Alcohol addiction and menopause: Rachel’s story

Content advisory: this episode includes themes of mental health and suicide

In this episode, Dr Louise Newson speaks with Rachel Birch, a doctor who shares her personal journey of menopause, mental health and alcohol addiction. Rachel discusses the lack of training on menopause in medical education, her experiences with anxiety and depression, how she found herself using alcohol as a coping mechanism and how she is navigating her recovery. Rachel emphasises the importance of self-advocacy, community support, and self-love in recovery. The conversation also highlights the need for better awareness and understanding of menopause and its impact on mental health.

Rachel also shares the following advice if you find yourself struggling with addiction:

• Listen to your body and trust your instinct
• Be your own advocate – you know your body best
• Prevention is better than cure: be alert to drinking habits
• Don’t suffer alone, reach out for help.

Click here to find out more about Newson Health

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

Transcript

Dr Louise Newson: [00:00:00] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast, I’m very excited actually. I’ve got someone who I’ve known for a little while now, and unlike many of my guests I met in real life when I was on my tour. So she is a doctor called Rachel Birch, and she’s got a very interesting, quite emotional story that she’s happy to share about. And it does have a happy ending, I just hasten to add. So welcome, Rachel. Thanks so much for joining me today. [00:01:12][72.1]

Dr Rachel Birch: [00:01:13] Thank you very much. I’m really excited to be here, actually. And I think I think the work you’re doing is great. I love these podcasts. I’m, I’m an avid listener and hopefully, you know, what I’m going to talk about today will, will help others. That’s the aim. [00:01:26][12.8]

Dr Louise Newson: [00:01:27] Yeah. Well, I mean, I set up the podcast because it’s just another forum, isn’t it? And I feel it’s such a privilege actually, because my diary, as you know, is really busy. So to have time with people understanding more, not just from people who are experts, leaders in their field, but also real people with real stories. Because as you know, Rachel, in medicine, you learn a lot from the from the data, from the studies, from the trials, from the academic papers. But actually, the icing on the cake, which really changes our clinical practice is, is clinical experience listening and learning from patients and people. And that’s the most privileged part of being a doctor, isn’t it, is being allowed to listen to these stories? [00:02:11][44.0]

Dr Rachel Birch: [00:02:12] Well, absolutely, yeah. I mean, I think almost everything that I learnt really has come from from patients, from listening to people. You know, you can learn, of course, you know, what books saying what the papers say, but, you know, how it translates to people’s real lives. It’s, you know, that’s that’s the important bit. [00:02:27][15.3]

Dr Louise Newson: [00:02:29] Absolutely. And I’m very fortunate at the clinic that we have we have a lot of time. And the time is something that has gone so much actually over the last 25, 30 years of me being a doctor is that people are so rushed and then you don’t get the bigger picture. So, so tell me a bit about you, if you don’t mind. [00:02:47][17.9]

Dr Rachel Birch: [00:02:48] Yeah. So, So, yeah, a little bit about me. Wow. What to say? I’m 53. I’m a mum. I’ve got two children who are now 21 and 23. I am a doctor. I trained as a GP and worked as a GP happily for many, many years. Now I work for an organisation that actually supports doctors, which is equally rewarding as being a GP actually in in different ways. Hobby wise, I love cold water swimming, I love Pilates. I’ve got two dogs that are very active and keep me out in nature. I practice Pilates. Yeah, photography. Got a lot of interests, but one of my passions is, is menopause as well. And even within my workplace, I’m part of menopause support network. You know, I’m, I’m passionate about mental health and I’m passionate about, you know, women’s health. So, yeah, they’re big interests of mine. [00:03:39][51.0]

Dr Louise Newson: [00:03:41] Really? And probably like me, you didn’t have much training about menopause and certainly menopause and mental health when you were an undergraduate student? [00:03:49][7.5]

Dr Rachel Birch: [00:03:50] Goodness no, no. As an undergraduate, honestly, the message was, you know, when women become menopausal, their periods stop. Like that was it, back in those days, I think we’re the same age. I qualified in ’94. I think maybe you did, too? [00:04:00][10.4]

Dr Louise Newson: [00:04:01] Yes, I did. Exactly the same. [00:04:02][0.6]

Dr Rachel Birch: [00:04:02] Say, well, yeah, we probably had very similar training then, you know? I mean, I think they didn’t know as much. It’s not that we weren’t necessarily it wasn’t hidden from us. But, you know, I really think that, you know, we knew about hot flushes and night sweats. We knew that the periods could become erratic, could become more frequent, could become less frequent, you know, but ultimately would stop. And that was it. You know, a woman was menopausal. They called it post-menopause back in the day. Yeah. Yeah. Mental health as well. You know, I mean, I did have quite a lot of psychiatry training as an undergraduate. And and, you know, there was really no mention of hormones and their relationship with mental health. So that wasn’t really an issue I kind of really got until I became a GP and started seeing for myself, you know, that actually, you know, they were very closely linked hormonal health and mental health, you know, listening to people, listening to patients. [00:04:55][52.6]

Dr Louise Newson: [00:04:57] Yeah. And I didn’t realise either. Like, you know, I’ve done a lot of psychiatry, I’ve done a lot of general medicine, a lot of general practice, but I didn’t put the two together. And it’s only the myriad of people we see who have actually come from psychiatrists and they, they’ve treated as much as they can about their mental health, but they’re still having symptoms as well as physical symptoms of menopause or hormonal changes. And then when we give them the right dose and type of hormones, everything fits into place. And then going back and reading papers, reading how these hormones work in our brain, reading how they affect the levels of, you know, serotonin, dopamine our happy hormone, our reward hormone, you know, it’s all there. But we just don’t, if we don’t teach it, you don’t know. So tell me a bit about your story. We said at the beginning that you had an interesting but not unique story. And actually, I think it’s more common than people were led to believe. So So tell me a bit about what happened with you Rachel, if you don’t mind. [00:05:51][53.8]

Dr Rachel Birch: [00:05:52] My story is not unique, actually. And and also, you know, what I’d like to say is that, you know, when I was working as a GP, I probably heard this story fairly frequently, you know, and perhaps didn’t really quite realise the implication of the story. So, you know, I think this story is a good one to share for, for, for women so that they appreciate, you know, what I went through and you know, for GPs as well, just, you know, to give another, another lived experience, you know, and put that out there. I think I was about 44, I was working as a busy GP, I had teenage children, I’m a single mum. I became really anxious and it was almost overnight, you know, I mean I’ve been quite stable, quite sane. Suddenly I just became really anxious. I couldn’t really put my finger on it. I just felt really on, you know, on edge, ill at ease. I was getting really horrible mood swings. They started to appear. They would occur over minutes. And again, mood swings is something I’d never really experienced before. So, you know, one minute I could be absolutely fine. The next bit I’d be snapping at the kids, you know, really losing the plot. I wasn’t really doing this at work because I think you can maintain a kind of professional persona, can’t you? And you perhaps don’t don’t give into your your personal sort of feelings just quite so much. But at home, I think I was a horror. You know, I was snapping at the kids. I felt really down. The kids started calling me volcano mom, you know, And that was appalling. I couldn’t believe that. Yeah, Yeah. I felt for the kids because, you know, I, I, I realised, you know, I was doing it, you know, it would come from nowhere. I didn’t really have any control. I was forgetting things. I couldn’t think, you know? I just felt like I was losing my mind. I felt quite down. That came later, really. I think, you know, the mood swings and the anxiety were all there, and I just felt helpless. And I thought, what is happening with me? I thought, I have I got dementia? You know, I’m forgetting. [00:07:55][123.6]

Dr Louise Newson: [00:07:56] It’s very scary isn’t it? [00:07:56][0.0]

Dr Rachel Birch: [00:07:57] It was terrifying, actually. It was terrifying. And I talked to friends about it and nobody at the time had really sort of experienced something similar. So I just thought, gosh, that’s me. You know, What, what’s happening? [00:08:09][12.4]

Dr Louise Newson: [00:08:10] That’s, do you know. Yeah. And that happens so much, actually, Rachel, that people blame themselves because if you don’t understand what’s happening, you know, you’ve already said you’re single mum, anyone knows bringing up children can be very hard. Bringing them up on your own can be difficult too. And then having a job. You know, it’s so easy to internalise and say, well, it’s probably because I’m not coping with my situation. And that happens so much, doesn’t it? [00:08:38][28.1]

Dr Rachel Birch: [00:08:38] Totally. I beat myself up. I thought it’s you. You’re not coping with with having a job and bringing up children. You know, this is a defect in you. This is your problem. None of your friends are having this, you know, totally,, I’m a perfectionist. I think many doctors are anyway, it goes with the territory. And and I did. I just I had a history of mental health, you know, issues. So I just thought, it’s it’s it’s you not coping Rachel. You know, it’s it’s really sad. [00:09:07][29.0]

Dr Louise Newson: [00:09:09] So what did you do? How did you get help Rachel? [00:09:09][0.1]

Dr Rachel Birch: [00:09:11] So I went to my GP and and, you know, explained what was happening. I mean I guess I probably you know, again, I’m not the best person at actually asking for help. And I thought, it’s me, It’s a phase, you know, I think I waited, I had a holiday. I waited to see if it improved when I’d had the rest and relaxation because again, you know, sometimes you’re overworked and perhaps you do need a holiday but, didn’t settle. So I went to my GP and she was lovely, you know, but she said, well, you know, you’ve got recurrent depression. This is another episode. And I said, Well, you know I don’t know if it is. And she said, you know, if you’ve got teenage kids now, this is kind of par for the course. You know, she had kids of a similar age. And, you know, I get that teenage children are challenging. You know, mine were challenging in wonderful ways if you’re listening kids. But you know and again, you know, I don’t blame her. I think, you know, it was it was a fair, it was a fair thought. You know, is is it recurrent depression? I had had three episodes of depression in the past. One was post-natal. You know, I think we all can realise now that that was probably hormonal. You know, the other two were in the sort of ten years before, you know, this episode and, and it could well have been hormonal too. But you know, I kind of, I suppose I’d been labelled and perhaps labelled myself as having recurrent depression, you know, almost like it’s a vulnerability in me. And therefore, of course that’s what it was. Yeah. So, you know, she increased. [00:10:34][83.0]

Dr Louise Newson: [00:10:35] So then what happened? [00:10:35][0.4]

Dr Rachel Birch: [00:10:36] She increased the dose of my medication, which, you know, I was happy to try, but it didn’t help. I just felt worse because I got sort of side effects from a higher dose. I kind of went back to her a few times. So, you know, I, you know, we talked, you know, she said, well, you know, let’s give it a bit more time. You know, do you want to change antidepressants? I wasn’t really keen on that. I went to see a psychiatrist myself privately. I thought, look, I’ll get some some input there. And he suggested changing the antidepressant, you know, which he did. So nobody really thought about hormones. And actually I didn’t think about hormones. So there’s no blame here because, you know, I’m a doctor, my GP’s a doctor, my psychiatrist is a doctor. I do think that we kind of fell into the trap of, it must be depression, you know, and it took four years before I really just suddenly thought. [00:11:24][48.5]

Dr Louise Newson: [00:11:25] Four years? [00:11:25][0.0]

Dr Rachel Birch: [00:11:26] Yeah. I mean, that’s shocking, isn’t it? Suddenly, you know, I just thought, Gosh, you’re 48 now. Hello. You’re perimenopausal age, you know, and I could have kicked myself. You know, I went to my GP and she immediately said, gosh, yeah, you’re right. And we tried HRT. [00:11:43][17.1]

Dr Louise Newson: [00:11:44] And is that because you you went to your, so you went to your GP saying, I think it’s my hormones? [00:11:48][4.3]

Dr Rachel Birch: [00:11:49] Yeah, I did. And she immediately said, No, I think you’re right. You know, I can see you’ve been struggling on, you know, it’s clear it isn’t just depression. You know, I think there’s always this suspicion, isn’t there, that that I that I could have two things going on and maybe I did. But the antidepressant medication and, you know, seeing a psychiatrist and trying, you know, counselling and self-help hadn’t been enough. So she was very open, you know, immediately. You know, she, she she is of a similar age to me, you know, possibly, you know, she she was on her own journey, you know, I don’t know. But she was very open straight away. So HRT that day, you know. And then… [00:12:27][38.4]

Dr Louise Newson: [00:12:28] And then what happened? [00:12:30][1.4]

Dr Rachel Birch: [00:12:30] Gradually, gradually, everything improved. It takes a time. I had a Merina coil, which I think clouded the issue because I haven’t had periods for 20 years because I’ve been one of the lucky ones to be amenorrhoeaic, no periods on the Merina coil. So since my son had been born, you know, so, so there was never that clue. You know, and again, you know, maybe if my periods had stopped I would have thought, or got erratic, we would have all put it together more quickly. But, you know, that clouded the issue. So, so I started on patches gradually increasing the dose and it just gradually got better and better. And, you know, I’m on the three hormones now, actually, I’m on testosterone as well. And and I feel absolutely great. You know, so it’s clear because none of the stresses have changed, really. You know, I still have a really heavy job, a really important job. I work full time, still got children who still need me, you know, got two dogs who need me, the crazy cat, you know, all the same things that possibly could have contributed to, you know, the worry pot in my mind, you know, they’re all there. So. So, you know, the only thing that’s changed is that, you know, I’ve I’ve, you know, I’ve got recognition from myself, from others. And also, you know, I’m on the treatment, which is really helping. Really helping. So. [00:13:49][79.2]

Dr Louise Newson: [00:13:52] But you had a few years of struggling on your own. Which is so hard. [00:13:55][3.6]

Dr Rachel Birch: [00:13:55] Yes. And I have to say, during those years, it was awful and I couldn’t do anything to get relief. And so the only thing that gave me relief was red wine. You know, at the end of the day, when everyone went to bed, I would have a glass of red wine. You know, I self-medicated. You know, it’s clear now to see that I couldn’t get rid of that horrible feeling of snapping. I also had, towards the the latter two years, I started getting quite horrific suicidal thoughts and urges as well. And and they came from nowhere. And again, you know, everything was getting worse rather than better. My confidence was going, I started not believing in myself. I actually changed jobs. You know, that’s when I stopped being a GP. I, I wondered, you know, maybe it was my job, you know, which was a really drastic step, but one I felt that I had no choice to make. You know, I started drinking a glass of wine a night, and it became two glasses of wine a night. Before I knew it, you know, actually, it was nearly a bottle a night, you know, which is a hell of a lot of, you know, if you add that up, you know, I was on 60 or 70 units plus a week, which is which is so damaging. I would wait till the kids went to bed usually. I mean, I have to confess, sometimes I didn’t and I would have a couple of glasses and that didn’t help my memory. That didn’t help my night sweats. That didn’t help the itch. That didn’t help my buoyancy and my mood. I felt more depressed. You know, the suicidal thoughts got worse. But the only thing that would just make everything stop was just obliterating it really, and just numbing everything. And I think that’s quite common. I’ve been reading a lot. I’ve listened to some podcasts, you know, of your on the subject. And I think I think it’s a trap that we can fall into because. [00:15:46][110.8]

Dr Louise Newson: [00:15:47] It’s very common. Yeah. And it’s very common. And I hadn’t realised how common it was until, like you say, before you said at the beginning, you learn from patients. And of course part of the history taking you ask people about alcohol and, and smoking and lifestyle and you can always tell when people are lying as well. And, you know, the beauty of our consultations is they’re confidential so that people then open up in a way that they often haven’t opened up even to themselves before. And so I do have a sort of maybe I’m a bit witch like, but I do have a way of getting things out of people. And when they do tell you and it’s not just often one bottle, it could be two or three, but it’s not just the bottles of of alcohol. People have told me about their drug addictions as well or their gambling addictions. Anything that’s, you know, escaping from reality, actually. And they know it’s not healthy behaviour, but they don’t know how to get out of it because they feel so awful. And actually, it might be a short term escapism, but it’s the reality still there that they’re feeling dreadful. And when I first started to hear these stories, I just thought, goodness, this is a bigger problem. This is a far bigger problem than perhaps people are realising. And last year, as you probably know, we did a questionnaire about addiction and there were free text answers as well. And you know, I still feel very sad when I read those free texts about people that have turned to Class A drugs in their late 40s because they need to escape from what was going on and they knew it wasn’t right. Now, these are highly addictive illegal drugs that women are turning to. And I’m not saying there’s, it’s very common, but it’s still there. But actually, what is very common, like you say, is alcohol, because it’s so readily available, it’s socially acceptable. People laugh about their wine o’clock. You know, children, a lot going on. Yeah. And that’s okay as a glass, but not when you’re using it as a tool. And as many of you know, I don’t drink alcohol at all. And it’s not because I’ve ever had a drink problem. It was because of my migraines. And if you, I, I know that if I had a drink, I’d have a migraine. So it’s easy for me not to drink, but so many times when I’ve been under stressful or difficult situations, either at home or at work, I can see why people go, oh I’ll just have a glass of wine. But I can’t. So I meditate. I do yoga and that’s good and probably a lot healthier, but it’s so easy to do it and it’s I think there’s many reasons. One of them is because people are feeling low and flat, they want to escape. But the other thing is the addiction side because like we said at the beginning, these hormones affect dopamine levels. Now dopamine is our reward, you know, that pleasure that you get opening the curtains, the sun’s shining. Oh lovely day. Now, if you don’t have dopamine, and often when your oestradiol, progesterone, testosterone are low, then you have a negative feedback. So you have low dopamine as well. So when you open the curtains and it’s sunny and you’re like, What the hell, it’s another day. I just don’t want to, I’m just existing, not living. Of course, then you’re going to need that bit more to actually just feel a bit of pleasure from something as well. [00:19:08][201.3]

Dr Rachel Birch: [00:19:09] Yeah, I think you’re right. I mean, yes, the pleasure would be short lived, you know, with that first couple of sips. But but, you know, it was there and I think it probably did give me a temporary dopamine hit. And the more I learn about, you know, chemicals, you know, brain chemicals, the more I realised that that that’s what happened. I mean, I, I, I, then COVID happened to me then while I was, you know, and obviously that, that caused so many challenges to people, I suspect that COVID and menopause and drinking was probably the perfect, you know, bomb but it wasn’t it? It got a bit worse, you know, three years and and two months and a couple of days ago, I. I just actually saw the light and thought, right, you’ve got to stop because I realised I was addicted. So, you know, I think some people don’t become addicted, but many people do. And I did become addicted. I became addicted to alcohol and I realised that I was at the stage where I couldn’t get through an evening without it. And that’s terrifying. There’s a lot of shame. A lot of shame. You know, I thought I should have known better because again, I’m a doctor, you know, forgetting that I’m actually a human and a woman, you know? And that’s okay. There was a lot of shame, and I had to accept it and I had to admit it. And again, that’s a really difficult step sometimes, but. But admit it I did. And then I hit it with everything I had. I told my GP, I went to Alcoholics Anonymous, I got lots of books and downloads, and I had started practising mindfulness by then and meditation. So I did lots of that. I just did everything that I could. I got an app on my phone, which was really helpful. That tells me how many days I’ve been sober. All of this, like I just used every tool because I didn’t want to fail. I wanted it to be the the only attempt. And it was really hard. I have to say, I did not know how hard it would be. I, I did have quite a lot of physical symptoms. I had crazy psychological symptoms where I just felt I really need to drink, kind of peaked around day 18, 19, 20. It was, it was it was unexpected. But Alcoholics Anonymous got me through that. I mean, I’m really grateful to all my all my colleagues and friends and pals there because, you know, they were really helpful and I managed to do it first time, you know. But, but I’m mindful that, you know, it’s it’s day by day. In the early weeks and months, I replaced my alcohol drinking with eating chocolate. Okay. So I couldn’t have a drink and I just needed something to get through those evenings so I would eat chocolate. And that definitely helped my dopamine levels, but gradually I weaned myself off that. And now, you know, hopefully the levels are a little bit better. I’m going out in nature loads more and cold water swimming even more than ever. Mindfulness, I think really does help with the whole dopamine thing as well. Some practices of self-love, self-compassion, you know, just giving myself love, give myself a hug. It all helps, actually. [00:22:09][180.4]

Dr Louise Newson: [00:22:10] I think that’s really important. And I think it’s something, this is a generalisation of course, I think it’s something generally people, especially women, don’t do. And, you know, the last few months have been quite difficult for me for various reasons, and I’m trying to teach myself some more self-love. And it sounds really cheesy when people talk about self-love because I don’t look at myself and think I’m the most amazing person or the most beautiful or the most lucky or the most whatever, or talented. But actually, deep down, there’s something inside everybody where there’s a bit of something that needs loving. And whether it’s related to past trauma, whether it’s related to a poor relationship, whether it’s related to just how you’re feeling. But it’s that deep down self-love. It’s not that, I’ve got a new dress on. Don’t I look lovely? That’s too superficial for me. It’s more something within, isn’t it, that I think even more when you’re on your own, even more when you’ve got lots of stresses. It’s actually two things really, taking time for yourself, but also acknowledging that a bit of you somewhere needs a bit of a cuddle and warmth and you’re not going to get that by drinking or talking or offloading to someone else. You’ve got to do it from within. And that’s quite a hard thing to do I think. [00:23:26][76.3]

Dr Rachel Birch: [00:23:27] It’s really hard and it’s taken me a while. I have been practising mindfulness. I’m studying it as well and I’ve been practising it for about two and a half years. And I can say actually on camera now that I do have self-love, I can say I love myself, which, you know, honestly, two years ago, there’s no way I would have dared say that. But, you know, and I do give myself hugs and I do gratitude journals and put myself in the journal. You know, I think it does make a difference. It does sound cheesy, but but it does help if you keep going and you get used to doing it. We are great, women are great [00:24:03][35.9]

Dr Rachel Birch: [00:24:05] I think you’re absolutely right… yeah we are and we shouldn’t be we shouldn’t be stripped down and we shouldn’t be gaslit and we shouldn’t be accepting something that isn’t right. But we have, it’s society. It’s history, but we shouldn’t. But one of the things I noticed when I was on the tour and you came to watch, you were with a group of other people. And there was a lot of, you give so much positive energy. And I wonder whether it’s come, I have didn’t meet you before all of this, but I wonder whether it’s come because you are in a better place physically, mentally, spiritually, that you are able to give others even more. You’ve probably always been that sort of person, but you’re just there’s something that’s coming out of you that I think is incredible. And it could feel other people picking up on that, too. [00:24:50][45.0]

Dr Rachel Birch: [00:24:51] That’s a lovely thing to say. Thank you. And I think you’re right. I think you’re right. That’s a really lovely thing to say. And I believe you’re right. I do think that if you exhibit positivity, you know that there is research that has been done. I mean, we have these things called mirror neurones in our in our brains. And and you tend to mirror other people’s sort of behaviour and, and, and, and affect, you know, mood. And so I think that has an effect. But also I think in a greater than that, I think, you know, I think we are all interconnected, you know, we are all human, we do have common humanity here. And I think positivity has a ripple effect. You know, my my, my Pilates class, I will shout out to them, Bev, Diane, Kirsty and Viv. Hello. They are brilliant and they have helped me as much as I have helped them because we are a small group that meet every week and we talk about the menopause, we talk about our mood, we talk about how we’re feeling. I think we all buoy each other up. So I think once one person is positive, the next person, you know, perhaps becomes more positive. And again, that ripple effect happens. So, you know, I do think being positive about the menopause as much as we can and being positive about our mental health and just thinking, look, let’s do our best, let’s let’s not shy away from talking about it. Let’s, let’s, let’s, you know, not embrace it because, you know, but but go with it. [00:26:12][80.7]

Dr Louise Newson: [00:26:12] But it’s so, it’s so important because I think so often people have, this conversation’s been normalised about menopause. Oh you will feel like that. You will feel that or you won’t feel like that and we’re all different. But also there’s this big conversation as you either take HRT and you feel wonderful or you don’t take HRT and you’ve got to try all these other things. But actually in my mind, whether you take HRT or not, you’ve still got to be thinking about ways to improve your mental and physical health. And that’s so important. You can’t just use HRT as something that’s going to turn you into this amazing person because you’re still going to have challenges in your day, whether it’s work or home, or you’re still going to be making food choices. You know, you’re still going to be making choices about doing exercise. You know, this morning I woke up and I’m really tired, but I still got up to do 20 minutes of yoga before I got in the shower. And I feel better for it. You know, it’s only 20 minutes, but actually it would have been really easy to have just set my alarm 20 minutes later. But, you know, I feel better. I ended in a headstand. I did some meditation and and I’m like I can fight this day, but that’s not HRT. HRT is good, but it’s not everything. But on the flip side, there’s so many women who aren’t able to access HRT who, like you were, thinking, this is just my lot. And this is nothing to do with my hormones. And this is also, and it’s sad because you were blaming yourself. But actually you saw different doctors. So how we do this joined up process where we can empower women, but also we can educate healthcare professionals from every speciality. Just to think, could any of Rachel’s problems been related to her hormones? And even if it was only 5 or 10%, treating your hormones might have been enough to stop you becoming, you know, having problems with alcohol. [00:28:01][109.0]

Dr Rachel Birch: [00:28:02] Yeah. [00:28:02][0.0]

Dr Louise Newson: [00:28:03] Or just having a better time with your children or just not giving up or changing your job. There’s lots of little things. And I think as doctors, we need to tease out every single bit. We’re not just blaming one part, but if we don’t have the whole 360 approach, like, you not having the hormones was definitely a bit of the puzzle that was missing. [00:28:22][19.6]

Dr Rachel Birch: [00:28:23] You know, it was. And I think once I got the hormones, I was able to see the bigger picture. You know, I think I think I think my mental health was I guess so impacted by this by the time, you know, I became 48 and I, I had my light bulb moment. I thank goodness for the light bulb moment. But, you know, I had started to make all those wrong choices with diet and with exercise as well. You know. You know, I think, I think, I think HRT just just just improved my my mental health to the, I mean, it improved hugely. But in the early days it improved enough for me to actually then tackle the alcohol. I mean because I am an alcoholic, it’s you know, it’s it’s that that’s what I am. I’m addicted to alcohol. And again, I have no shame in saying that, you know, probably a couple of years ago I might have done. But, you know, it happens. It happens. It’s just something that happens. We’re humans, you know, what can I say? You know, it’s there’s no shame. I, I really want to break down the stigma as you do. I really want to get conversations opened. I think it’s really great work that you’re doing and back at you with the positivity. I mean, your positivity has a massive ripple effect, too. And I think, you know, talking about this has a massive ripple effect. And we have to keep spreading the word because people, you know, women and doctors can be educated. I mean, me, my GP, the psychiatrist back in the day, none of us thought menopause. I would like to think that if the same person had the same symptoms as I had now, you know, nine years on, I would really like to think that maybe it would be different. But I guess it’s only from talking it through more and more that we can get it out there to every doctor and every woman. [00:30:05][102.1]

Dr Louise Newson: [00:30:07] Yeah. Well, it’s been amazing, Rachel, and I’m. I feel very honoured and privileged that you’ve shared your story as well, because I know it’s going to help people, either people directly who’ve been listening or people indirectly who will know, you know, people will know others that they might be able to reach out to and just start that conversation and try and help. So I’m very grateful. So before I end, I always ask for three take home tips. And you’re no exception. You’re not escaping from that. So three things I think that you would either say to your former self or to others that were maybe just realising that they’re on that slippery slope and addicted to, it doesn’t matter what, to anything. What would you say to those people? [00:30:49][41.5]

Dr Rachel Birch: [00:30:49] Yeah. Okay. The first message I think in many ways is the most important message. And I would say, listen to your body and trust your instinct because you know your self best and you know you live with yourself 24/7. Your mind and your body are one. So your body, when it’s telling you things, is as valuable as your mind. And just look at the whole picture. Listen to yourself, notice and and, you know, don’t put them down to anything. Just think. Look, my body’s trying to talk to me and I’ll listen. And what’s it trying to say? And that leads on to number two, because then I think number two is be your own advocate because you’re the one that knows your body most, best. It can be particularly challenging for for people like me who had pre-existing history of mental illness. I had a history of episodes of depression. But if you think this is different, if your body’s telling you this is different, tell your GP and don’t be afraid. As I say, to advocate for yourself and say, Look, I know you think this is depression, but you know, could this be the perimenopause? I’ve done a bit of reading. I’ve listened, I’ve watched podcasts. My body is telling me that that something is different because for me, my mood swings and the suicidal thoughts and all the crazy sort of up and down-ness, that that was new, you know, so new things. I think listen. The third thing relates to alcohol addiction really. Prevention is better than cure. Okay? I wouldn’t really want anyone to get to where I was because it was pretty horrible and a little bit lonely until I accepted it. So be alert to the fact, notice if your drinking is creeping up and tell people, you know, tell people, don’t suffer alone like I did, you know, because there’s help out there. If you want to prevent problems as well as you know, if you find you are addicted and you are drinking too much, there’s help there at that stage too. Hit it with everything. Alcoholics Anonymous, you know, friends, GPs, family, you know, tell as many people as you can to get the help. Don’t suffer alone because, you know, there’s loads of help out there and you know this this can all be better. So that’s what I would tell myself. That’s what I tell myself but she didn’t listen. [00:33:02][132.8]

Dr Louise Newson: [00:33:06] Well, hopefully others will say, thank you so much for your time. I really appreciate it, Rachel. You can find out more about Newson Health Group by visiting www.newson health.co.uk and you can download the free balance app on the App Store. [00:33:23][17.4]

ENDS