SH interviews Prof John Studd who continues to care about improving hormonal health in women.

SimplyHormones Presents: Professor Studd on Bio-identical Hormones

KC:      I'd like to talk if I may about bio identical hormones. A lot of women are very interested in this because they are told it's a more natural way to go because the hormones are absorbed in a more natural way than the equine oestrogen that's mostly prescribed. Do you have an opinion on that?

Bio-identical hormones have been available in the UK for 20/30 years!

PS:      Sure, I mean I've used nothing else but bio identical hormones for the last 20, 30 years. It's been very common in Europe and what's happened now is the Americans, now that they've overcome their love affair of horse urine and horse oestrones, they've just discovered it, they've just discovered the importance of using oestradiol, oestrone, testosterone and they've labelled this bio identical hormones and gullible people all around the world are thinking of this new American discovery which is a re-awakening on their part, a discovery of what we've been doing for 20 or 30 years and it's quite true. If I hadn't used Premerin for 20 years I think there's no place for it whatsoever. We're not horses, we're not plants either, we should use natural human hormones, and that is oestradiol, oestrone and testosterone EHEA, which is the precursor to testerone perhaps, and natural progesterone if you can, and that's all possible except the progesterone; we by and large use progestogen because it works. Progesterone cream doesn't work, it's not even absorbed, we've just spent, or I've just spent £100, studying this preparation and it's not even absorbed, it has no effect with the bones, the mood, the flushes, the sweats.

KC:      It's not metabolised.

Want effective Progesterone cream? Ask your GP for Utrogestan

PS:      It's still a racket that you go on the internet for £35 a pot per month and it's a waste of your money. I wish it did work, it would be very, very useful and convincing logically and so we really, although we use the bio-identical oestrogen and testosterone we are by and large stuck with sythentic norethisterone or Provera, although there is a more natural progresterone called Utrogestan, which is effective, and so the compromise is that I use this almost natural progesterone Utrogestan.

KC:      So are the bio-identical hormones that you ‘re identifying with, where are they derived from, are they?

Hormones naturally sourced from Vegetables

PS:      They all come from a laboratory. They don't dig them out of the ground or dig them from trees, they are all made in a laboratory, by vegetable precursors and they're pure and they are the same as the natural hormones in your body and my body.

KC:      So it's just a case if women really want to go down the road of  bio-identical hormones it's really only available from a private practice isn't it?

Get your bio-identical hormones from your GP!

PS:      No that's not true. There's no reason why a general practitioner should not give you oestradiol either by tablets or preferably transdermally, that's by patch or by gel, that would be my ideal way of giving hormones, through the skin, just rubbing the oestrogen gel or testosterone gel, or a patch, but the patch caused rings, black rings where they use it very much or with an implant of course, which is very effective, a very convenient way of giving natural oestradiol and natural testosterone.

KC:      That's very interesting that you've explained that more fully, women can now go to their GP and say that I heard that you can prescribe me XYZ and they are then getting a la carte prescription aren't they?

PS:      They may choose not to, and this happens more and more these days, and so many GPs have just shut up shop for HRT and the menopause and there's no justification for it and it's wrong.

GP's could offer effective, cheap treatment

KC:      ‘Cos there are about 7/10 women that experience debilitating symptoms, so it's not good on their part that they are not getting the advice they need.

PS:      They are not getting very simple, very safe, very beneficial treatment. It's also very cheap treatment.

KC:      Yes, OK, we'll have to stir up the GPs then to get their act together. I know the British menopause society is trying to push for GPs to be more informed.

PS:      We've been trying that for now for 20 or 30 years!

KC:      Yes, trying to get everybody singing from the same songsheet it's a difficult one to achieve isn't it?

Thank you very much for that. Interview ends.

If you’d like to know more about Professor John Studd: www.studd.co.uk

Professor John Studd DSc, MD, FRCOG was consultant gynaecologist at the Chelsea & Westminster Hospital, London and also professor of gynaecology at Imperial College.

He is now in fulltime private practice and runs the London PMS & Menopause Clinic at 46 Wimpole Street London W1G8SD. At the same address he has The Osteoporosis Screening Centre for the assessment and treatment of osteoporosis.

He is Vice-President of the National Osteoporosis Society and Chairman of the British Menopause Society.

In 2008 he was awarded the Blair Bell Gold Medal of the Royal Society of Medicine which is given every five years for the obstetrician/gynaecologist who has made the greatest lifetime contribution to the specialty.

www.studd.co.uk

For information on Menopause in a non-medical setting, there are over 200 pages waiting for you  at www.simplyhormones.com

 

 

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SimplyHormones presents: An Interview with Prof John Studd, Vice President National Osteoporosis Society and Chairman of the British Menopause Society.  Osteoporosis is a natural disease of aging but one we can ALL do something about – this brittle bone disease most often eats away at bones  after degeneration of hormones at menopause.

SimplyHormones Presents: An Interview with Prof Studd on Osteoporosis          

Prof. John Studd

KC:      I'd like if I may now to talk about osteoporosis, the silent disease as it's often described. It's something I very much don't want to happen to me, I just can't visualise myself walking down the road with a zimmer frame. The press and magazines, womens' magazines are full of information telling us that we are supposed to be doing lots of exercise, weight bearing exercise, having better nutrition, in order to stay fit and healthy and stop the degeneration of our bones. What would you say, is that the right answer?

Overweight? You won't get osteoporosis!

PS:      Well there is some truth in that, but it's more complicated. Having a good lifestyle, good diet and exercise is very good for you and what about exercise, it's very good for the brain, it's very good for the heart, it's very good for the mood, depression etc and in large amounts it's not bad for the bones, but I think it's somewhat of a deception to think that if you just keep a good diet and you're exercised by walking the dog for an hour a day, then that's going to prevent osteoporosis, and I see it very often, you have these healthy 60 year old women, slim, healthy, who walk for 2 hours a day, with a dog, without the dog and they've got rotten bones. And they mustn't think that because they are dog walkers and they exercise, that they are free from the risk of osteoporosis. Particularly, as I say, the thin women, the healthy thin women. By and large fat women don't get osteoporosis, and the reason for that is because with this excess fat they make oestrogens in their body fat, and that protects the bones.

Thin women and anorexics at risk of osteoporosis

The thin women don't make the same amount of oestrogens, so they are at higher risk, although they don't know it, if they have a healthy lifestyle with lots of exercise. So it's these women, they may have the menopause, they may have had anorexia when they were young, and they were very thin and healthy, and have lost their periods for 2 or 3 years when they were teenagers, they're the ones that are at risk, whether they exercise or not.

KC:      I suppose that's why women have a natural propensity to gain weight as they go through menopause, because their cells are changing into fat cells instead of energy cells and in our day and age that's something we don't really want to see, women don't enjoy putting on weight, but actually it's good for us.

Weight gain in men and women is complex

PS:      Well, weight gain in men and women is a complex thing, I don't think it's that simple. As you get older you do less exercise, you probably eat more, you might even drink more.

KC:      Metabolism is slower.

Fact: HRT does NOT cause weight gain

PS:      Metabolism is probably slower with age, so you tend to put on weight and I don't think it's a great deal to do with hormones, it's to do with age and exercise. And the same thing applies to giving HRT, because HRT causes weight gain when it doesn't .  All the studies looking at thousands of patients over the years, what we call a longitudinal study does not show any increase in weight with HRT. There is an increase in weight, a small increase in weight with age and the menopause, but not HRT. Now that's quite clear, but of course there is the occasional woman who has an idiosyncratic effect of oestrogens who does put on weight.  You stop the hormones and they loose weight so you have to accept that. But if you are looking at a big population apart from these odd cases you don't really put on weight with hormones.

I used HRT and did not put on weight – that came later!

KC:      No, I found that myself actually.  Thank you very much.

Here is a brief bio of Professor Studd together with his contact details: www.studd.co.uk

Professor John Studd DSc, MD, FRCOG was consultant gynaecologist at the Chelsea & Westminster Hospital, London and also professor of gynaecology at Imperial College.

He is now in full time private practice and runs the London PMS & Menopause Clinic at 46 Wimpole Street London W1G8SD. At the same address he has The Osteoporosis Screening Centre for the assessment and treatment of osteoporosis.

He is Vice-President of the National Osteoporosis Society and Chairman of the British Menopause Society.

In 2008 he was awarded the Blair Bell Gold Medal of the Royal Society of Medicine which is given every five years for the obstetrician/gynaecologist who has made the greatest lifetime contribution to the specialty.

www.studd.co.uk

You will find a huge variety of information on menopause at www.simplyhormones.com. Over 200 pages of qualified information.

See you again soon.

Kathryn Colas signing off…

 

 

 

 

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Testosterone for libido, oestrogen for depression – when the imbalance of hormones with monthly PMT and later on menopause are the cause depression, why are women referred to psychiatrists and prescribed mind-numbing anti-psychotic drugs? You may well ask! Prof. John Studd, specialist  obstetrician and gynaecologist tells us here, in the first of three interviews, about his quest to break down barriers in the medical profession to correctly treat women when hormone imbalance is not obvious.

SimplyHormones Presents: An Interview with Prof John Studd on Testosterone, oestrogen and depression

Prof. John Studd

 

KC:      I wonder if we can start in this interview by talking about low levels of Testosterone. Headlines that are attracting a lot of media interest, especially in space are talking about this, how men can improve their sex life just by having more testosterone. What's your view  from a woman's perspective and the menopause?

JS:      It's certainly true, there's a relationship between Testosterone and libido and levels of Testosterone and ease of orgasms and so on, and we've literally known for a long time, and certainly in this country we've been using Testosterone for many many years. So it is not an American discover, it really is not.  They are becoming aware about Testosterone about 20 years after we have in Europe, mind you the Americans are rather keen on treating men with Testosterone and they are just getting round to treating women with Testosterone. We forget that Testosterone is a normal female hormone. Women have 10 times Testosterone in their system, it's just that we men happen to have more than women, thank the Lord, so it is not a male hormone, it's not a foreign hormone and I would think that of all my patients that have HRT in various forms, probably about 80% have Testosterone as well as Oestrogen, and the reason for that is that it is good for their energy, good for mood, depression and of course for libido. They generally feel better if their Testosterone levels are at the correct level.

KC:      And I've read and even attended your lecture, when you've spoken in depth about this, but what do you think about the placebo effect? Do you think that plays a part as well?

JS:      There's a placebo effect with any drug that you want to give, this is why it's a very important that the study that we do have a placebo belonging to it. And I think I wrote the first paper on ‘Testerone and Placebo' about 30 years ago and that was an uncontrolled study, and it is the one paper in my career that I regret writing up inadequately, because I did not, then, 35 years ago have a placebo belonging to it, so you are absolutely right, the results could all have been worthless, in fact they are not, they've been repeated many times and it's quite clear that apart from a placebo effect there is an extra effect of Testosterone.

KC:      Yes, so it's beneficial.

JS:      There is no doubt it's beneficial to women.

KC:      And I've also read that you feel it's beneficial, especially for depression as well.

JS:      Yes, absolutely. Depression in women is a complex thing. Much of it is hormonal, and improved with Oestrogen, transdermal Oestrogen; that's Oestrogen put through the skin by gels, patches or implants. And also the addition of Testosterone does improve mood as well. And it's very important because depression is more common in women than men and it occurs at times of hormonal fluctuation, like pre-menstrual depression, post natal depression, depression around the time of the menopause, depression after removing ovaries at hysterectomy. All of these types of depression in women should be treated as first option by Oestrogens and perhaps also Testosterone.

KC:      So there are a lot of benefits there and thank you for making women more aware of what it can do for our health.

JS:      What I would like to do is make psychiatrists more aware of this, because psychiatrists are very unwilling to treat this sort of depression with Oestrogens and it's obvious to any woman if they have depression that's cyclical, every month, for 10 days every month, it's related to their periods. Psychiatrists don't see that. There is a severe depression, which is pre-menstrual or post natal, it's an endocrine problem, it's not a mental, psychiatric problem and the first option of treatment should be oestrogens. In the case of pre-menstrual depression, to suppress ovulation; if you suppress ovulation you suppress the cyclical hormonal changes whatever they are, which reduce the cyclical symptoms of PMS. It's very obvious and it is very effective treatment.

KC:      And so many women are experiencing PMS.

JS:      Well they're given anti-depressants, worse still. I certainly have patients who have spent a month in a private psychiatric hospital for their PMS or for misdiagnosis of bipolar disorder and they are given heavy duty anti-depressants, mood stabilisers like lithium, or worse, when they have an endocrine problem that is so easily treated with Oestrogens.

KC:      Yes, I must admit when I was going through menopause I self-diagnosed myself as being leaning towards bipolar because there moments, days when I was on a complete high and other days when I was in the depths of despair and that can be quite frightening, to be referred to a psychiatrist as I was, was quite frightening as well, but I declined the heavy drugs and went for the talking therapy, which did get me through it, but it was emotionally quite painful.

Thank you for that information. See below for a short biography of Professor John Studd together with information on http://www.simplyhormones.com

Professor John Studd DSc, MD, FRCOG was consultant gynaecologist at the Chelsea & Westminster Hospital, London and also professor of gynaecology at Imperial College.

He is now in fulltime private practice and runs the London PMS & Menopause Clinic at 46 Wimpole Street London W1G8SD. At the same address he has The Osteoporosis Screening Centre for the assessment and treatment of osteoporosis.

He is Vice-President of the National Osteoporosis Society and Chairman of the British Menopause Society.

In 2008 he was awarded the Blair Bell Gold Medal of the Royal Society of Medicine which is given every five years for the obstetrician/gynaecologist who has made the greatest lifetime contribution to the specialty.  www.studd.co.uk

Tune in for our next two interviews on Osteoporosis (Prof. Studd is Vice-Chairman of the National Osteoporosis Society) and finally, Bio-identical Hormones (natural HRT) where you will find out how to get this treatment from your own GP.

There are over 200 pages of advice and support for individuals and companies at www.simplyhormones.com. Sign up for our Newsletter on the Home page.

 

 

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My interview with Gill Burgess tells you everything you ever wanted to know about this silent killer; cervical smears – why they’re important and much much more.  Gill Burgess is the Cancer Screening Co-ordinator for Croydon PCT, specialising in Breast, Bowel and Cervical Cancers.

Gill is innovative and forward thinking – just listen to what she has to say and the full transcript appears below.

Interview with Gill Burgess on Cervical Cancer

KC:  Hello everyone, it's Kathryn Colas here from SimplyHormones.com and I'm here today talking to Gill Burgess, who's a Cancer Screening Co-ordinator for Croydon PCT (NHS Primary Care Trust) and her speciality is breast, bowel and cervical cancer, and we're going to be talking to Gill this morning on cervical cancer to see if we can find out some more about it. So good morning to you Gill.

GB:   Good morning.

KC: We're going to be talking about cervical cancer, and I think the first thing our listeners would like to know is what is it exactly?

GB:  Well, it's the most common cancer affecting women in developing countries Kathryn, and it's caused by Human Papilloma Virus, which is an infection of the cervix. It's associated with cellular changes which can be detected early on under microscopic examination; for example the smear test. HPV infection usually clears within a few months, I think it's about 90% within 2 years. The problem is it's persistent infection beyond 12 months which is associated with the high risk of cervical cancer.

KC: And who is most at risk?

GB: It's transmissible mainly in the younger age group.  You find most of it in women under the age of 30, but it's younger people that will pick up this virus. It's a very transient virus and it just goes from one to the other very very quickly, but like all viruses they move on as well, it's those, that as I said earlier, that persist that create the problem of cervical cancer. And only a very small proportion will go on to develop the cancer as well.

KC:  So it's still quite rare in a sense?

GB:  Yes the risk infection is soon after sexual activity begins. In some populations               there is another peak among women actually at the menopause in older women, and although HPV is sexually transmitted, penetrative sex is not required for transmission. Skin to skin genital connections, penile to vulva for example, contact is a well recognised mode of transmission.

KC: That throws a different light on it, doesn't it?

GB:  Yes, I think some data was brought up a while back on age specific prevalency of HPV, suggesting that there's a pattern of infection between regions and socio- economic groups. Also HIV infected individuals are at a higher risk of HPV infection. And they can be infected by a broader range of HPV types. So if you've got HIV you've got a low immune system and you're very sexually active with different partners, then you are at a much greater risk.

KC: I've also, continuing on risk, I've read some research that says the pill could increase the risk. Do you have a view on this?

GB:  Yes, there are risks to the pill. It is actually one of the contributing factors alongside having a lot of children, at the early age of the first sexual activity. Cigarette smoking is another huge factor. And long term use of the pill, you're absolutely right, it is another risk along with co-infections like Chlamydia, because persistent infection, again, this is the risk factor. And the peak prevalence of the infection is in women under the age of 30, and, as I said earlier, those that are actually over the age of 50 going through the menopause.

KC: So you say long term use of the pill, what would you describe as long term?

GB:  They won't give the pill to obese women, or women who are over the age of 35 or women that smoke, because there are risk factors involved, but to me the pill is a better scenario than getting pregnant, because pregnancy is the biggest risk factor of all. So the pill is a contra-indication, a slight one, but then so is smoking. Smoking is a huge risk.

KC: And it's better to stop smoking. It's all relative isn't it? You've just got to take a balanced view, because all drugs have side effects of some kind or another and you've just got to work out whether the benefits are greater than the risks.

GB:  If you put somebody on the pill you've got look at their risk factors. You can ask the question about sexual activity, I don't know whether I would. If you get a girl in who wants to go on the combined or contraception pill and she is a smoker and you can talk sexual history to her, you could say “well actually the pill is a risk factor” and you could offer alternative methods of contraception. But there is a way round it.  But as you said quite rightly, smoking is what we need to get rid of first and foremost.

KC: Yes, that's a killer for everything, a big no, no! Just touching again on the over 50 age group, which of course is what I fall into and post menopausal women, I don't think women of that age group fully understand why they have suddenly become vulnerable and of course it's because the divorce rate is now much higher within that age group so of course they're changing partners and exposing themselves to the same risk.

GB: They are Kathryn yes, you're absolutely right. And I think you've got to look at the screening and the risk factors to women over the age of 50 and then tame the screening programme actually to individual needs and it is all about divorce rate and women becoming more sexually active. Woman today have a lot more sexual freedom and they are very happy to have much fuller and richer lives than our previous generations did.

KC:  So just when they thought they could throw the whole thing wide open and say “yippee” now there's no risk of pregnancy and all the rest of it, all of a sudden they've still got to be careful of who they have sexual relations with because this is a sexually transmitted disease, as we've already discussed.

GB: And another consideration of course is that men are also becoming more sexually active. We're not taking into consideration what the men are doing as well. Because men have got more money at retirement age haven't they? And they're meeting older women and so that's something else we need to be thinking about really. At what age should we stop doing cervical screening? Should we extend it into the older age group?  I know that some research has been done on that in the last couple of years but that again comes with its own little set of risks because if you start taking smears from women that are over age 65, you've then got the problem that it's difficult to take a smear from a woman who's over 65, because she's got the risk of vaginal atrophy, then you're going to a whole new world aren't you.

KC: I'll just explain to our listeners a bit about that. That's vaginal dryness. I'm always standing on my soapbox about this, as you know Gill, because it's not really addressed properly in the doctors surgery, if women ever get that far because it's such an embarrassing subject, it's usually when they go for a cervical smear that the problem arises because the swab can't take the test.

GB: Yes, that's right.

KC:  But touching on the screening programme, there is a national screening programme in place for cervical cancer, so it sounds to me like there's a fixed age group at the moment, is there?

GB:  There is, it's 25 to 65.

KC: So it's quite broad then.

GB: It is, we stopped screening under 25s, five years ago, although there is some controversy about it, because girls, if they've had early sexual relations and they've had a few partners, they feel that they ought to have a screening test done and it can be quite controversial and it took us a long time to get over to people that this is a screening programme, it's not a diagnostic test and so we have to be looking at signs and symptoms and I see many girls in my clinic, saying to me “please Gill can we please just do the smear test”.  I'm a great believer is educating women so I spend a lot of time showing them pictures and demonstrating exactly why we're doing it, what we're doing and what the outcome is and if they've got symptoms then we look at why. Why have they got bleeding in-between periods, or they might have another infection. It might be that they have missed the pill or the pill packet is out of sync. There are different reasons, so you would then refer these women to the GUM (Genito Urinary Medicine) clinics or the GP who can take swabs from these women to test for sexually transmitted infections and that has to be ruled out. The answer is not to get a woman in when she's 22 to start taking a smear test.

KC:  It comes back to this, where we are in society at the moment, that we rush off to the doctor as soon as something is wrong and ask for a magic pill and we've just got to recognise our own bodies more, understand what's going on, and with people like you teaching us how to recognise things, and what we can do about it.

GB: That's absolutely right and the cervix doesn't actually mature until the girl is probably 20-21 so if you start taking smear tests under that age you will automatically get an abnormal smear result in most cases.

KC: So it's not helpful is it?

GB: It's not helpful at all, it creates huge amounts of anxiety within the girl and the mother, or the parents, or whatever. It's a really difficult situation sometimes, but it's educating people, it is all about that and lots of explanations.

KC:  Gill, can you describe to us what actually happens in a smear test?  They're called up for a smear test, they go along to the clinic for their appointment, and I know lots of girls and women might be very nervous about what's going to happen next.

GB:  I opened my own cytology clinic (cytology: the study of cells), a womens health clinic almost 8 years ago, as an alternative to a GP and the reason I talk about that is because I worked in a nurse-led scenario, on a huge housing estate, looking after many single women and their children, and one of the things I found was that the women were never having their smear tests done because they were so terrified of the smear test, and it could have been due to child abuse or rape or domestic violence, whatever.  And these women were the women not coming for smears and I was very agitated by that because I couldn't understand what the problems were. So I was hell bent on educating them and then several years later I was given this wonderful opportunity. I put in a business plan to my PCT and said “let me have an alternative to a GP practice.” So I opened my own clinic and I went off and did  psycho-sexual training in London and I was able to recognise why these women don't want to have their smears, and as I said earlier it's all based on fear and lack of understanding. So what my clinic offers them is time, and there's comfort and we have long chats, and if they come and they're terrified, it can take up to something like 4-6 sessions to take the smear, but we find out what the problem is. So when they arrive, providing it's a nice normal scenario when women arrive for their smear, you explain the procedure, you do a sexual history, you talk about their menstrual cycle, the children that they have. You talk about what contraception they're using and I always ask the question “do you know why we take the smear?” and 90% of them will say ”well it's a test for cancer”, but of course it isn't a test for cancer, it's a screening programme. And then I will bring out my little pictures, I'm a great one for pictures, and show them where I'm taking the smear from, what's happing in that little corner and what the results are likely to be. And then I'll explain that they will have a letter from me, or their GP, or the screening programme, very quickly, to tell them what the result is. I show them where they have to lie, it's all very private and confidential and then the smear is taken and it's a very easy insertion of a speculum and then you just quietly take cells using a very soft brush. The cells are put into a pot and they are sent off to the laboratory.  It's a great opportunity for women to discuss all areas of their sexual life if they want to, anything they are unsure about.

KC: I think that's very helpful Gill, because I think so many women think that when you're going for the cervical smear, as you said, we think it's to see if we've got cancer or not, but you're just testing for abnormal cells, and when you find those abnormal cells you can take action to clear those abnormal cells. It's not cancer.

GB: I always say to women if you found a lump either in your breast, or your nose, your ear or wherever, you'd go and show somebody. But down there you can't see a damn thing, you know you can't see anything, so we take cells to have a look at what the changes might be. It's a screening programme, it's excellent. Well worth doing.

KC:  And you've also explained in there, you get people that don't turn up for their appointments?

GB:  Oh yes, the DNA (did not arrive) rate in my clinic is pretty high actually, so we have shortened appointments, but women get very fearful, of course if women have got their period it's not useful to take it then, and you can't take a smear on anybody who has just had a baby, you have to wait till they are 3 months post natal, because hormones need to go back (to normal), but culturally women don't agree with it, there are certain cultures that don't think it's a good idea. And of course many cultures are not sexually active and don't want to have smears and we have to recognise that as professionals, it is a screening programme, it's patient choice isn't it? And it's about recognising that the opportunity's there and if you want to take it you can, so professionals have to be very careful that we're not forcing the issues, if you understand what I mean?

KC:  Yes quite, but it's in your own best interest to take part really isn't it?

GB:  That's right, absolutely.

KC:  And finally Gill, you've mentioned the HPV, the human papilloma virus as being a major cause of cervical cancer. Would you like to say something about the vaccination that is now available and how it helps, etc?

GB: Yes, it came out about 2007, 2008 I think. There were two types of vaccines. As we said earlier, one of them looked at four different types of virus and the other one, two. And we chose Cervarix, because, although it covers two viruses it was the one that has had the longest evidence from America, it's now up to 8 years, whereas the Guardasil didn't have the amount of evidence.  A lot of people thought it was about  costing, which one we would use, but in fact it wasn't, it was just that the Cervarix had a longer evidence-base against it in America, so that's why it was chosen. It's actually given to young girls between the ages of 12 and 13 and they get three doses over a six month period. They (the researchers) are constantly looking up all the information on this file, the evidence goes on all the time in America.  

KC:  I think I'd like to add in there, if the girls miss that vaccination at 12 or 13 is it recommended that they have it later on, or what happens then?

BG: They can have catch up on it. It was recognised I'm sure that it was not cost effective to run a national vaccination programme for women over the age of 18, which is because as soon as the woman has started to have a sexual life is at risk of catching the virus anyway. And women not covered by the vaccination programme will still be invited to be screened routinely as part of the programme. Tests for HPV vaccination exist but these are primarily for use for research purposes and not normally available on the NHS, but I know that there's a lot of work being carried out on that.

KC: And I also think another key area is what you've just said, that those girls that are invited for vaccination aged 12 & 13 will also be on the screening programme at the relative time later on, it doesn't mean just because they've had the vaccination they don't need screening any more, I think that's very important too.

GB: Yes. It's my granddaughters that will be the beneficiaries, I feel, of all of this, it's not going to be immediate. It doesn't mean to say that were going to stop taking smears because of the vaccine. The largest bonus for me is that it's the first vaccine against cancer and that's got to be a real bonus hasn't it?

KC: Definitely, yes.

GB: Absolutely.

KC: Something that can really help and my very last question to you today Gill, is to do with sexual discrimination!  The HPV virus as we know is a sexually transmitted infection and it seems to me that what's good for the gander is good for the goose, so why aren't the boys in on the vaccine programme?

GB:  Well I think the thing to remember is that because it's a relatively new vaccine, there's insufficient evidence to know what would happen to boys. There's also a cost issue as well, but also vaccinating the girls will also reduce the transmission to the boys won't it? So there is that school of thought. And this should lead to the reduction in rarer forms of cancer caused by HPV in both boys and girls, so I think with all of this, cost is the thing. I'm sure in America they'd love to vaccinate the boys and yes if it goes out there it will probably come over here, but at this point in time it's still very new and we're still learning a lot, but you're quite right as far as sex discrimination is, why not? Perhaps we should have given it to the boys first?

KC: Listening to you speaking perhaps the boys need a slightly different vaccine, because of course they don't have the same hormone structure as girls. It may be a whole different ball game for them altogether.

GB: Yes that's right, but certainly vaccinating the girls will reduce the rarer forms of the cancer, which is the big bonus isn't it?

KC: That's brilliant. Thank you so much for that Gill, we've covered so much today and I think I must just reinforce to tell everybody to turn up for their cervical smear when they're called forward.

GB: I have a very good motto actually you know: ‘never fear to have a smear'.

KC: I like that.

GB: It's not as painful as people think; it's just that it is about looking after yourself.

KC:  And not worrying unnecessarily.

GB: That's right, absolutely.

KC: Well, thank you very much Gill.

GB: Thank you Kathryn.

KC: It's just been brilliant speaking to you and I'm sure that this information that we've discussed this morning will be of help to a lot of women.

For further information on this subject please go to http://cancerhelp.org.uk and http://www.patient.co.uk/health/Cancer-of-the-Cervix.htm. For more information on any aspect of menopause, please visit http://www.simplyhormones.com.

This interview was brought to you by Kathryn Colas of SimplyHormones.com

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Listen to Alexandra Pope discussing HRT, The Pill; their toxicity and what is the tsunami of menopause? Such powerful information – if only I knew then…

Transcript of INTERVIEW with KATHRYN COLAS and ALEXANDRA POPE

Hello, Good morning. It's Kathryn Colas here from http://www.simplyhormones.com and I'm here today with Alexandra Pope. Now Alexandra, together with Jane Bennett wrote a book called: ‘The Pill, are you sure it's for you?' And I think it's absolute reading for everyone. Alexandra is also featured in a documentary called The Moon Inside You which has already been seen in a number of countries.

Some background to Alexandra is that she was originally a teacher of English in both the UK and Australia before training as a psychotherapist and in Psychosynthesis resulting in 20 years of private practice in Australia. She now continues in the UK and Europe, running private and public workshops on menstrual cycle education.

Kathryn Colas: Now, Alexandra, Good morning to you…

Alexandra Pope:  Good morning to you, Kathryn. It's lovely to be talking to you like this.

KC: Thank you, yes, we have been trying to do this for ages, haven't we

AP: We have indeed

KC: I'd like to start with your book, Alexandra, The Pill, are you sure it's for you. Now I've read your book and found it so informative. Tell me, what prompted you to research this subject  and write a book, together with your co-author Jane Bennett and what's your connection with Jane?

AP: Well, I'll begin with my connection to Jane. Jane and I have been friends for a number of years. This is in Australia and we both share a passion for menstrual education and Jane was particularly focused on girls work and has written a book in that area, you know, preparing girls for their first period and I, of course, was doing all the women's work and so we would often rave about our favourite topic and we would also bemoan the low status that menstruation has, you know, that it just seems such a negative in our culture and we are just passionate about transforming that and what brought us to The Pill, was that Jane, herself, is a teacher of natural fertility management which is teaching women how to chart their cycles for birth contraception and conception purposes and so that is her area of expertise and she has written in that area and works with a very well-known Australian woman, Francesca Naish and then of course I was doing the menstrual work and women often use the pill for dealing with menstrual problems. Both of us were tracking the research, you know, as it would come out, it would be in the press and would be more research on the dangers of the pill and always this research was dismissed as it's not, you know women, don't really have to worry and oh, yes, yes that it causes and potentially causes this cancer and that cancer and don't worry, keep on taking it.

KC;  It never seems to make the national press does it

AP: It never seems to cause any kind of wake up. My God, this is a drug that is having all these side effects. It seems to have some sort of diplomatic immunity from any kind of questioning and the medical profession, generally speaking, there are individuals but they don't speak out. We know of them because women have told us and individual doctors have spoken with us but in general the medical profession sees the pill as entirely safe that the jury is in. It's safe. Women don't have to worry; they can go to sleep now on contraception, you know; take the drug, don't worry, that's contraception solved. Big tick there let's go on and do something else and actually, Jane and I are saying, no, no, no! The research is compelling. And anyway, it's a drug, you know and all drugs have consequences and you're shutting down a really vital system in women – the menstrual cycle. You can't shut down a cycle and not have consequences.

KC; Absolutely, yes

AP: So Jane and I were getting more and more apopleptic and with rage and then, one day, we looked at each other and said: why don't we write a book on the pill because no-one was writing on it. No-one was speaking out and we looked at each other and said: Oh, we should do it and then we both went,   oh, no, not another book! Ha, ha, ha and how do we find a publisher and so on, but of course the book wouldn't let us go. You know how it is. And of course the rest is history.

KC: Yeah, and you say in your book: a woman who appreciates her menstrual cycle can deepen knowledge of herself, build self-esteem and develop high sensitivity and so thereby, contrary to that, by ignoring this monthly function it's more or less declaring that we keep saying to ourselves that we're unclean and that has the opposite effect which results in, you know, bad health and low self-esteem, yes, absolutely. But we don't seem to have the knowledge to embrace the menstrual system, do we. We've totally ignored it for so long.

AP: We have, indeed. It's really interesting. I mean, there's a huge cultural taboo around really valuing the cycle and I love when I run workshops, I love to begin with a silly example to try and make a point. Imagine going to your doctor and your doctor says: Ah, you should ignore your circadian rhythm, that's your day/night rhythm, you know it's such a waste of time, you having to sleep eight hours a night, you could be doing so much more. You know, take this drug, you know you can stay awake all the time, you know it's so much better and you would think your doctor was seriously mad. You know you'd probably be reporting them to the Medical Council. So, how come, we women have got caught up in this thinking that the menstrual cycle is somehow expendable, that there are no consequences to shutting it down and we are talking about our fertility system. This is our capacity for creating life. This, surely, has to be the most awesome cycle on the planet!

KC: That's right. And I suppose it's very difficult to have a balance because when you look at young women, just starting out in life and not necessarily being promiscuous but certainly being sexually active and as a mother I know I feel very protective of my own daughter and that I would rather she were on the pill at this stage because I think their education and being up front with boys and saying, you know, have you got a condom and all the rest of it, it just ain't gonna happen, is it. I feel quite strongly that it benefits younger women until they start to understand more.

AP: What you bring up, Kathryn is a really huge and very important issue and we do address this in the book. You know, how do we deal, how do we approach our teenage daughters. And, obviously there are no clear cut answers and one of the themes of our book is really empowering women to make their own choice. So we're not preaching: you should do this, or you should do that, so just some thoughts around this. As long as we have a culture, Kathryn, that doesn't value the cycle and doesn't empower women around the cycle, girls aren't going to value it, so we do need a cultural shift, so essentially, it's not something that's going to happen overnight but this is our high dream for Jane and I. Our high dream is that girls are firstly given wonderful preparation for their first period and it's not just plumbing, you know. It's actually more emotional as well as all the technical stuff. It's really dealing with their feelings and giving them a really positive message and we've really done a lot of work on this in Australia in this area and it's really exciting what we've seen in girls, with this. We've also done mother and daughter work around this and it's so empowering. So, girls really get this lovely bond with their mothers instead of this negative thing around menstruation and its' so important, that and once a girl is menstruating the girl needs another level of education which is to teach her about her cycle as a self-care tool, so we're not even talking sex, although sex is going to come up, obviously but it's about teaching the cycle as a self-care tool, so Jane has been doing a lot in this area to teach girls how to chart their cycles. You know, how to read the signals and signs of their bodies and to teach this as personal development tool, as a fundamental personal development tool for girls. And then, research time and again shows that when girls are properly educated around their bodies and around sexuality, they start having sexual activity later. So, education in itself is a very powerful means of prevention, here. And then, you know, our feeling is that girls should have body literacy  so that's our emphasis and then when you come to have the conversation about contraception, yes, you talk about the full range and the truth is, girls have to use condoms anyway for protection against STD's (STI's sexually transmitted infections). They've got to get the message, you've got to use a condom. Now if they're more conscious about their cycles they're going to have more self-esteem, more confidence to be able to take care of themselves . I'm not saying it's 100%. Nothing is 100% and what we have to emphasise here is that the pill, whilst it looks like something really safe, it's not 100%. You know if girls forget to take it for one, two or three days, they have the same protection as a condom. Finally. I mean the other key thing here is, some people would then suggest, well give them an implant, you know or the injection then there's no problem with them forgetting but the health hazards, the health consequences are awful, Kathryn and the earlier you go on the pill and these other hormonal forms of contraception, the bigger the consequences are going to be, especially further down the track, so we feel education, education, education in a really wholesome, menstrual affirming, woman affirming, girl affirming way and then let the girls make their choices.

KC: Yes, I think you're absolutely right and what brought me into this, as you know, I deal with the other end of the cycle, I'm dealing with menopause and it was as a result of my own research into that, that took me back into women in their 20's and 30's with PMS and then, of course with my own daughter beginning the cycle, she and I both understood it more because she was just beginning and I was just ending, so the whole thing clicked and that took me into schools and I thought, why aren't we educating more at that level and even boys to getting them understanding, what's going on in women's lives with these hormones and then, perhaps we'd all have a safer passage right through to the end but that links me nicely in with menopause, Alexandra, because as you know, I created my own website, www.simplyhormones.com to raise awareness of the trials and tribulations of menopause and in the light of ‘the million womens study' a few years ago, now, on HRT, I wanted to ask you: what are your thoughts on the pill and HRT. Do they share any common ground? I know that HRT is not a contraceptive and women must understand that, that just because they're on HRT they could still become pregnant but what are your thoughts, you know, comparing the two?

AP:  Um, they share a common ground in the sense that they are both delivering synthetic hormones to a woman's body. And so, they will have similar kinds of side-effects. They will have side-effects because they are potent drugs. They are both listed as a class 1 carcinogen by the World Health Organisation. This means that they are cancer causing and they're in the same category as asbestos and tobacco. Now, I've re-checked that just recently, because…

KC: Good grief! It sounds unbelievable, actually, doesn't it.

AP: I know and I thought to myself my God, why isn't that statement out there? And then I started to doubt myself and I thought, no, no., I shall go back and check it and there it is and it is a known carcinogen. You know, it's a drug, it's a potent drug and I think the thing is, they both give the message to the female, to women, that the menstrual cycle is a problem…

KC: Alexandra, what do you mean by that?

AP: What I mean is that women see and actually this is also the message that's now being given out by the medical profession more and more, sadly, that the menstrual cycle is a problem in women in that it, ah, it's quite an interesting question, actually. It's seen as a limitation or a weakness to a kind of normal successful, healthy life and if women didn't have a menstrual cycle, they could be as successful as men.

KC:  I think that is the picture that is being painted, isn't it? I don't know what the stats are but there are a lot of women out there, certainly that I know of, that are taking a particular pill and they don't menstruate at all. I spoke to one woman who hasn't menstruated for years, and she thinks it's great.

AP:  Oof! Oof! oof! I feel for her body when I hear that. Yes, it's a real problem this. I mean, historically, the menstrual was seen as a limitation, that it weakened us, that menstruation weakened us and that therefore we were not fit for high office, you know whether it was economical, political, or business, or whatever and then, you know,  feminism came along and started to shift that and the message we got with feminism was that women could do anything they want whenever they want and I think that's a fantastic message and I think that message is still true today and what I'm introducing here is the notion that, yes, we have a menstrual cycle and this menstrual cycle can be a huge asset in all sorts of different ways but counter to that we are also getting the return of this old message that menstruation weakens us, that the menstrual cycle is a problem and that menstruation causes all sorts of health problems, you know, weaknesses and I think the weakness is not that menstruation weakens us it's the thinking we have around this that weakens us and the moment that a woman starts to appreciate her menstrual cycle and the different kinds of assets and powers she can tap into, it would be like the lights going on inside her, it's a whole new kind of world or consciousness that she can open up to within herself. Yes, that's really what I'm kkkkkk at here.

KC: And also you were mentioning back on an historical note and actually it's not that long ago when they were locking away women going through menopause because they were declared ‘nuts' and they were locked in menstrual, no, lunatic asylums.

AP:  Yes, Mental asylums, yes ha ha ha

KC:  It might just as well have been menstrual asylums

AP:  You know it might just as well have been. You know, I didn't know that about menopause. I do think that actually many women who are highly sensitive, you know, almost intuitive, probably historically really suffered at menstruation because that aspect of them was never valued and they would have appeared highly, kind of, out of it; because menstruation is a natural ‘high'. We do go into an altered state of consciousness but because women are not initiated into that language about their bodies, I think that women can appear to kind of ‘lose it' and, certainly in more restrictive times, you know, any woman that was full of herself and ecstatic in any way was nothing but trouble, a disturbance and I really fear that many women were put away because they were natural ecstatic and no-one knew how to care for that and I think they would have gone mad and I think I would have gone mad, too, living in that kind of environment.

KC:  It's that fear and ignorance, isn't it? About anything that you know little about you lock it away to keep it out the way because you don't know enough about it and certainly as you were saying, women don't understand their own bodies properly so they felt so out of it, too that they were in a different place and didn't know how to deal with it. You sometimes lose contact with the daily world, don't you?

AP:  Yes, if you repress something in you, it's going to turn up as trouble in some way. And, yes, I think you said it well.

KC: Yes, I'd like to move on, back to your book, actually, I particularly like your chapter on ‘the natural way to menstrual wellbeing', can you tell us something about that?

AP: Yes, I'd love to. Now, I present a very different approach to menstrual health and it's actually connected to what I was saying earlier about getting in tune with your cycle rather than seeing it as a problem and in many ways, menstrual problems are exacerbated because women are fighting their cycles. You know, they are trying to remain the same all the time and they're not in tune with that inner rhythm. So my approach to menstrual health is based on re-connecting with the power of your cycle with the real intelligence of your cycle. Now, what does that mean? It's very simple… I encourage women to chart their cycles on a daily basis. What I'm looking for here is your energy, your mood, your feelings and to just make a note, each day, of what comes up for you and it's also great to have a journal where you're charting your dream results as often you have very significant dreams at particular times of the month, and then, as you do that, as you start to get in touch with your cycle, you start to see a pattern and the pattern goes something like this, although each women will have her own version of it. But the pattern is a little bit like the seasons of the year and I talk about the inner seasons of your cycle and in the first half of your cycle after you come out of menstruation, the pre-ovulatory time, say from day 5 – day 10 or 11. I talk about that as the ‘inner spring' and women will generally notice a greater aliveness, energy, and motivation, and more focus and clarity and that's as it is, the nature of spring. You have this natural growth happening, a natural motivation and ride it, surf it, get the most out of it. You have this amplified talent, of course you do anything at any time but capitalise on this time. Ride the wave and then as you come up to ovulation, this is the summer of your cycle. This might be from, I'm talking of an average cycle of 28 days and everyone will have their own version, as I said, but let's say from day 11 to day 19 or so, something like that, day 11, 12. It's a bit like the summer which we're in right now and, you know, the summer energy is very kind of out there. Women feel most sexy and gorgeous at that time, you have a natural energy to connect with the world. Your focus is on the outer world and here, we create harmony. As one woman said ‘we hold court' at this time. Yes, you're totally ‘queen' of your queendom. Your riding high. This is ‘superwoman' territory. It's very creative in the sense that it's very productive. You know, in the first half of the cycle you initiate, in the spring you initiate. In the summer you fulfil that. You really fulfil it. So you really produce things. You know it's like nature producing all this wonderful food for us. So that's what you do and then as the wheel turns, as your cycle turns, you come into the pre-menstrual stage which may be from day 19 or day 21, something like that. I'm being very loose with dates here until about day 26 or so and here, just as the energy changes as you come into autumn and you feel yourself pulling inwards a bit and closing down, that's what's happening pre-menstrually and you have a different kind of power, here. A very gutsy power, it's very insightful, you can see into things. Your energy is dropping a little and this is normal. If you have extreme fatigue, that is not normal and you need to rest. But the pre-menstrual phase gives you feedback, so I call it ‘feedback time'. I call the summer of your cycle ‘having it all'. Ha ha. And the Spring phase is ‘new beginnings'. So you have New Beginnings, Having it All and now this is Feedback Time. This is the ‘get real' time. So you have real insight here and this is where you kind of clean up and edit and sort out and refine, so this is really where you polish what you do and this is the difficult phase because in any creative project you have to stand back and go ‘ OK. I've got a lot of stuff here, what's working and what isn't working?' and this is where you have to cut stuff out and our critical energy comes up here most strongly and a lot of the pre-menstrual stuff is that women not knowing how to handle that negative, that critical energy that can become really negative and destructive, if you don't know how to use it. So, in my work I teach women how to manage that.

KC: We just lash out and have a row with somebody, don't we

AP: That's right, we do. Now, that energy behind that is actually really positive and you've got to learn how to use it. You may need to speak very strongly but it's not a licence to abuse people,

KC:  No!

AP:  So, learning how to manage that energy is a very important part of my work and then, as you pull into menstruation and this energy of pulling in can happen a day or two before you bleed. You'll actually much more vulnerable, like you don't want to do anything, or socialise, and you'll often go off to a very kind of quiet, detached, still place or, you could go to a place of quite a dark place, for women who have difficulties, for women who have difficulties, a kind of anxiousness and so on.

KC:  You certainly don't want to communication, I know that for sure

AP:  Isn't that fascinating, we so don't. And this is wisdom at work, you know. You actually, this is about you pulling into yourself, now. It's not about the world, so you think about, this is our inner winter and if you think about winter, we want to hunker down by the fire place, don't we? Well, that's what you're doing in your own spirit, now. You're wanting to hunker down, deep into your own being and just saying ‘no' to everybody else. And this is really healthy. If you want to have it all, you've got to have a time where you do nothing, where you can completely chill and you say ‘no' to everybody else and you put all your juice into you. So, the winter time of the cycle is ‘you' time, ‘me' time; where I take care of myself absolutely. And when you start to co-operate with that rhythm it just transforms your experience of yourself and of your symptoms and a lot of symptoms fall away, or are eased considerably. Women generally feel more confidence in themselves, more dignity and a greater capacity, then, to take care of themselves, which is turn means you have more motivation to do all the other health practices that I will now mention and there are many things you can do to heal your symptoms but the first remedy is to restore, is the wisdom of your cycle, cycle awareness, is the first remedy; to be aware of your cycle and to respond accordingly.

So that's the first remedy, the second, and these are not in any particular order, the next remedies but diet and the state of your digestion are crucial. This is non-negotiable, you've got to have a good healthy diet and there's plenty of good information out there and it's in my books as well but, essentially, it's real food, cutting the junk basically and eating real wholesome, whole, fresh foods; mineral rich, you know and to have good quality protein and, really to get rid of the junk. To get rid of white flour, white sugar and so on. And then, the other crucial area, I think, is environmental. There's so much environmental pollution out there; there's so much junk we put on our bodies, the chemicals we use in our houses to clean. Now a lot of the pollution we can't control, like air pollution, you know out on the roads, and so on. But control what you can control in your own home. Make your own home as clean and green as you can and there are so many good products today that do not have toxic chemicals in them, so we've got no excuse there. And yes, it is a little more expensive but you can use things like bicarbonate of soda.

KC:  Yes, that's brilliant, I use that

AP:  I use it for everything

KC:  All these old-fashioned remedies…

AP:  And there's so much good information out there on the web, on that, so in a way, you have no excuse, now.

KC:   Actually what I noticed is, I changed my soap powder to a more natural version. I'll give you the name, it's Ecover, I went to and as a result of using that, I've really noticed, it's like when you come up to somebody and you know they've been smoking, you can smell it on their clothes and you can smell the other generic brands of washing powders, they stand out and all you can smell is the washing powders and, you know, I don't want to be near these people because all you can smell is the soap powder and you go into their homes and their homes stink of soap powder and it's so off putting. You change the powder you use to a less toxic one, it's amazing your sense of smell completely changes.

AP:  That's very illuminating, I totally agree with you. It really, you will be quite shocked when you get rid of the chemicals and not just the soap powder but all the other cleaning agents, will really shock you how shock that acrid, chemical smell is. And I go into more detail in my books on the environmental stuff, but again, there's so much information out there today, people can easily access that for free on the internet.

And the other area is ‘structural exercise' and the structure of your body and I'm afraid exercise is non-negotiable, you have to do it, you absolutely have to do it and preferably outside in natural light, as well, as much natural light as you can get because we need vitamin D and I think it is probably important to supplement with that but I'm not a practitioner so I can't, you need to see a practitioners. So, yes, get out and get natural light and exercise, it's just fantastic but also things like yoga and pilates, anything that strengthens your core muscles and your core, is critical and then you may need to work with a massage practitioner, you know, chiropractor, osteopathy, that sort of thing because there may be structural issues going on with your pelvis that are causing menstrual problems and the one remedy I recommend to every woman with menstrual problems, almost regardless of what their problem is, I recommend Maya abdominal massage and there aren't a huge number of practitioners but the beauty of this is, that once you've had a session you can do it for yourself, they teach you how to do it yourself but it's really good to have a few sessions with somebody but even just one and you start doing it for yourself. I'm very big on all the things you can do for yourself.

KC:  And this is just as it sounds, is it, it's just abdominal massage

AP:  Yes it is abdominal massage and it's very effective. God, you know if I had menstrual problems today, that would be my first port of call, beyond all the stuff I'd be doing for myself.

KC: Actually, I remember this, and sorry for interjecting here, Alexandra, when my mother-in-law, when my kids were small and they had abdominal problems, she would just lay them down, put some oil on their tummies and massage it and I learnt that from her and it helped. Now whether it was just psychological or she actually knew what she was doing, I have no idea but I picked up on that and I used to do it on my kids when she wasn't around but, yes, I totally believe in what you're saying about that and we stop doing it when we get older. I certainly didn't do it to my teenage daughters but they could learn to do it themselves.

AP:  They could indeed and it just releases a lot of stress and tension, I think. Yes, I can't recommend it more highly.

So we've talked about diet, we've talked about environment, we've talked about structural stuff. Now with women who have extreme menstrual problems it's going to be necessary to work with a natural health practitioner and, you know, I've already mentioned chiropractors and osteopaths and massage therapists but also they may need to work with Chinese medicine, is very good; Ayurvedic medicine, naturopathy, homeopathy, you know, different strokes for different folks. I got a lot out of Chinese medicine to strengthen me but it was chiropractic work that made a huge difference to my pain and it was also the self-care stuff that made a difference to releasing the pain, along with the Chinese medicine nourishing me but naturopathy has a lot to offer as does homeopathy and, you know you may be drawn to a particular practitioner who happens to be a homeopath or a naturopath but there are lots of good things out there, but they are not a substitute for your own self-care and there is so much you can do for yourself.  I really want to emphasis that.

So that's my natural approach, Kathryn, to menstrual health

KC:  I think it's brilliant and I think when you first hear about it, you think, oh, god, here we go again, more form filling but you describe it so easily and you can understand it so quickly you feel better already just hearing you say the words

AP:  Well do you know something? I got the most lovely feedback from a woman in Ireland. I had just been in Ireland and I got coverage in the Irish press, in the three main newspapers and each of the papers spoke about, you know, my approach; the seasons, getting in touch with the seasons, every cycle and one woman, she didn't even come to a workshop or she hadn't even read my book yet but she just thought ‘I'm gonna try this' and I just got this email from her saying ‘I've done it for two cycles and already my insomnia has cleared up and I'm not eating packets of chocolate biscuits five days, for five days before my period'. How cool is that! All I wanted to say was, yeeees! How cool is that! And she's just done that off her own bat, you know, with no more input from me, you know. Isn't that amazing?

KC:  It is, you've just got to ignore the rest of the world and do it for YOU. You are important. Do it!

AP:  Yes! And then you just release all this energy inside and inspiration and in the end it isn't, ah, you know, another job to do, it becomes, like, ah, yes, what I might open up to and discover and then you release energy. It's energising, you know? Yes.

KC:  And all of that to me, that obviously leads on to a better experience going through menopause because you've already gone through this process of understanding yourself better, so, surely, that should be a better passage through menopause?

AP:  That is absolutely the punch line, Kathryn, really. I can't emphasis this more strongly. I think the crisis we are experiencing around menopause is because women have not been grounded in their menstrual cycle. When you have worked with your cycle over many years and, you know, you're intimately connected with it, you are intimately connected to yourself. You'll be practicing really good health care and you will understand the nature of the psychological passage at menopause and you are probably going to be a whole lot healthier because you have been more in touch with yourself. You are just going to be more empowered and it just then becomes the next transition and you have already worked with transitions through working with the cycle. It's, you know, really, when I think about menopause, I, women ask me about help at menopause and I just want to tell them to come to my menstrual workshops. I could achieve that information before I go on to talk to them about menopause.

KC:  Absolutely, yes. The way I see it at the moment is that menopause is a huge metamorphosis but it doesn't need to be if women are practicing understanding their bodies at a younger age then it's an easier transition, an easier metamorphosis and it's not a huge problematical thing that causes so many challenges at home and in the workplace.

AP:  Yes, exactly. And women would be able to ride it better. They'd be able to get the juice out of it because there is a transition, you are being changed but women don't know about that and if they knew about that, it's just, it's like being given the rule book, not the rule book, the instruction manual. And they're coming at it with no instruction…

KC:  Yes, as we always are, isn't it. We more or less make it up as we go along because nobody understand us enough and now you're telling us what to do and I think that's just brilliant. Because what I've been finding, what I keep telling women now is stop all this multi-tasking…

AP:  Yes!

KC:  We wear multi-tasking as a badge of honour because, hey, we've got something over the guys, look, we can do all of this stuff all at the same time and all you're doing is causing problems to your own health. The sooner you realise that, the better off you will be and start asking your partner, saying, look, so and so's coming up, I've got an important meeting but I've got the kids to deal with can you help? Or what can be do about it? Share this home life that you have with your partner and I'm sure, it's only because we don't ask the question because we think, oh, I'd better not ask because, because, there'll be a row. You don't know that til you ask the question. And that certainly happened to me and as soon as I started opening up, and said, oh, look, this is happening, can you help – of course I can, there's no problem.

AP:  That is very wise, that is absolutely it and if, you know, if women had been in touch with their cycles, each month they would have been practicing the very thing that you have been talking about; because ovulation time is multi-tasking time. That's the superwoman time, you can do it. And then, menstruation is when you drop it all and you just take care of yourself and renew yourself. Now women are not renewing themselves on a monthly basis, they are trying to keep going the same as before and that is a recipe for disaster and then, of course, the real disaster happens at menopause, that's when it all comes to a head, so if a woman is practicing it on a monthly basis then menopause isn't going to be a breeze.

KC:  Yes, absolutely, because at the moment it's like a tsunami, it just builds up and builds up until it eventually you can't, literally can't cope and in my case have a nervous breakdown, so, you know there's got to be a better way.

AP:  There so has to be, Kathryn and I just think what you're doing is magnificent, it's just so vital. I mean even just that statement about multi-tasking, that is radical and the impact of that is huge.

KC: Yes. You think so?

AP:  Yes, absolutely, absolutely, it's nuts that we just keep going, we women have to ask for help

KC:  Yes, and not be afraid to. I'm talking to women, I go into business now and am talking to women and mixed audiences and what I've noticed and I don't know why it took me so long to pick up on this but of course, if you're in the workplace, whatever job you're doing, you're never going to stick your hand in the air and say ‘Excuse me, I can't cope'; you carry on and try to deal with it and make your, you know, grind yourself into the ground even further, so I think with people like yourself and myself, talking to women to get them to think about themselves more, then perhaps we won't find ourselves in this awful place of not being able to do what we thought we could do and feeling totally rejected, loss of confidence, self esteem, the whole three yards and feeling depressed about it. There's got to be a better way, hasn't there?

AP:  I really think so and I think that there's something that we should really think about putting together, there, just around this, you know. I think there's a really core message there that would just transform women's lives and in the workplace particularly, I'm thinking.

KC:  Yes, yes. Because men do want to help, I get a lot of emails…

AP:  Oh, yes. The vast majority; I mean, there's always going to be someone who doesn't, you know, it's the same with women but in my experience, men are completely bewildered, they're shut out and actually they, in the main, they want to be able to do something but they just do not know what to do.

KC:  Yes, and anything they suggest, they are just rejected because they don't know how to approach it and of course, the woman is in such a mood at that time that she thinks everybody's against her and just, you know ‘ get out of my sight, I don't want to talk to you, you don't know what you're talking about …'

AP:  That's right, yes. That's very similar to what happens pre-menstrually, so what you're talking about at menopause, it's laid out monthly, pre-menstrually…

KC:  It does, and at menopause it's played out every day, that's the problem

AP:  Every day, instead of a few days, monthly but if we'd understood the pre-menstrual stuff then we wouldn't have that fall out.

KC:  Yes, I'm absolutely convinced that you're right on that, Alexandra

So, just bringing our conversation, here to a close, would you like to tell us a bit about your other work that you do, Alexandra?

AP:  Yes, I'd be delighted to, Kathryn and one aspect of my work is menstrual health and we've just been talking about that, but actually my work has relevance in all areas of women's lives, women's leadership, women coaching, counselling and therapy, education. I want to restore the intelligence of the cycle, you know, there's a core kind of practice in any kind of work with women, you know, to develop mental work, leadership work, counselling work, it's just a wonderful ground, foundation for anything, so I'm, so what I'm developing is a training programme, a course, called The Woman's Quest Apprenticeship, that would be over a year, where I would basically, I'm working with women, well, it's open to women who want to go on a personal development journey, spiritual development journey, it's both those, but it's also for women who want to take this material and use it in their work in some way. So you might be a coach, you might be a counsellor you might be a healer, a naturopath, you know, whatever, or you may be want to work with girls and teenagers because that, we're just crying out for people to take on that work, to properly prepare girls for this work for their menstruating years, so I'm offering a year long programme that would be three residential workshops over 3 ½ days and then mentoring in groups, you know on-line stuff and the three themes are ‘healing, creativity and spirituality'' that we would be working with and so it's open to any woman who has done some work on herself already and you really need to apply to me but if you've already done a workshop with me you've already had a taster and it's particularly for women who want to work with this in some way with the training in it.

KC:  I think that's excellent work, yes, sounds brilliant, yes.

AP:  It's very exciting

KC:  Yes, and in a way, you probably feel like me that, you're not exactly fighting a losing battle but it's very difficult being one man, as it were, just going out telling the tale. We need a whole lot more of us, don't we.

AP:  Yes, exactly, and I feel it growing, actually because I've been doing this work for quite some time with people around the world. In fact I just got an email from a woman in Chile, this morning, saying she wants to run menstrual workshops and she wants some guidance. So I wrote back and said I'd be delighted to mentor you.  The other thing, also, is that I'm wanting to develop some on-line programmes so that if you're living, you know, not close to me, then you'd be able to still participate in this work and the other thing that I have with my colleague Shani Hugo is the Women's Quest community site that any woman can join. You do need to be invited so you need to email me first, but this is a community, and on-line community where women are sharing their experiences and discoveries, whatever, around this work and I want to see, you know, thousands and thousands of women, talking and raving and sharing and, you know. That's our vision on that and eventually I want to work towards, Shani and I would like to create a centre where, a place that's held in perpetuity, actually, for this work, where it is exclusively focussed on restoring the wisdom of the menstrual cycle and then its application in, as I've said, leadership, therapy, healing, fertility, birth; that's another area I didn't mention. Girls education and we develop people who are experts in these different areas, working with the cycle, as a core element of any of these things.

KC:  Yes, well I feel that's absolutely fantastic and I wish you all the best with your continuance of that because I see we get books every now and again coming out about different areas of menstruation but to actually have a programme that people can attend either virtually or in person, I think that shows great insight and I hope it becomes very successful and others see it in the same vein.

AP:  Yes, thank you. It will, you know. I decided, this life time, we're going to crack this one.

KC:  Yes, definitely. That's absolutely brilliant. Well thank you so much for talking to me today, Alexandra and let's set the world alight!

AP:  Yes, absolutely! Absolutely! Ha ha ha.

KC:  I so thoroughly enjoyed talking to Alexandra Pope, we covered so much ground, didn't we. You'll find both Alexandra's and my contact details at the end of this transcript and thank you for listening, this is Kathryn Colas of SimplyHormones, signing off. Bye for now.

Alexandra Pope: Co-author of ‘The Pill: Are you sure it's for You?' is available from Amazon. Do go to Alexandra's website:  http://www.wildgenie.com and you can email Alexandra: [email protected]

Kathryn Colas: You'll find lots of information on menopause, including my own personal journey at http://www.simplyhormones.com. Sign up for my Newsletter:  http://www.simplyhormones.com/cc.asp and do watch ‘Menopause: The Movie' highlighting how relationships are affected at menopause; here's the link: http://www.simplyhormones.com/video.asp and do join me on my blog for my own views on what's going on in the world: http://www.simplyhormonespodcast.com – feel free to comment on my ramblings and podcasts. Last but not least, you can contact me: [email protected] .

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There are 3 areas to concentrate on but first off, take it easy by listening to how to achieve your body shape – then put all your promises into practice!

KC:      Hello everybody, it's Kathryn Colas here from Simply Hormones.com.  And today I'm here talking to Celia Johnson who

Celia Johnson

specialises in health fitness and wellbeing, and how that fits in with going through menopause.  If you've been listening to these podcasts you may already know that Celia has interviewed me about menopause and we've discussed the seven dwarfs of menopause and the symptoms and how they are affecting women and we've also done an interview on depression but today we're talking to Celia who specialises in heath fitness and wellbeing and how she can help us as we go through menopause, to understand our bodies better and get fitter. But first off, let me introduce you to Celia and we'll find out a bit more about her.

 

Hello Celia and welcome. How are you today?

CJ:      Oh hi Kathryn, great thank you. Very excited to help those women out there on the topic of exercise and menopause.

KC:      Good.  First off, can you tell us a little bit about yourself, where you come from, how you got into the health industry and where you are today?

CJ:      Right, well it started a long time ago. I was born in Preston, Lancashire, England. As from 18 I moved away from home. I lived in London and had a feeling that there was a career that I wanted to go on to and that started off with health and beauty. So I started off working for a cosmetic company in London, in the department stores, working with Mary Quant and Revlon, yes it was really great. I was into the makeup and everything and I really really loved it, I always thought the women in stores looked so glamorous I thought that's what I want to do.  T

Then later on I moved to Ipswich, where I found my partner and   then we got married, moved over to America, and again went in the department stores there, still working with the makeup, then I had a baby and started going to the gym because afterwards trying to get rid of…  I was really big and fat, so I joined Gold gym, and I started in the gym and as then as I started to see results I thought “oh God this is fantastic”, but the problem there was I got addicted.  I was in there morning noon and night, and also working as a job when I had the baby, I also did another college course in America, which was ‘cosmetology', which includes hairdressing and manicure, pedicures, so I got a bit more into the beauty side of it by going to college and getting more experience there. Then I became a hairdresser.

While I was hairdressing I started the gym and it just happened one day the instructor was off and the manager of the Golds gym said “oh God sorry ladies and gents we have no instructor, but I see someone who's here 24 hours a day and that's Celia. Celia what about if you'd like to take the class?” I said “what?”.  He said “well you're here 24 hours a day I know you know what to do” and I said “of course I know what to do but I've never taught a day in my life”. And all the people were saying “Oh great, come on Celia” edging me on, and then she said “Oh Celia, if you do it we'll give you a month's free membership”. So anyway I did it, but then after I finished it, it gave me a real great buzz, everybody was clapping and I though “uhh, God I could do this as a living, I love it”, so that's when I transitioned then.

Later moved over to Saudi Arabia, because my husband had started working over there, and so I thought, oh I'll give some exercise classes to women. So 5 0'clock every afternoon I put on an exercise class and experimented with the ladies. Did different types of exercise and later on moved back to England, back to Preston where then started to work for a leisure centre and then decided I'm going to get qualified in the industry, so I got all my qualifications and then took this job very seriously and started working full-time in the industry. Then it just progressed from there.  I had been going back to college over 10 years in time to find out more so another 10 years of studying and finding out what the ladies want, and then just working round in different areas of Preston doing things like personal training. I had my own studio, so I had my own community classes, so that we had our own group so people started to know each other, so I brought the women together, so really I've helped and transformed around about over 30, 000 women's lives as well as working internationally in different countries. So I think that's about it. I could go on a bit more but that's an overall view of where I came from and what I did.

KC:      Yes, that's pretty comprehensive and the chain of events seem naturally to have led one to the other doesn't it?

CJ:      Yes it has, still concentrating a little bit on their health, the beauty side I still love it, that will never be dropped, so I've got my hands a little bit in everything, but it has been mainly working mainly in the fitness industry now for 30 odd years.

KC:      Now we're all involved in a particular time of our lives and I think because it's affecting us we want to know how we can improve things and make things better. And from what I understand from when we chatted before you're getting women in your classes now that are going through menopause and are asking for particular help. So can you tell us how does exercise help us?

CJ:      Right well exercise can help us because in many cases with the symptoms of menopause, such as you've got, as we explained the hot flushes, we get joint pain, we suffer from anxieties, sleep disorders and we've been in the profession suffering from a lot of weight gain, and really other related diseases that can spring off there which is osteoporosis and heart disease.

KC:      I don't think enough people know that osteoporosis doesn't happen overnight, and you're going to tell us now more about that.

CJ:      Yes, so I think you know mainly because I'm in my 50's I attract obviously an older clientele, you know because of experience and I've heard lots of women, when they're going through the menopause,   “oh Celia, I'm going through menopause, what can help?” and they're really concerned about their weight gain and especially around the abdominal area you know I can see just with normal people on the street, and a lot of my friends are in their 50s I've seen what we call the spare tyre, the Mitchellin tyre, they have this in the middle which isn't good especially if they're not doing any exercise.

KC:      What exercise help in particular, because I know that must be one of the biggest complaints I hear women talking about, that spare tyre, they just can't shift it. And don't know what to do about it.

Exercises to reduce that Spare Tyre

CJ:      Of course, yes. There's not one particular exercise, there are a couple of exercises which I'm going to explain. The first exercise is very important, which is an aerobic type exercise. Now these aerobic exercises will help strengthen the heart and also help women lose weight by burning calories. These are aerobic exercises and also work the large muscles in the body which benefits and helps the cardiovascular system and helps your weight.

The Zumba Craze

It's important actually to do about 20, well as I said we were just talking before about exercises and before it was like work an hour in aerobics, but you don't need to do that any more, you can work less time but as long as you do a lot of intensity exercises, between ranging from 20-30 minutes at least 3 times a week and these aerobic exercises can consist of anything from brisk walking, swimming, cycling and if you go the gym you can do dancing or you can do dancing at home as Zumba is the latest craze or the latest craze we have is also ballroom dancing. All these type of activities will get that heart pumping so that we can get the benefits of strengthening our heart. But it's very important especially if you're doing that type of aerobic exercises that you do actually feel the workout.

Find Exercises you Enjoy:

You've got to find exercises that you really really enjoy and just really, simple exercises at home, you can do ecercises at home, even gardening or just doing your housework can be exercises, just do it differently. So that's your aerobic component.

Aerobic plus Strength Training is Key

Now the other type of exercises also very important we can't work one without the other, and that is strength training. Now strength training will help our muscles and bones of our body and especially the bones because they deteriorate, you know they get less dense and also help increase our metabolism, which will help burn fat.  So as we gain weight. So the strength training improves our strength, the posture and also helps reduces risk of lower back injuries and also will help us tone our body up.  You can use little things, if you go to the gym obviously you'll go strength training classes or you'll work in the fitness hall and you'll work on the machines, or if you go in your class you can work with the little resistant tubes, or the medicine balls, or all types of equipment. Also at home you can have, they're very light you don't have to have any extra space in your house and you can just use these bits of exercises or these little exercise trolleys as I call them at home.

KC:      We were talking before and I do star jumps now as part of my exercise regime at  my home, and I do those scrunches, I stick my feet under the wardrobe, so rolling up doing scrunches, so there's a lot you can do at home.  Personally I don't like going to the gym itself and going on that equipment and I think I can probably speak for a lot of women on that too. But yes if you can find somebody who can do this core training, just like you and I think, don't you record yourself doing this on your website?

CJ:      Yes I have lots of exercises which I'll talk about at the end and try and get women directed to the exercises that I have. The strength training as I said is very, very important.  What I have seen in the gym when I'm working, I talk to ladies all the time.  They just do kind of aerobic training. They think “oh, I'm going big time, oh I'm sweating”, and I keep telling them, “if you're really really want to do a type of exercise, the most important is the strength training”, because also with the strength training your heart will be pumping more especially in the strength training that you're increasing intensity, so you can in the strength training part, you can do your aerobic exercise and strength at the same time, which is in the industry now which is now becoming more popular. Like you said you do your circuit training, which is involving aerobic and strength training, like you said doing your star jumps, squat jumps, all different types and especially, as I said I was talking about using little toys, but at the end of the day you can also, if you haven't any equipment you can use your own body weight, so there is really no excuse not to be doing your exercises.

KC:      Or you could use those small bottles of water, a full bottle of water as a weight.

CJ:      Yes, because you've got your litre, which may probably weigh around about, just less than a kilo so, really the strength training again try and get at least 3, do it 3 times a week, and as I said minimum 20 minutes – 30 minutes a day. But you can probably do one day on, and have a rest the next day, because obviously your muscles are going to get sore. But minimum 3 times.

KC:      And you get fitter of course.

CJ:      Then you get fitter and you can do more as you go on.  The last type of exercise which is very important is stretching. Now stretching is also absolutely fantastic and it helps with menopause, especially when you're suffering from sleeping disorders or you're feeling depressed as we talked about last time. Because it has that hormone cortisone, that comes in, so you must also really do either stretching in, you can do the type of exercises like yoga, pilates, or just some really deep stretching exercises.  And the exercises will help maintain flexibility and help the range of motion in your joints, which when we get older they do get more stiffer, so you must really keep going with your strength exercising also.  Yoga is absolutely fantastic because you can get into deep stretching, you can do some simple basic aerobic exercises at home. I teach yoga and I also teach pilates, which is another added benefit which also concentrates on your core, concentrates on aligning the body up and also helps increased ability and balance, which as we get older we start to lose balance, especially if you don't do any stability or core exercises. So again it seems like, “oh God we're doing all these types of exercises”, but these 3 types I don't think you can have one without the other.

KC:        Once you get into it, it becomes part of a routine and I think that's the key isn't it?

CJ;      Yes you've really got to try and make it a part of your life and especially if you want to stay strong and healthy and fit you know and that will help your weight problems. So as I said you've got to find what you like. Some people might like to do yoga, some might want to do pilates, but you've really got to find out what you like to do. You're going to stop if you're doing exercises you don't like so really try and find something that you do like.  Maybe you just want to do some recreational exercises like just social group walking or something. Like your tennis for instance you know.

KC:      Even a bit of golf.

CJ:      Yes golf if you don't want to, sometimes people don't want to, work with a group of people, so maybe you can find a friend or something that you like to do, go bicycling or whatever.

KC:      So, I think that's brilliant, I just wholeheartedly put my hands up and say yes, we've got to do that because there's nothing worse than feeling like you're becoming an old woman, because I'm 60 now and I know that you've got to use it or lose it. So just finally then Celia, just as a last piece to our interview here, how do you think exercise compares with people taking HRT therapy? Is it, they can do one, do you think exercise could overcome some of the symptoms to reduce the distressing symptoms so that they don't have to take HRT what's your view on that?

CJ:      Yes my view is like you said, while we discussed in other ones, that I think it can be a major part of helping us with menopause, but if you are really suffering and you do need to go to your doctor then talk to you doctor, but on a wellbeing and natural way would be try the exercises. I'm going through the menopause myself and I haven't taken a tablet  I've never gone on any type of HRT hormone, because as you're going through, when you're doing your exercises you get different hormones coming into your body, and I felt that helped me a lot you know. Yes there's times I have suffered from depression but as soon as my mental state starts going into my exercises, and same with the women which I try to explain, takes it away you know you think you forget all about it.

KC:      You're in a different place.

CJ:      Yes you are, you're in a different place, you're so focussed on you body and what you want to do and also enjoying it you're releasing those type of feel good hormones, so once you release those type of hormones you think “oh God I feel great now”, you know.

KC:      You're absolutely right, I've spoken to a few women who I know that take exercise classes, you know they conduct the class themselves, and they say “do you know what, I've never experienced any menopausal symptoms, the odd hot flush but I don't notice it, I just get on with stuff”. There is definitely something in it isn't there.

Fitness and Nutrition go hand in hand

CJ:      Yes, as I said I can only speak for myself, but as I said if it's happening to me and this is from my experience, can help the people who haven't been through it, and also  the other side of it is the nutritional side, what you put in your body.  It's fitness and nutrition goes hand-in-hand, so I think the exercise and the nutrition plays is a major part as we are going through menopause. And just to let the ladies out there, you know, try it, what have you got to lose?  If you like it, some people get their hormones released, they want more, that's from my point of view. I experienced that, it's like a drug. That's the reason why I got into the fitness.  All these hormones releasing and fitness to me became like a drug.  Okay for some people it doesn't, but for me it was “I want more, I want more”, the feel good factor, I felt great. I'm keeping my weight down. As I say that's what people out there experienced.

KC:      I think for others, sometimes we get bogged down with “I'm working full-time, the kids, the husband, partner, or whoever else is in your life, the house and all that stuff, and I don't have time for exercise. But I think at this time of life it becomes a lifestyle change that you need to focus on and recognise, otherwise you're going to end up with your medicine cabinet full of pills from the doctor to save your life.  And then you start getting side effects from the pills, other pills to reduce the side effects, it's just a vicious circle isn't it? So we don't want to go there ladies do we?

Before you head for the doctor, try exercise first!

CJ:      Try the exercise first, there's bound to be something that you like to do, we don't all like to do the same, just find out what you like to do and just do it.  Keep active, you've really got to do exercises and keep fit for the rest of your life because as the body ages, you know it will help tremendously through the benefits through your health. I just advise find something, carry on and I'm sure you'll be reaping the benefits of it.

 

KC:      Most definitely.  And finally Celia, you've given us so much information about the exercises we can do and why, and the benefits that they will have for us, so just in closing can you tell us a bit more about your website and what happens on there?

CJ:      Yes, I have a website, address is www.celiajohnsononline.com and on that website I have lots of articles that will help ladies, all to do with how to get rid of weight problems.  There's some recipes I've started putting on, and I have loads of exercise videos and I've also got some products that will help, especially the little toys that you can use at home that you can take a look at.  I have done some reviews on this so you can see what these toys are all about and what I personally think, because I've used them myself.

KC:      Because some of them can be rubbish can't they? You can end up spending your money for nothing.

You Tube – 60+ videos

CJ:      Exercise is, again on the different components of what we've been talking about. For dancing, I teach Zumba, which is the latest dance craze, so there are some Zumba exercises on there. I also have Youtube that you can click straight into from my website and see. I've got around about 60 odd videos now, so I'm sure you can find something you can do at home.

KC:      Something there for everyone.

CJ:      Some focus on certain parts of your body, some the overall component and also you can find me on Facebook. You can go on Facebook and click to join my fan pages and I've just opened another fan page on weight loss, so there's lots of tips on there, on Facebook to help lots of women that are suffering from weight problems, and also another fan page, “Life is Golden” with Celia Johnson, that focuses more on women over 40 and things, so there's lots of fitness tips and again the menopause.

KC:      With the advent of the internet it doesn't matter where you are in the world you can find something to suit you, you can even get your exercise regime sorted out, can't you, it's just brilliant.

CJ:      That's for a fact

KC:      Excellent, well thank you so much for all that Celia, and I'm going to go onto your website afterwards and get some things sorted out. I know my own daughter loves Zumba, so I can get her cracking on that. So that's www.celiajohnsononline.com, and thank you so much . And this really concludes our trio of interviews that we've been doing on menopause, and we're going to get together after, in a little while to do some more on this, because it's working so well isn't it Celia? And it just helps people understand a little more about what's going on in their life on a woman to woman fashion. We're not talking medical problems here, it's closer to home than that, and I do hope everybody's enjoyed our talk here today and so thank you once again Celia, and we'll talk again soon.

CJ:      That's great thank you Kathryn, I enjoyed that. Take care for now.

Find exercise, recipes and a host of other information  on Celia Johnson's  website www.celiahohnsononline.com and don't forget you can find over 200 pages of information on symptoms of menopause and what to do about it on my website: www.simplyhormones.com

Until the next time …

 

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True story: healthy woman and menopause at 38 who had to come to terms with no children  and her sex life was over. Anne Scott wasn’t told about her condition until she wanted to prepare to have children at 40.  In my own research, I’ve spoken to a number of  ‘early pausers’. They do feel really isolated even more than their older sisters. Listen to Anne’s story, now. I’m grateful to Anne Scott for sharing her story with us. Full transcript follows and all references to herbal tonics and medical practitioners involved in Anne’s care are noted throughout.

Anne Scott interview – Early Menopause: 

Kathryn Colas: Hello, everybody, good morning, it's Kathryn Colas here again from http://www.simplyhormones.com Today I'm here to talk to Anne Scott, about her own journey through menopause.  I met Anne at a women in business conference last November and we started talking about hormones, as you do, and I thought she had a very interesting story to tell.

Now Anne's background is IT and communications, delivering technology, and now she's completely turned that on it's head and is now helping businesses.  She specialises in business creation and transformation, helping people to be intuitive in their leadership and she calls herself Crossing Frontiers now. So let's go on to that Anne, and talk about your journey through menopause. What would you say were your symptoms, the symptoms that you first recognised, that made you think it might be menopause and what age were you then?

Anne Scott: Good morning Kathryn, great to speak to you.  Yes this is a really interesting question, because retrospectively I can see that my first symptoms were probably night sweats. And I was having those probably in my mid thirties, 35, 36 up to about 39, got really hot, really sweaty, woke up at night had to change.  Sometimes had to change the sheets.

KC: So what did you do about that then?

Night Sweats

AS: Well, actually I just lived through it, and I think part of it was at the time, what I worked out myself, was that there was a relationship between the night sweats and at night when I had a couple of glasses of wine, so I thought OK the alcohol was exacerbating this so I thought I still want to have my few glasses of wine. So I assumed that it was purely to do with the alcohol, but now that I am where I am, sort of like 15 years later, I clearly realise that was a very significant symptom.

KC: Yes. So that's all you did about it at that time.  You felt it was alcohol related and had no idea that it was potentially hormonal and that you were starting to go through menopause, you were peri-menopausal.

Early 30's: 10 months without a period

AS: I didn't, because the other thing that had happened to me in my early 30s is, I had, I think about 10 months without any periods… Bearing in mind that I'm not under weight and nor am I significantly overweight, a robust person.  I lost a bit of weight at the time.  I was very delighted at the time, as I was travelling. It was when I was 30, I was travelling in Asia, I was really pleased not to have periods; it was a great convenience actually. But it did cross my mind that potentially there was something else going on there.  About literally 9 months later I got to Australia and my periods started again, so I didn't particularly worry about it, but when I got to my mid 30s, when I was having periods I had a very clear 7 day period, which was quite heavy and it was certainly very heavy at the beginning of the cycle so I would have to wear tampons and sanitory towels and just be very aware of it, and in my mid 30s that changed significantly, so that was the other change I noticed.

Heavy Periods then less and less

My periods, quite quickly, I suppose over a period of about 2 years, went from 7 days down to 5, then down to 3 and probably in my late 30s and moving into my 40s I was actually having a 1 day period. So that was another significant change. For me I didn't actually go to the doctor.  I didn't treat it as a medical issue. But what I am interested in, and some of this is because of my study, I am interested in alternative health, so I was going to an acupuncturist and I also found a great homeopath at that time and so I did start taking herbal and homeopathic medications, but not specifically because I thought I was menopausal.

Didn't even consider Menopause as a cause

KC: No.  Did you know about menopause at the time? It probably didn't even enter your radar did it, at that age?

AS: The only reason why it even peaked my interest is because an Aunt of mine, on my fathers side, had what they called an early menopause. They had just got married when I think she was 36, and within a couple of years, very similar to my story I suspect now, she was menopausal, but this was a bit of a family anecdote, it wasn't something she talked about.

Doctors insisted NOT genetic, therefore NOT menopause!

But every time I talked to a doctor or talked to somebody in the medical profession about it they were very clear that the menopause, that your genetic predisposition would come from your mother. Now my mother didn't start her menopause until she was well into her 50s.  In fact she was pregnant when she was 48, and I think she had her periods into her mid or late 50s. My mother's story was completely different.

KC: So listening to what you have to say there, your symptoms didn't seem to follow the norm. You were following this homeopathic regime and so, was that helpful?

Significant Hot Flushes kicked in

AS: I found it helpful particularly; I then started getting hot flushes in my early 40s, so that was much later. I had night sweats and hot flushes, very separate. When my night sweats stopped, there was then a break and I had hot flushes, then I was getting a hot flush say once every half hour. Very, very strong for about 2 years and it was at that point that I really found that the homeopathic and the herbal medication really helped. I would also say that probably in my 30s I suspect now that the… what I was taking really helped the flow I guess. What I noticed as well was I had a massage at one point called a Chi Mei Teng massage, and it really loosened up or really got things flowing.  I really felt I was stuck and that's how I would describe my system, my menstrual system, in my late 30's, was that it was stuck. And I felt that these things I was taking were helping.

KC: Yes, they do say that certain massages to help the flow of the organs and help us to unblock certain areas. I know from my own self and a lot of other women would concur that I have reached what I would describe as a tsunami, the symptoms all came together at one point and were so overwhelming, I didn't know where I was or what I was doing. So did you reach that point at all?

Hot Flushes were most distressing

AS: I'm not sure that I did, I think the most excrutiating symptoms were the hot flushes. Particularly because I was working in a corporate environment with a lot of men, and also because my normal disposition was to feel cold, so I dressed for the cold and suddenly I'm having these experiences and the way I dressed just didn't suit. The idea of wearing a polo neck, I just wouldn't dream of wearing a polo neck now.  So I really had to adjust the way I dressed. And also at the end of a hot flush, how cold and clammy you feel, so I really found that very discomforting.

Awful to discover my mother suffered badly with heavy periods, flooding

The one thing that I am aware of, having talked to women and my mother say for instance, this thing about heavy what they call flooding I've never experienced. I'm sure you know a lot more about that. I've never experienced that. What happened was my periods tailed off, they didn't get heavier. It is possible that they did get heavier but might have been in my late 20s. It's so long ago I just would never have correlated it. So I didn't have this experience of my periods getting heavier and heavier before they tailed off they just tailed off and that was a convenience. It was a convenience not to have heavy periods. But my mother particularly suffered flooding and she suffered them out in public and that was something I was always apprehensive about because she told me some horror stories about that.

KC:       It can be a nightmare for some women. And unfortunately it's still the case that so many women are then offered a hysterectomy to be the method of reducing that problem and it so is not, there are so many other avenues to explore before you take that vital track. So, your symptoms, apart from the hot flushes, or the night sweats rather, and then the hot flushes, there weren't any other symptoms that you particularly experienced.

Menopause not discussed by sent for ovarian scan

AS: No but I did have a bad experience at this time, I think when I was probably 40, 41.  I think because, and I'm not sure, unfortunately, why I was prompted to go to the doctor, but I was prompted to go to the doctor potentially because of my periods in fact. At this point they never discussed menopause with me, but what they said is I should go for an ovarian scan, which I did, and at the time I think they said they couldn't see one of my ovaries, and they said look maybe you should come back, but you know what, you look healthy, you look you… you're not having any other issues, just leave it, but about 6 months later I had a niggle and I thought I'm going to go back and see if there's anything going on, so  I went back and they said there is definitely an ovarian cyst, you should have come back sooner than this, and we're referring you.

Ovarian Cancer and it was my fault?

This all came through my doctor and they were referring me to potentially an ovarian cancer clinic, which was obviously very shocking for me and the decision I took was to use my private health care and find somebody that I could talk to privately and I ended up in the Queen Charlotte Hospital in Hammersmith. A lovely gentleman there, whose name I've forgotten, and he said “right we'll get you down for a scan and straight away”, which they did, no ovarian cyst and in fact I had had a number of pains a few weeks before which maybe suggested that it dissipated but what was interesting is that he said I'm referring you to a clinic for follow up, which I thought was an ovarian clinic.

‘You're menopausal, you know that' – I said, ‘no, I had no idea'!

I ended up in a menopause clinic which I wasn't aware, they hadn't briefed me; I was examined by a woman, who reported to the nurse while she was examining me that my uterus was closed, that it was, I can't remember the words she used but it really sounded quite shocking, and it really implied that my uterus wasn't operational.

And I said “I don't understand what you're saying” and she said “well you're menopausal, you know that”. And I said “no I don't know that. I had no idea about that” and I would have to say that was the most shocking experience and it was shocking to receive it from a woman. And there was this big expectation that I understood, I think I was 41 at the time. Implication is that actually I was well menopausal.  Well into my peri-menopause at that stage.

Why don't doctors ask patients for their opinion – they've certainly got one!

KC: So yes that is quite shocking and it still shows, that doctors aren't talking to, well not so much not talking to each other, they seem to know who to refer us to, but they're not talking to us to make the connection and discussing it really to get our opinion and we certainly have one.  It's sad news isn't it.  So as a result of that you didn't go back after that referral to the menopause clinic?

Attending a Menopause Clinic for 8 years

AS: I did and I've been going there ever since. I've been going for 8 years now and unfortunately I'll be 50 this summer. But what that triggered for me was then this realisation that I probably wasn't going to have children. I'd left a relationship with somebody who couldn't commit. I'd been with them for 5 or 6 years, they were never ready to have children and I thought well I still had the opportunity, the possibility, so at the age of 41 I really had to start going through that grieving period about that.

KC: So do you think it was because of the uterine, what appeared to be a uterine malfunction that was probably the reason you couldn't have children, that it was all linked somehow?

AS: Well, I think they made it very clear. Potentially I guess if I got together with a partner, I wasn't with a partner at that point, suddenly you just thought well I'm going to have to fast track this, find some guy, have sex all the time and hope for the best, then realised that I was on the downward slope. For me the likelihood of it happening is really much more limited. I'm sure if I said I'll go for hormone treatment, I'm sure if I took a very directly focussed approach I potentially could have children now, but at the time it was just this realising that my natural cycle and my body, and I've always felt actually that really I like being in tune with my body and I have actually never been on the pill. So I've never taken the contraceptive pill and haven't actually had HRT either, for the reasons that I really would love to work with my body with the more natural approach around it. So it was that realisation that my body in it's natural state, obviously wasn't for having children and also allowed all those components of things that have happened in my 30s like the year of not having periods, or hot sweats or night sweats all suddenly fell into place really.

KC: Yes, you could see the pattern, then but you were too young to acknowledge it at the time and nobody else helped you to find the right answer.  So how do you feel now, health-wise?

Good care from Mr Nick Panay's clinic

AS: Health-wise, I feel healthy, I am aware of and I've had some challenges around this.  I think medically because the menopause is medicalised in this country you know, but medically the three things that you know certainly I've been advised about in the clinic, which I really love actually, Mr Panay, it's a gentleman called Mr Panay (Mr Nick Panay http://www.nickpanay.com).  I like him, I like his clinic and apparently he has told me I'm the only person in the clinic who is not on HRT and we've had a number of discussions around it. My mother had oestrogen related breast cancer, so that was a very significant factor for me.  As well as the fact that I didn't really want that kind of intervention, a chemical, pharmaceutical intervention.

3 important areas of concern for me now: bone, heart and brain health

It wasn't really of interest to me, but the three things that they mentioned was bone health, heart health, brain, bone and heart health, and as a result of going to the clinic they sent me for bone scans, and the key deficiency, that's obvious now, is that I've got osteoporosis. And over the last 8 years that has been quite significant, the decline in my bones and to add to that I've been kaycene (dairy product) intolerant. I've been allergic to kaycene all my life, but actually only became aware of it in my late 20s. It's only been medically acknowledged in the last 2 or 3 years, but I haven' t been taking dairy products since my late 20s, so I haven't drunk milk.  I have goat and sheep products but I don't drink milk.

KC: I think it seems to me that a lot of women are lactose intolerant, I know myself and I didn't recognise it.  As a child it was always a treat on a Sunday to have a coffee made with boiled milk, and I used to love it because of all the frothy stuff on top and I always used to feel ill afterwards and never associated the two things. Until I was going through menopause and now I don't have lactose and all the rest of it and I have changed the way I drink that type of thing altogether, so it's very interesting isn't it?

The benefits of cow's milk are a myth

AS: I believe it's a myth about milk and bone health, and in fact what they said to me when they first did the scan is my bone health was really good, and so from the age of 28 through to 40 I hadn't taken milk, but what I was very dedicated to, probably up until about 2 years ago, was weight bearing exercise, and I will go between 3 and 5 days a week to a gym and in addition I did pilates, I did hiking.

KC: All the right things.

Suffers with Tendonitis

AS: All the right things, but then what's happened in my 40's, I've had, and I guess this is with the menopause, the things around bones that I'm thinking of now is I've had more things like tendonitis, I've had things like, I had really bad tendonitis in my wrists, ended with problems with my ankles, so I actually had to stop the weight bearing exercises for a while. I then took up pilates and did some yoga and more recently I'm getting back into more weight bearing exercises again.  But I have had nearly 2 years of not doing as much weight bearing exercises, and now is when I need to do it but really my body hasn't been supporting me as well as I would have loved it to.

HRT can help arrest the decline of bone strength

KC: And I don't think enough women realise that it's the decline of our hormones and the changing of our hormones that does affect the heart and our bones and that you do have to take extra care about diet and exercise and make sure you're eating lots of fruit and vegetables and doing, if not weight-bearing exercises, swimming, it's still a strength exercise to do swimming, but do whatever makes you happy, and that's why they're still recommending HRT to a lot of women as a secondary prescription to support those areas because it has been shown that it helps avoid those problems, but I think women have got to be more proactive, and say we're not going to rely on pills, I can do this myself, as long as they are aware of what's happening in their body and how hormones are so powerful in our lives that we don't realise how they have been supporting our good health all our lives. Because we have so many more of them than the men, of course, and then we come a cropper at menopause and nobody tells us anything about it, so end up with zimmer frames and all the rest of it, and a cabinet full of pills. We don't want to do that, do we?

A good supplement is Udo's Choice

AS: No we don't really and I do think that when I realised the reverberation actually of oestrogen through our bodies, you did ask about some supplements earlier, but one of the things I was really pleased I was taking earlier, because I was having joint pain (that was another symptom I had was having joint pain), my sister-in-law is a physiotherapist and normally not into alternative therapy at all, but because of her physiotherapy she had come across a supplement called Udo's Choice (available at http://www.bodykind.com) and she started using that, absolutely sang it's praises and for somebody who would pop a pill before she'd do anything else, I was really pleased.  So I started taking Udo's Choice and that's probably the supplement I've been taking for the longest period of time.  I take 3 dessert spoons of that most days and that certainly has made a big difference to joint aches and pains.

KC: What's it got in it specifically?

AS: I can check the ingredients, but the significant thing about Udo's Choice, relative to some of the others, like there's Linseed Oil, there's Cod Liver Oil, and the way this is marketed certainly, I think that it contains Omega 3, Omega 6 and Omega 9, in the proportions that are appropriate for humans. Cod liver oil will have maybe Omega 6 and Omega 9, but not Omega 3 and they don't necessarily have it in the right proportions, so I found that using Udo's Choice, I've tried some of the others, but I've nearly always reverted back to Udo's Choice, even though it's more expensive,  I really notice the difference around my joints, and also it is supposed to be very good for mood as well, and take the edge off depression.  A lot of this is anecdotal as you probably know Kathryn.

Depressed, me?

KC: Yes, you don't know when it's happening to you.  I was listening to Ruby Wax recently who says, I think the title of the piece that was in one of the papers was that she had been mentally ill all her life and she is doing this show at the moment, I think it's very brave of her to do that, but you don't from my, and from a lot of women, you don't recognise, that you're going through this crazy period and that you're actually mildly depressed and you don't have time to be depressed most of us because you're always doing things, and it's only when you sit down and talk to yourself one day and they say right, I've really got to do something about this and that's when you, I think, become more spiritual in yourself and begin to recognise your own intuition, and lead a better life as a result of it.  And many women change course and do completely different things. I've certainly come out of it a completely different human being with so much energy and vigour to run with things and do things ‘my way'. It's quite a different thing that happens to women that is still not written about and we've got a long way to go to recognise the whole true effect of menopause in women, and we're all working longer as well.

AS: Absolutely.

KC: And now you're taking on a new career, post-menopausally and I bet you feel ready for it and you're invigorated by the challenges that you're now facing.  I know you mentioned to me that you've studied medical anthropology and this is all new; suddenly we've become sponges again and can't get enough information about certain things and we want to do other things to bring those areas of education into it. Would you agree with that?

AS: Yes. I wouldn't necessarily feel it was directly related to the menopause, I could be wrong, because I've actually studied over the course of my life starting with the BSC and in my early working career I did marketing and then I followed that up with the medical anthropology, but what was fascinating about the medical anthropology for me was I did it through the school of Oriental African Studies, who have a very humanistic approach and really what the question is,  in different cultures, is what does health mean? What is illness, what is cure? and what was fascinating was to realise that menopause is medicalised in this country, it's a medical condition and I'm not demeaning it by saying that it shouldn't be but it's this idea, it's like childbirth, it's a medical condition instead of being natural events in our lives, but in a country like Japan for instance it's not very medicalised.  They actually don't have a notion of menopause.  According to what I've read.

KC: Until they move to the West.

In Japan: no menopause but do experience joint pain

AS: Exactly and they've done studies around that.  And the key issues apparently that women present with in that age group is joint pain. It's the bone issue, but they don't have all this horrendous hot flushes and night sweats and I think there has been a lot of conversation about the relationship between that and things like lactose and milk and I wasn't taking those in my diet, so it may well be, because I didn't think I had a serious menopause, I don't feel that it really impacted on me in that way.

Shocking realisation that my child bearing years were over

The shocking things that really happened to me were really coming to terms with the fact that my child bearing years were over earlier than expected and just also what that meant not to have periods.

My girlfriends are still talking about all of those issues and they're asking questions and I'm in a different stage, so for me those were the really challenging things for me. It's interesting, I don't feel like I had to deal with lots of medical effects. I could go to the menopause clinic and they would offer me HRT and their whole thing around HRT, by the way, as you know, was for me to take it till I was 50, purely to cover that gap because the way they explained it to me was that when you're around 50, 51 a number of other systems come into play which actually supplement oestrogren, and I decided not to do that. I think if my symptoms had been not so severe like I don't really feel that I had significant depression for instance.  I feel that the level of depression I had was the same as what I'd had with pre menstrual tension (PMT), so I may well have been lucky in that respect.

Atrophic Vaginitis a complete shock

But I do think the social aspects were very significant for me and just the only other thing I forgot to mention earlier, which was a shock to me, was discovering that I had atrophic vaginitis, and that again is oestrogen-related.  And that's pretty shocking because I hadn't realised it and I was in a new sexual relationship and sex was very painful and I didn't want to talk about it and only talked to a girlfriend who said “go to your doctor”. I said “I can't do anything. I'm sure it's menopausal” and I am actually taking local oestrogen for that.

World's best kept secret – Atrophic Vaginitis

KC: And again, it's such an embarrassing subject even for women that have been in, like me, been in (long term) relationships. I've been married 38 years now and I just couldn't talk to my husband about that, I couldn't talk to my doctor about it and it was only when I attended a medical conference that there was lecturer up there talking about it and saying what could be achieved by prescribing women locally applied oestrogen and all the other different products that are available, and I was so cross because there are so many women that are affected and nobody's telling them that there is a simple solution. There's a moral error there and you were talking about medicalising menopause, and I think you're right. It seems to me that unless when you're going through menopause and you've got all these symptoms,  and some women going completely crazy and don't understand it unless the doctor can put a medical label on it, like depression or it's gynaecological or anything like that, if it fits into a department then you get taken care of, but it's all those other women where there is no medical label attached and they're disappearing under the radar and just being sent away with a pat on the hand saying “never mind dear, it's your age” and to me that's all wrong, they're just not getting the right information.  So again, they're having to put up with it because they don't know what else to do and the information that's getting out there is very slow and it's certainly not coming from the medical industry. So we've just got to get out there and do it ourselves haven't we?

“Oh my god, my sex life is over now as well”

AS: Absolutely, and I think a far better and more nurturing way to do it, to be honest, I feel, is women to women, and I don't think it has to be medicalised, but I do think it's so  essential to have a forum and to be able to discuss, and also having better end results, to be able to say, yes I still want to have a sex life.  Atrophic vaginitis, I got that when I was 45 and I thought “Oh my god, my sex life is over now as well”, and I really don't believe it has to be like that, and being able to support each other whether it's natural remedies, whether it's something medical, let's be open to all of it.

KC: Yes, because it's all different and it's choices we're looking for and we all need to try different things to find the right things that suit us. And we shouldn't be put off that, even the women that go for HRT, I say well go for it.  If that's suits you, if it's sorting out your symptoms, bringing your life back into a steady pace for you to move forward then what's wrong with that, but obviously be aware of the medical history, but all pharmaceuticals have their side-effects so we shouldn't highlight HRT as being the worst case scenario because there are other drugs that have bad side-effects too; we've just got to be balanced, haven't we.

Consult a Herbalist or Homeopath

AS: Yes, and it's interesting that you should talk about that, because just I'm just looking here, I've got one of these tinctures I've used, and one of these if Black Cohosh, and many women may well have come across Black Cohosh, which isn't a herbal tintcture, but it's actually a very powerful tincture and potentially toxic, which I think is why there's an awful lot of concern around herbal tinctures.  It just goes to show that herbs are  the basis of our pharmaceuticals, so equally we should be as respectful and cautious of something like herbal tinctures as we are of HRT. I feel quite passionate about this, I really would suggest to anybody if they want to use anything for menopausal management that they work with somebody like a herbalist or a homeopath, you know somebody who can come up with a journey plan, if you like, if they want to try these things for two or three months it may not be appropriate to keep going with some things for more than that.  It may not be appropriate to put certain things together.  So I think we have to be… to me it's like about personal responsibility and values. You talked about people who choose HRT, women who choose HRT viz-a-viz those who don't, and I think it's all about resonating with ourselves, whatever resonates with us and if you do something that doesn't resonate with you it's not going to work with you and that's my opinion.

KC: Yes I think you're right.

AS: I think it's not just the pharmaceutical, it's about your relationship with it, I know that sounds a bit crazy but it's that intuitive thing you were talking about, and I think that if you're in tune with something it may well work for us, and if somebody else uses it, it may not.

KC: That's right.  That's exactly what's happening of course and it's for us to be better informed to allow us to make those decisions for ourselves.

What's next?

I think that's been absolutely brilliant Anne we've had such a good conversation about so many different things there and I'm sure that all that information will help other women that are experiencing, maybe not everything you've gone through, but little bits here and little bits there, and it's all so helpful.

AS: I'm very pleased for you to hear my story, Kathryn. My story's going to be different to other people's stories. What's wonderful about what you're doing is you're really eliciting that.  Your story is part of the patchwork quilt.

KC: Yes, well put; a patchwork quilt. And it's all of our stories and we all pick a bit from it. It's not that my story is the right story, we've all got little bits that match up and we think “yes, that happened to me, ah maybe I'll try this, maybe I'll try that.” So if it's going to help women to be in better control of their own health and understand where they're going with this I think we can all come out of it leading much better lives  because it's a metamorphosis, and we should come out of it leading happier and healthier lives.

KC: Thank you once again Anne for joining me on this journey this morning, and we'll talk again another time.

AS: Lovely, thanks Kathryn.

Kathryn Colas: Well, that brings us to the end of the interview with Anne Scott who spoke most eloquently about her own journey through a very early menopause.

If early menopause is affecting you, there is a specialist website: http://www.daisynetwork.org.uk you may find useful. And can I remind you that there are over 200 pages of information on menopause symptoms and how to create your own pathway to wellness at http://www.simplyhormones.com

Until next time…

 

 

 

 

 

 

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Liver function, bowel health, weight gain-all in a day’s work! Here’s my interview with Shirley Ward. It was a great pleasure interviewing Shirley; she’s helped a huge number of people understand their health especially as they approach menopause. Click on the link to hear the interview, get top tips plus the transcript is set out below. 

KC:      Hello, good morning everyone, it's Kathryn Colas here from

Shirley Ward

http://www.simplyhormones.com. And I'm here today with some very good information for you on nutrition. That's a subject we all need more information on to avoid further confusion.  I'm talking to Shirley Ward from Down to Earth Nutrition who's an established nutritionist and runs her own practice  http://www.downtoearthnutrition.co.uk

in Brighton, which is where she delivers a range of health improvement solutions.  She gives private consultations and runs corporate workshops for improving employee health and wellbeing.  Shirley has noticed a steady increase in clients with hormonal imbalance issues such as pecos which is polycystic ovary syndrome, which is becoming more prevalent and PMS of course, premenstrual syndrome, as well as menopausal symptoms.  Shirley recognises that each client is an individual and has a unique lifestyle which can impact on their health quite differently and she helps clients take back control of their health by recommending small changes for significant benefits to their health so she's really singing from my songbook there.  Let's start having a chat.  Hello Shirley.

SW:     Hello Kathryn, good morning everybody good to be here.

KC:      I know you've helped a number of women going through menopause which is really why I really wanted to interview you, and I know our listeners are keen to hear more about the true values of nutrition.  So let's get started.

“Why do I keep putting on this weight, when I'm watching what I eat”?

I was so surprised to find out during my own journey through menopause how women's metabolism is turned on its head and we store fat than energy, which of course then answers that question, “why do I keep putting on this weight, when I'm watching what I eat”?  Can you describe for us Shirley your view on this?

SW:     Yes of course, it is actually quite a common issue with many clients that come to see me.  But if we look at, as well as dealing with the menopause, around that age obviously we are ageing as we age our bodies become less efficient, converting food to energy rather than fat, you've got to combine that fact with the hormonal changes that are going on during the menopause, which combined can actually lead to additional eight gain for some women. If you think during the fertile years reduction of progesterone and she helps increase her metabolism so we therefore burn fat more efficiently, we're going to turn less food into fat and more food into energy.  During the menopause when we stop production of this fertility hormone, so this can be one fact linked with weight gain, combined with declining levels of oestrogen, can also be a factor, as this hormone can help stimulate production of controlling weight and mood balancing hormone called serotonin, it's important, declining levels of oestrogen and this can therefore lead to increased cravings for carbohydrates.

KC:      We all know that one.

SW:     Especially, you can find yourself choosing the wrong type of carbohydrates which are linked with weight gain, so that can be quite an important factor.

KC:      Yes definitely and it seems to me a lot of women put that weight on around their middle and they become the apple shape.  What tips can you give us to address this?

SW:     OK, well, perhaps if we can firstly look at why that may actually be the case, so when we store weight around the middle it can be a classic sign really of stress process and when you look at the way some women perceive the menopause, unfortunately it can actually be quite a big source of stress for a lot of women. They don't like these changes that are going on, they find it really impacts on their quality of life, it does actually really stress them.

KC:      If I just interject there, they don't understand what's going on as well which just impacts on all these things that you're talking about.

SW:     Absolutely, yes, that's a key factor.  So when you've got additional sources of stress, these can combine to actually increase that weight around the middle because the stress process, any source of stress, is actually producing a lot of energy to create that fight or flight feeling, but in reality we don't actually run, we don't fight, so this excess energy is not used up.  This energy is then stored for future energy reserves;  the body is clever at storing it for future energy, it's trying to be efficient, and the reason it stores it around the middle is because it's located very close to the liver.  The liver has a number of key health functions, one being that it actually converts stored energy as fat, back into energy for future reserves, so therefore it's very close to the liver it's very efficient at converting it back when it needs to.

Liver: your detox friend

KC:      Yes, that's very interesting about the liver.  That's just an area of our body that we don't even consider.  I suppose I learnt that everything we eat passes through the liver including pharmaceutical drugs, which is why women need a stronger drug than men might do for instance, but to think of it in that way with the storage of energy for the future and that the liver is a key element in that function.  So what do we need to do to make sure our liver is functioning efficiently?

SW:     OK, well as you just touched on, the liver is responsible for detoxing, and a lot of toxins from the food digestive process, from additional drugs, from partially digested food if you're having digestive food issues as well, but it's also responsible for converting that stored energy and it's also responsible for deactivating hormones in the body before they're actually excreted so coming back to that hormone balance issue, three key areas that we need to be aware of that the liver's responsible for and why we need to keep it working properly.  So some liver-friendly food sources to regularly consume are your cruciferous vegetables, your sprouts, your broccoli, broccoli has been termed as a super food by the media, it's certainly a good option to include regularly in your diet, cabbage, brussle sprouts, green leafy vegetables, so these are all helping the liver with it's detoxification functions.  Also fresh beetroot is liver support food, so fresh not pickled; plus onions and garlic again are helping the liver with it's detoxification pathway, so helping to support the liver with one of it's functions means it's going to be able to function overall much better.

Don't overlook your Adrenals

KC:      So if we just go back a bit to the stress we were talking about and how, I didn't realise that when we are in a stressful situation that that's creating energy, and I suppose that when you do think about it logically it is stimulating the adrenals isn't it?

SW:     Absolutely

KC:      As you said the fight or flight.  I didn't take it through to it's ultimate conclusion.  So let's talk a bit more about that, we've now detoxed our livers, but we need to still balance our hormones and it's that stress factor that I know only too well that causes hormonal imbalance and we forgot to look that in tandem with what the adrenals are doing.  So can you tell us more about how the adrenals come into the whole picture?

SW:     Sure, adrenal health during the menopause is very important, as even though our oestrogen levels are reducing, the ovaries actually stop producing oestrogen, the adrenals are actually another source of producing a form of oestrogen, so can help to keep those levels adequate and help avoid some of those symptoms that are linked with low oestrogen levels, and also regular sources of stress are going to overwork the adrenals, they are not going to be as efficient, in carrying out their other functions of producing this form of oestrogen.  So looking at reducing sources of stress, I appreciate it's not always easy to reduce external sources of stress but a lot of listeners may be unaware that there are actually some stresses that can be incorporated into your diet that you may not be aware of so we can talk a bit more about those.

Obviously reducing your consumption of those can certainly give back control of your health, you can actually reduce those and reducing your sources of stress that help those adrenals.  So dietary stresses such as caffeine containing drinks, tea and coffee, those artificially stimulating the body producing that stress process. Reducing consumption of those is certainly a good idea and good alternatives, a whole range of fruit and herbal teas out there to try, there are so many different, nice combinations.

Right and wrong carbs

Also other dietary stresses, we touched on earlier, we spoke a bit about the right and wrong carbohydrates, so now might be a good time to actually explain that a bit further. As choosing the wrong type of carbohydrate can actually create stress in the body as well.  So carbohydrates, at the end of the day we need carbohydrates to provide us with energy, we can't create our own energy we need to obtain this from dietary sources, but it's choosing the right type of carbohydrate that produces those sustainable energy levels.  And sustainable energy levels are going to avoid that stress process happening.

So, if we look at what are termed the right kind of carbohydrates, which are mixed with good health and with sustainable energy levels, these are foods such as brown rice, oats, wholemeal pasta, beans, lentils, fruit and vegetables, so these all contain good levels of energy but they contain that crucial element of fibre and it's fibre that actually moderates that release of energy to produce the sustainable energy levels.  So producing some good levels of energy that the body can use.  It's not too much energy, it's not too less energy.

KC:      Steady.

The key is to balance blood sugar levels

SW:     Absolutely, it keeps those blood sugar levels balanced and we should always be aiming for blood sugar balance for weight control and if we are a bit clearer when we talk about the wrong kind of carbohydrates, these are foods like white bread, white flour products, white rice.  Biscuits and cakes that you find yourself reaching for when you get those carbohydrate cravings and a lot of those sugar-laden fizzy drinks are included here as well, so these foods have all been through that food refining process that has removed most of their good fibre and vitamins and minerals, so all these foods are left with are high levels of energy.

Stop multi-tasking!

KC:      Yes, well it seems to me that if women start focussing on good foods, they're going a long way to helping reduce a certain level of stress in their bodies and perhaps when as a result of doing that they start looking at external stressors, and I know women wear a badge of multi-tasking, I used to do it myself, and we've just got to learn to say no more often, and not take on these tasks, and try and accommodate ways of doing things differently, like saying, if somebody says “can you just do this for me” and you say “I might be able to next Tuesday, but not right now”, that it's sending out the signals that people can't just jump on you with all these extra jobs that they don't want to do and that's got to help your stress levels as well hasn't it.

Important to make time for ‘me'

SW:     Absolutely yes, and I think it's important from a lifestyle perspective that actually incorporating a relaxing time for yourself and time when you can just actually just switch off.  All the time you're multi-tasking, you're constantly on the run, again you are over-stimulating your body, you're actually being ruled by what we call the sympathetic nervous system, and this is when you're over-stimulated, and your body can't function efficiently when it's in that mode all the time.  You will want to get back to that relaxed state, you're moving into your para-sympathetic nervous system mode, and that's when you're relaxing more, your body can function efficiently, so that's what you want to be aiming for, is getting that balance.

KC:      And I think it's also learning to recognise when your body is screaming out for that quiet time as well and I think it's when you're feeling at your most stressed state and want to strangle somebody, that's when you've got to walk away from situations and either be able to take 5 minutes to yourself at that time or make a mental note to take time out later when you are able to be on your own.

SW:     Absolutely, especially when external sources of stress, if you can just remove yourself from that situation so that even if it's 5 minutes, take yourself off for a walk, if it's a work situation, if you can get outside even better, because we need to have, from a hormone balance point of view, we need to have regular exposure to daylight.  It can actually help boost hormones to such as seratonin as we mentioned earlier, it is the key hormone for balancing not only the appetite, but sleep patterns and mood. It's very inter-related.

KC:      It is, yes and I noticed that myself, because about 6 months ago, I live near the Ashdown Forest and I started to go out for a walk and a bit of a jog on the forest and I found that I loved it so much it almost became a drug, I couldn't wait to get out there every day.  Not this spring unfortunately, the weather's been so miserable I'd be frightened of falling over in the mud, but yet it was just, I'd get back and I'd feel wow, I'd feel so good and you can go on the treadmill in an indoor situation but you do not get the same feeling as when you're outside.  It's just a whole new drug isn't it?

SW:     Absolutely, and it's what our bodies are built for, we need regular movement, we need to be outside. We haven't evolved to stay inside, for 12 hours a day or whatever that people can find they're stuck in offices, for that length of time, it's not what our bodies need.

KC:      No that's right, get on train in the morning, go to work, straight to the office, come back again, same routine and you haven't been outside for 10 seconds have you.

SW:     That's right, yes.

KC:      It's not good, we've got to take more time to understand our bodies a bit better.

SW:     Exactly, just listen to our bodies a bit more.

KC:      Yes, because our bodies do talk to us and we've got out of the habit of listening haven't we?

SW:     Absolutely.

KC:      Once you do start taking notice of little pains and niggling things going, on it's your body saying “excuse me, I've got a problem down here, please see to it.”  It doesn't mean going down to a doctor and popping a pill, it's probably just a lifestyle change that will help.

SW:     Absolutely, as we touched on in the introduction, it's small changes to incorporate into your diet and lifestyle, that your body can adapt to that can make significant, beneficial…

Don't forget Bowel Health

KC:      Can be more beneficial! We've covered a lot of things here Shirley and perhaps we could talk all day.  I always feel I could talk all day to people I interview. But the one other area that I'd like to bring into this, and I know it has a lot to do with nutrition as well and that's bowel health, and again from my own personal experience I think I experienced more constipation going through menopause than at any other time in my life and just couldn't understand why, but once I started looking at nutrition and exercise the whole thing changed, but perhaps you could tell it from your perspective, from the professional point of view?

SW:     Yes of course and you're absolutely right Kathryn, you need to have good bowel health to achieve good health, especially if you're dealing with hormonal imbalance issues as an additional factor.  We need to be removing the waste products from the food digestive process, regularly.  We don't want those waste products to stay in the bowel, putrefying, and start giving off toxins which can then start circulating round the body and causing a range of detrimental health issues, so you need those eliminatory channels to be open and working properly.

The  bowel actually houses a range of good beneficial bacteria and these bacteria are very important for keeping the immune system strong.  They produce white blood cells, they also produce B vitamins, which we need to convert energy from our food, so going back to that metabolic rate.  So bowel are very very important, so going back to what we were talking about the right and wrong carbohydrates, that fibre element I mentioned in those right carbohydrates is really key for bowel health, because that fibre is actually adding bulk to the food as it moves through the digestive tract. And food can only move through the digestive tract by muscle action, so going back to what we were just talking about, with regular exercise, not moving around regularly, not getting regular exercise, well that muscle action can't happen, so you can then find you're experiencing issues like constipation.

KC:      Even just stretching exercises, when you get up first thing in the morning, do some good stretches, even that helps.

SW:     Yes, absolutely right. And, finally, with constipation, just for overall good health,   make sure you're adequately hydrated.  Again for bowel health, you need to have adequate levels of water otherwise that's going to lead to very drying elements, if there's not enough water to actually move that through properly. So keep yourself hydrated.  On average we're losing about a litre and a half of water a day just through functioning, normal body function. So we need to be replacing that, as well as increasing water intake, reducing elements that can contribute to fluid loss such as tea and coffee which have mild diuretic properties is also a good choice, but keeping those water levels up is such an easy way of improving bowel health, improving overall health.

KC:      And a combination of doing all these things correctly will stop that bloating feeling that so many women feel.  You get to see these adverts on tv for these wonder yoghurts, which I doubt have the benefits they say they have, but just purely by eating the right foods, wherever you can and drinking plenty of water and getting a little bit of exercise, a lot if you can but a little bit is fine, will help to relieve that bloating feeling, because surely that bloating must be just a build up of what's in the digestive tract waiting to be excreted?

SW:     Absolutely, it's going to get back into the circulation and cause issues like bloating, you're absolutely right Kathryn. I think with bloating suggests that there's potentially digestive issues going on there that actually need to be addressed, so it's digging a little bit further, a bit deeper, looking at the family history, the diet, the lifestyle, what's actually creating those digestive issues for that person as an individual, then addressing those factors through modifications to diet and lifestyle. Advice that we've spoken about so far is certainly going to have a beneficial impact on the bowel health definitely.

KC:      And I think it's reaching that point of ownership of your own body and your own health and just sitting yourself down and saying, “well I must be doing something wrong, let's go through this” and write loads of lists, but just do something to help understand you and your body, a little more.

SW:     Absolutely, and it's looking at factors that aren't working for you, identifying those factors and then looking at addressing those through modifications, but being aware that you're not actually cutting out key food groups, keeping that balanced diet and that's where going to see a qualified nutritional therapist can be very useful.

KC:      And eating properly of course not skipping meals, because that doesn't help.  In fact skipping meals can cause you to gain weight not loose weight.

Skipping meals will not help you lose weight

SW:     That's a very good point Kathryn, yes, so let's go back to looking why that might be. Skipping meals can create a form of stress in the body so let me explain. Actually if you're going for long periods of time without eating or you're not a major breakfast fan, if you don't tend to have anything in the morning at all, especially when you wake up from sleeping you've actually been using up a lot of energy, because that's the only time your body's got to repair and replace those damaged or worn out cells, so you need to top up those energy reserves and if you're not eating anything in the morning, where are you going to get that energy from?

You've got to set yourself up for the day and that's exactly the same, if you're going for long periods of time, especially office based work, you come in you sit down at your computer, get completely engrossed in your work then hours pass and before you know it you think, “gosh can't concentrate properly, I'm irritable, I'm shaky, what's going on here?” Well you energy levels have gone way down, so you've got to keep them topped up, with regular sources of good sustainable energy, choosing those right carbohydrates that we spoke about earlier, very important, and also you don't want those energy levels to get low, because that's when the body can try to counter that energy dip by actually producing stress hormones, stress hormones as we said earlier produce energy, but it's not the sort of energy you want.

The wrong carbohydrates

You want to be obtaining your source of energy from those right carbohydrates and also a point to finish off on, is wrong carbohydrates that we spoke about earlier, your white bread, white flour products, white rice, biscuits, cakes, they produce an initial energy high. but because there's no fibre to actually slow down that release that's quickly used up, so you quickly experience an energy dip and again that energy dip occurs, that's when you're body is trying to counter that by producing stress hormones to produce energy, but as we just said, that's not the way you want to be producing energy, so it's another way to think about, “mm, let's chose the right carbohydrates, not the wrong carbohydrates, and those wrong carbohydrates, a large amount of energy that they actually contain is way in excess of what we need, so that excess energy is actually going to be stored as fat. That's where that comes from.

 

KC;      Before we finish, so what can we eat as a snack between meals?  Is it OK to eat dried fruits, or are they too sugary?

Are dried fruits good to snack on?

SW:     Dried fruits tend to be; fresh fruit in itself is part of a balance diet, but bear in mind that dried fruit is actually going to concentrate that fruit sugar those fruits contain, so I would say probably not the best choice.  I would say actually go for a fresh piece of fruit, combined with a small handful of unsalted nuts or seeds for example.  Because then you're getting the carbohydrate element from the fruit for energy, but that's actually going to be moderated by the protein and good fat that are contained in those nuts and seeds, so the energy release is being moderated to produce sustainable energy levels to keep you feeling fuller for longer.  So that's a good balance and avoiding those blood sugar highs and blood sugar lows that we touched on.

KC;      And you can always tuck some fruit in your handbag can't you?

SW:     Absolutely, but always try and combine it with that protein and good fat element which is actually going to help moderate that energy release even better.

KC:      Yes, the combination of everything. That's brilliant.  Well I think we've covered all sorts of good things there Shirley.

SW:     It's been quite comprehensive hasn't it.

Have a better informed conversation with your Nutritionist

KC:      It has, been right through the whole body function system so I think there's a lot of information there that women will find beneficial to understanding their own health, and then perhaps saying “right, now I know what it's all about, I know what to ask when I go to see a nutritionist”. Because when you go to see somebody like yourself you sit there with a blank expression on your face not really knowing what to say, so if you've got some idea of your bodily functions you know you've put on weight or not, or whatever the reason for going to see a nutritionist, then you can have a much better conversation together can't you?

SW:     Absolutely yes, but bear in mind you will always complete quite an in depth questionnaire beforehand which will go through your family history, lifestyle and that is my role then to identify those factors that are linking to the health issues that you want myself or that nutritional therapist to address.

KC:      Of course yes that's a great source of information isn't it? That's brilliant.  OK then Shirley, thank you very much for your time this morning to discuss all that with us and I feel a lot healthier for having done it and I hope everybody else benefits too.

SW:     I hope so too, that was the aim of our chat Kathryn,

KC:      And for everybody that's listening I'm going to put Shirley's contact details on the transcript so they can get in touch with her if you wish to.  Thanks for that Shirley.

Here are Shirley Ward's details –  http://www.downtoearthnutrition.co.uk     T: +44 (0)7590 527665. Shirley also runs a clinics at The Sundial Clinic, Queens Road, Brighton, East Sussex and the phone number there, is: +44 (0)1273 774114 and the Aloka Clinic, East Street, Brighton and their number is 01273 823178

Don't forget there are over 200 pages of information on symptoms of menopause and how to cope at http://www.simplyhormones.com. I'm also available for consultations, full details on the website.

Until the next time…

 

 

 

 

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As seen in the Daily Mail, here is the interview:  It was a privilege to interview Sue Brayne on her book: Sex, Meaning and the Menopause. Written for men and women, this book describes the pain and anguish, the broken relationships through misunderstanding menopause. A highly recommended read, now listen to the interview.

Interview with Sue Brayne, author of Sex, Meaning and the Menopause

KC:      Hello everybody it's Kathryn Colas here from Simply Hormones.com, and I'm here   today to talk to Sue Brayne.  Sue has written a super book that's just come out called Sex Meaning and the Menopause. I'm going to just say a bit about that before we start talking to Sue.

I've had a preview, and I like it very much. The book tackles taboos around sexual changes, looks at the grief of saying goodbye to youth and fertility, explores deeper spiritual significance of the ageing process, provides a different perspective on medical treatments and alternative approaches, and hears from men about what it's like to live with a menopausal woman. I know my husband would like some input on that one. Anyway, hello Sue, nice to talk to you at last.

SB: Hi Kathryn.

KC: If we can just plunge straight into your book, I'd like to ask you what thoughts ultimately led you to wanting to write this book?

SB: I got really fed up trying to find information that worked for me personally, and being told that I ought to have my menopause fixed through hormone treatment. I felt angry about that. I was certainly having some changes, but I was lucky with my menopause – I only had a few tepid glows, as I call them, and some headaches – but I noticed huge sexual changes. That was the big thing. I didn't understand what was going on, but all the information I read about it was that I should get it fixed. If I didn't, there was something wrong with me. I found that really distressing.

KC: Yes, and it's that dreaded ‘M' word, nobody wants to mention it do they? So is it a dysfunction in need of treatment?  What's your view on this?

SB: Well, I don't necessarily think it is [dreaded]. Some women have a lot of symptoms that I didn't, which are very distressing. When it is extremely distressing, we do have modern medicine that can help. Certainly to contain it, or to re-balance what's going on. Everybody has every right to that treatment if it is available.

But I think there's an awful lot of women like me who aren't necessarily distressed about what is happening to them, except there is a confusion about the sexual changes which are happening. Certainly my libido took a major plummet. [At the time] I didn't understand this. [Most information] talks about the body beginning to malfunction. I thought, ‘No, it's not. I'm 52. I'm just normally going through what my body should be going through at this age.'

KC: I read recently research on how it's now being accepted that menopause is a major health event in a woman's life.  There's so much information out there if you want to become pregnant, if you are pregnant, and if you're a new parent, but there is still so little on the menopause itself.

SB: My big issue is that the menopause is much more than a medical event. It's much much more complex than that. [It's also] a profound spiritual deepening. You're called to the deepest part of yourself. You have to say goodbye to the woman that you were. You have to say goodbye to your fertility. You have to say goodbye to the fact that men don't fancy you particularly any more – or certainly find you attractive in a different way – and you have to face the fact that you are now ageing.  For me, it was a confusing time. I couldn't find anything out there to help me. That's why I ended up writing the book. So, the book is not about medical symptoms. It's about deeper, complex issues that we face as individuals, and collectively, as we go through the menopause.

KC: Yes, that's right, because it is an emotional rollercoaster. You do feel as if you're all over the place, and you can't cope. This can be quite scary. It was certainly scary for me.  In many instances – I hear from so many women, and it's in your book too – that they think they've got Alzheimer's.

SB: Well, I think a lot of women get very confused and concerned about the fact that they start forgetting everything, or they find themselves saying “What am I up here for.”  I think [what happens] isn't explained properly.

Basically, it's to do with the drop in oestrogen levels. As soon as your ovaries start turning off, or the menopause happens in other ways, that plummet [in hormone levels] affects every single part of you. Of course, it affects your brain [too]. These things aren't spoken about, but I don't want to stay with the medicalisation of the menopause.

For me, it's such a profound experience.  But, most information says that once you stopped having periods for 12 months you're through the menopause. That's rubbish! The menopause is huge life change. It takes years, sometimes up to 10 years, to really feel your way through to the other side of post-menopause.

KC: That's right.  I think it's not until you are post-menopausal (unless you've had a better understanding earlier on in your life) that you understand it so much better.  You start to have more energy again. You want to take things in a different direction, do different things, and, in effect, have a new life.

SB: [Speaking] as a post-menopausal woman, I actually think there is a gift to be found in the death of fertility. The death of being a young woman is a very painful experience to go through, for me anyway. But now I'm out the other side, I feel much more peaceful with who I am. I can see  –  I witness this through the lives of younger women who I work with in my psychotherapy practice, when they talk about their midlife crises at 40, 45, maybe, even 50 –  I can actually see the archetypal journey that we're all on.  I understand that being in a post-menopausal state means I've been freed up.  It's such a cliché to talk about ‘the wise woman', but I do feel I have a much more objective viewpoint, and a much clearer view about how life plays itself out. I'm deeply grateful for that.

KC: Do you feel that if you'd had some of this information at the beginning of the journey it might have been an easier one?

SB: I asked quite a lot of people about that.  Some interviewees said, ‘I don't think you can ever prepare for it.' In a sense, I agree because menopause is such a personal journey. You can't really compare yours with anybody else's. It's like dealing with a death. It's such a personal thing, yet, at the same time, it's also collective.

I think I would have liked to have been told that the sexual changes I went through were normal. They were not abnormal. It's what happens to a woman as she gets to a certain age.

Some women carry on being just a sexual as they were. Fantastic. But a lot of women, in fact, one in two women, experience something called vaginal atrophy, where it's very painful to have sex. I wish had I understood that more. I wish I had understood what it was going to mean to me, what it was going to mean to my husband and my relationship, and how much pressure it put on my relationship. My husband certainly wasn't prepared for it.

We went through quite an interesting experience. That was one of the reasons I wrote the book.  I wanted to say, ‘Look, these changes that happen are normal, except we're sold [the notion] that they are a dysfunction. That's not true.'  [Unfortunately] I think that's very much down to what happens, the fact that our sexuality is so medicalised now. You go on the pill when you're a girl. You go on HRT as an older woman.  Hang on a second, who are we in between?

KC: And if you don't look good at the same time, then there's something else to throw at you.

SB: I've chosen to go grey, because I wanted to make a statement. ‘Actually, yes, I am an older woman, who in 18 months time is going to be 60.'  That doesn't mean to say I don't feel alive. In fact, I feel more alive than I did as a younger woman. But, personally, and I can only talk for myself, I don't want to deny the fact that I'm getting older, I actually want to celebrate it. There's no reason why I can't look good with grey hair. But I think it's about what works for you inside. However, I don't want to chase youth, because youth is not part of who I am any more, although I do feel incredibly young inside!

KC: Yes, it's not the book. It's what inside the book that's better.  I think also talking about the confusion that goes on. I don't think women understand that hormones are messengers. The brain is sending messages all round the body to do x, y and z, and because the hormones aren't the ‘right quantity or quality' any more, then strange things happen. I liken it to being re-wired.  Having a new IT system installed, if you like. Some of the wires aren't joining up properly, which is why you get sparks going off in different directions. Things aren't working too well.

SB: I think the word ‘atrophy' is quite relevant here. Things do start to dry up after the menopause. You're just not a juicy fertile woman any more, and I think [the message] we're sold – the image in the media that we're sold – is that we should be this juicy young woman age 60. Well, sorry, the reality of evolution means that at a certain point in our lives, this is what happens. The trouble is that, in a way, we've gone beyond evolution. Now, of course, we're living maybe 30 years after our menopause.

KC: And working longer.

SB: But, the whole sexually-obsessed culture that we live in saying, ‘Oh God, you shouldn't look that old. You should look like a 20 year-old.'  Look what happened to Joan Collins, the classic example, trying to get into a dress (for an Oscar party this year) fit for a 22 year-old, and she ends up in hospital having fainted. Come on!

The problem is the baby boomers are growing up with media that is completely youth-obsessed. This is the first generation this has ever happened to. So, we're straddling these two worlds of growing older, but still being thumped every day with the message, 'You shouldn't look that old.'

KC: Yes, do something about it. You're supposed to have plastic surgery, and all the other stuff.

SB: Get the Botox out!

KC: Going back to your book Sue, was there any one interview that particularly struck you?

SB: Yes. It was, without question, talking to the men. I found this a most enlightening, encouraging, heart-warming experience. I interviewed [most of] them on Skype, or on the phone.  I suppose because I was this kind of disembodied voice, they opened up.  Virtually none of them had spoken about this before. They were so confused about their wives. [Some] were [also] feeling rejected because their wife suddenly didn't want sex. They took it personally, and were struggling to make sense of it. But they didn't want to leave, they loved their wives.

KC: And wanted to support them, but the woman is saying ‘go away, and leave me alone.'

SB: Absolutely. That's why I wrote the book for men as well. They can read about other men's experiences, and not feel so utterly alone with it.  [Some] told me that they'd been going on the internet and all they can find out [about the menopause] is, ‘You need to go on HRT.'  So they would say to their wives, ‘You need to go on HRT.'  But the wife says, ‘I don't want to.' And, then there's a  huge row.

I interviewed two sex therapists about the psychological aspect of what happens when sexual changes occur in a relationship later in life, and how hard it is. The men [interviewees] were graphic when they talked about how they cope when they don't have sex with their wives.

KC: I get a lot of men emailing me too, and talking to me on the phone, in great distress in some cases. But, what I have noticed over a period of time is that the men seem to notice these physiological changes before their wives do. Or, perhaps, women don't want to recognise it, and don't want to acknowledge it.  But the men do see those changes, and they want to do something about it. But don't know how.

SB: Yes, I think that's absolutely right.  But, I think that a woman goes through such a deep, profound change in who she is.  A man, yes, he does have a midlife crisis, that's scientifically proven now, but [he] doesn't have this almighty fall in hormones that a woman does when she goes through the menopause.  First, she has to go through the 40's midlife crisis, which is more about ‘who am I', and then, ‘Wham!' She goes straight into the menopause, without much of a breath in between.

So, the [inner] changes that she experiences, [which prompt her to ask] ‘Who am I?' ‘What am I here for?' How can I find my place in the world without the role of mother and wife?' I think are much more profound than a man's experience.  Normally, but I don't want to categorise all men as this, when they [men] are unhappy, they will often leave to go to another woman. A woman tends to leave to be on her own to find out who she is. That's a very different experience.

It can be a very frightening for men who've been married for ever, when their wives, who've been looking after the cleaning and washing, and so on, suddenly say, ‘Hang on a second, I don't want to do this any more.' Husbands end up asking, ‘Where's my wife gone?'

KC: Yes, ‘I just want my wife back', is very common.

SB: Well, a wife isn't going to come back as she was. She's going to be a different person. Unless, of course, she chooses the role of carer, and steps into being the grandmother. But, again, we're not talking sexual here. We're not talking about sexual identity.

KC: I think none of that is really covered in magazines or newspapers. They may make a few ripples, but they don't really get into the depths of it.

SB: The other thing I found really interesting was interviewing women who had chosen to take HRT.  There are plenty of women that don't need this [HRT] by the way. They don't experience these sexual changes. But a lot of woman do. [HRT] enables older women to continue to be sexually active. There's a huge issue now, of older men and women getting sexually transmitted diseases because there's no sex education for older couples who are changing partners. They think nothing happens to them.  HIV is one of the biggest dangers of  sexually transmitted diseases in older couples. So there's a major health warning about that in the book. Take responsibility, and put a condom in your pocket!

KC: Yes, just when you think you don't need that [sexual protection] any more you've got to be vigilant once again, haven't you? It comes up time and time again.

SB: I think there's a huge lack of general information and understanding about sex for an older person.

KC: Yes, because it has never been spoken about. I keep hearing time and time again that to enjoy an intimate relationship it isn't necessary to have penetration.

SB: Absolutely, I hate to say it, but we are now riding on the back of the porn industry. That comes from what's happened on the internet. It is driven by the porn industry, I can't remember, but something like 500 million pages on the internet are to do with pornography.

And, pornography is about penetration.

For a guy who looks at pornography on the internet, he's going to see that it is all about penetration. [It's difficult for] a man to understand there's other ways to be intimate.  There's a big, big problem here. A lot of older women don't want to be penetrated any more.  It doesn't mean to say they don't love their husband, they can actually have a different kind of intimacy. But for a man, there's an almost evolutionary need to have penetration to feel fulfilled [sexually]. It's a big issue, and it doesn't match necessarily with a woman who's growing older on a sexual level.

KC: That's right. And, of course, men are being prescribed Viagra, but the poor woman on the other side has vaginal atrophy.  So, all hell breaks loose. But I don't think it's necessarily the internet either, I think it's just men's upbringing, and how men talk to each other. That it's all about penetrative sex.

SB: About having a good bang. Are you getting it?!

KC: It's all about that, isn't it? Yes.

SB: [Message is:] ‘No? Oh, well, then you couldn't have had sex.'  A lot of the men are ashamed about the fact that they aren't having sex. They feel embarrassed, and find it very difficult to admit. Or, if they do, they kind of say, ‘Oh God, I didn't get it again this weekend.'  There was nothing about intimate connection. It is all about the physical penetration that goes on. I can understand, having talked to these guys [interviewees], how frustrating it must be. The trouble is so many woman are having, it seems to me, penetrative sex just to keep their husbands quiet, to shut them up. That's no way to have a relationship.

KC: No, it isn't.

SB: [Sex] isn't spoken about. It's made fun of. It's highly distressing for a woman to feel that she has to have sex just to keep [her husband] quiet. And, it's highly distressing for a guy to feel he's having sex with his wife, and he knows she doesn't want it any more.

KC: Yes, they must know that.

SB: I've got a lot of interviews in the book with women talking about this. The solution is that you have to communicate, and find a way which works for you both.

KC: It's very embarrassing – just like vaginal atrophy is very embarrassing to talk about. Sexual problems are difficult to discuss, aren't they?  And so they avoid them like the plague, and just carry on pretending there's nothing's wrong.

SB: Research that has been done into this say that women who are in happy relationships and want to continue sexual intimacy, find it much more stressful and upsetting to have these sexual problems as they go through the menopause, than  women who think, ‘I don't really care, levitra' or, ‘Thank God I don't have to do that any more'.

So there's quite an interesting psychological difference. The trouble is that a lot of academic research doesn't come out into the public domain. Academics normally just end up talking to other academics.

KC: That's right. Yes. There's always a conclusion at the end, and what should be achieved from here on in. But that's rarely taken up by anybody, is it?

SB: [And usually] impenetrable to read, excuse the pun. The layman in the street doesn't want to trawl through academic journals. They just want to know what's going on in plain English. That's what I hope I have achieved [in the book].

KC: Yes, I think you have. I think it's a lovely book to read. I think we've just about covered everything, although I think we could talk ad-infinitum about this subject of menopause and sexuality.

SB: I just wanted to add – and I know you're very involved yourself, with women in the work industry –  just how many women, struggling with the menopause, are in positions of authority, or in management. They really do need a huge amount of support. I spoke to several [business] women facing these issues, and then I spoke to a whole bunch of women in their fifties, academics or working for themselves, who said they felt as if they were just beginning to hit their stride. So again, it's quite a complex area. You can't just say this is what the menopause does for everybody. It's a very individual journey that we're all on.

KC: Generally speaking 50% of menopausal women do not declare the real reason why they're taking time off work. This is usually it's to do with line managers.  The average age of a line manager is 43, and they are either disinterested or embarrassed. Again, if they [menopausal woman] are a senior executive, they've got nobody else to confide in.

SB: One interviewee for the book told me how she now found herself working in a very youth orientated business. She realised that she couldn't work in that industry any more because clients ‘don't want to be buying from their mothers.'

KC: Oh dear, how awful, yes!

SB: That's a really hard thing to come to terms with. It wouldn't happen for men. That's why the menopause is such a different experience for women than it is for men at the same age. They don't age the same way that we do.

KC: That's why I think there needs to be a whole programme for men and a whole programme for women.

SB: Education.

KC: They'll start talking, hopefully.

SB: Well, at least everybody can understand more. I think if you understand more, then you're actually more allowing.

KC: If you are a little better informed, you have a better understanding of where you can go from here can't you, and make better decisions.  So let me just remind everybody the name of your book Sue. It's called Sex, meaning and the Menopause.

SB: Yes, it's due to be published on June 9th, by Continuum Books, and it's out already on Amazon: www.amazon.co.uk. More information is on my website www.suebrayne.co.uk, where I also blog about issues to do with end of life, menopause and ageing.

KC: That's excellent. Of course, this book is for men and women. I found it very good. Thank you so much for that Sue. I'm sure we'll talk again soon because you've got another book that I'm very interested in called the D-Word, which is about dying.

 

SB: Different ways to talk about dying, yes.

 

KC: I've just bought that myself. We'll get back together on that one.  Thank you once again Sue, lovely to talk to you.

SB: And you, Kathryn.

Will Your Marriage Survive the Menopause, was adapted from Sex, Meaning and the Menopause, and published by the Daily Mail on 2nd June, 2011.

For more information on menopause do take a look at my website: http://www.simplyhormones.com and you can see more about what Sue Brayne is up to at http://www.suebrayne.co.uk

Until the next time…

 

 

 

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A no-holds barred open discussion on breast cancer, the pill and menopause. Check out this online radio http://www.redshiftradio.co.uk, the Scarlet Ladies slot – a bit like Loose Women only it’s audio! It’s already happened, so click on the link for the recording.

It’s great to have a UK based internet radio – check it out.

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Get the real story behind Mammograms and my preferred route of Thermal Imaging. Listen to Prof Gordon Wishart on why this disease is on the increase.

Here’s the full transcript of the podcast interview:  

Hello it's Kathryn Colas here of http://www.simplyhormones.com and I'm here today to talk to Professor Gordon Wishart about the early detection of breast cancer and how thermal imaging fits into this profile.

Before I speak to Professor Wishart, let me tell you something about him. He's a consultant breast and endocrine surgeon at Addenbrooke's Hospital, Cambridge. He is distinguished for his pioneering work in the treatment of breast cancer, where he has introduced innovative and sometimes controversial techniques, which have subsequently seen wide acceptance and adoption. (If you want to find out more about Professor Wishart I've put all the details at the end of this transcript.)

KC: Hello, Professor Wishart, and welcome…

GW; Good morning.

KC: I'd like to start if I may by discussing the current breast screening program. There's currently a very good NHS screening program in place that calls forward women aged 50+ every 3 years, until the age of 70 for a mammogram. But it seems to me that evidence is becoming more widely available in the public domain about an alternative, less invasive method, and perhaps more effective method that can detect tumours at a much earlier stage, and that is thermal imaging. The use of a heat seeking camera. Professor Wishart, can you explain to our audience in layman's terms how thermal imaging works?

GW: Yes well, thermal imaging has been around for approximately 50 years, but the reason it's come back to the fore is because there have been great advances in the digital camera technology, mainly because these are now being used by the military. And in addition to that we now have the ability to interpret these scans, which are lots of different colours, and we can interpret those with computer algorithms much more easily. So because of that we now have a system where we can take digital temperature pictures of the breast while it has been cooled and what we are looking for are areas of the breast that have abnormal blood patterns, or areas of the breast that don't cool down during this period of cooling, and the reason that the cancers and tumours don't cool down is that they encourage their own blood supply to go around them to feed the tumour, and these are abnormal blood vessels that don't contract when they meet cold air, so they retain their heat, so those are the things that we're looking for on an infrared scan.

KC: It seems to be working quite effectively doesn't it?

GW: Well the recent research study that we publish said that it was very effective in detecting breast cancer especially in younger women, and that's the great challenge for us. Most of the delays in diagnosis in breast cancer occur in women under 50 and it's in that age group where the breasts are more dense, the mammograms are less sensitive and it's just much harder to actually detect breast cancer in those women.

KC: But it also seems to me that no-one is paying any attention to looking at ways of reducing the incidence of breast cancer. In my view I wouldn't want to be faced with such a diagnosis and be subjected to disfiguring surgery and a lifetime of dependency on drugs, but instead it's become the norm, if you like, where both the NHS and cancer charities channel the research and thus our understanding of the process towards looking at a truncated life after diagnosis and how they would  provide a reasonable quality of life through drugs. What would you say to this?

GW: Well I think the prevention of breast cancer is probably going to be something that we are going to talk more about. Up until now the two main risk factors for breast cancer are being female, and having a family history, of course neither of which you can do anything about. I think some of the things that have increased the risk in recent times are essentially reproductive factors.

A lot of women are now having their first pregnancy at quite a late age; they're not breast feeding because they're anxious to get back to work and in general having less children than they had before.  All of these things increase your risk of breast cancer, by small amounts, but they all add up at the end of the day and so I think when you look at the incidence of breast cancer in western countries compared to say rural Africa or Asia, they have a much higher incidence because they have multiple pregnancies; they start as teenagers and they breast feed, and so I think that this is something for public health to tackle there.

But I think there are two other risk factors that have now really been much more recognised and those are alcohol and obesity and we know it this country that we do have a teenage and a young adult alcohol problem and there's much more binge drinking and much greater alcohol drunk by women. If we look at the generation of my mother or my grandmother, women didn't really indulge in alcohol, but that's changed dramatically, and we do have quite a lot of young girls now who are both drinking heavily and are overweight, and we already know that incidence of breast cancer are going to increase to about 1 in 7 by the year 2024 But with alcohol and obesity moving forward at the rate they are, it could actually be higher than that.

KC: And that's in younger women you think?

GW: Yes it is, the risk factors are occurring in younger women, we don't know how long that will take to feed through to increase the incidence, but it's something we need to monitor.

KC: Obviously, as women age their incidence increases, but now you're saying it's going to become a serious problem with women even younger?

GW: I suspect so yes.

KC: That leads us nicely to my next question to you. If we could move on to how information is made available to us. My own research has revealed that published information on early detection of  breast cancer focuses on personal breast awareness, feeling for lumps that you haven't noticed before, but not much else really. What are your recommendations on personal breast awareness?

PW: I think that probably there are 3 main areas to focus on. One is knowing what to look for, one is knowing when is the best time in the month to actually examine yourself, and then the third element really is what is your risk? Is it average, is it lower than normal or is it higher than normal? I personally think that the breast cancer charities are giving a very mixed message to women during the last 10 to 15 years and I think that discouraged many women from carrying out self-examinations. I think when they introduced the breast awareness campaign I think what they were trying to stop was women examining themselves every day and becoming very anxious about everything they felt. But actually, given that women detect 90% of breast lumps themselves, unless they know what a normal breast feels like, I can't see how they're going to find a new lump easily, so I think examining yourself once a month is the right thing to do. I think the best time to do it is about day 10-14 of your cycle so that the normal lumpiness that can often come with a period has settled down by then, so then you have the best chance of spotting something new. So I think self-examination is a good idea; doing it mid-cycle is the right time, and then the other thing is that now we can actually give someone an idea of what their own personal risk is and at Breast Health UK we've been using a well-validated model, which looks at family history and lifestyle, called Tyrer Cuzick, and by filling in this questionnaire we can give someone a prediction of their lifetime risk and feel that if it's lower than normal that must be quite reassuring, although low risk doesn't mean no risk.

KC: Vigilance is key isn't it?

GW: That's right, but if someone's at higher risk, then there are a number of things you can do. They might want to start screening at a younger age, or have more intensive screening, I think those are the key things.

KC: And do you think that's where the thermal imaging could come in, because you could see more than a mammography would pick up?

GW: We've certainly got a number of younger women under the age of 50 who are now having a digital infrared breast scan, which is a type of thermogram, because they want to start something at a younger age and so it has become very popular with women who just can't get access to mammography.

KC: That's good, and also just to bring in the older woman, with women who are already post-menopausal, obviously they're not in a cycle any more, so would you probably just pick a date in the month, say the middle of the month for arguments sake, when they should check their breast?

GW: Absolutely and I know that these things are always difficult to remember and just one of the things that we are introducing as part of breast awareness month is an actual text reminder service through Breast Health UK, so that women who sign up for this will get a text at the right time of the month, so that they can remember to examine themselves and there's also a very good video showing women how to examine themselves so that's something that we hope, through the Breast Awareness Month, people can get access to this. To be quite honest I think the majority of women do not examine themselves and those that do are not very sure what they're looking for.

KC: It's certainly raising awareness isn't it, in a much better way because it's quite random at the moment, where women may find out how to examine their breasts properly?

GW: I think that's absolutely true.

KC: Moving on again, I recall listening to an interview you did recently on Radio 4 Woman's Hour with Professor Hilary Thomas from Breakthrough Breast Cancer. .I remember Professor Thomas expressing a view that thermal imaging was not an option, as the evidence in research was just not there. What would you say to this?

GW: Yes, I think any representative from charities would always give a very balanced view, and there's always a balance between early results and getting those new technologies out there and not really raising women's expectations too high. I think what she was trying to say is that we haven't done a screening, a research study of 10, 000 women and followed them for 10 years, and the reality is that whatever new technology comes along we're not going to be able to do that now. We're just not able to wait that length of time, we have shown in our research study that it can detect breast cancer and so the way that we have been using it recently is in addition to mammography, so we're not trying to take this up as an alternative to mammography. What we're trying to say is that mammography is not very good in younger women. Why not add this on so they have a better chance of detecting something if it's there? I wasn't surprised by that approach and you always get a very cautious approach with any new breakthrough.

KC: I think it's different with drugs though, because you have to do so many tests to make sure that it's safe, but with something like this new technology, it's like new computers with ipads for example, it's so fast isn't it? The technology is coming into our field of recognition in such volume and so quickly that we need to understand it more quickly don't we, ourselves?

GW: Yes I think that's absolutely right, but I think it's all to do with being cautious and managing expectations. For instance you will remember that there was a story just a few months ago about a possible vaccination to stop women getting breast cancer. And that was very well exposed in all the media, but the reality from that is it's only been tested in animals. You would then have to do a study in humans where you took a group of women and you randomised half of them to the vaccine  and half of them not to have a vaccine and then you'd have to follow them up for a very long period of time to see who got breast cancer and whether it was less in the vaccinated group; so I think that's an example of where expectations were raised far too high and there wasn't really a balanced reporting. I think it's always difficult to get it right

KC: Because people want these things to happen yesterday don't they? When they hear the news they want to start queuing up and getting it sorted.

GW: Yes they do and of course every time there is one of these large news stories, those of us in breast cancer clinics just see people coming in with bundles of papers that they publish from the internet, and they want to talk it through asking “why did I not have this” and it does create a lot of anxiety, so I think we have to just talk it through in the best way that we can.

KC: And finally I'd like to talk to you about improving the early detection of breast cancer must surely be a long term goal for the NHS, not least because it could save so much money and of course the disfiguring surgery along with chemo and radiotherapy, the psychological trauma for women, and the savings overall in all those things must surely run into millions of pounds, what's your view on this?

GW: Well, I think that there's no doubt that breast screening in this country has been successful at detecting smaller tumours that are less likely to have spread and as you say require much less treatment. So I hope that despite the economic crisis and the reductions in funding for the NHS that the breast screening program is here to stay. It does seem to me however that the people running that program are reluctant to change the way that it's organised, for instance it's the same screening program for everybody regardless of your age and regardless of your risk.

One of things we know for instance is that if you have more dense mammograms you have a higher risk of breast cancer. We've known that for many years now; it wouldn't be that difficult to look at the first mammogram that someone has at the age of 50, and if they were very dense they might go down one particular route that might involve more intense screening and if it's less dense they might need less screening. In addition to that there are genetic tests that you can do that modify that risk up or down now, and so it seems to me that a screening program that would stratified according to your risk might actually be more cost effective than just doing the same thing for everyone. But despite asking these questions I think that it's unlikely that it is going to change and it's unlikely that new things are going to be added in to it. I suspect that it's going to remain very much the way it is at present.

KC: So from a personal perspective, and I know many women agree with me on this, that mammograms can be very very painful and you also run the risk, I've heard women say, and I've said it myself, that I'm not going for another mammogram, they're just too painful. So I think they would probably embrace thermal imaging, but of course they'd have to do it on private basis wouldn't they?

GW: Well yes unfortunately that's correct. If we look at the uptake for the invitation to come for a breast screening, across the UK it's about 70-75% in the best areas. In some of the parts in inner London where there are large numbers of ethnic minorities, where maybe the message hasn't come across about the importance of it, the pick up rate can be as low as 30%, so there are clearly a large number of women who either don't want to come or choose not to come, so at least we now have an alternative that they may want to explore.

KC: Yes absolutely, well thank you so much for all that information Professor Wishart. I think it's been very helpful and I'm going to put all the information at the end of the transcript about the breast health program you're running, because of course it's breast health awareness month in October and I think there will be a lot of people that will be picking up on this. I've already spoken to some friends about thermal imaging and the things I've discovered, and they're saying oh yes, give me the details, so breast cancer I think is something that really hits home to women and they want to be aware and to do something about it. So thank you once again professor.

The FREE service launched by Breast Health UK to remind women when and how to check their breasts is detailed here  http://www.breasthealthuk.com/index.php?option=com_content&view=article&id=290 and here is the reminder form:  http://www.breasthealthscript.com/form.php

New breast screening technology offers breast cancer detection hope to women under 50

Research from Addenbrooke's Hospital in Cambridge in May 2010 revealed that using Digital Infrared BreastScan (DIB) to detect breast cancer in combination with mammograms, increases the sensitivity of detecting tumours to 89%. The study showed that dual imaging increases sensitivity by 11% compared with mammograms alone (78%). Read more … http://bit.ly/97egsa

Kathryn Colas: You'll find lots of information on menopause, including my own personal journey at http://www.simplyhormones.com and do watch ‘Menopause: The Movie' highlighting how relationships are affected at menopause; here's the link: http://www.simplyhormones.com/video.asp and do join me on my blog for my own views on what's going on in the world: http://simplyhormonespodcast.com and feel free to comment on my ramblings and podcasts. Last but not least, you can contact me: [email protected] .

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