dr Louise: [00:19:07] You see, I think this is really interesting because we know there are health risks of being overweight and smoking. Of course we do. But I would never refuse treatment for, of any treatment, you know, I’m not talking about hormones here, any treatment. I wouldn’t say to someone, you’ve got raised blood pressure, you’re overweight and you smoke. I’m not going to give you any treatment because you know, your lifestyle increases your risk. Whereas women are being told there might be a small risk of breast cancer, but we’re not going to give you this treatment. But if they were overweight, their risk of breast cancer would be more but they still have allowed to have treatment for other conditions. And the same with medication. We can choose if we’re consenting adults whether to accept or refuse certain treatment. We do that in every aspect of medicine. And as you know, if you do surgery, this is what the consent process is about. Whereas somehow women are not allowed to choose, they have to adapt and have this menopause transition where they take a second rate job or they give up their job, they have to accommodate to the weather if they’re having flushes. I was listening yesterday, there was a clinic in Manchester where they have a memory and concentration clinic for women who are menopausal. It’s like, what about giving them some hormones and seeing, if they want it? And my problem is, is that a lot of people tell me that we’re pushing HRT, the social media doctors are pushing and it’s terrible and all this misinformation. But actually, I’ve said, I don’t mind the percentage if it’s 4% for you and 14% of us of women who take HRT, and that’s all the people that want it, that’s fine. But what I really want to keep working for is that 100% of women who want to take HRT can easily get it, and whether that’s 4 or 40% is irrelevant, really. And it sounds like you’re getting the same horrendous stories that I am every day from women who are just refused it. [00:21:08][121.5]

Dr Mary Claire: [00:21:09] What’s not happening in the US is women aren’t given informed conversations like, I don’t think every woman should choose HRT or that’s the magic bullet for everything, but women are being denied the conversation. I think 100% of women deserve the conversation of her particular risks and benefits. [00:21:26][17.4]

Dr Louise: [00:21:27] I totally agree. [00:21:27][0.0]

Dr Mary Claire: [00:21:27] That’s not happening. [00:21:28][0.5]

Dr Louise: [00:21:28] No. And that’s the same. I think, you know, I’m, as a family physician, really holistic. Everybody should have a conversation about nutrition, about exercise, about lifestyle. And actually how I would talk to a teenager about their nutrition is quite different to a menopausal woman or an athlete. We adapt and we change and it’s really important. And women, when they’re menopausal, should have individualised consultations, which don’t just look at hormones, they look at everything together. And they might choose one thing first, whether it’s they might decide well I’m going to sort my nutrition out first, Dr Newson, because that’s really important. And then I’m going to think about hormones. Or they might say, I’m going to do everything together. Everyone’s different. You know, we dress differently, we talk differently. We’re allowed health choices differently as well. But they have to be controlled by the patient really it’s so important isn’t it. [00:22:18][50.0]

Dr Mary Claire: [00:22:19] Agreed. Agreed. [00:22:20][0.8]

Dr Louise: [00:22:21] And it’s not happening. [00:22:21][0.3]

Dr Mary Claire: [00:22:21] It’s not happening, no. We have no nutrition training in the United States for medical healthcare providers. Unless you happen to, like me, go back to school and learn or happen to have an undergraduate degree in nutrition science. My daughter, who’s a first year medical student here, her undergraduate degree is nutrition science. And I’m like… [00:22:39][17.4]

Dr Louise: [00:22:40] Amazing, that’s so good. It’s so important. So it is looking at everything to improve health because you’re the same as us over here. But globally, the commonest cause of death is cardiovascular disease and dementia. But all these inflammatory diseases, I know, like me, you’re very interested in diseases of inflammation. And we know increasingly which is good people know about inflammatory foods and processed foods and everything else and how exercise can reduce inflammation. Good sleep can. But we’ve known for decades, way before WHI study how anti-inflammatory our hormones are as well. [00:23:16][36.2]

Dr Mary Claire: [00:23:17] Right. All the observational, you know, studies before clearly pointed this out. You know, and although WHI was originally thought to do was going to confirm these things, but they started too late. You know, all we did was confirm that oestrogen is better at prevention than cure. [00:23:34][17.7]

Dr Louise: [00:23:37] So moving forward we’ve got a lot to do in it. And you know the platform that you have that you’ve got your book that’s coming out, which is great. And like me actually you’re very open about your own experience and your own strengths and weaknesses as well, which I think is really good for people to listen to. I know some medical professionals over here really don’t like it when I talk about my own experience. They’ve told me off, but actually, I think it’s good for people to know that we are human. We have some days that are better than others, and we’ve made choices that are right for us. They’re not necessarily right for everybody, but I think showing that you’re so motivated with your own health has got to be a good thing. [00:24:17][40.8]

Dr Mary Claire: [00:24:18] I think transparency is everything, and I think trying to create this false narrative of you’re not human and you don’t have good days and bad days, and, you know, it’s all about moving that needle towards a better health for women. And that’s going to incorporate nutrition, exercise, stress reduction. And you know, you’re not going to check every box every day. But we all can be healthier. And there’s multiple paths to get there. [00:24:44][25.6]

Dr Louise: [00:24:44] Absolutely. And it doesn’t happen overnight as well I think because the other thing. It’s so easy to look at people and think, wow, but you have to chip away at things and not do it alone. I think is really important, isn’t it? [00:24:57][13.3]

Dr Mary Claire: [00:24:58] So in my clinic, my patients are not coming in wanting to look great in a bikini. I mean, that would be nice, but that is not their motivation. They’re looking at their mothers. They’re looking at their aunts. They’re looking at older women and their generation and seeing the frailty, seeing the dementia, seeing the heart disease, seeing that ten years of chronic disease and that long slog till death. And they know women live longer than men, but we live 20% of our lives in poorer health than men. And they’re like, I don’t want that. And one of the biggest motivators for me, after dealing with my parents and my older brothers, I don’t want to burden my children with the pain of my chronic illness as much as I can do to avoid that. And that is really a big motivator for most of my patients, is they don’t want their children to disrupt their lives, to come home, to take care of them. You know, they want their children to be living their best life and for them to be living with them, you know, in a way that is supportive and not the children taking care of the parents or for as little as possible you know. [00:26:01][63.2]

Dr Louise: [00:26:01] And that is so important because, you know, we are generally living longer and it’s not the age we die it’s the journey to that age and how we can keep as well as possible. Because I want to be independent. I don’t want to be cooped up in a nursing home. I want to be able to think as well. You know, my mother is really mentally active and reads a lot and is interested in life, and I want to do that. It’s not the age that I die, it’s how I keep going. And you have to invest now for the future. And sometimes if you don’t, it’s never too late. But you, the earlier you realise that simple hacks in your life can make a difference. It’s really important that knowledge is power, actually. And I think what we’re both doing between us and there’s some great people across the world, there’s some really good healthcare professionals who are joining our little group, is enabling people to have access to data that they couldn’t have before. And, you know, like me, you’re very evidence based, you read papers and then you share like top line. And I think that’s crucial because in the past patients haven’t been allowed this information. And I know some doctors still don’t like it, but I think it’s wonderful to be able to educate people, don’t you? [00:27:21][79.6]

Dr Mary Claire: [00:27:21] I do, I do I think that’s everything. That’s my favorite thing to do. I get so excited every morning I read articles, and I can’t wait to share the things that I find. [00:27:30][8.7]

Dr Louise: [00:27:30] Yeah, I think so. And I think, you know, I’ve said to many people I’m just a messenger, like, don’t shoot the messenger. I’m just regurgitating evidence. And if sorry, if it’s evidence that you don’t like or it feels uncomfortable but actually, I think we deserve to know and increase our knowledge don’t we. So lots to do. We’ve done a huge amount, but it still doesn’t feel enough. I don’t know about you, but I feel inadequate every day and think about all the things I need to do, not things I’ve done. But what we’re doing is definitely making a difference. People are listening and people are very grateful and that’s really important. So before I end, Mary Claire, I always ask for three tips and so three things that you think globally would make the biggest and quickest difference to improve the health of menopausal women. [00:28:18][47.8]

Dr Mary Claire: [00:28:19] One is really focus on your nutrition. Make sure you’re getting adequate fibre in your diet per day. Most women in the US at least, and probably UK, are only probably getting around 12g of fibre per day and we really should have 25 or more that hits multiple, that’s insulin resistance, gut microbiome health, staying full longer, you know, in those fibre-rich foods are also other vitamins, minerals, nutrients. So that’s one. Two is make sure that you are limiting your added sugars. So sugars added in cooking and processing, not fruits and vegetables, you know, or dairy, to less than 25g per day. Women who do that consistently have less visceral fat. Visceral fat is tied to increased risk of all the chronic inflammatory diseases. And three don’t just focus on cardio for your movement. We really need to be trying to keep our muscles strong. We have an accelerated muscle mass loss, which leads to increasing bone loss. So multiple studies in menopausal women showing much better outcomes for osteoporosis with resistance training. So, you know, at least two days a week picking up some weights to try to keep those bones and muscles strong. [00:29:28][68.9]

Dr Louise: [00:29:28] Great advice that everybody can learn from actually, you don’t even have to be menopausal for a lot of that advice. So thank you so much for your time. It’s been wonderful. [00:29:36][7.6]

Dr Mary Claire: [00:29:37] You’re so welcome. [00:29:37][0.4]

Dr Louise: [00:29:42] You can find out more about Newson Health Group by visiting www.newsonhealh.co.uk, and you can download the free balance app on the App Store or Google Play. [00:29:42][0.0]

ENDS