E33- Dr Louise Newson- Menopause and The Silent Strain Couples Don’t Talk About

can talk about how much sex we have but not how much we don't have.

Pete Hunt

Global voice on the menopause. couple of listeners might be thinking on a men's podcast why are we talking about the menopause?

Dr. Louise Newson

A lot of men do internalise and think, is it me? What have I done? It's like you've got this demon in your brain, it's hard to describe, but nothing's right. Women say to me, I prefer to drink toilet water than have sex with my husband. If you've got, you know, big important jobs, you come back and you're this person that you thought you loved is just this completely awful person and you're not even getting any sex either. Often people say to me, if I knew then what I knew now, I probably wouldn't have left my partner.

Pete Hunt

What is it that we can do for our loved ones? What is it that we can do for our partner?

Dr. Louise Newson

I think the most important thing is to be empowered with information that's right for you and your partner. And I think we all need to have somebody to advocate for us. If you say, look, I really love you and care for you, I can see things aren't right, let's listen and I'll come to you and find the right doctor to help you, then that can be really transformational.

Quick favour from me before we start. If you like the show, please subscribe and give us five stars. It all helps in bringing in the best guests. As well as the podcast, Monumental is a leadership network for men in their 40s, 50s and 60s. We meet online and in person. For more, please visit the website, monumental.global. This episode of the Monumental podcast is brought to you by Burgess Me. So Louise,

Welcome to the Monumental Podcast. Thank you so much for being here today.

Dr. Louise Newson

thanks for inviting me. I feel very honoured that you've asked me to come, so thank you.

Pete Hunt

It's an honor for us to have you here as a global voice on the menopause. A couple of listeners might be thinking on a men's podcast, why are we talking about the menopause? But as I've said much in my social media before, it has such a huge effect on men's lives, particularly on most of our listeners who are in their forties and fifties. So I think just before we try and save a few marriages during this conversation, could you give just on your credentials and how you came to being a global voice of the menopause.

Yeah, thank you very much. So I'm a physician. I've got general medical training and then I was a GP for 25 years, but I've also got a pathology degree, which pathology is the study of disease. So I'm quite geeky into science and I've written a lot of books on evidence based medicine. I went part time as a GP because I've got three daughters and I wanted to see them and help bring them up. So I worked as a medical writer and educator for 25 years as well. And then 10 years ago,

just over the nice menopause guidance. First ones came out and I was asked by the Royal College of GPs to summarise the evidence. And so I did. And then I was 45 and a lot of my friends were being given antidepressants for their menopausal symptoms. And I was like, what the hell, you're not depressed. Why? the doctor says HRT is going to give me breast cancer. It's too dangerous. And I was like, really, what's going on out there? So I then ended up sending up my clinic.

Just one day week, I couldn't get a job in the NHS, not because I've got a bad CV, it was because it was all set up by gynaecologists who didn't want a GP. And so I set up a clinic one day a week to try and help some of my friends and mums at school get off antidepressants and onto hormones, which will improve symptoms in future health without increasing the risk of breast cancer. And I started to get a bit gobby on social media, mainly because my children were teenagers and they were teaching me how to use social media. So I thought, just try it see what happens.

And I started to reach out to a lot of journalists who kept writing HRT causes breast cancer to say this isn't right. I was bit gung-ho actually, felt like I playing with fire actually, but I did it and everything got quite busy. And so my clinic got from one to two to three days a week. I started to see women from all over the country, social media, hearing for women all over the world that were struggling to get evidence-based treatment. And because as a GP you just work and see the patients who come in the door.

I'd never listened to this suffering before. I'd never heard people giving up their jobs because of a condition that had treatment that they couldn't have for the wrong reasons. I'd never heard the stories of the mental health harrowing stories of women. then paradoxically, I was getting some symptoms myself, age 45, not surprising, but I hadn't pieced them together. I have a very stable marriage. I've been with my husband since I was 18.

And I just couldn't stand the way he looked at me, the way he chewed his food was annoying me, the way he breathed, the noise, everything was just awful. And I'm, I'm not really a cross person, but I was really shouting at him. The children, just like, everything was an effort. I do a lot of yoga. I couldn't do yoga. My joints were stiff. I was putting on a bit of weight. Even my husband, who's very direct, was like, oh, Louise, you've got a bit of a tummy there. I don't know if I'm allowed to swear, but I did swear at him quite a few times.

But I also I get migraines. I was getting a lot more severe migraines, quite, quite, you know, debilitating, getting night sweats. But as a doctor, I thought I had a lymphoma type of cancer, never even thought about my hormones. And I was also struggling at work. And, know, I only working one day a week as a GP, so I couldn't reduce my hours as a GP. That was like non-negotiable, of course. But I was.

couldn't remember some of the patients. I couldn't remember their names or they tell me their symptoms. I said, oh, sorry, can you just repeat that? And it wasn't going in. And I couldn't remember drug doses. And that's really scary as a doctor who prescribes medication. I kept looking at my examination couch and think I just needed a bit of a nap, actually. I'm really tired. And then I cried once at work, which is just the most ridiculous. It was something really trivial. I should have just sorted it out. I didn't recognise what was going on and sadly neither did my colleagues.

And it was my daughter, middle daughter, who was about 12 at the time. One time I was shouting at her to get off her phone to go to bed. And she said, mommy, you know, you're really miserable at the moment. She said, you're just not much fun to be with. So of course that made me shout even more. And then she said, maybe if you had your period, your mood might improve. Cause some of my friends, their mood improves with their periods. And I remember I was chopping an onion in the kitchen. put the knife down and I said, Sophie, this is awful. I'm perimenopausal. I haven't had a period for a few months.

Like all these symptoms will be related. And this is the time I'm setting up a clinic. I'm educating healthcare professionals about all the symptoms and I didn't recognise it myself. Like women who are in it don't always get it because they don't join the dots. you know, often it might be different in other people's households, but if I'm in a bad mood, the whole family are like trembling and it's really hard. If my husband's in a bad mood, which he isn't often.

He just goes into the study and we just ignore him. Somehow it's like the women are the glue, know, the children that get fed properly, they don't get their school bags sorted out. They don't get them, you know, I don't help them in the music practice. I just put on the telly and I move away because I'm just everything's such an awful effort. So it was really revealing. then what do I do? I can't get GP from I can't get HRT for my GP because GP is giving out antidepressants. So then it's like so wrong, you know, so I sort of

Had this in my belly and now I run a massive clinic. I run Balance App. I do a lot of medical education. I do a weekly podcast. it's my work really now is about educating people, men, women, children, so they can understand not just menopause, but hormonal changes and how they can impact people.

Pete Hunt

Sure. mean, well, thank you for that intro. mean, the context is important and the story of it all is really important because, know, your passion is clearly there. I mean, your following is into nearly a million, is that right? Or over or something like that. mean, clearly to get that many people following you about the menopause, you've got to have a really distinct passion. So it's really great to get the context of where the sort of pain.

Pete Hunt

I guess came from. And so with that, could you give us a explanation of what is actually going on? What is the menopause?

Dr Louise Newson

Yeah, I can do, but just with a caveat that I hate the word menopause and I would love to get rid of it because if you break it down, menopause is menstrual cycle and pause is stop. So it means when a woman's period stopped. The official definition is when a period stopped for a year. I've already told you, I didn't have a clue where my periods were. And actually as a woman, I don't want to be defined by my periods and my womb, which is what's happened in history. Like it's about my brain and my body and everything else. So it's a ridiculous.

Diagnosis because as a physician, I want to diagnose my patients today. I don't want to say to come back in a month. And if you've not had a period, I'll tell you your menopausal. And basically what happens is our ovaries have a finite number of eggs. They produce hormones, progesterone, estradiol, testosterone, and levels of those hormones stop or go very low when our ovaries don't work as well. And we're sort of, could, you could sort of say evolutionarily, we're not designed to live for so many years without.

Our ovaries functioning. Yeah. So they decline, but they decline at different rates, but actually they decline or start to decline about 10 years before our periods stop. And that's where you might've heard the term perimenopause and perimenopause around the time of. I hate that word as well. Like, how can you say around the time of something that happens a year after your last period? Like it's just, we haven't got a crystal ball. We don't know what's happening in the future, but I much more sort of.

those hormones do.

keen to talk about what's happening. is it progesterone or testosterone or estradiol that's lowering or is it all three? Because then we get into the nuances, which I think is really important for listeners to think about as well is PMS premenstrual syndrome, PMDD, premenstrual dysphoric disorder, which again is due to hormonal changes. And the hormonal changes can trigger a myriad of symptoms and they're the same symptoms. If you've got PMS, PMDD, perimenopause, menopause.

And for most women, they're worse actually in perimenopause and for PMDD because in menopause they're low and they sort of flat line, but it's the change of hormones, especially in the brain that can trigger all these different symptoms. So a lot of my work now is actually moving across women from all ages. know, my, I've got three daughters I've already mentioned, they all have changing hormones. My oldest daughter has PMDD and she's has natural hormones. And if she didn't.

every month she had very dark intrusive thoughts which were ruining her life. So anyone listening, it's not just looking at midlife, it's looking at, you employ women, it's all age women, if you've got children, it's not just your partner, it's your children as well. Can that start? mean, some children are starting their periods at nine and 10 now, earlier than before.

Pete Hunt

and how early?

There's a lot of girls with hormonal changes and it's normalized. Oh, you will feel bad. It's a few days before your periods. Well, actually, if it's a hormonal change that can be treated, I don't understand why as women we have to feel bad for any days of any other month.

Pete Hunt

Just a quick interruption here. If you can give me 20 seconds to highlight the supporter of this episode, I'd be really grateful. Today's podcast with Dr. Newsome is sponsored by Burgess Me, the family law firm supporting men and women through the emotional and legal complexities of relationship breakdown. When your world feels like it's falling apart, Burgess Me offers calm, expert guidance.

helping you move forward with clarity and dignity. more at BurgessMe.com. Now, back to the conversation.

Pete Hunt

really, really interesting. mean, so coming back to this thing that happens in midlife to women, I'll try not to say the word too much. On average, when does it, when are we, what are we ages are we?

So not that any women's average, of course, but the average age of menopause in the UK is around 51. Perimenopause can last 10 years or so. So most women in their 40s will be perimenopausal, but around one in 30 women under the age of 40 will have an early menopause. So that means one in 30 women, at least in their 30s will be perimenopausal. So it's, we don't need to, again, be just thinking of older women and my youngest.

patient became menopausal when she was a teenager. Her ovaries didn't develop properly. But a lot of these women aren't picked up, they're not recognised and they're not treated appropriately. All of these conditions are associated with hormones and our hormones are just chemical messengers that go in our blood, affect every single cell in our body. And there's loads of symptoms that can occur, especially affecting our brains.

But whether women have symptoms or not, there's still health risks of not having those hormones because they're biologically active, very anti-inflammatory in our body.

You can just talk about hormonal changes. If you talk about hormonal changes and it opens the conversation.

hormonal changes is treatable with hormones. It doesn't actually need to happen.

Yeah, absolutely. It's not rocket science. I don't want to sort of talk myself out of a job, but it's not difficult medicine what I'm doing. You know, if you were having tiredness and I found that you had low iron, you'd probably say to me, could I have some iron? What dose do I need? If you were a woman and you had low progesterone and you had, you know, low mood before your periods.

And we know progesterone drops off before your periods. And I said, I think you've got low progesterone. Probably the next question should be, how do I get progesterone? And there's been a real confusion with hormones. You know, I've already mentioned this breast cancer risk, this clot risk, heart disease risk, but these are all with synthetic hormones like the contraceptives. They've been made in a different chemical structure and they are associated with small risks. Whereas the hormones I prescribe

that are available in the NHS as well are the natural replica. So you're replacing like for like. So essentially your body doesn't know whether it's a hormone that you're giving through the skin or taking as a capsule or you're having endogeny in your body.

Wow. It's just totally fascinating. I've just got so many questions. It really is. So why is your voice controversial in this discussion?

Dr. Louise Newson

So I don't know that it is controversial when I really think about it. I said to someone recently, why don't you call me another word that begins with C, but it's not the four letter word. Because I suppose maybe I'm clever. Maybe I can unpick the science quicker than others. And I understand basic physiology and how hormones work in the body. Because, you know, there's been other people talking about hormones for many years and they've been silenced almost.

said risk of cancer, risk of clots, everything else. And HRT prescribing fell off a cliff. So over the last 20 years, people have just started to prescribe other things for women with symptoms. people would get heart tablets for their palpitations, they'd get painkillers, they get antidepressants for their mood symptoms and so forth. But people have forgotten that actually hormones are still beneficial to the body and they've forgotten about choice for women, which in my mind is the most important thing.

So as soon as I realized, you know, like I said, 10 years ago, these women are really struggling. I've just used my knowledge to empower people and people don't like women being knowledgeable. I think the other thing is I'm a GP, a general practitioner. Menopause and hormones has been owned by gynaecologists for many years. So quite a few gynaecologists don't like the fact that I'm a GP and medicine is very hierarchical.

And I'm the lowest of the lowest when it comes to the pecking order in medicine. It's just fact that's the way medicine has functioned for decades, centuries, really. And also I think there's probably a bit of a pharma influence because hormones are very cheap. You can't make a new hormone. It's got a specific chemical structure. So the contraceptions, they can make new ones because they just alter the chemical structure and then they...

It's when you bring a new drug to market, it's obviously when you make more money. So there's lots of politics involved as well, which I try not to keep hold of, you know, and work with. don't work with any pharmaceutical companies. I don't endorse any brands. I'm very impartial with my advice because I think it's important for women to know that my advice and the huge amount of information I give comes from scientific knowledge and evidence and research, but also a huge amount of clinical experience as well.

Pete Hunt

The thing that I'd really like to talk about is the effect and what I see in my network and within my conversations with men in their 40s and 50s, is this just sort of complete, almost sort of days that men can find themselves in of like what has just happened. And it feels so, it almost feels so sudden.

Good

that there can be such a numbness in their relationship that there can be such violence when I'm talking I don't mean physical violence but sort of almost like emotion.

Dr. Louise Newson

It be as well. There can be as well. you know, I worry a lot about the women that are harder to reach. Usually women from different ethnic groups, women from low socioeconomic classes. There's some research actually showing that domestic violence does increase during menopause when people have symptoms. And women actually subject to domestic violence are more likely to have menopause at an earlier age, but the symptoms are often attributed to what's going on at home rather than a hormonal change.

And so I think for partners, whether it's male or female partners, somebody who's suffering with hormonal changes, it can be very difficult. And I reflect back to my experience. If my husband had said to me at the time, do you think you might be perimenopausal? I'd probably have just gone mad with him because I, nothing, it's like you've got this demon in your brain. It's hard to describe, but nothing's right. Like everything he said was annoying and that's really hard for people, you know, and I get it if you've got, you know,

big important jobs, you come back and you're this person that you thought you loved is just this completely awful person and you're not even getting any sex either. So then it's like a lot of men do internalize and think, it me? What have I done? What's going on? And I used to do a lot of work with West Midlands police, but also the five brigade who have predominantly men, lot of men then in their forties, taking time off work with stress, talk to them.

And then they're just opening up to say, yeah, no, I just thought it was me. I didn't realize like the way she talks to me, the way she looks to me. We don't go out anymore. She's always in bed. She's pretending she's got a headache. Can't have any like, can't even kiss or cuddle, let alone any, you know, penitentiary sex, but I can't talk to my friends about it. We can talk about how much sex we have, but not how much we don't have. And it just made me realize that men are very, and female partners of course, can feel very sort of.

isolated and vulnerable and not knowing who to talk to. Because what you don't want to do is make a joke of a hormonal woman. And they have been a butt of a joke for many years because for that person, they don't like the way they're changing. And one of the reasons I set up Balance app is because people can say, look, why don't you download this app and we can look together? I just wonder whether any of your, the way you are related to hormones and doing it in a non-judgmental way.

is really important because then it can help everybody.

Yeah, it's super interesting. so just picking up on that point about men not being touched and not even being hugged or kissed or anything like that. Could you, is there a specific medical reason, hormonal reason for that in particular?

So there's lots of reasons. One of the reasons is women just feel shit, excuse my language. Like a lot of people, they just don't like what they've become. So they've, like I say, maybe put on a bit of weight. Physically, they're looking different. They might be more tired. They might have skin changes, hair changes, muscle and joint pains, you know, and they're exhausted. Like tiredness is a really common symptom. So you're not going to feel like,

just being the better version of yourself. And you often people feel like they don't deserve to be loved in the same way. There's lots of that going on. And then libido, you know, enjoyment of any pleasure actually often goes. And that's partly because the hormones, especially testosterone, but estrodial and progesterone can, if those levels are low, you can get low levels of dopamine in the brain and dopamine is our reward hormone. So it could be as simple as opening the blind.

and you see the sun shining and normally you go, thank goodness, how lovely. Like if you've not got much hormones and not much dopamine, you open the blind, it's like, well, it's the sun, you know? And so then it's like the same, it's about the partner. And then it goes to like sexual pleasure as well. Like women say to me, I prefer to drink toilet water than have sex with my husband, you know? And people, you know, say even if George Clooney walked in the room, I'd go, so what? I'm really not interested. I want to just go to bed. And...

And that again, know testosterone as well as a really important hormone for sexual desire. And also, I'm sorry to talk about this on the podcast, but localized symptoms. So people can get vaginal soreness, irritation, discomfort, and they can get urinary tract symptoms. So if every time you have sex, you're getting urinary tract infection, you're probably not going to have sex very often. Or lot of women tell me how painful it is and the partner doesn't want to inflict pain.

Or sometimes the partner might not care about inflicting pain because he just wants to have sex. And so there's all sorts of things going on there as well. And, know, I do quite a lot of work at the British Society of Sexual Medicine and Professor Mike Kirby, I've listened to many of his talks where he says, you know, sex is really important for men. If men have sex at least twice a week, they perform better at work. mean, research has shown this and, you know, I don't want to trivialize sex at all. And I think

We know we're very British. We often don't talk about it. In my consultations, I talk about everything. We have a questionnaire where people will talk if appropriate about sex. And often women say to me, I've never had this conversation ever before. Like I haven't had sex for three, four years. I saw someone who came to my clinic from Holland last week. And she said, she came with her partner, but she said, we haven't had sex for three years. It's off the table. And she was having awful local symptoms, but lack of libido and other physical symptoms.

But her partner still really loves her. But who's he talking to? How's he getting support? You know, and it's, it also shouldn't be normalized as well, because if I treat these people with systemic hormones, but also vaginal hormones, you know, they're transformed, not just them, but their partners, their whole relationship. And I worry because divorce rates increases in the forties, relationships break down. It has an impact on the children.

And often people say to me, if I knew now then what I knew now, I probably wouldn't have left my partner. And that's really sad, isn't it?

Pete Hunt

It is desperately sad. So I'm hoping, as I said, right at the top, this podcast is going to save a few marriages because I guess, you know, there is that element. You know, we talk about, I talk about isolation a lot. I don't necessarily talk about a lot of men who are in leadership, who are going to be listening to this. Don't necessarily compute with loneliness surrounded by people at work. They've got, you know, maybe mates who they play golf with. They've got their wife and actually they've got loads of kids.

or whatever. So they are actually surrounded by a lot of people, but the one, the one person that sort of best friend, you like, from 20 years ago or 10 years ago, whatever they got together with that relationship is, is sort of breaking down. there's a sort of isolation in that. You can't share because you're worried you're going to get shouted at. You can't share because you're worried that, you know, again,

this sort of element of emotional violence that goes on under the surface.

Dr. Louise Newson

It's really important and I do think, know, lot of people have really high powered jobs. They need a bit of stability at home and externally, they don't want to show that there isn't that stability at home. And internally, when they're in that home, what do they do? It's really difficult and people then end up living these parallel lives and you see it so much. And I feel it's interesting because my oldest daughter is a 21 and 23.

And my 21 year old has just come back from Australia traveling. And she said, mommy, like, I don't want to like big you up, but people were amazed that you're my mom because we have different surnames because I kept my maiden name. She said, but people my age, because they're saying thank you because my parents getting on so much better. Like the stepmother is better when she looks after us, you know, those things. it just, but we have to remember, although I'm talking about hormones.

Globally, only 5 % of menopausal women are prescribed hormones because of these unfounded fears. So everyone's going to know someone who's suffering needlessly. And this is where, this controversial thing annoys me because all guidelines are clear that hormones are first line treatment. There's no other area in medicine where doctors are refusing to give evidence-based treatment, i.e. hormones to women. And it's exposing them to...

risks, obviously health risks, but also risks of, you know, the job going. If anyone's listening who employs women, about 10 % of your female workforce will leave because of hormonal change. know, we did a study recently of women working in the NHS and 37 % of women wanted to reduce their hours, but they couldn't afford to do so. So they're not the women that are getting to work on time and giving the best of their, they're just existing in the workplace. And then if you look at

women who take time off because of their symptoms. It's a lot of women who take a lot of time off and that's a huge resource to just replace.

Pete Hunt

Isn't it? mean, anything, you know, you come to a controversial, mean, anything really that goes against societal norms nowadays is deemed as controversial. mean, I'm controversial because I'm not a coach or a therapist, but I've had 15 years of lived experience of talking to men and actually hearing what's going on for them. But isolation doesn't come under a medical bracket and nor does loneliness. So it's therefore not a problem, but yeah.

No, it's you see, and I see this more and more actually with, you know, the hostility that I've had from the medical establishment and also running my business. You become more lonely the higher up you go. And I didn't really believe it when I started reading books about business. And obviously when I started, there were just two employees and I knew where the broom was. knew where everything, I still know where the broom is by the way, but I, you know, and I'm very down to earth.

But then I realized when I go into like one of our offices with loads of our admin, they're different because I'm there and I'm like, Oh God, I'm just the same person. I still go to the toilet. still like have, you know, clear up the cat's sick or whatever, but there is different. So I can't talk to them about all the worries I have about the finances and the bills and the tax and whatever. So you become quite isolated. The more senior you are, I don't need to tell you that. So then I think you need that network even closer, but then if you're not getting the support.

from your family or identity of being a father of however many children or being a partner of whoever, then it's really lonely. I, know, people, we did a survey of people who go to gambling and addictions with, this is women suffering, but I wonder how many men are turning to other, you know.

other behaviors. mean, there's a reason why the golf courses are so busy and it's not all because people like golf. It's a way of escaping from home.

Well, absolutely. I can absolutely guarantee it. It's all escapism, porn, prostitution, alcohol, work. And the biggest one of all is worklism, know, working, working, I'm just on my phone. I'm just, I'm just, I'm just. It's become the new buzzword. I'm just, you know, rather than being there and present for one another. It's just too, it's just much easier to get the dopamine hit quickly.

But in the long run, it's causing so much, well, it's causing the destruction of families, which ultimately is the saddest conclusion of all. So, I mean, with that in mind, it's actually quite interesting what you just said about men and networks, but also what some of our men say is that actually they're women go, I wish I had that. And there's this very much this mindset that women have it all sorted out. They have their networks, they're very social.

But I'm wondering, like, is it also a very isolating time for women that we don't actually maybe perceive it as being?

Dr. Louise Newson

I think it is because it's really hard to, you know, be this sort of role model for your company, for your organization. People look at you and I'm a very weird person. Like I don't mind doing public facing things, but I haven't got much self-confidence. I much prefer to be at home in my jogging pants and out doing all these, I hate all these networking dinners. They just fill me with horror, but they'd fill me with more horror if I didn't have hormones propping me up, if you see what I mean.

And the other thing is, you know, hormones enable me to have a better lifestyle. So like this morning I've done yoga. I've got an infrared sauna at home, which I love. So I've been in the sauna. I've started work, but I feel like just better in myself. So I feel a bit more, you know what, bring on anything. It doesn't matter because my brain works better. I can think better. can read books quickly. can rationalize. I'm not internalizing and some of the

Awfulness that happened last year. If I hadn't been on hormones, I would have completely gone under, you know, but you can think clearer. A lot of women and the hormones fluctuating or not the right level, they ruminate and overthink and catastrophize. And that can be really difficult in the workplace and outside, but they can't, they can't sort of work out what they should or shouldn't be getting worried about. And then you've got

No one telling them, actually, you really don't need to worry about this because the bigger picture is X, Y, Z. And then they can't talk about it at home. So I think there's lots of loony people out there without realizing it. And if you've got stress of work, like if I'd said to you, when I cried at work, I was really struggling as a GP, you'd say, well, you're working for the NHS. It's really busy. But I knew it wasn't. I'm a hard worker and I knew there was something not right.

But you can always blame it on somebody else or something else. And that's where I think men and women who are not hormonal need to look out for other people. And there's big conversations in the workplace about there's all these companies that do menopause in the workplace and they're basically just normalizing it. you know, nevermind, go and have a little rest, go and reduce your hours, go and do flexible working. No, I want to be the best I could be at the age that I am.

Dr. Louise Newson

And that means balancing my hormones so I can work. So we don't want to normalize the conversation. So it's like, oh, there, there, you will feel like this, but don't worry.

Pete Hunt

Yeah, again, getting to the root of the problem rather than treating the symptoms, right?

Dr. Louise Newson

Back to my low iron thing. If you were going to work and you had low iron and you were tired, I wouldn't say to you, do you know what Pete, just take a bit of time off work and, you know, have a bit of a lie in and we'll adjust your hours and give you reasonable adjustments. You'd say, if I just take iron, surely I'll feel better.

Right. Well, I mean, in terms of, so you just mentioned a couple there, but if I'm a man, which I am obviously in my forties and fifties, but this you're seeing now, you're going, having a few aha moments listening to this. What is it that we can do for our loved ones? What is it that we can do for our partners that is like this? I've heard hormones and the infrared sauna so far, but what could be like a list of what we can do?

I think the most important thing is to be empowered with information that's right for you and your partner. I certainly think downloading Balance app and going through it or listening to some of my podcasts together and a lot of women are scared of hormones because their doctor, their friends, their family have put them off. There are more risks of not taking hormones than taking them.

for symptoms, future health. And I think we all need to have somebody to advocate for us for our future health and sort of saying, look, let's just talk about it. Let's just work through this. If any of it's related to your hormones, it's not just your symptoms, but your future health. Like, I don't want you to have a hard time. I don't want you to have osteoporosis. One in two women will have osteoporosis if they don't take hormones. Like, that's a lot.

One in three will have an osteoporosis hip fracture. I'm petrified of osteoporosis of my spine because it's painful, it's uncomfortable. So you don't have to say, you know, your moodiness, your lack of sex. If you have hormones, then I'll have more sex. That's the wrong thing, by the way, to say to someone who's in all of this. If you say, look, I really love you and care for you. can see things aren't right. Even if your symptoms aren't related to any of your hormonal changes, it's a future health that I think maybe we could talk. Let's listen and I'll come to you.

and find the right doctor to help you, then that can be really transformational. know, people don't get medals for suffering with hormonal change symptoms.

Yeah, but it's, and well, I think the education piece is so key. you've got a YouTube channel and your Instagram page is there and the balance app.

Yes, the Balance app is very separate to my clinic. So it's never going to do consultations. It's never going to sell supplements. It's really for it's a global app for information. It's a bit like having sort of a bit of me in your pocket until you get into the consultation room and then whatever happens after that. and then I do like live Q &A through it. All my podcasts you can access through that as well. But I do podcasts that come out twice a week, actually.

with lot of experts and yeah, my Instagram, YouTube, there's quite a lot of ways of getting information.

Given that you can't treat every woman under the sun, where does someone go, I mean, for a trusted doctor, say you're in, I don't know, Manchester or...

I mean, I found in my clinic, Newston Clinic has been running for eight years. So I started on my own and then I set up a dedicated clinic and I employ lots of doctors. So we see about two and a half thousand women a month through the clinic. So it's a private clinic because the resources are so bad in the NHS. A lot of people actually only come once or twice to the clinic. And once they're on the right hormones, because they're still prescribable in the NHS, a lot of GPs take over the prescribing.

So that's a really good way to do it, to think about it. There are GPs that are trained and some are better than others. But I think if women know what they want, then they just have to advocate quite strongly. I mean, it's awful really. Healthcare professionals are letting women down all the time. But if you don't get the first opinion that you want or the treatment that you want, go and see someone else. You know, I get quite intimidated going to see a doctor.

But at the minute I'm trying to get my HRT from my NHS GP and I've sent them two messages, three messages now and they haven't replied. And I'm really frustrated because I want to try and prove a point that they either will or won't prescribe it for me. So it's hard. It's a system to the, you've got to battle. But because menopause lasts forever, the low hormones last forever, the health risks last forever, hormones normally are taken forever.

We need to sort of make the decision thinking it's just not for a short term gain, it's for long term as well.

Pete Hunt

Right. So this is something that is, you're going to be taking these hormones 60s, 70s.

Yeah, same way as if you had an underactive thyroid gland, you would take thyroxine forever. If you've got low hormones, you can't make them. I mean, we make them in our brains, we make them in our other tissues. You know, when our muscles are more metabolically active, they can produce some hormones, but not enough to replace the missing hormones.

So what's the argument against this again?

Well, the older types of hormones have been associated with risk of breast cancer, but that's not statistically significant. Drinking alcohol is more than any risk. There isn't really a reason to deny HRT. And in fact, the FDA in America recently announced the black box warning about risks of estrogen is coming off. And they they've admitted that millions of women have been suffering with their health at risk because they've been denied hormones.

So no one could stand up and say there's a reason why the majority of women are denied an evidence-based treatment. It's unfounded fears, actually, that's what's happened.

Pete Hunt

Very interesting, isn't it? How things are changing so dramatically, so quickly, and it sounds like the positive. so just closing, not to minimize it, but this hormone change in men being named the andropause, which maybe a lot of men don't know about. I certainly didn't up until a couple of years ago. Could you quickly explain that and maybe give a bit of perspective on what's happening for us?

Absolutely. mean, I know a lot about hormones in men and women. don't treat men, but testosterone deficiency is very common as a fee for age and up to around 30 % of men will have low testosterone with increasing age. And it's a real problem. And again, it's trivialized because people think testosterone is a bodybuilders drug, which I guess you argue it could be. But the other thing is, is we have to remember that

there are different types of testosterone like I've said about synthetic estrogen and progesterones. There's synthetic testosterone so most of the testosterone people abuse and use and inject are not testosterone, they're a chemical. But if you think about natural testosterone it works in every cell in the body and men and women so it can help with mood, energy, motivation, stamina and libido obviously as well. So when men have low testosterone they have symptoms exactly the same actually as women that have hormonal

changes and they also have the same health risks. So we know that men who take testosterone have a lower future risk of heart disease, diabetes, osteoporosis, dementia as well. Yet most men are not able to access testosterone. And if they do, they think it's just for erectile dysfunction. It's not just for libido. It can help future health. And again, it's been trivialized by the medical establishment for many years, even when it was first discovered.

In fact, before it was discovered, they knew there was something being produced in the testes of animals and humans and a doctor took some of some guinea pig testes as an elixir and he called it the elixir of youth and said he felt amazing. And the medical establishment turns against him and said it was quackery and he was awful. And he was right. know, then a few years later, they discovered testosterone. People started to use it and prescribe it, but then it got into the hands of pharma and they changed the structure and then it had the risks and it's had the bad rap.

And then, so that's why people don't see it as an essential biologically active hormone in men and women, which is what it is. So it's exactly the same. Men are suffering the same as women. A lot of men listening to your podcast will probably have low testosterone.

Pete Hunt

OK, gotcha. So you talk about the pharmaceutical companies got a hold of it and ruined it. What kind of testosterone are we talking about here? Are we talking about something that is created or a...

So when I talk about testosterone, I'm talking about the natural testosterone. So it can be usually given as a gel actually. And so for women, we give it as a gel or a cream. The men is a gel and there are injections of testosterone, but they have been altered slightly. They still have beneficial effects. So I don't think he'll mind. My husband uses testosterone. A few years ago, he was coming home a bit more irritable, falling asleep on the sofa after work. Just not quite himself, you know, just a bit flat.

It's easier with men, you can do testosterone levels. It has to be done at least twice before 10 o'clock in the morning because there's a diurnal variation and his level was slightly low, not massively low, but the guidelines say he can have a therapeutic trial and he's so much better, but he just slaps on the gel because it's the same structure as the testosterone his body would be making. So it just goes through the skin into the bloodstream and he's fine again.

Pete Hunt

Well, it's been a really fascinating 45 minutes. Thank you so much for joining us.

Dr. Louise Newson

Thanks, well thanks again for inviting me, it's been really great.

Pete Hunt

Pleasure, thanks for your time. So thank you for listening to the Monumental podcast. For more on our podcast and network, please go to monumental.global.