Perimenopause and mental health in prison: Lisa’s story

Advisory: this episode contains themes of suicide and topics which listeners may find upsetting.

In this week’s podcast Dr Louise Newson is joined by Lisa, who shares her deeply personal and challenging journey through perimenopause, mental health struggles, and the impact of her experiences on her family.

Lisa discusses the devastating effects of her mental health decline, which led to a crisis point and ultimately a prison sentence for attempted murder. She also reflects on her time in prison, the realisations she had about her health, and the transformative impact of HRT on her recovery.

The conversation also delves into the impact of hormonal changes on women’s mental health and the often-overlooked connection between hormonal imbalances and criminal behaviour. Dr Louise and Lisa also discuss the importance of education around hormonal health, especially during perimenopause and menopause, to prevent tragic outcomes such as suicide and criminal behaviour.

Click here to find out more about Newson Health.

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

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all them in. So today on the podcast, I’ve got the most incredible person with the most amazing and very inspirational, but also very sad and frustrating story with me today. So someone called Lisa who actually came to one of our events and shared her story. And my staff said, oh my goodness me, you’ve got to talk to Lisa. And so on a Saturday morning, I spoke to Lisa. and said, please, can you come and share your story on the podcast? It’s going to be a hard listen, but it’s a really important story. So welcome, Lisa. [00:01:37][85.9]

Lisa: [00:01:37] Hi, thank you, Louise, for having me today. [00:01:39][1.8]

Dr Louise Newson: [00:01:40] So it’s a long story, so we’re going to try and keep it as brief as possible so we can get as much information out. So if you just don’t mind, just by starting, Lisa, how old are you? [00:01:48][7.9]

Lisa: [00:01:48] I’m 54 now, nearly 55. [00:01:50][1.9]

Dr Louise Newson: [00:01:52] So we’re similar ages, and you’ve got two sons. [00:01:54][2.4]

Lisa: [00:01:55] I have, 22 and 24. [00:01:56][1.8]

Dr Louise Newson: [00:01:58] So tell me about things before it came to the bigger story, how your sort of health was and how you were and whether you knew much about the sort of perimenopause and menopause. [00:02:07][9.4]

Lisa: [00:02:08] I had sort of researched, knowing my age, I had researched about the perimenopause and the menopause and obviously I just did actually visit the GP with my concerns that I might be around the age and I was also struggling at the time I just lost my mum and there was a couple of events going on in the background. But I visited the GP twice, one was five months before what’s happened in this incident and I did request HRT then six weeks before my incident of what the story is about today. I did visit the GP once again, and it was just put down, I did say I was struggling, and they took me off the contraceptive pill and still wouldn’t put me on HRT. I just had a lot of brain fog. I was the one who did the research first around my age, and they just totally overlooked it and put me on antidepressants, for low mood. [00:03:04][55.8]

Dr Louise Newson: [00:03:05] And as we know, the role of hormones, in fact, all our hormones but oestrogen, testosterone and progesterone can have really beneficial effects in our brain. And the more we look at symptoms. the more we understand that obviously hot flushes and sweats can occur, but the commonest symptoms affecting people that we hear in the clinic, we see on the balance app where we’ve had thousands of people reporting their symptom, is the brain fog, the anxiety, the low mood, the memory problems, the poor sleep. [00:03:32][26.8]

Lisa: [00:03:32] That was me. [00:03:33][0.5]

Dr Louise Newson: [00:03:33] And we know that for many women, it’s really important, yeah. And you know, our hormones work as neurotransmitters and they can affect all sorts of pathways and antidepressants can help, of course, with people who are clinically depressed and they help serotonin levels, mainly they can help in other ways, but also oestrogen and testosterone can help serotonin levels, but they also help dopamine and they also help various parts of our brain to light up so we’re more likely to remember, more likely to have pleasure, more likely to sleep, just feel connected with life and our thoughts and our actions as well. So then what happened? [00:04:13][39.7]

Lisa: [00:04:14] You’ve explained it quite well. You do feel quite disconnected. You feel like, you know, you’re not being heard. So six weeks prior to what happened was I did go to the GP and obviously carried on struggling, not aware myself. And two weeks before Christmas, my son became ill and I just had this extreme anxiety off the scale. I cannot explain. I know I’ve always been a bit of a natural worrier, but I just knew this was something, I was just living in daily fear of everything and my mind was overthinking. I started to work in palliative care which was extremely distressing seeing the sights that I was seeing. So I was putting it down to events in life, but I was just so emotional I couldn’t stop crying and total brain fog. You just feel like you’re in a constant hangover state. You can’t explain it to anyone and you just feel completely different, out of sorts, you know. [00:05:08][54.1]

Dr Louise Newson: [00:05:09] So then what happened? [00:05:09][0.4]

Lisa: [00:05:10] So in between Christmas and New Year, something’s just clicked. I don’t know what happened. I beat myself up every day. How I’ve got to this point, but suddenly I was researching about my son’s illness and then there was some searches down in Google on the next rows down about peaceful way out and little did I know I had sort of started with suicidal thoughts, not wanting to die or anything or, but I just couldn’t see. I just got ended up in the darkest place that I can imagine, just thinking it was events. And you feel different and you just want the anxiety to end and I think it’s this irrational fear every day. I could feel myself, my mental health declining. I was looking after everybody at work and at home, but what I didn’t realise was my own mental health was declining and just trying to cope, but I just felt incredibly disconnected, in fear of everything. So I just couldn’t see a way out of everything. And then the suicidal thoughts started to occur. And then I actually contemplated suicide. But I couldn’t leave the boys behind. And I knew my son was struggling at the time. Two weeks before Christmas, I could feel myself declining even more. My son was poorly. So this overthinking just happened even more. I was going into bed overthinking and just really intrusive suicidal thoughts, which I’ve never had. I couldn’t see a way out for all of us. I actually thought I was protecting us all with this irrational thought process that has never been like this at all. And I did actually try to take my own life and my two boys. I’m, I’m totally mortified, ashamed, horrified. I ended up getting arrested and ended up in prison for almost three years. And it wasn’t until I ended up in prison, I didn’t even know then, and all I was doing was beating myself up every day wondering how have I got to this point. I’m in total shock, trauma, disbelief, and it was only when I started to see the TV in prison and ever so coincidentally, the timing of Davina McCall starting to raise awareness. It all started to click into place and I thought, oh my goodness, you know, this is exactly how I felt of all the other ladies. I had books sent in to prison. Everyone said it sounds like you’re on the menopause. I had no resources to research any of this in prison. So I had books sent in and this is when I started to realise the symptoms that other ladies and mainly celebrities were talking about were exactly the same feelings I had had. And it was just that turning point. And then I found out the ages of 50 around this age is the highest rate of suicide in women. And I just cried when I read that. And I thought, I’m in prison, nobody’s listening to me. [00:08:14][183.7]

Dr Louise Newson: [00:08:14] Yeah, I mean, there’s one thing knowing about the psychological impact of the metaphors is something else thinking about suicidal thoughts or feeling very, like you will do want to end your life. And I didn’t realise how common it was until I exposed myself to so many patients and so many women. women. Also, when I did psychiatry many years ago, I never was taught that any of these feelings could be related to hormones. And it’s only because giving hormones back to people and seeing the transformational difference to their brains, to their thoughts, to their intrusive thoughts, their dark thoughts, knowing it’s not just a placebo, it’s actually having a really important physiological effect in people’s brains. So you were in prison and I know in prison it can be very hard to access the right medical health. [00:08:58][44.4]

Lisa: [00:08:59] That’s right. [00:08:59][0.0]

Dr Louise Newson: [00:09:00] But you managed to see a doctor, didn’t you, in prison? [00:09:02][2.6]

Lisa: [00:09:03] I did, yes. [00:09:04][0.7]

Dr Louise Newson: [00:09:04] And they prescribed your HRT, didn’t they? What happened? [00:09:06][2.7]

Lisa: [00:09:07] Yes they did. I was prescribed HRT eventually and within not even two weeks it was just like a switch turning on and I’m in the worst environment, the worst situation, not knowing what I was going to receive as a sentence but all of a sudden I had this urge to fight, I had more energy, less brain fog, I still wasn’t sleeping in prison because it’s so difficult to sleep, you’re sharing rooms, there’s no privacy, but all of a sudden I just had this massive determination that I wanted to live, I wanted to fight but… I was still suffering in silence, I was invisible, nobody would understand. I was trying to convince my solicitor, barrister, all male solicitor, male judge, male barrister and it was brought up in the, I had to have a psychological assessment for the case and even they had mentioned menopause but this was not mentioned in court. [00:10:01][54.2]

Dr Louise Newson: [00:10:02] So did you have your sentence reduced at all? [00:10:04][1.9]

Lisa: [00:10:04] Only because they said to me if I pled guilty, they would consider less time and I would know, I would find out sooner. And to be honest, the state was in, I was in such shock, they said I could go to trial but I just knew I wasn’t up to that. So I did go down the route of pleading guilty. I was completely honest when I did get arrested that I just said I thought I was protecting us all and, you know, I didn’t feel right at all. But none of this was taken into consideration. I was actually initially told it was an eight year sentence, then it was down to five years, four months due to the guilty plea. But even then I was absolutely devastated. I was hoping I might get care in the community that people might realise that it was a menopausal and hormonal issue, which in turn also goes to the mental health side that’s been brought on or exacerbated by the menopause. It’s the fact, it’s the perinmenopause as well, is the fact you don’t, because you’re still having periods, you think you’re not on the menopause. [00:11:10][65.8]

Dr Louise Newson: [00:11:11] Yeah, absolutely. And you were in more than one prison as well, won’t you? [00:11:14][3.0]

Lisa: [00:11:14] Yes, yes, so you’re just transferred five -minutes’ notice, so one minute I’m in one prison in Cheshire, then I’m given five minutes notice, you go into another prison in Staffordshire, then I did open prison for four months in York. I came out of prison and had to go to a female hostel and I had to do that for three months, whether I wanted to or not, in Liverpool, nowhere near home again, and just the mental. It’s the worst environment and the way you’re treated. It’s the worst treatment for any kind of mental health, menopause. And it’s just, you cannot, you just feel invisible. It feels so archaic in this day and age. [00:11:52][38.4]

Dr Louise Newson: [00:11:55] It’s quite something. I’ve, as some people listening, and you know, I worked in Styal prison, women’s prison, many years ago, actually, in 2000. I did a week’s work and I’ve still got my notes there from when I used to admit people that came in. But the stories women told me, and it was very different. I’ve watched, I love Louis Theroux, and I’ve watched a lot of his documentaries about prisons, but it’s been in male prisons, and male prisons are very different. The crimes that they commit are very different. The way that they’ve lived their lives have been quite different. Whereas the women who I met, and I’m sure you met a lot, were quite almost naive, very vulnerable, lots of mental health issues. And also a lot of them had been abused in the past and felt they deserved the life that they lived. They couldn’t see a way out. And the more work I’ve done now about mental health and hormones, the more I’ve read not just about perimenopause, but also about PMS, PMDD. women are more likely to commit a crime in the days before their periods. And that’s because our hormone levels are lowest then. And someone called Katharina Dalton wrote about this many, many years ago. She actually was an incredible doctor that no one listened to and she went to my old school as well. Sadly, she’s died now, but she writes about going to trials, listening to women and knowing that it was related to their hormones and everyone just thought she was being ridiculous and she was ridiculed really. And she wrote some amazing academic papers about this, but people just still laughed about her and she was giving not just oestrogen but quite high doses of progesterone especially to women with PMS and PMDD with transformational results. But again, people didn’t like it. They didn’t like what she was doing, but it’s all there actually. And we also know that if people are addicted to certain drugs, especially class A drugs, more likely to switch off their ovaries, more likely to have lower hormone levels. A lot of these people have very poor diets. If they don’t eat well, then again their periods are likely to go off. If they’ve got sort of just a chronic illness and also a lot of the antidepressants and some of the antipsychotic medication that are often prescribed for the mental health issues will switch off our own hotmones. And so I’m sure most women in prison will have some hormonal issue, which is not being addressed at all. And I’m so keen to try and help educate people, but also a lot of people that work in prisons will be of menopausal age, as they are in other areas of work. And the people that work in prison, it’s a hard, really hard job. It’s a relentless job. They’re trying to do the best they can with very limited resources, with people in very difficult situations as well. And so to be perimenopausal or hormonal or menopausal when you work in a prison it’s really difficult as well. [00:14:52][177.0]

Lisa: [00:14:51] Amongst other women, yes. [00:14:52][1.2]

Dr Louise Newson: [00:14:53] But they’re a forgotten group of people, actually, a lot of the time. And as you say, you know, you put you away, that’s it, but you’re very eloquent the way you talk. You’re not someone who’s ever committed a crime in the past. You know, you love your children. It’s very irrational what you did. And I feel that it’s really sad that so many systems had let you down by not being able to think. [00:15:18][25.6]

Lisa: [00:15:18] That’s how I feel, yeah. [00:15:19][0.7]

Dr Louise Newson: [00:15:19] What’s the reason? Was there something else? And I know since you’ve come out of prison, you’ve had your HRT optimised a bit more. So you’ve got on the right dose and type of oestrogen, you’re on some testosterone and your brain is feeling different to how it was before, isn’t it? [00:15:36][17.4]

Lisa: [00:15:37] Totally. I mean, I was placed, I didn’t have a choice of which HRT I went on in prison, obviously. So I was put on a basic, you know, treatment, but there was still a massive difference and it was that realisation to me as well, that you just can’t explain it, to be honest. You know, when I was put on the HRT, you cannot explain to anyone how the clarity you start feeling, the brain fog has gone, but it’s the intrusive thoughts have gone and the anxiety has gone and I’m in the worst, most intimidating situation in the worst hell on earth situation. And then when I came to consult your clinic and I was placed on the latest treatment again, there was a massive improvement again. I’m now sleeping better, just full of energy. Just back to my normal bubbly self, how I was probably a good four years ago, even before prison. You don’t realise the decline that you’re going under due to lack of oestrogen and, and how it does, you don’t even know your own body and it’s frightening, really can be frightening how I look back. [00:16:43][66.1]

Dr Louise Newson: [00:16:44] Yeah. Absolutely, and I think the problem is we’ve all spoken about the menopause related to periods and so everyone is fixated on periods and when I was working with NHS England, the National Menopause Programme, somebody who was leading it said to me, we’ve spent hours discussing about periods, whether it should be, are they changing in frequency or are they changing in pattern or are they changing in the amount of bleeding? And I said, but do you know what, it doesn’t actually really matter. And he said well you’re telling me that women don’t know about their periods enough, so how do they know about their symptoms? I said because a lot of us have a period, it comes and goes, we don’t mark it in our diaries, we’re not bothered about it. But what we are bothered about is the way our brains work, the way our bodies work, the way we’re changing. So we need to get away from just thinking about periods. Women should not be defined about their periods. And a lot of women don’t have periods, or they might have unnatural periods if they’re on contraception. So what we should really be thinking about is about our hormones and the roles that they have in our bodies, regardless of when our ovaries actually finally stop working, as in the menopause. So it’s that sort of decline and change before, and we know with suicide rates, actually, they increase around seven times in women in their late 40s, and there’s a lot to make us believe that actually it’s worse in the perimenopause or it’s worse when hormone levels are changing. to change. Because our brains like homeostasis. They like everything the same. So that’s why, you know, our bodies are better if we sleep the same, if we eat at the same time, if we don’t abuse our brains, as in if we, you know, drink alcohol, we feel dreadful the next morning, because our brain doesn’t like any sort of metabolic change occurring in our body. But we know in the perimenopause, our hormone levels fluctuate. They go up and they go down, quite quickly sometimes. And so that change can really trigger a lot. So a lot of people, once they’re menopausal and they’ve got very low levels and they last forever, very low, actually their mental health might be affected but not to the way that you’re describing as you were before. And so we’re, as you know, we’re funding a PhD student from Liverpool looking into suicide prevention in the perimenopause and menopause. And she’s been interviewing quite a few of our patients actually and really getting to understand more. Because we need to have ways of being more aware, not just as healthcare professionals, but actually for women and their families and friends to understand so we can recognise it in others as well. [00:19:18][154.3]

Lisa: [00:19:18] That’s right, it affects everybody surrounding yourself. I mean, like you said, I didn’t even have problems with my periods ever, so I only went to the doctor’s thinking I’m around the same age, and even when I researched on the internet at the time, there was nothing about suicidal thoughts. You just see the physical symptoms online at the time, but it only seems now since I’ve come out of prison and I’ve started to do my own research that now, due to lovely, thankfully, people like yourself and other celebrities at the moment raising the awareness. I think the research is now coming out more so and going, you know, informing women about the mental health side. But I still think you don’t realise until you’re going through it how important hormones are. Yeah, you just feel, this is why you feel totally disconnected. [00:20:03][44.8]

Dr Louise Newson: [00:20:04] Yeah, and so many people, including myself, it’s not until we’ve got our hormones rebalanced, the right dose and type for us, that we look back and think, goodness, no wonder things are so hard. [00:20:14][10.0]

Lisa: [00:20:15] And then you start trying to tie everything in, thinking… [00:20:17][1.7]

Dr Louise Newson: [00:20:18] And obviously, you know, you’ve got a son that was poorly, you’ve had things going on, and you always, not ‘you’ always, but people contribute it to other reasons. They’ll say, well, I’m going to feel like that because I’ve had a difficult time or because of this or because of that. But actually, we’re all bad as women. Well not all, but lots of us are that we don’t reflect and internalise ourselves. And I think the other message is if we don’t get the help, care, advice, treatment from the first healthcare professional we see it’s really important to try and it’s difficult, I understand, to be the best advocate so you can go back and ask. And, you know, I think that’s the same with any treatment. You know, if you’re refused a treatment that you think is right for you, it’s okay to say, could you just give me a reason why you’re refusing it? Can you just tell me why I can’t have X, Y, Z? And that’s not just for HRT, that’s for anything. [00:21:10][52.0]

Lisa: [00:21:10] Yes. [00:21:10][0.0]

Dr Louise Newson: [00:21:10] You know, if I had an infection on my arm and the doctor said you can’t have antibiotics and I thought I needed them, I would like to challenge that in a nice positive way. And that’s the same, I think, with HRT and also testosterone. You know, we need to be thinking as women. Why aren’t we allowed our own hormones back? [00:21:27][16.6]

Lisa: [00:21:29] Well, you do trust the doctors too much. You do trust that they know what they’re talking about and you are putting your life in their hands. And this is how, you know, I took their advice. But I do, I know now, if I had have been put on HRT before this, I know I would not have ended up in this situation for definite. And that’s what’s so upsetting. This could have all been so prevented. It’s not just myself who’s suffered, my whole family, my friends. They said, it’s so out of character, you know, I’m so bubbly and caring, absolutely doted on my boys, did everything for them. They said they felt like mum had died when they’d gone into prison. And, you know, they’ve had three years of not being able to see me. We also went into COVID lockdown when I was in prison. So I was on double lockdown, couldn’t see any friends or family. I then caught COVID in prison as well. So I thought I’m going to die in prison. It was terrifying. I’m not an aggressive person. you’re put in with a lot of very aggressive women unfortunately and you know with really very serious crimes, you know, mine was as well but it’s just you just cannot get your head around how am I in this situation? It’s horrific. [00:22:41][71.6]

Dr Louise Newson: [00:22:42] Well, obviously, it’s horrendous. And I can’t, and I don’t think many people listening can really, really imagine what you’ve been through, Lisa. But what I’m incredibly grateful for is that you’ve been strong enough and brave enough to share your story. And what I don’t want to do in this podcast is say that every perimenopausal woman is going to think about committing a crime or end up in prison. Of course not. But there are women who are not being listened to, who we should be thinking more about how to help people in different ways and also how to address this inequality of care in prisons and to improve education about hormones in prisons as well. [00:23:22][39.2]

Lisa: [00:23:23] I think it’s also the NHS as well though because really they should have picked up that it wasn’t the usual, I know it’s a unique, terrible, horrific crime, but really, you know, I think maybe I should have had hospital care at the time or trying to get to the root of what has sent somebody to this extent when, you know, there was no thought gone into it at all, you just suddenly, you know, you’re just sent to prison. And I think they’re so snowed under these health practises that there’s not the correct process there either in place to distinguish, you know, whether somebody should be having care in the community or hospital care or whether they should go to prison, there’s no distinction at all. [00:24:02][39.0]

Dr Louise Newson: [00:24:02] So there’s a lot we need to do, a lot we need to change, and I really hope us all working together can hopefully make a difference. But before we end, Lisa, I’d really like to just ask you three take-home tips. So really three things that you think me, you, us, people listening could do to help the community of people in prisons, including those working in prisons. What three things do you think would make the biggest difference? [00:24:25][23.4]

Lisa: [00:24:27] Information for definitely. More awareness, people not just going off the awareness side of hot flushes, you know, I think there’s so many women suffering in silence, not knowing and you’d feel like you’re going mad, you really do. They need to be more explicit with that information. I think also there does need to be a lot more research of looking at someone’s age in relation to how they’re feeling and not just taking like you said the first answer from the doctor if they’re saying, you know, you’re fine or, you know, you don’t need HRT. Try and get a second opinion and fight for it. I was too soft. Again, just research it yourself more, to be honest. I think a massive point was for me, a turning point was Davina McCall’s Sex, Myths and Menopause documentary that was totally, this is the other reason. I thought, oh my God, this is what’s happened to me. and she’s stated everything in the documentary. How women aren’t getting diagnosed, they’re not being treated. [00:25:29][61.8]

Dr Louise Newson: [00:25:30] So there’s a lot we need to do, we need to educate people, we need to allow people to be advocates of themselves and we really need to just learn and talk and share. And it’s been brilliant having you today and I’m again really, really grateful for your time. Thank you. [00:25:46][16.5]

Lisa: [00:25:47] It’s okay. I’m doing it to save other women’s lives because it’s only when I came out of prison that I realised and I started to have the resources, the internet and everything to do my own research and realise how many women have committed suicide and it’s about raising awareness. If I can save one or two lives. It is horrific. I’m totally mortified having to share the story. I’m so ashamed. But I do realise now I have, it helps to know it was, what the cause was, was down to hormones. I’ve been treated on the correct medication. If I can help other women now, that would be worthwhile, you know, going forward. And I am here to help raise awareness now and work with people. You’re the first person I’ve shared this story with because I trust you so much. And you’re the only one who really understands apart from Davina McCall when I saw the documentary. And I can’t thank you enough for all the work you’re doing. [00:26:41][53.6]

Dr Louise Newson: [00:26:41] Thanks, Lisa. [00:26:41][0.4]

Lisa: [00:26:42] So thank you. [00:26:43][0.8]

Dr Louise Newson: [00:26:48] 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. [00:26:48][0.0]

ENDS