Kate Muir: everything you need to know about hormones but were afraid to ask

This week, Dr Louise is once again joined by journalist and activist Kate Muir, who made the Davina McCall documentary Sex, Myths and the Menopause. In Kate’s new book, Everything You Need to Know About the Pill (but were too afraid to ask), she turns her attention to the hormones commonly used in the contraceptive pill.

Kate shares personal stories of how women have been negatively affected by synthetic hormones and uncovers the bad science and patriarchy that have had such an impact on women’s health. She also offers hope that women have options and can demand change.

Finally, Kate shares three things every women should know about hormones and the pill:

1. Progestins are not all the same. Some of them are androgenic and some of them are oestrogenic, and they have very different effects. So, women can be on the wrong pill for them.
2. You can always take a pill holiday. There’s nothing wrong with taking a few months off and seeing how you feel. And you may be a different person, or there may be other reasons for why you are in that state of mental health.
3. There needs to be more research into every bit of what synthetic hormones do in our bodies, and particularly in our minds.

You can follow Kate on Instagram at @muirka and on @pillscandal

Click here to find out more about Newson Health.

Transcript

Dr Louise: [00:00:11] Hello, I’m Doctor Louise Newson, I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today I’m going to be talking about contraception, which some people think isn’t relevant when it comes to the menopause, but it is really relevant for two reasons. Firstly, because it’s talking about hormones. But secondly, a lot of women who take HRT still need to have contraception because HRT isn’t licensed as a contraception. And I did a great podcast recently with Dr Clair Crockett talking about contraception. And today I have someone with me who isn’t a healthcare professional but actually I have said to her many times, knows more about this area than some healthcare professionals. So Kate Muir, who I’ve known for quite a few years now who is a… I admire for her work, but I also she’s become a really good friend and confidante as well. So she’s been on the podcast before. This won’t be her last appearance on the podcast, I’m sure, but welcome back, Kate to the podcast. [00:01:51][100.5]

Kate: [00:01:52] Thank you. It’s great to be here with you, talking hormones as ever. [00:01:56][4.0]

Dr Louise: [00:01:57] And it’s funny, isn’t it? I was talking to someone about you this morning, actually, a doctor who was talking about the Davina documentary, and I said, well, actually, it’s all thanks to Kate Muir. And how we first met and I couldn’t remember how many years ago, but it was before Covid, so it feels like many years ago. [00:02:12][15.1]

Kate: [00:02:13] It was in 2019. [00:02:13][0.1]

Dr Louise: [00:02:15] So 2019. So what, five years ago nearly, you came and I’m not breaking confidentiality because you’ve spoken before. You came to my clinic as someone had recommended, and I’m not very good with names, and I treat everyone the same. It’s just a policy I have that doesn’t matter who they are, everyone gets the same amount of my energy and attention and empathy and everything really. So it wasn’t till after you left, I was like, oh wow, that’s Kate Muir, film critic. She’s like, my husband loves films and has, you know, oodled over your articles for years. But one of the things you said in your consultation was, why didn’t I know this before? Why did I not know about hormones? And you, you were sort of like, I am. I get very cross thinking, why didn’t I learn this at medical school? Why didn’t I learn this as a junior doctor? But your approach was why didn’t I know this as a woman? And why didn’t I know this as an investigative journalist as well? And actually, I think we’ve taught each other a lot. Because sometimes in medicine you’re looking at trying to treat the solution rather than prevent a disease and look at basics. And one of the things my pathology degree did was enable me to think about how our bodies work. And if we know how they work, then we understand pathology more and how things go wrong. And so you have written amazing book, Everything You Need to Know About the Menopause But Were too Afraid to Ask. And now you’ve got another book coming out but it’s all based on hormones, and it’s basic science that has led you to be thinking like you are to write the book, Everything You Need to Know About the Pill but Were too Afraid to Ask. So is that a fair summary of how your sort of mind is working with a lot of this? [00:03:54][98.5]

Kate: [00:03:54] Yeah, I suddenly realised, and I think I realised in your office at that moment when you told me about a woman getting electroconvulsive therapy for her menopausal depression, and that was the moment I, as a journalist, my little radar went up and I thought, and the more you told me about it, and the more I investigated what was happening with the menopause and women not getting the new safe HRT, I realised it was one of the great stories of our time around women’s health. And you get a kind of animal instinct and you think, oh my God, how many women’s lives could be changed if we make a documentary, if we keep writing about this, if we go on social media and, you know, your social media has gone from, you know, a few thousand to hundreds of thousands and, you know, millions downloaded the balance app. And when you think about what’s happened in these last five years, it has been world changing. It will be world changing. And it probably came from all these women, like us and doctors, and it’s not just us it’s a load of people, particularly in Britain, who are fantastic. And they have brought menopause to tipping point. And I suppose I was at that stage and this is again a personal story. I was at that stage, I was looking at the world through hormonal glasses. It was lockdown and my daughter Molly got really depressed and she’s agreed for me to talk about this in the book. She came home from Edinburgh University, she went into the basement. You know, we just thought, no wonder she’s miserable. That’s not surprising. Everybody is. And then about a couple of months she was at home and she really didn’t even want to come up and have dinner. She was just a different person. And I got her an art therapist online who was around to try and help, and that helped a bit. She had, there were questions in her life, but there came a point when she ran out of her pill from Edinburgh and it was Rijevidon, which is the most basic levonorgestrel progestin and ethinylestradiol pill. So it’s like your bog standard kind of androgenic pill. Anyway, she was on it. Came off it. Months later popped up in the kitchen, really cheerful. And we thought, what’s changed? And she and I thought, what’s changed? And then we began to think, it’s the pill. And there I am, having written a whole book on menopause and hormones, unable to see my own daughter’s pill problem. And I had been on the same pill at university, which was then Microgynon, but the same ingredients, and I’d felt really flat and had a lowered libido slightly. And I just realised I had not seen the synthetic hormones in the pill. I’d just been looking at older women and it was a revelation. So that’s where it began. [00:06:40][165.8]

Dr Louise: [00:06:40] It’s so interesting because you learn either through your own experience or others who are close to you, and some of you might have listened to the podcast I did with Jess, my oldest daughter. And again, I learned a lot from her, Kate because she, as you know, has PMS and it was in lockdown because you’re so close. Of course you’re close because you’re all locked in together. And at the beginning of every month, she’d be putting out of sheets in the washing machine. And she’d flooded. But her mood was so low. She’s like, oh, what’s the point of playing the trombone? And obviously that’s her passion. What’s the point of reading? What’s the point of doing anything? And I was like, what’s going on? Like we’re all a bit, you know, low because of Covid and how it was restricting us, but it was more and then her migraines were getting worse and worse. And I spoke to someone who’s part of the Faculty of Sexual Reproductive Health for advice about contraception for her. And they said, just give her the implant. Just go and see someone and she can have the implant. And I just said no. And they said, but why? And I said, because I don’t want all her hormones being switched off and they didn’t understand it. And then I then reflected, which you often do, and thought about the many, many, many women I’ve given the Depo-Provera injection to. So some of you listening might know that there are different types of contraception. And what Kate was talking about the Microgynon is this combination pill where you have oestrogen, progesterone. Traditionally, actually people had it for three out of four weeks. They’d have a withdrawal bleed to make us feel more like women because we’re having periods. So a quarter of the time you would not have it and then it would go on like that. And they’re all synthetic, but the implant or the Depo-Provera injection are just pure, they’re called progesterone only, but they’re not progesterone. They’re synthetic progesterone so they’re unnatural, manmade types of progestin. And what they do is they’re quite high doses. So they switch off ovulation. If you don’t ovulate, you don’t produce an egg. Therefore you’re not fertile therefore you can’t get pregnant. That does its job. But and the big but is, they switch off your hormones. And hopefully those people who have listened to my podcast before know that our hormones, the natural hormones, oestradiol, progesterone and testosterone, have biological processes, they are very important for every cell to work properly. And so we’re switching them off to stop women becoming pregnant. The contraceptive pill does the same. And often now we say you can take the pill back to back, which basically means you keep taking it so you don’t have to have a withdrawal bleed every month because women don’t have to have a withdrawal bleed. But the flip side is you’re always suppressing your hormones. [00:09:15][155.1]

Kate: [00:09:17] I think it’s really interesting. And and we did a big poll when I did a pill program with Davina McCall called Pill Revolution, and we polled 4,000 women, and we just found about that period that 69% were having a bleed, actually, and 48% thought they had to have a bleed. But I am really interested in what happens generally when you don’t have any bleed at all. And I started looking into the neuroscience, which has really changed in the last few years. And, you know, in Denmark they’re studying, you know, what a brain looks like on progestin contraception, what it looks like without, over the months. And, you know, you can see that the serotonin receptors, so your happiness hormone, your contentment of functioning is about 10% less on the pill. And so you can actually see what’s happening. It’s not women saying, you can actually see what’s going on in the brain. And again with that poll, we also found out that 57% of women were worried about their mental health on the pill, and that a third had come off because of anxiety or low mood or depression. Now, that is not what you read in any of the official documents, and I really saw it parallel to the menopause as a gaslighting of younger women and younger women just not knowing that existed. Because if you look in the literature, it says you may have mood swings and you think, oh, that’s up and down, isn’t it? Oh. And it’s not it. As one of my favorite professors, Jayashri Kulkarni in Australia, says, we do not have a steel plate at our necks, which stops the hormones going to our brain, and I don’t know who told us that. [00:11:04][107.4]

Dr Louise: [00:11:05] Yes. And it’s really, really interesting, isn’t it? Because you’ve read Unwell Women by Elinor Cleghorn… [00:11:11][5.9]

Kate: [00:11:12] It’s in the bookcase there. [00:11:13][0.8]

Dr Louise: [00:11:12] Very good. And it talks about when the oral conceptive came out in the 60s, and it was quite a revolution for women to be able to have their sexual freedom, of course. But when it was trialled, it was just a population of women, wasn’t it, that it was trialled on initially and they were black women? [00:11:29][16.5]

Kate: [00:11:29] Yeah. I mean, this is extraordinary, right? I researched the history and of course it’s all about women and not men. The pill is credited to two men, Doctor John Rock, Doctor Gregory Pincus. They, you know, got all sorts of points and prizes. It turns out that there are 256 Puerto Rican women. They are given doses of the pill in the late 1950s, which are ten times the dose of progestin we use now. It’s a sledgehammer, and they’re given that and quite soon, three of them die and they don’t investigate the causes of their deaths. They’ve just died in a slum in Puerto Rico, actually a rebuilt slum. And then guess what? A quarter of the women leave the trial because of dizziness, nausea and headaches. And what we know after that, of course, is that the pill at that level was causing clots and strokes in lots and lots of women, and that was happening to those 256 women who tried the pill for us. And then they took the evidence and got rid of the three dead people, got rid of the quarter who couldn’t tolerate it, and then took the tough folk that could just handle it for a few months and used them as the evidence to which they took to the FDA, the Food and Drug Administration. The pill was passed, and there we are, we all we all had it. Within a couple of years, a million women were on it. It is a typical shocking piece of science. Those women deserve a statue, a medal, because, you know, they died for us. [00:13:04][94.8]

Dr Louise: [00:13:04] I totally agree and I didn’t know it. It totally is. And the other thing is they were saying they felt sick. They were saying they had headaches, they didn’t feel well and they were ignored. And then which again, I didn’t realise because I’m ignorant, was that it was only allowed to be given to women who were married. And then they started listening to those women. So, like, why are you only listening to certain groups of women? You know, this is the patriarchal society that we live in. And this is when I said at the beginning that all my patients get the same treatment from me, whether they’re down and out drug addicts who have got criminal histories or they’re, you know, the most famous person in the world is irrelevant because they’ve all got needs and problems and, you know, risks and benefits or whatever. And so actually, to do data where you’re ignoring people telling, and it’s not just one person. So this is gaslighting at its most extreme, but it’s involved in a trial. And then they decided to reduce the dose. And actually I’m quite old. And so when I started prescribing the contraceptive it was a higher dose than it is now. We had a 50 microgram. Yeah. And then it went down to 30 microgram and now there’s 20 micrograms. [00:14:14][69.6]

Kate: [00:14:15] But when you look at the doses, because I’ve done a chapter on clots and breast cancer, and I’ve interviewed a 25 year old who had a stroke, which you don’t expect, and she’s fantastic and she’s fine now and she’s written poetry about it. But she went through that. It was really shocking. And I was looking at the rates of clots on the pills. And you look and it says, oh, it’s around between five per 10,000. Then you look at the pill, Yasmin, which is among the most popular pills for young women because it’s good for your skin. And it you know, it’s a bit of a diuretic. People love it, you know? I mean, it turns out that it’s 9 to 12 out of 10,000. So wait a minute. That’s a 1 in 1,000 getting clots on Yasmin. That is the risk. And OK, the risk is even higher than it says because that was in a done before there were vapes and done before so many younger women were overweight. And, you know, people were cancelling the Covid vaccine because it was a 1 in 250,000 risk of a clot. And we are giving this and I’ve just totally questioning that. And I have to say, I’m absolutely pro contraception. I’m pro hormones, I’m just pro the right hormones. And indeed my daughter got on the mini coil, the Kyleena, and it has been great for her. And it didn’t affect her mood, despite it being the same hormone that was in Rigevidon, it’s levonorgestrel, but it’s in the Jaydess in a tiny amount and it’s a smaller coil, easier to fit. And so there was a solution for her and it is within the system. But I don’t think enough people know that. [00:15:52][96.8]

Dr Louise: [00:15:52] Well I don’t think they do. And I know with Jess, my daughter as you know, she has a the same coil and she doesn’t mind me talking about it either, which is great because for her, her heavy periods were very disabling and you could say, oh, it was only three days a month but only any time a month with heavy periods. And she’s limited what she can take orally with her migraines. And actually, the first time she had a coil in, you know, it’s like having a horrible smear test really. They are invasive. They’re not very nice. But actually the relief she has and the gloating that she does to some of her friends that she never has periods, is wonderful. But that’s only part of it, because sometimes even the coil can switch off ovarian function as well. And so again, as many listeners know, if you switch off your ovaries functioning, you’re switching off not all your hormones, and this is what’s really interesting I think because our ovaries do produce these three important hormones, oestradiol, progesterone, testosterone, but our brain does as well. So and I’m not aware of any research, but if you’re just switching off your ovaries, you’ll lose some of your natural hormones but not all because your brain will produce them too. But if you’re having a synthetic hormone in the some of the contraceptive pills of a higher dose that’s in your bloodstream, as you say, the bloodstream goes into the brain, it’s going to have different mechanisms, and it will block the way that our natural hormones work. And this is where I think some of the more problematic risks are with these systemic hormones compared to local. [00:17:23][90.8]

Kate: [00:17:23] Yeah, I think you’re right. I think the thing is, nobody knows what the effect is of a synthetic hormone fighting your real hormone in the brain. And I think it’s different in every brain. I think it’s different with every progestin. And it’s very clear to me that progestins do so many different things, different ones. One of the things I loved, and I’m trying to bring positives out of this because it is a very strongly critical book, but it does say, here are the solutions. Is again talking to Jayashri Kulkarni, who used one of the body identical pills to test on her PMDD patients who had a lot of, you know, really, really bad mood before their periods and genuinely seriously depressed. And more than half of them did so much better on Zoely, which has got a body identical oestrogen, and it does have a progestin in it, but it’s one called NOMAC, which is one of the better progestins and newer ones and, you know, less likely to also to have effect on your sex life too is quite good because a lot of the progestins just knock out your testosterone. And we got that big poll saying 21% their libido crashed on the pill. That’s kind of important if you’re 20, I think. [00:18:35][71.8]

Dr Louise: [00:18:36] It is important and do you know what, I’m going to be really embarrassed admitting this but I’ll tell you, this is what I was taught about the contraceptive pill when I was doing my obstetrics and gynaecology job many years ago. Was that the pill often, contraceptive pill often does reduce libido, so we’ve known that for many years. But then I was told do you know what, it doesn’t really matter because women when they’re young have really high libido. So reducing it a bit doesn’t matter. And that was what was sort of ingrained in me. But then I sort of think does it matter if women have a good libido? Why should we be suppressing it? But the other thing is, as you know, testosterone is a biologically active hormone that works all around our body, that if we suppress it, it might have long term effects. We don’t know because it’s not been studied. We know, like many years ago, in the sort of late 90s, there were some studies coming out showing that women who had the Depo-Provera had increased incidence of osteopenia, osteoporosis. And when I questioned that, because I am questioning and I realise I irate people because I question like an annoying two year old saying, but why? But why? So when it happened, I was saying to my partners and some of the other doctors, but why? But why? There’s a reason. Oh, it doesn’t matter because they’ll catch up when you stop giving it to them. And I said, no, no, but what’s happening in the body? If it’s happening to the bones, what else is it happening to? And a lot of these women I’m giving Depo to, because it come in every 12 weeks and I would inject them usually 11 weeks, because you don’t want it to go over the 12 weeks, they would be quite sluggish and quite slow. And they tell me that put on weight. And I would say, yeah, but you’ve got four children and life’s really busy and let’s talk about your diet and nutrition. And they said, but nothing’s changed, but you do this conveyer belt medicine and you’d learn what you’ve been taught and you don’t challenge it and question it because you get told off for being too inquisitive. But this osteoporosis thing really like, just didn’t sit right. And then when I learnt more, that osteoporosis is an inflammatory disorder. And as you know, I’m really interested in inflammation. Then you think, oh my goodness. Like we’re giving these women a chemical menopause. Without them realising. And this is what, you know, is teasing in your book. And I know it’s negative but it’s fact. And sometimes the truth hurts. But there are options and that’s what’s really important. And your daughter’s generation, my daughters generation want to know the facts. They don’t want to be gaslit. [00:20:48][131.8]

Kate: [00:20:49] That’s really interesting. [00:20:50][1.1]

Dr Louise: [00:20:51] And that’s what’s really important, isn’t. [00:20:52][0.9]

Kate: [00:20:52] Yeah. I mean, what has happened and Molly showed me after we had our discussion and we started researching this together, and she researched kind of the young generation version of it with me, and she showed me Tik Tok and gathered Tik Tok of people unfurling the kind of pill side effects leaflet and snuggling up under it on their sofa because it was so big and lots of stuff on Tik Tok was absolute rubbish, and a lot of it was right. And all the things they were saying about brain changes were often the exaggeration of a science paper. But young women, that is where they go for their medical information. They Googled the best retinol and they get the top ten and it works. Or acne cream. Why not Google? Here’s someone. And also there’s a lot of people coming off the pill, and it’s all rainbows and joy, which it is for a lot of people. A lot of people have this incredible mood lift sometimes when they come off the pill. But again, they’re saying, oh, and you should go on natural cycles because that really works if you measure your temperature every morning, but not if you’re hungover at university, you can’t remember your name in the morning and you may well have taken a drug. You know, you’ve got to have a very steady lifestyle to use natural solutions as contraception and say, no, absolutely we’ve got to use a condom today on, you know, the middle of the month or wherever it is. So there’s all that. So the absolute chaos out there in contraceptive world, young women, the pill prescriptions on the combined pill have gone down by half over the last ten years in the UK. And what are they doing? Well, a few are going on, progestogen only is going up. The other thing that’s happening is nothing. There are people taking risks. There are STDs racking up. There are people using the morning after pill consistently. You know and the natural cycles, the abortion rate is the highest it’s ever been since the Abortion Act in the UK. And there’s nothing wrong with abortion, but it’s not your best form of contraception. [00:22:43][110.6]

Dr Louise: [00:22:44] No. And it’s totally true. And we really need to be thinking, and I don’t know what others are doing to really educate about choices, because that’s what anything in life is about. But when I have read about contraception prescribing going down, lots of people go, but this is awful, this is awful, and it’s all focused on fertility for women. And what they’re not looking at is the bigger picture. And I think this is what’s really important when we’re looking at future health and choices and everything else as well. And we’ve known and I don’t need to highlight on this podcast the perceived risks of HRT. And every day we’re told how it’s “dangerous”. And I say that in inverted commas because we don’t have evidence and like you say, quite rightly, the body identical hormones. Yet the synthetic hormones that are the more dangerous parts in HRT are lower doses than the contraception. [00:23:34][50.5]

Kate: [00:23:35] I know. [00:23:36][0.2]

Dr Louise: [00:23:36] But no-one’s banging on about the risks. [00:23:38][1.2]

Kate: [00:23:38] I think you’re so right. I think the enemy here in the world of women’s health on the whole, I mean, some people can use it usefully, but on the whole, the synthetic progestin is what we should be looking at. It did increase the risk of breast cancer by a tiny amount. And, you know, natural progesterone does not. And we’re giving it to younger women. We were giving it to older women, the HRT. We’ve now realised there is a different version of this story for us because we’ve got the safer version, the good body identical HRT. We’ve got a copy of our own hormones, but apparently young women don’t deserve that and it’s too expensive. It’s £8 a month as opposed to £1.50 to give them the better hormones. [00:24:20][41.6]

Dr Louise: [00:24:20] And how much is a termination for the NHS? [00:24:22][1.9]

Kate: [00:24:23] You know, it is, I was just listening to Lesley Regan yesterday and she said you know every £1 you spend on, you know, women’s health, you save £5 in the long run. You know, every £1 you spend on good contraception makes such a difference to so many outcomes. [00:24:37][14.6]

Dr Louise: [00:24:38] Totally. We see a lot of women in the clinic who have PMS, PMDD, or want to ask about contraception, who are younger. And I feel very strongly that women should be allowed to have a choice of the most natural hormone. And I do also think a lot about suppressing testosterone and mood and the rates of SSRI prescribing, so antidepressant prescribing, in teenagers is really escalating. And we know that once people are on these drugs it’s very hard to get them off. But the other thing that many people I’m sure know is that antidepressants, the SSRIs, are associated with increased risk of osteoporosis. So if you’re giving something like the implant, like the Depo that we know is associated increase incidence of osteoporosis, then you’re giving an antidepressant, which increases the risk, then actually, osteoporosis is common and it’s not without risk. And I see a lot of young girls, women who have had stress fractures and then they’re found to have osteoporosis. What are their bones going to be like when they’re 50? When we’re talking about preventative medicine, we need to be thinking about this as well I think. [00:26:23][105.3]

Kate: [00:26:24] Yeah. I mean, no-one has studied any of the long term stuff in this. And what I most would like to see is this to be in schools and that young girls are, everybody says, oh, it’s sexual, but actually it’s about heavy periods, it’s about acne, it’s about PMDD. And the idea that because we have sex, we are punished for all the other things hormones do in our bodies is so wrong. But we discovered in that poll, this is the thing that really worries me as a sort of mum, that 64% of people went on the pill while they were in school. So schoolgirls are making this decision on Tik Tok with their mates. Mums like us, I had no idea what was in my daughter’s pill four years ago, right? And you know I’m studying this, so guilt, shame but that is what you know. And you really, really worry about how those brains are changing because we know our brains rewire in menopause. We know our brains rewire in puberty completely. Are they rewiring differently because we’ve got them on a steady, low dose, a flattening dose of hormones? Are we producing these sort of duller brains? Maybe safe brains. [00:27:30][66.5]

Dr Louise: [00:27:32] I spoke to a lady recently who has had an implant in and she’s getting very dry, very itchy skin. She said, I can’t think. She said, it’s like thinking through treacle and I’m not sleeping and I’m getting some sweats. And then she was talking about vaginal dryness. She said well she can’t wipe herself, she has to drip dry because it’s so painful and she’s just been told it’s all in your mind. And I said, but how, when did this start? Well it was started not long after having the implant. She said I’ve been fine otherwise. But they won’t take the implant out because I keep saying I think it’s implant that’s caused it. But they said, no, of course it wouldn’t do that. But I said, hang on a minute. Of course she has become menopausal. She’s 38. She’s probably got less ovarian function than she would have had when she was 18, because she’s older and she’s the same as any menopausal woman I see in my clinic with all these symptoms and so, you know, there is an option of having add back hormones. There is an option, obviously, with people who have the Jaydess or Kyleena or Mirena coil, we often give oestradiol and sometimes testosterone as well. So there are definitely options. And I think that’s the way people are going to go going forwards, Kate. More people will have the, low dose coil if they haven’t had a baby, if they’re older, they can have a Miriena. There’s options for that. And then add back with a natural hormones or consider Zoely. I think those are definitely the way that people are going to be choosing because they want the natural hormones, as you say, have less risks, but they also are designed to work in our body. They’re designed to improve ourselves the way they function. Whereas the synthetic hormones lock onto the receptors, but they don’t have this lovely biological cascade of processes that go on in the cells. [00:29:11][98.6]

Kate: [00:29:11] Yeah, and I didn’t know till I did all this research that your progestin can go in and lock onto a progesterone receptor, a testosterone receptor or an oestrogen receptor, depending on what it feels like doing. And you just think, oh my God, that’s chaos. I mean, the science itself is really interesting and we so kind of need to understand more. What I loved though was I got to research a chapter on male contraception towards the end, and that having been so ignored for so long, and we’ve been just putting foreign bodies into our bodies for 60 years as women, suddenly there is the shoulder gel, which is Nestorone/Testosterone, and that’s quite a good progestin testosterone gel. Rub it on your shoulder every morning, and it’s going really well in trials. I mean, it’s going to be a while, but, you know, men like it and men like to share, share the burden. They love it in a couple to be able to not, you know, have the woman being the person going for all these miserable coil appointments or whatever it is. [00:30:08][56.5]

Dr Louise: [00:30:08] Well wouldn’t it be interesting if it makes men feel better as well? Because men often have testosterone deficiency and also, again, it’s really under-researched underfunded is the role of progesterone and oestradiol in men as well. So we have the same hormones. It really freaks men out when they’re told they have oestradiol and progesterone too. And their cells will respond in the same way. So there’s so much we don’t know and we really need to be focusing on doing research into these areas to improve health of women. So your book’s coming out, I honestly devoured it in a day. I just like forgot to eat that day because it was so good. And it so, you write in such a brilliant way, but what you do is you bring in other people. There’s lots of stories, there’s lots of facts, and it’s evidence based as well, which is brilliant. So it’s, a really good book to have on your bookshelf. And it will just make you think. I think having curiosity is great. So I’m very grateful for your time today, Kate. But three things before we end is three reasons that you think anybody should know about contraception and obviously read your book, but what are the three things that have really opened your eyes that you didn’t expect to sort of shock or surprise you? [00:31:24][75.9]

Kate: [00:31:25] Well, one thing is that progestins are all not the same. And, you know, some of them are androgenic and some of them are oestrogenic, and they have very different effects, and some make you spottier and, you know, some suit other women better. Nobody explains that very, very clearly to women, and they’re often on the wrong pill. I think the other thing I would say is you can always take a pill holiday. There’s nothing wrong with taking a few months off and seeing how you feel. And you may be a different person, or there may be other reasons for why you are in that state of mental health. But I think that’s also really worth knowing. And I suppose I’m screaming that there should be more research into every bit of what synthetic hormones do in our bodies, and particularly in our minds. [00:32:16][50.8]

Dr Louise: [00:32:16] Yes. Brilliant. So there’s a lot of information today, and some of you might need to listen to it more than once. [00:32:22][5.8]

Kate: [00:32:23] Or read the book. [00:32:24][0.5]

Dr Louise: [00:32:24] And read the book not or, they need to do both. But any questions that you have when we post this, please ask, because I think we should do more and more about this and bring in other experts as well. And this conversation is not going away. It absolutely isn’t. So thank you again, Kate, for highlighting something that is huge, that’s been under the surface for too long. So look forward to seeing how your book goes. And thank you again. [00:32:49][24.6]

Kate: [00:32:50] Thank you. And I’m going to be on pill scandal talking about the pill on TikTok and Instagram. [00:32:55][5.1]

Dr Louise: [00:33:00] You can find out more about Newson Health Group by visiting www.newsonhealthcare.co.uk and you can download the free balance app on the App Store or Google Play. [00:33:00][0.0]

ENDS