Get comfortable with the uncomfortable: mental health and the menopause

Content advisory: this podcast contains themes of suicide and mental health.

This week on the podcast, Dr Louise is joined by Andrea Newton, a postmenopausal woman whose own experience of mental health during the menopause lead her to train as a tutor with the National Centre for Suicide Prevention Training. Over the last six years, Andrea has trained thousands of people in suicide intervention skills and she is now training to become a menopause coach.

Andrea explains how her work in the corporate world has allowed her to share the importance of educating line managers, HR managers, and everyone about the menopause. She is also the author of the book, Could it be Your Hormones Love? (And Other Questions Not to Ask a Menopausal Woman).

Andrea shares her tips on widening the conversation about menopause:

1. Women need to educate themselves more about how the menopause affects all aspects of their health and be better at advocating for themselves.
2. Let’s take the conversation to the wider audience and stop the awful, narrow, stereotypical view of menopause. Instead, educate people so we can avoid tribunals, retain talent and have more menopause-friendly businesses.
3. Get comfortable with the uncomfortable and have conversations about things like menopause, mental health, suicide risk. We need to stop waiting for people to reach out, and we need to get better at reaching in and being proactive.

You can follow Andrea on LinkedIn, Instagram @in.her.right.mind and Facebook @InHerRightMind  

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.

Related articles

Westlund Tam L, Parry BL. (2003), ‘Does oestrogen enhance the antidepressant effects of fluoxetine?’, J Affect Disord. 77(1):87-92. Doi: 10.1016/s0165-0327(02)00357-9

Ibrahim WW, Safar MM, Khattab MM, Agha AM. (2016), ‘17β-Estradiol augments antidepressant efficacy of escitalopram in ovariectomized rats: Neuroprotective and serotonin reuptake transporter modulatory effects,’ Psychoneuroendocrinology. 74: 240-250. 10.1016/j.psyneuen.2016.09.013

While there are limitations to these studies – one is a small cohort, one is an animal study – they help demonstrate that more research is needed on how oestrogen levels affect antidepressant efficacy.

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. Today on the podcast, I’ve got someone called Andrea Newton with me who reached out to me on social media through the internet, as many of my contacts have, and told me the most amazing story about herself, but also about the work she does. So we’re going to spend the next half hour really exploring it, and it’s not an easy listen, but it’s definitely worth listening. So Andrea, welcome to the podcast. Thank you so much for agreeing to come today. [00:01:28][77.1]

Andrea: [00:01:28] No problem at all. Thank you for having me. [00:01:30][1.7]

Dr Louise: [00:01:30] So we were just trying to work out how to introduce you because you’re a woman of many talents, and I think all women have many talents, actually. And I can say that as a woman, and most of us actually don’t like talking about our many talents, we just say, oh, I am just a doctor, I’m just a mother, I’m just a whatever. But actually we are often more than just something. So you are a speaker, a trainer, a author, and also a menopausal woman. And lots else as well. So if you don’t mind just telling me a bit about you as a person, and then we’ll talk about your work in a bit if that’s OK. [00:02:05][34.8]

Andrea: [00:02:06] Yeah. So actually, I’m a bit of a woman on a mission, actually. Louise. [00:02:09][3.6]

Dr Louise: [00:02:10] Good, I’m one of those, too. [00:02:11][1.4]

Andrea: [00:02:11] Not unlike your good self. But me personally, I am 56 years of age. Which I think that’s important to let’s talk about the age thing. I went through a really difficult divorce. Very stressful. Outside agencies involved, all sorts of stuff, which basically left me in a bit of a state. And even when that was all finished and done and life was so much lighter and brighter than it had been for many years, my low mood, my depression, my anxiety just wasn’t lifting. And so that was a really difficult time for me. And I have to say, the power of tribe is something that should never be underestimated. I had three fabulous female friends and my amazing son who, you know, between them it was a bit like a relay race. They each took it in turns to see me through. And after a career of 24 years in the corporate world where I’d always been super confident, standing up on stage, delivering keynotes to audiences of hundreds, I was an absolute mess. The wheels really did fall off, and obviously that’s where I first got interested in this subject. What is happening to me as a midlife woman? I was told that I wasn’t menopausal more times than I’ve had hot dinners since. [00:03:37][86.1]

Dr Louise: [00:03:38] Is that from healthcare professionals? [00:03:39][1.0]

Andrea: [00:03:40] Yeah, that was from my GP, who did the good old blood test because I was insistent that there was something more than the impact of the divorce. So yeah, I’ve been through the mill. I wallowed in a fur-lined pit of pessimism for a while, and thankfully got the help I needed in the form of an online consultation with a wonderful lady who in 20 minutes said, actually, you’re probably now post-menopausal and you’ve not had what you should have had. And here I am today as a woman on a mission to share my story so that other women don’t have to go through that same challenge. [00:04:19][39.2]

Dr Louise: [00:04:20] Yeah. And how did it feel Andrea when you when you were told that? Because we hear it every day in the clinic. And what’s really sad for me for many reasons is that women aren’t being listened to and you’re there telling me that you’ve told or explained that you think it’s not just because of the awful circumstances you’ve been in, but you’re still not being listened to. And it’s the history of medicine. It’s the history of women. It’s not just about menopause. It’s lots of things that women are absolutely not listened to. And I find it very frustrating when people don’t listen to me. And sometimes I’m wrong. And I’d much prefer people to tell me, I’m listening to you, Louise, but what you’re saying is not right, but actually to not be listened to, this gaslighting that occurs, happens a lot in the menopause. And when we know how important hormones are to us because they’re biologically active, when we know they’re more than just something that regulates our periods, when we know the effect in our brains of our hormones, and when we know that the perimenopause is when hormone levels change and the menopause is when hormone levels are low, why is it so hard to realise that our mood, our anxiety, our you know, mental state is going to change when our hormones change. I don’t understand which bit of it is difficult to understand. [00:05:42][82.1]

Andrea: [00:05:43] And I have to say, it’s that feeling of powerlessness I think is the only way I can describe it. I knew there was something else that actually, you know, was underlying. And I remember distinctly in one appointment in a very ridiculous layman’s terms, saying, is there something that happens internally? Because actually, sometimes I feel all right and sometimes I don’t. Could it be my hormones? And that’s when they did the blood test. But it’s that feeling of powerlessness. And actually I think that’s what made my condition worse. Because if somebody just said to me, well, actually, this is the problem and this is how we’re going to fix it, whatever the problem is, at least you know, you’ve got somebody on side with, you know, some sort of effort. But to be told, you start thinking, am I imagining this? Am I making it up? Am I a malingerer? Do I just need to get a grip? And that’s the point where it was coincidence. I’d nipped around to see a friend. It was her birthday, and I’d called round unexpectedly with flowers and a card, and she made it clear that she’d got plans and that people were coming and candles and cake. And to me that said, you’re not welcome because you’re such a miserable bat, nobody wants you around. And that was the day that I actually made a plan, I made a plan to end my life. And I knew what I was going to do, where I was going to do it, how I was going to do it. I got everything mapped out because I just felt so hopeless. You know, I’d battled through the divorce of all divorces. I’d come out the other side thinking, why did I bother? Because if this is what life is, nobody’s listening to me. I am clearly losing my mind. There is very little point, and it’s only now that I’ve learned, as you said, the hormonal effect and the fact that living through that stressful period, the cortisol impacts that that probably would have had on my body, no wonder I was in such a bad state. And by the way, I was 50 years of age. It was my 50th birthday. How many more clues do you need? [00:07:52][129.1]

Dr Louise: [00:07:53] Well, I think, this is the thing, and actually, you know, talking about blood test is a really important point because we know that we don’t have to do blood tests. If someone’s 50, they will be either perimenopausal or menopausal. That’s fact actually, because our hormone levels will never be the same at the age 50 as they were age 30. The average age, not that you’re average, but the average age of the menopause in women in the UK is 51. So it doesn’t happen overnight the menopause, it usually happens gradually. So this perimenopause when hormones start changing, happens usually for majority of us in our 40s. And it’s this change in hormones that can trigger problems with our brain. And we know we did a survey actually around the time of my book launch of 6,000 women, nearly 6,000 women just asked them various symptoms, and 96% of them had psychological symptoms, 84% of them had anxiety and 79% said they felt overwhelmed. And the majority of them had been offered or given anti-depressants as well, instead of HRT. And so the instead of HRT bit I think is relevant because it’s showing that these women are asking for hormones and it’s a lot easier, I know it is, from talking to thousands of women to get a prescription for antidepressants than it is for hormones. Of course some women need antidepressants. Of course, some women will be clinically depressed, but we know that antidepressants work better with oestrogen on board, so they work better in younger women who have their own hormones, naturally, or women taking HRT who have natural oestradiol. And oestradiol has been described as nature’s psychoprotectant, as in, it protects our brain from psychological and psychiatric conditions. And we know that women who take hormones have a lower risk of clinical depression, schizophrenia, bipolar, and even addictions as well. You know, they work really well. And our hormones, oestrogen, progesterone and testosterone actually have really important effects in our brain, and they’re made in our brain. And one of the first things that happens if we have a brain injury is that the nerve cells produce more hormones. So it’s not just about our ovaries. And also like I think it’s very relevant you talking about stress because we know about our stress hormones. You’ve said cortisol but also adrenaline and noradrenaline are big important hormones. But they also work as neurotransmitters in our brain. Now what’s very interesting is if we have low oestrogen levels in our brain, then our brain compensates and it produces more of these other hormones as well. So the adrenaline, noradrenaline and everything else, the whole balance is out of kilter. And our hormones, oestrogen and testosterone have effects on our dopamine, our reward centre of our brain. So you going around to your friend’s house, you’re getting no natural endorphin release. That sort of feelgood factor when you’re with someone who’s happy or someone who loves you or someone who cares, you just flatlined. And a lot of people say to me, I just feel joyless. I have no zest for life, I just exist. I’m not living and that’s often a lack of oestrogen, but also testosterone as well. And these hormones light up our brains. Not for everybody. Other people find they can go openwater swimming, they can do whatever and they might get the same hit. But actually, it’s really important that we don’t ignore this, which we have for so many years. I was reading a history book recently, and it just reminded me about, you know, the hysteria after hysterectomy, women locked up in mental asylums in the Victorian times, and then women were given benzodiazepines as sort of nature’s little helpers to calm us down so we were in a fit state to prepare food for our partners and, and be, you know, not a complaining housewife and even people that had lobotomies as well to calm us down. Well, this is all related, I’m sure, mostly related to our hormones. And without the hormones, you can’t just pull yourself together. You know, you’ve been through a very traumatic divorce, but you’re a strong person. You knew you could get through it, but you can’t make these hormones again. You can’t just have them. And that’s what’s really difficult. And actually, that’s also what we see in our clinics. We have a lot of clinical experience seeing thousands of women that we do that these symptoms often do improve and they’re not usually improving in isolation with hormones. But once people have hormones, then they can function better. They can work better, their mind is clearer, they can have CBT, or they can have other psychological help, or they get the support from their friends as well. So you’re obviously better because you’re not planning anything horrendous. [00:12:40][287.3]

Andrea: [00:12:41] No. [00:12:41][0.0]

Dr Louise: [00:12:41] But I mean, what happened to make you change the way that you were thinking and feeling about yourself? [00:12:47][5.2]

Andrea: [00:12:48] I think what happened was I got to that point where I was absolutely peering into the abyss. You know, I was on more and more antidepressants. They’d given me diazepam. I’d also got propranolol, you know, the whole nine yards. And I said to the GP, I actually went and said, look, I am having thoughts of suicide. My intention is to end my life. I do not want to live like this. And what I didn’t know then, that I do know now because of the training and work that I’ve done since, GPs are not routinely trained in suicide prevention and as we know, GPs have not been routinely trained in perimenopause menopause symptoms. So I was presenting in his absolute blind spot. I was presenting two normal human conditions overlapping and he just did not know what to do with me. And his best suggestion was let’s take away all the medication for a few weeks and let’s see where we start again. And I was in such a state then, because you do get to the point that you think there’s just no hope. This is just hopeless. It’s pointless. Nobody’s listened to me, nobody cares. And I just went, yeah, OK, if that’s what we need to do. And I literally went home and I phoned a friend of mine who’d been very supportive and explained to her what the GP suggested, and I won’t repeat the words she used, but let’s just say she wasn’t best pleased at that as a solution. She actually lives five hours away, and she was so worried about me that she got in her car, drove up and spent the weekend with me, and now tells me that she engineered that because she really felt that weekend they would lose me. Because once you’re in that place where you know where you feel completely overwhelmed, you’ve got nowhere to turn. You know, the GP makes you feel as though you’re just an idiot really. I started to think, perhaps I’m imagining it. Perhaps I just need to get a grip. But now I know in that blind spot of what are two normal human conditions I just wasn’t on this radar in terms of, he just didn’t know what to do with me. So lots of leaflets for CBT and EMDR and tapping and all sorts of therapies, along with diagnoses and prescriptions for all sorts of medications. That was his best offer, and none of it was even touching the sides. And so I set off with my plan. And it was the weekend that my friend came up because she was worried and we started to do our own research. We got online and we were sort of, you know, and I was, actually I’ve spoken to my GP since, and they tell me that it was back in 2019 that I actually asked them about menopausal symptoms, but I’d had nothing to deal with it. So we created a plan, we did some research, and I actually booked a private consultation. And I have to say, apart from a fabulous pair of shoes that I own, that is the best money that I have ever spent, and literally 20 minutes with somebody who knew what they were talking about. And she actually said to me, I actually think you’re now postmenopausal, and therefore this is what I want you to do. And she gave me a prescription. No surprises. She gave me patches and also Utrogestan. And she said, you know, you’ll have to see how your GP responds. And I was expecting a bit of a fight. I was thinking, oh, he’s going to get a bit funny because I’ve been and seen someone privately and I’ve got this private prescription and he might not be very happy. And do you know what? I think he was as relieved as I was because there was a solution and he knew how to do this bit, you know, give me that prescription. I will write that prescription. This will make you go away. So I actually think he was as relieved as I was. So, yeah, here I am. And a woman on a mission. [00:16:46][238.7]

Dr Louise: [00:16:47] Very good. And you’re absolutely right. It’s very difficult, actually, as a GP or any healthcare professional, when you have someone in front of you where you haven’t got the experience, knowledge and education and, you know, we’ve all done it absolutely in medicine where you feel a bit out of your comfort zone. And one of the things that I learned very early on, actually, by my amazing GP trainer Dr John Sanders, was share uncertainty with your patients. You are human. You’re not a robot. You’re not a machine. So I have done it over the years. When someone comes with some difficult myriad of symptoms or I’ve given like first-line treatment, say for raised blood pressure and then second line and they’ve still got raised blood pressure. And I will say to them, I’m not quite sure which way to go here, but what I am going to do is ask a specialist. There’s a really good raised blood pressure clinic at the hospital, I’ll refer you. Or with migraines, you know, you go through the first layer of treatment and then if it doesn’t work, and I think patients expect that, they don’t expect you to know everything. I often say also to patients, I’ve always done it and I still do it now, if this doesn’t work, I can help you by doing something else. And that something else might be another prescription, it might be a non-pharmacological treatment, or it might be a referral to somebody who will know the answer or hopefully will know the answer. [00:18:02][75.4]

Andrea: [00:18:03] I didn’t get that. He was embarrassed by my state. He was more uncomfortable with my presentation than I was. And you know, I don’t blame him. I absolutely understand that GPs are expected to know a little about a lot. [00:18:19][15.3]

Dr Louise: [00:18:19] Yeah. And it is difficult. [00:18:20][0.8]

Andrea: [00:18:21] Yeah. [00:18:21][0.0]

Dr Louise: [00:18:21] But at the same time, I think it is a really big but in this conversation, menopause affects 51% of the population. You could then say oh, but Louise it’s not an illness. So why do they need to learn about something that’s a natural stage, a natural progression. But actually if it progresses as an increased risk of diseases and I often compare it with raised blood pressure in the fact is raised blood pressure is not really a disease. It doesn’t usually cause symptoms. It’s just a number when you have your blood pressure done. But we treat it because it reduces the risk of heart disease. Now menopause as you know, increases the risk of lots of diseases. But heart disease is one. We know that if women take hormones they reduce their risk of future heart disease. And actually, if you compare what’s the efficacy of HRT compared to blood pressure lowering treatment, reducing risk, which one’s more effective? Well, you know what I’m going to say obviously, it’s HRT. So even if we’re just looking at reducing risk of heart disease, which is number one killer globally for women, why are we not thinking about hormones and so but we also know it reduces risk of other conditions, including mental health conditions, like I said earlier. So we need to be thinking why are we not being educated? Why are women not being offered it first line? And actually a lot of women who are going back and forth, you know, you say you went to your doctor many times, probably now you’re feeling better you don’t really go very often. [00:19:43][82.3]

Andrea: [00:19:44] No, I haven’t been. [00:19:45][0.7]

Dr Louise: [00:19:46] Well, precisely. So so when I get sort of told, Louise, you know, we’re overprescribing HRT, your media work means too many women are coming asking for HRT. It’s short-term pain for long-term gain. And that’s where, you know, people who have made policy decisions, people who are overwhelmed in general practice, need to think actually it’s quite good. But also the more we can educate women, and certainly, you know, with our Confidence in the Menopause course, we’ve made it that anyone can it be educated through it. Then the more empowered you are as a patient, the more likely you are to go do you know what, I’ve read about hormones. I’ve read about NICE guidance, I’ve read about HRT. I would like to try that first. And actually, there’s also this easy HRT prescribing guide that we’ve done, very easy to find on the balance website. Just search easy HRT and you can say, I’d like this and I’d like this. You know, I’d like the patch, I’d like Utrogestan. And that makes it quite easy or even to say to your doctor, look, I’ve done this course, I’ve got this information, I’ve downloaded the balance app, this is my hhealth report and this is easy HRT prescribing. Maybe if you could just reflect on the fact that I would like this patch and this, I’ll come back in two weeks’ time and can we have another discussion? And that’s happened and worked quite a lot for people. Because no one wants to be confrontational with their doctor or nurse or pharmacist. We want a really healthy relationship, but it’s how we can empower them in a sensible way, where your health and your future, certainly your future mental health, don’t deteriorate while you’re waiting for that treatment. So you’ve obviously so much better, which is wonderful to hear. But what about your work as a speaker, trainer, and author? What do you do then? [00:21:29][103.3]

Andrea: [00:21:30] Well, that’s taken a bit of a different route, to be honest. I’m now qualified as a suicide intervention tutor with the National Centre. I’m currently training to be a menopause coach and my work in the corporate world, I actually want to take the message a little bit further than women. I want to take the message to everybody around them, to men, husbands, spouses, partners, tribe, managers in the workplace, health and safety professionals in the workplace. Because I genuinely believe that we need people around us who also understand what’s happening, because we need to do something about the whispered conversations, the stigma, the silence. And I know that if I hadn’t had my people around me, I wouldn’t be here to tell you the story because I wasn’t getting the support I needed from the person that I thought I would, being the GP. So my work I am now speaking at conferences. I’m speaking within organisations, raising the importance of getting comfortable with the uncomfortable. And I talk specifically about menopause, the impact it can have on mental health, and the suicide risk that comes with it. Because I know that there is research that shows an increased risk of suicidal thoughts in perimenopausal women. And if you look at the ONS statistics in the UK for the number of deaths by suicide of females, the most significant number is age 45 to 49. And interestingly, we also know that the divorce rate peaks at that age. So I’m on a mission to encourage society as a whole to be better informed, to be more aware, because I don’t want anybody to go peering into the abyss in the way that I did. Nobody needs to be in that place. [00:23:26][116.2]

Dr Louise: [00:23:27] No, I totally agree. And as you might know, we’re funding a PhD student in suicide prevention. And, you know, this is the area of work that to me is the most important work, of course I like people feeling better and of course I like them when their joint pain improves and the headaches improve and their physical symptoms improve. But actually it’s the psychological symptoms. But the suicide thoughts and, you know, some of our early research is showing far more women than we thought actually, have had very negative, dark thoughts before they come to the clinic, but they’re not always revealing them because you have to, as you know, it’s asking in a certain way. And, I gave HRT to someone recently, she wasn’t really wanting, she didn’t think she needed it and I could see that she probably did. So at the end of our meeting, I emailed her and said, do you like me to just talk to you through about hormones? And I did. And her mother had dementia and she’s in her 50s. And she said I didn’t really have many symptoms. And I said, well, there are disease preventative effects as well, especially looking at osteoporosis and heart disease and probably dementia as well. So she said, well, I said you could try it for three months and just see, and then we can review it and you can stop it if it doesn’t help, it’s fine. So I had her three-month review recently and she said, Louise, do you know what? For the first time in about 20 years, I’m waking up not having that feeling that I want to end my life. And said, I’ve never I would never end my life. But she said, I just thought that was me. I just thought that was my personality, that I would just have this really negative thoughts, especially in the morning. But she said but I don’t anymore. Then I thought, it’s so interesting. And actually for her, the biggest difference has been testosterone, actually. And we see that a lot in the clinic. That people have oestrogen and they feel a bit better. And then you give them testosterone. And often they’re like, wow, I can see in colour, I can sing in the shower, I can smile, I could… Just those little things very hard to measure when you’re doing proper research. But actually, you know, I’m skipping down the stairs. I’m not plodding down every morning thinking it’s Groundhog Day. Here I go again. But those little things can catastrophise in people’s minds. And that’s what, like you’re saying about your friend, normally you’d shrug it off or go, oh, why aren’t I invited, oh, can I join in? This looks really fun. But you feel worthless. You feel like, what’s the point? And this is where I completely understand about the suicide risk. And we have to wake up and realise, you know, it’s so important. And hormones are not harmful either. They are not going to get everyone out of suicide. They are not the panacea treatment, but they are a treatment that is often missing in women who have suicidal thoughts. And this is where we have to change the conversation. But you’re absolutely right. We need others to recognise it and help us as well when we’re having these dark thoughts. So show us your book. Show us your cover. [00:26:27][179.9]

Andrea: [00:26:29] I’m very excited. [00:26:30][0.9]

Dr Louise: [00:26:31] So Could It Be Your Hormones Love? It says. I can read that. [00:26:36][4.7]

Andrea: [00:26:37] It’s Could It Be Your Hormones Love? And Other Questions Not to Ask a Menopausal Woman. Except it begins with the line, or maybe that is the question. Maybe we don’t talk about these things openly and honestly in the way that we should. Settle down. I’ve got a story to share. [00:26:54][17.5]

Dr Louise: [00:26:56] And that I think is really key. So a lot of the work we’re doing at the moment with our organisation, Newson Health, is not actually talking about the menopause. Certainly we want to be talking more about hormones because it isn’t just menopause as you say. It could be perimenopause, it could be PMS, it could be postnatal depression. But I think when you say to someone, oh, are you menopausal, lots of people go, no, of course I’m not, don’t be ridiculous. Whereas if you say, could it be related to your hormones? It’s actually an easier conversation to start. And I think also a lot of work I want to do, and I’m trying to do, is enable people to understand what hormones are. They’re not something that just makes us irritable or makes us a bit, you know, sad a couple of times a week or makes us mouth off to people. They are biologically active in our body and have really important effects. And that’s where we’ve got to change this narrative. And it is easier. But we have to understand when we’re really young. So the same way that we can pick up clinical depression or we can pick up if someone’s broken their arm, it’s quite obvious. Or if someone’s got a wound, you know, you can see it. But the same with the hormones. We need to be picking it up earlier in others. But not making is oh, it’s just your hormones there there, there’s no treatment because that’s what’s sometimes happening. And in organisations it’s sometimes like, oh we’ve ticked that box, we’ve talked about hormones. We’ll give women a bit of there there treatment and allow them to reduce their hours. Actually, what these women are crying out for is someone to listen to them, to understand them, and more importantly, to treat them appropriately with the right treatment because you’re investing in their future health as well. [00:28:34][98.3]

Andrea: [00:28:35] Organisations need to listen because this year there’s been more and more tribunals. [00:28:39][4.1]

Dr Louise: [00:28:40] Course there has. [00:28:40][0.0]

Andrea: [00:28:40] With menopause symptoms at the root. And, you know, there’s been some pretty significant cases against well-known organisations. So, you know, I absolutely do believe it’s time that we help those businesses get their house in order, because not only do they risk tribunals, they also risk losing talent, women with experience, expertise who are stepping down, who are not taking promotion/progression, women leaving the workplace. There’s so many reasons why we need to understand and talk. [00:29:13][32.4]

Dr Louise: [00:29:13] Course there is and I didn’t really understand that. Many years ago, The Health of the 51% came out with Dame Sally Davies, who was then the CMO, and she’s talking about menopause in the workplace. And I’m really embarrassed because I remember listening to it. There was a program on Women’s Hour about it. And I remember thinking, oh my goodness, it’s just a few hot flushes. Why are they talking about it? And I hadn’t done my training and I hadn’t listened to the stories. I hadn’t understood that it’s the symptoms of anxiety, low mood, memory problems that is the, the main problems that are affecting people at workplace. But I also didn’t understand how effective the right dose and type of HRT is at that. And so it’s the loss of the workforce with sick leave, with time off work, with not going for promotion has a massive effect. So we’ve got a huge amount to do. But I’m really grateful for your honesty and openness actually, talking about quite a difficult subject, but in a very positive way, which I hope has really resonated with people. So before we end, I have just got obviously three-take home tips. So three tips for people who are recognising, could it be your hormones and others? What are the three things that you would say to those people? [00:30:28][75.1]

Andrea: [00:30:30] Am I allowed to say, don’t ever marry a narcissist? Could that? Yeah, you could say. [00:30:33][3.7]

Dr Louise: [00:30:34] I think that surveys or even actually work one as well. Maybe. [00:30:38][3.8]

Andrea: [00:30:40] No. But seriously, I think the first piece is about women, as you said, understanding more for themselves and recognising that actually all our systems are affected, mental health, cardiac health, digestive health. And being better educated, being better able to advocate for ourselves, as you said. The second thing for me is absolutely taking the conversation to the wider audience and stopping this awful, narrow, stereotypical view of menopause as you said, it’s the woman stood by the open window in the middle of December wearing a T-shirt, yeah. And actually educate people in terms of what is going on. Avoid tribunals, retain talent and be known as a menopause-friendly business. And my third point is really a much wider message. I am a big believer in really useful conversations, and I want more people to get comfortable with the uncomfortable and conversations about things like menopause, mental health, suicide risk. We need to stop waiting for people to reach out, and we need to get better at reaching in and being proactive. As you say, I can see if you’ve got a broken arm. I can’t see if you’ve got a broken brain, but if I care enough to ask a couple of questions and engage in conversation, maybe I can help you get the help you need. So those would be my tips. [00:32:06][86.6]

Dr Louise: [00:32:07] I think they’re fantastic tips actually. I would like to say they’re one of the best group of take-home tips that I’ve heard, and I really like reaching in. I think that is something that should resonate to everyone listening and the work that we do. And I do try and reach into as many people as possible with the work, the awareness, the education. So brilliant. And thank you so much for your time. Really good. So thank you. [00:32:30][22.7]

Andrea: [00:32:30] You’re so very welcome. [00:32:31][0.8]

Dr Louise: [00:32:35] 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. [00:32:35][0.0]

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