Dr Louise’s new paperback book: what’s new and who’s it for?

This week is a celebration of Dr Louise Newson’s new paperback book, a revised and updated version of the bestselling The Definitive Guide to the Perimenopause & Menopause. Dr Louise is joined by Kat Keogh, who worked on the book with her and is the head of editorial at Newson Health and across the balance website and app.

Here Kat turns the tables and asks Dr Louise the questions, discovering why the subject of HRT doses warranted more attention in the book, the importance of hearing directly from women experiencing the menopause as well as experts in their fields, plus how Louise felt sharing her personal experiences.

Finally, Dr Louise shares three reasons she thinks people should buy the book:

1. The bright yellow cover is uplifting, and when you’re happier you’re healthier.

2. It’s packed with information so you’ll learn something that will either help you or a loved one.

3. Increasing awareness of hormones, perimenopause, menopause, plus PMS and PMDD will help women feel less lonely, more included and more listened to.

Pre-order the paperback book here

Click here to find out more about Newson Health.

Transcript

Dr Louise: Hello, I’m Doctor Louise Newson, I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today on the podcast, I’ve got someone with me who’s been before on the podcast, and hopefully it won’t be her last time. Kat Keough is someone I’ve known for many years, and she has worked very closely with me on my previous three books. And many of you know, the updated version of the hardback book is now coming out on paperback. It’s still called the same, The Definitive Guide to the Perimenopause and Menopause, and Kat has worked tirelessly with me to create this updated version, which I’m very, very proud of. So today we thought we’d talk about it, but I’m going to spin it on its head, so she’s going to ask me quite a few questions instead of me asking her. So welcome, Kat. Kat also works in Newson Health. She’s head of editorial and education, so she leads or co-leads the team with doctor Penny Ward, who’s our clinician who heads the education as well. So the education program that we’ve written and developed for healthcare professionals. She also is head of all our content across balance, across our website and works phenomenally hard. And I wouldn’t be able to work as hard as I do without Kat so publicly, I want to thank you, Kat. So over to you.

Kat: Thank you Louise, what an introduction. And then I’ll just point out that no money is exchanged hands before you gave that intro, it’s very nice. So I’m grateful. But yes, I feel like it’s a bit of a podcast takeover this week because I’m the one who gets to ask the questions, which is brilliant because I’m a journalist by trade, so it’s my happy place being the person asking the questions rather than answering them. So yeah, so I’m going to jump straight into it. So as you said, the paperback version, which is a fully updated and revised version of The Definitive Guide to Perimenopause menopause, is out on the 2nd of May. I know it was a huge amount of work for you over the last couple of years putting this book together, but I think if I was someone who didn’t know the background, I’d probably be thinking, what’s new in the paperback version? So can you just kind of give us a precis of what’s new in the paperback?

Dr Louise: Yeah, there’s quite a lot that’s new, actually. There’s a lot that’s the same because it is a definitive guide. For those of you that haven’t seen the original version, it’s a quite comprehensive book that’s very well referenced, and there’s lots of information for, I would say, everyone. I hope you agree, Kat, because…

Kat: Yes. No, absolutely.

Dr Louise:  So it has to be written that we can either read it cover to cover, you can pick it up, read little bits, take bits away. There’s parts for partners, there’s parts for children, there’s parts for colleagues as well. So it’s very inclusive. But there were areas in the book that I felt needed developing further. And these are the areas that we’ve concentrated on. So one of the areas that has caused quite a lot of confusion, actually, and quite a lot of noise is about doses. And the NICE menopause guidance is very clear about individualisation of care when it comes to menopause. And we’re all different as we know. When we prescribe HRT, we really work very hard to make sure that women have the right dose and type of hormones for them at that particular time, and so we’re all different. So there has been this confusion about doses. And some people talk about high doses. Whereas actually the oestrogen we usually give through the skin as a patch, gel or spray because it goes straight through the skin into the bloodstream, doesn’t change its form, doesn’t need to be metabolised. But, and this is where the but is as you know Kat, the skin is a barrier. So we don’t rub on our moisturiser in the morning expecting it to go into our bloodstream. And so there is a variation between the thickness of our skin, the temperature of our skin, the blood supply to our skin. And so we talk quite a lot in the book about but and that’s why some people need higher doses than others to get the same amount absorbed in the skin. So I looked at the evidence, we’ve reference to that as well, and hopefully that will reassure people why they might be on a different dose, either higher or lower than a friend or a colleague or a relative. So I think that is a really important part, isn’t it?

Kat: It is. Yeah. And I think we found on certainly on the balance website, we’ve published an article that’s probably about a year ago now, and it is month after month after month, it is our most read article. I mean, it’s got a really simple title: HRT doses explained. And that really was the kind of jumping off point to include it in the revised edition of the paperback. And I know when I’ve sat in on any talk you’ve done or any webinar you’ve done, so many questions come back to HRT types, HRT doses, trouble shooting, and it’s just those basic questions just crop up time and time and time again. And although the hardback original version of the book, I mean, it’s got a really meaty chapter on HRT, like you said, you know, at the beginning, it’s a definitive guide. It’s a weighty book, but this was really important to tease out in the updated version, because I think it’s obviously something that’s at the forefront of women’s minds. And, you know, it’s understandable really. HRT isn’t a one-size-fits-all treatment. There are so many different types, there’s many different doses. You know, certainly for me when I started, I mean, I talk about menopause every day in my working life. But even I got my first prescription and sat there with the leaflet, wrestled with it and had to look on the app and had to find this. And that’s someone who talks about menopause more than I talk about most things, so it is needed. It’s a really useful addition. And the other thing just while we’re on HRT is we’ve included a new section around what to do if the HRT that you use there’s a supply issue or similar. So could you just kind of talk about what we’ve included and why that’s important as well?

Dr Louise: Yeah, absolutely. Because, hopefully there won’t be more supply issues, but because HRT prescribing has increased, which is actually really good, and I think we should be really pleased with that. We have to just to take it a step back really, in the UK in 2001, before the WHI, the Women’s Health Initiative study, was produced that scared people away from HRT. HRT prescribing was about 30% of menopausal women and it was on the increase. In the US, it was about 40% of menopausal women and on the increase, because people were learning that not only women felt better, but they had better future health. Then this study came in, which was misrepresented, misreported, and obviously we talk about that in the book. But, and this is the problem, people then stop prescribing. And doctors were told actually to stop prescribing HRT. So overnight.

Kat: I remember my mum stopped.

Dr Louise: Yeah. And so in the US it’s still only about 4%. It went down to less than 10% in the UK. It has increased. It’s gone from 10 to 14%. And we then had a shortage. And that’s partly because the manufacturers are looking, you always look don’t you at your previous year’s figures. So if you, you know, carry on previous year, previous year you’re not going to have enough. So it is a supply and demand issue. And there’s quite small drug companies that make HRT. HRT is not patented anymore. So it’s not very expensive. There’s not much money in it. It’s not like some of the other pharmaceutical agents. And so no one’s been that interested, not really been invested. But the drug companies, to be fair, have really tried hard, certainly in the UK, to increase supply. They’ve put in lots of processes, but everything takes time. We’re waiting for the newer figures to come and I think they’ll be a lot better. There won’t be as high as 30%, but it’s going in the right direction. And, you know, it should increase even further because it’s just this is the body identical hormones. This isn’t the synthetic hormones, which are a lot safer than the types people were taking in the 1990s. So hopefully, as more people realise that there are health benefits, even as NHS England, the Department of Health and other health authorities across the world realise that all these diseases associated with the menopause inflammatory diseases reduce with people who take HRT, it’s very cost effective treatment and we do talk a lot about that in the book. You know, the evidence behind reducing risk of osteoporosis, heart disease, dementia is another area that we’ve really expanded on. And some of the listeners may have heard of Lisa Mosconi, who’s a fabulous neuroscientist.

Kat: I was going to ask you about that because she’s updated her section because she’s I don’t know, if you’ve read the book before, then you might be familiar with that. Each chapter we’ve got experts in there. So that’s everyone from Lisa Mosconi, a neuroscientist. We’ve got Julia Samuel, the psychotherapist. Joe Wicks talking about exercise. Saj Rajpar, who I think has been on the podcast a few times, talking about anything to do with skin and hair. He’s great. But yeah Lisa in between writing her own book, The Menopause Brain has updated her section, hasn’t she?

Dr Louise: Yes, and this is really important. Lisa is fabulous and her book is incredible too. I had the privilege of reading it before it came out, and she’s working very hard looking at the role of female hormones in the brain. And, you know, menopause affects our brain more than any other organ, as we know. But she talks about the biological effects of the hormones on our brain. And her research and her latest research was a review of papers looking at the effect of hormones on dementia. And the results were really reassuring, actually showing that certainly women who take hormones, bigger effects when they’re within ten years of their menopause actually have a lower risk of developing dementia, which is no surprise because we’re replacing those hormones in our brain, which are really good for helping the connections between our brain, helping our brain cells to work, our neurons to fire better. Helping the balance of chemicals in our brain, reducing neuroinflammation so inflammation in the brain. Helping the blood supply to the brain. So her part in the book is really important. And I think also to have a neuroscientist, you know, who’s top of their game, who’s female, who’s pushing boundaries is brilliant actually.

Kat: Yeah, it’s great to have her in the book. And I know she’s she’s been everywhere recently. She’s been on this podcast a couple of times. But it’s absolutely fascinating finding out that kind of brain menopause connection and what happens. But as well as Lisa, we’ve got not just experts, but woven through the book are the kind of real stories. Because this wasn’t a menopause textbook. It’s about reflecting a breadth of experiences of women. And we’ve got in the revised edition some great case studies, including Margaret, a woman with ADHD, talking about sort of managing her ADHD when menopause hit. And that’s really, it’s quite a powerful account. But you’d also co-opted Joanne Harris, the author, to write a piece as well, haven’t you?

Dr Louise: Yeah. So Joanne Harris is amazing. Some of you might have read her book many years ago or watched the film, Chocolat. And it’s quite a small book. Have you read it Kat?

Kat: Years ago. I mean, you know, I was a big Johnny Depp fan as a teenager. So I may have watched the film a couple of times, but no, it’s a brilliant book.

Dr Louise: It really is. I don’t eat chocolate, but I just look at the cover and I just want to I can smell chocolate, you know, it’s it’s incredible. And so she’s very talented as a writer, of course. But then she wrote this another book didn’t she.

Kat: Broken Light, wasn’t it?

Dr Louise: Broken Light, yeah. Which has this menopausal women as the main character. And I won’t spoil it for those who want to read it. Really powerful. So I reached out to her through Twitter, I think, and managed to interview her on the podcast. So she’s been on my podcast.

Kat: Yeah, she was great.

Dr Louise: But she talks a lot about women being invisible and how convenient it is for society for women to be invisible. And when I first read it, I thought, what is she talking about? I don’t want to be invisible, but actually I was invisible when I was menopausal because I could barely string a sentence together, let alone, you know, portray myself as who I really am. And we’ve been suppressed as a female sex for many, many, I’ll say years, but centuries actually. And she talks really eloquently. So we asked her to contribute to the book, looking at this in a bit more detail, and because she writes so well, as well, I think it comes out really well. What do you think?

Kat: Oh, it’s amazing. It’s in the, almost like the conclusion. It’s not a conclusion because it’s just ever evolving. But it’s fairly short. It’s only a few hundred words. But what she packs in to six, 700 words. It’s such a, as you say, such a vivid description of, you know, why have women been made to feel invisible at this point in their life? And, you know, why, that’s not on anymore and why women aren’t standing for that anymore. So it’s such a fitting sort of end to the book. So along with her, there’s an existing first person piece from Kate Muir, the journalist and author and menopause activist. I’m sure lots of people have read or heard her and that, yeah, I think those two voices at the end, it’s incredible. And it adds to the conclusion of the book where you literally address, you know, employers, women themselves, teachers, partners, children. You finish the book. And I think that’s really important with menopause because it can and you can feel a bit browbeaten. It can feel like it’s just something to endure. But actually it could be an amazing jumping off point.

Dr Louise: Yes. And that is powerful even in the workplace. We’ve got a section from Louise Tyson, who’s managing director at Newson Health, talking about the imbalance of gender in boardrooms often and about so many women leaving the workplace as well. And, you know, I think when we’re looking at the book, trying to make it as inclusive as possible, but it’s not just thinking about that poor woman who’s left her job because of her symptoms. It’s looking at the effects on the organisation. You’ve got staff that have trained, they’re at the top of their game and then they’re leaving. And how does that work for the employers and the money that they have to then invest to retrain somebody who’s left?

Kat: It’s huge. I mean we’ve worked out I think it was, was it £10billion? I think that’s the cost of, it was an analysis we did a couple of years ago for World Menopause Day. And that’s the cost of, you know, someone leaving their job, the costs of rehiring, the cost of retraining. It’s a massive drain. It’s not just the brain drain and the economy. You know, if you a really hard, dispassionate employer, you’re losing an awful lot of money if you’re not taking this seriously and properly supporting your, you know, it’s not about virtue signalling. It’s not about just, oh, we’re going to have a menopause awareness day. Do something meaningful with it. If you have a policy, don’t let it gather dust on a shelf. You need to actually practice what you preach. You need to give women information, space, support and adequate support. And it you know, it does go beyond a token desk fan or suggesting that you might be able to remove your jacket in the office. It’s about actually giving people access to healthcare professionals, support groups, and recognising that it’s not just your female employees. It could be people with partners at home or relatives or colleagues, and everyone needs to kind of have that kind of 360 awareness about menopause. Now, I know we’ve talked a lot about other people who’ve contributed to the book and new things, but one thing I did want to ask you, because I know you sent me a picture a couple of weeks ago when you were recording the audio book for the paperback, and you haven’t done that before, and you were quite resistant when the hardback came out that you didn’t want to do it. But what changed your mind this time? But also, what was it like reading your own words back in a booth for a few days?

Dr Louise: Yeah, it was interesting. So when when the hardback came out, the publisher Yellow Kite who are fantastic, as you know, said, oh, could you do the audio? Well, my diary is really chock-a-block and I couldn’t cancel patients. It didn’t feel morally right to cancel patients, cancel other work, just to record. And we didn’t have much window. And I said no. When I meet people in public and I love it when I do public facing events, is they say, I feel I know you Louise because I hear your voice every week. So when I go for my dog walk, when I’m out, I’m often listening to your podcast and I really enjoy it on a Tuesday when a new one drops in. And so that was one of the reasons that I thought, yes, I should do the book because it’s my book. I’ve created it. So therefore I should be using my voice. So I went to a studio in Birmingham and the guy, Paul, who was there was just amazing. And he said, right, we’re not going to read the introduction. We’re going to start with the main chapters, and I’m not going to spoil by talking about how the book opens, but it is very sad.

Kat: It is.

Dr Louise: It’s a sad, real story. And I did it for a reason, for an effect. But it’s also to make a change and make people think more about the mental health aspect of the menopause. And I always get very emotional even reading it in my head, let alone out loud. So I thought, well, that’s more than I could do, he said. It takes it a while to warm up and to get used to everything. So I’m in this room and oh my gosh, it’s so hard because I realise I read quite fast in my head and you miss out words when you’re reading in your head, don’t you?

So it did take a long time. But I also found out quite a lot about myself, because in the book, there’s some quite personal parts about…

Kat: I was gonna say, was that difficult to kind of talk because you do talk about your own sort of story.

Dr Louise: Yeah. So when I was talking about other people’s, because there’s quite a few, as you say, of other people’s experiences in the book, that’s fine. When I was talking actually about, I don’t know, HRT, about hormones, about exercise, that was fine. It’s very factual. It’s very easy. And then suddenly I’m talking about me and even Paul commented and said, gosh, you’re very not, you’re not comfortable talking about yourself, are you? Because I would stutter, I would stumble, it would take a lot longer. And then are some emotional bits. I always get emotional when I’m talking about my father, when he died, when I was so young and and I said, oh gosh, does this sound really silly? Because now I feel a bit emotional. He said, no, it’s great because this is you and how you’re feeling. But it did make me slow down, because actually one of the things Paul said to me was, if you’re worried or you’re going to mess up, let’s slow down. You can’t do it slow enough. And actually, it taught me again, a bit of a life skill that sometimes we’re in such a race to do things. That’s when we make mistakes and it takes longer to unpick them. So I was thinking, I know this sounds a bit ridiculous, but I was thinking about my yoga practice, thinking about the way I cook for the children, the way that I write articles. Actually doing it a bit slower. It might be like that whole tortoise wins the race at the end of the day. And so actually talking more slowly, reading more slowly gave me time to think a bit more. So that was just something. I know it sounds a bit silly, but I don’t know. I learned that that I thought actually a bit slower isn’t bad.

Kat: No, it doesn’t sound silly at all. And I am going to hold you to that next time. So I’m glad that we’ve got this committed to audio and video that we’ll bring that up. But no, I mean, it’s amazing advice for any, any aspects of life really. And I suppose one of my final questions that I wanted to ask you is what part of the book, new or existing, what part are you most proud of and why?

Dr Louise: Oh, that’s quite a hard question, Kat, because do you know what, as I was reading it, I was really proud of it all. And I was really surprised because if any of you’ve written a book, it’s a lot of work and you’ve got copy coming back and forth. And, you know, Kat and I have shared so much, haven’t we? It takes a long time. It’s not even just the writing. It’s the thinking. It’s the creating. It’s putting it together.

Kat: It’s the references.

Dr Louise: I was going to say the references and doing all that, and then you get a bit fed up with it because it’s like, oh, here it goes again, here it goes again. So I never read it out. Obviously a book out loud that I’d written before. So I’m reading it and I had a pause not long after every chapter. And I thought, actually, this is a really good book. And actually, I’m not often proud of what I do, as you know, because I always think about things I need to do. But I was really, I am really proud of it. I still am really proud of the book, but I also got more cross the more I read it. Because as many people know, I get very frustrated for people that are not able to access not just the information, but treatment that’s right for them.

Kat:  Yep.

Dr Louise: And so I, I was just like, it’s all so obvious. It is so obvious. I’m telling people things that everyone should know, they should have heard before, yet they don’t. And it’s a really holistic book. So it’s not just about hormones. It’s not just about HRT. It’s not just about a type of exercise. And it’s not just about me either. So having different women’s voices coming through of different ages, different ethnicities, the chapter that we added as a last chapter, it was not at the end of the book, but we added it as an extra in the hardback about women that have more disadvantages than others, we’ve extended that more as well in this book. So women from ethnic minorities, women who are LGBTQ+, also women with drug addictions, women who are homeless, women in prisons as well.

Kat:  Yeah. We’ve got the, we ran that and it’s a supplementary survey to the original book survey, but we looked at, alcohol and other drug addictions in menopausal women. And I think that was I think about 3,000 women replied. And we looked at how drinking habits and not just alcohol and drugs, but things like over-the-counter medications, prescription medications, and about how the menopause, effected use of all of those things. And that is included in your chapter around kind of, you know. I know we’ve spoken before, I mean, we use picture libraries, and if you put in menopause, it will come up with a white middle aged woman with grey hair in a cardigan.

Dr Louise: With a fan.

Kat: Nine out of ten times with a fan, yeah. And it’s that ridiculous, really hackneyed kind of image of menopause. So this chapter kind of tries to blow that out of the water, really, and just make sure that we’re hearing everyone’s experiences because we’re not all white, we’re not all middle class, and we’re not all middle aged.

Dr Louise: Yeah. And that’s what I found. I kept thinking, right, if I was young listening to this book or if I was old, or if I was, you know, from another country, or if I was, whatever gender you are, there’s something for everybody in it. And so I did come away thinking, oh, do you know what? This is amazing. I’m really chuffed and I’m really proud of it. And I’m also proud that it’s not just my book. Like, you’ve obviously helped me and worked incredibly hard, but it’s not just our book. It’s a book by women and men, actually, because men have contributed too. So it just feels really inclusive. And that’s what the menopause should be. So I hope that everyone who reads it will be able to helicopter into this space of thinking, yes, my menopause is going to be really good and really positive.

Kat: Absolutely.

Dr Louise: I’m going to share that knowledge with others. And that’s I sort of did come away exhausted, but with a really.

Kat:  In need of a glass of water.

Dr Louise: Yeah, I was shattered actually, but thought, actually, I’m proud. And I’ve got a warm feeling, you know, in my body thinking this book is going to help whoever picks it up. And that’s, I can’t think, a better thing for a book, actually.

Kat: Well, I think you’ve summed it up there better than I ever could. I think the kind of reasons behind it, and you should be proud of it. It’s an amazing book. And, you know, the new additions make it even better. But before we finish, I feel like I’m parroting you. Could you give me three take-home-tips? I hear this in my ear almost every week when I listen to the podcast. Can you give me three reasons rather than tips why people listening should either buy a copy of the book for themselves, or maybe someone in their life to read.

Dr Louise: So the first one is going to sound really trivial. It’s got a really lovely cover. It’s yellow, it’s bright. It’s, you know, you know, when the daffodils start coming out, you think good spring is here. I feel happy.

Kat: Spring has sprung.

Dr Louise: Yeah. And so just the cover. So if you don’t buy it, just look at it, you know, look at it in the library. Look at it in a bookshop and just smile because, you know, people need to be happy. Of course they are. When they’re happier, they’re going to be healthier too. So for the cover, that sounds really shallow. And I’m not a shallow person, but I actually really like cover and the colour. So just have a smile when you look at the cover. But more than that, I challenge anyone to read something in there that they don’t know already. So I think there’s something that someone is going to always learn from because there’s so much information. So I think you should have a read, with an open mind wanting to learn, because knowledge is power. And every day, certainly in the work I do, I am learning. I mean the learning from references from scientific journals or from patients, from experiences or just from life and learn from my children all the time. I learn so much. So go in there with some, you know, inquisitive mind and learn something. And the third thing is, I think people should read it so that they can reflect and share knowledge. And the menopause and perimenopause and PMS, PMDD, which we write about as well. Hormones should be shared, knowledge should be shared so that we can empower others. So even if you think it’s not relevant for you, just pick it up, learn a bit and share that knowledge with others. Because menopause and perimenopause and PMS, PMDD can be very, very lonely for people. And so the book, I hope, is going to make people feel less lonely, more included, more listened to.

Kat: Couldn’t have said it better myself. That’s brilliant. I’m not sure he does the sign off now whether it’s you or me. But I’ll probably leave it to you actually.

Dr Louise: I think I’m going to finish by saying thank you, Kat. Kat also works behind the scenes on all my podcasts, and it’s amazing that we’ve managed to do over 250 now, more than 6 million downloads. So very grateful because it’s not my book. It’s a book by others as well for as many people as possible. And it’s great to have, although I don’t, I feel a bit uncomfortable being put, I much prefer to be a host than a guest of my own podcast, but thank you.

Kat: [00:34:54] You’re never going to have me back on again after this.

Dr Louise: No, I don’t think so, but no, thank you for giving me the opportunity to talk about the book, which I have spent many an hour on. And as people have just heard, I’m really proud of. So thank you Kat for your time today.

Kat:  Thanks for having me. And yeah, it’s been lovely to talk about it. Thanks a lot.

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