WEBVTT - Hormonal Changes, Menopause and Perimenopause. Uncut with Dr Louise Newson 0:00:00.200 --> 0:00:03.840 Life Uncut acknowledges the traditional custodians of country whose lands 0:00:03.880 --> 0:00:06.560 were never seated. We pay our respects to their elders 0:00:06.600 --> 0:00:10.319 past and present, Always was, always will be Aboriginal Land. 0:00:10.600 --> 0:00:23.160 This episode was recorded on Cameragle Land. Hi guys, and 0:00:23.200 --> 0:00:25.200 welcome back to another episode of Life un Cut. 0:00:25.239 --> 0:00:29.200 I'm Brittany and I'm Keisha, and today we are discussing 0:00:29.240 --> 0:00:32.520 a topic that so many of you have written into us. 0:00:32.600 --> 0:00:35.560 The guest has been one of the most requested guests 0:00:35.600 --> 0:00:37.520 that we have had in a very long time. 0:00:37.720 --> 0:00:41.040 We are speaking to doctor Louise Newson, now Dr Newson 0:00:41.200 --> 0:00:43.080 or we will refer to her as Louise, I have 0:00:43.200 --> 0:00:45.720 asked for that permission. Is a leading expert in the 0:00:45.760 --> 0:00:51.080 field of menopause and perimenopause. She's a GP menopause specialist, educator, podcaster, 0:00:51.280 --> 0:00:54.480 and author. She's the woman in the know of menopause 0:00:54.520 --> 0:00:57.320 and today we would like to break down the misunderstandings, 0:00:57.320 --> 0:01:02.760 the myths, the misconceptions and medical misogyny surrounding menopause. Louise, 0:01:02.840 --> 0:01:03.920 Welcome to the podcast. 0:01:04.200 --> 0:01:06.840 Ah, thanks for the great introduction and thanks for inviting me. 0:01:07.080 --> 0:01:09.760 We've done a couple of episodes on the podcast on 0:01:09.959 --> 0:01:13.399 all Things Women's Health, and the current theme seems to 0:01:13.440 --> 0:01:15.840 be that there's a lot of medical misogyny that we 0:01:16.000 --> 0:01:18.399 all go through, to the point that a lot of 0:01:18.400 --> 0:01:21.520 people didn't know what perimenopause was, and I was one 0:01:21.520 --> 0:01:23.679 of them. I knew about menopause. I knew that when 0:01:23.720 --> 0:01:26.840 my mum experienced hot flushes, she would say, oh, I'm 0:01:26.840 --> 0:01:29.319 going through menopause, and she had a lot of side 0:01:29.319 --> 0:01:32.080 effects to do with her mental health and changes to 0:01:32.160 --> 0:01:34.319 her body, and other than that, I didn't really know 0:01:34.400 --> 0:01:36.959 much about it. Louise, can you talk to us about 0:01:37.000 --> 0:01:39.600 the difference between perimenopause and menopause? 0:01:39.760 --> 0:01:41.920 Yeah, for sure. The whole thing about all of this 0:01:42.080 --> 0:01:45.039 is that there's just a hell hormonal imbalance. So in 0:01:45.080 --> 0:01:47.000 an ideal world, I don't think we should be talking 0:01:47.120 --> 0:01:50.880 about perimenopause menopause, because then we're forgetting women who have 0:01:51.080 --> 0:01:55.520 PMS pre mental syndrome, or PMDD pre mental dysphoric disorder, 0:01:55.880 --> 0:01:59.520 or even postnatal depression, which is related to changing hormones. 0:02:00.040 --> 0:02:02.760 What happen is usually as we age, but it can 0:02:02.800 --> 0:02:06.240 be at any age. Our hormones fluctuate and reduce. Our 0:02:06.280 --> 0:02:09.239 hormones are just chemical messages that they're all around our body, 0:02:09.400 --> 0:02:12.600 but they're really important, so they affect every cell in 0:02:12.639 --> 0:02:15.560 our body. So when the levels aren't optimal in our body, 0:02:15.840 --> 0:02:18.480 we can get a myriad of symptoms and also some 0:02:18.639 --> 0:02:22.760 biologically negative effects in our body as well. The whole 0:02:22.760 --> 0:02:25.960 definition of menopause is a year after our last period, 0:02:26.040 --> 0:02:29.160 which is I just think, really just I'm not bothered 0:02:29.200 --> 0:02:31.240 about my period. I'm not bothered when it is, I'm 0:02:31.240 --> 0:02:35.200 bothered about my function, bothered about my brain. So the 0:02:35.240 --> 0:02:38.440 perimenopause is defined as when periods fluctuate and change and 0:02:38.440 --> 0:02:41.600 people get menopause or symptoms. But lots of people don't 0:02:41.600 --> 0:02:44.400 have periods, or they have artificial periods because they're on contraception, 0:02:45.120 --> 0:02:47.560 And a lot of women are saying, well, I'm getting 0:02:47.600 --> 0:02:50.639 regular periods and my perimenopausal or not, and that's why 0:02:50.720 --> 0:02:52.680 I think, I don't know. I hope you agree as women, 0:02:52.840 --> 0:02:55.680 I'm more than just my periods, do you know. So 0:02:56.080 --> 0:02:58.120 it's looking at what are hormones, what do they do 0:02:58.160 --> 0:03:00.440 in our body? Why are they having this effect? And 0:03:00.480 --> 0:03:03.519 then we can open the conversation to my thirteen year 0:03:03.520 --> 0:03:06.720 old who's started periods and feels terrible a day before 0:03:06.760 --> 0:03:09.320 her periods to my I can't tell you how old 0:03:09.320 --> 0:03:12.959 she is, my mother who has been menopausal for thirty years. 0:03:13.040 --> 0:03:15.640 You know, it's sort of we've got to be changing 0:03:15.680 --> 0:03:19.040 the conversation because otherwise people are no. My doctors told 0:03:19.080 --> 0:03:21.760 me I can't be menopausal because it's only eleven months 0:03:21.760 --> 0:03:24.320 and you know, two days since my last period. Therefore, 0:03:24.440 --> 0:03:27.080 it's like, oh, come on, please, you're having symptoms affecting 0:03:27.120 --> 0:03:29.840 the quality of your life. You have health risks without hormones. 0:03:30.120 --> 0:03:32.400 Let's just be a bit more grown up about this conversation. 0:03:32.520 --> 0:03:34.720 And that's why I think a lot of work has 0:03:34.760 --> 0:03:35.320 to change. 0:03:35.520 --> 0:03:38.560 Well, I think that's really interesting because I've always been 0:03:38.640 --> 0:03:41.600 under the understanding exactly what you just said before that 0:03:41.680 --> 0:03:44.320 menopause happens when you have from a year to the 0:03:44.400 --> 0:03:47.160 day not had a period. So it's interesting that you say, like, 0:03:47.240 --> 0:03:50.360 that's rubbish. How would you define menopause then? 0:03:51.040 --> 0:03:53.440 So I don't think I need to define menopause. I 0:03:53.440 --> 0:03:55.880 think what we need to define is a hormone imbalance 0:03:55.960 --> 0:04:00.680 in women's bodies and a hormone deficiency or insufficiency. Because 0:04:01.080 --> 0:04:03.320 the thing about menopause, if you take a step back 0:04:03.320 --> 0:04:05.440 and think, actually, what happens to our body a year 0:04:05.480 --> 0:04:08.520 after our last period? And if it's elite year, do 0:04:08.600 --> 0:04:10.640 we do three hundred and sixty five days or three 0:04:10.720 --> 0:04:13.240 hundred and sixty six days? Like? It's just getting a 0:04:13.240 --> 0:04:16.120 bit silly, now, isn't it. Like I'm trying to read 0:04:16.200 --> 0:04:17.919 I've read a lot of history books from the eighteen 0:04:18.000 --> 0:04:21.520 hundreds recently for a tour I'm doing in September, and 0:04:21.560 --> 0:04:24.880 I can't work out who actually decided who sat around 0:04:24.880 --> 0:04:28.000 a table and were it was all men obviously because 0:04:28.000 --> 0:04:31.240 they were only male doctors then, so who actually decided 0:04:31.520 --> 0:04:34.640 that it's a year? Like it just doesn't seem right. 0:04:34.880 --> 0:04:37.440 It's another way of sort of gasiting women and putting 0:04:37.520 --> 0:04:40.560 us into a box and just making everything normalized when 0:04:40.560 --> 0:04:43.560 we're feeling terrible. So I think we should be talking 0:04:43.600 --> 0:04:47.920 about a hormone insufficiency. I think we should be realizing 0:04:47.960 --> 0:04:51.800 that the three hormones we're talking about are estrogen, progesterone, 0:04:51.800 --> 0:04:55.839 and testosterone, and we can lose or have changes in 0:04:55.880 --> 0:04:59.040 these levels of hormones at different times. So some people 0:04:59.080 --> 0:05:02.719 are more testosterone deficient the nestrogen deficient. There's a lot 0:05:02.720 --> 0:05:07.360 of women out there, especially with endometriosis who have progesterone 0:05:07.400 --> 0:05:11.560 deficiency more than estrogen or testosterone. But all these hormones 0:05:11.880 --> 0:05:14.880 are just derived from cholesterol. They're all natural hormones that 0:05:14.960 --> 0:05:17.560 are made in our ovaries, of course, but they're also 0:05:17.640 --> 0:05:20.680 made in our brains and other organs in our body. 0:05:20.760 --> 0:05:22.919 So we have to be thinking about what's going on 0:05:23.000 --> 0:05:26.160 in our brain, because without our brains, with nothing are 0:05:26.160 --> 0:05:29.320 we And for too long we've just been concentrating on 0:05:29.560 --> 0:05:32.200 how heavy are your periods? Do you get period pain? 0:05:32.240 --> 0:05:35.479 Are they regular? Are they not? Like it's irrelevant. Actually 0:05:35.880 --> 0:05:38.560 I can cope with any periods if I'm functioning as 0:05:38.560 --> 0:05:40.440 a person, if you see what I mean. 0:05:40.880 --> 0:05:44.000 Yeah, absolutely, Louis. Not many of us would be going 0:05:44.080 --> 0:05:46.280 for regular blood tests. Not many of us would have 0:05:46.480 --> 0:05:49.520 kind of any idea of what levels our hormones of 0:05:49.760 --> 0:05:52.320 any of the three that you mentioned were at. So 0:05:52.360 --> 0:05:54.760 what are some of the other symptoms that there could 0:05:54.760 --> 0:05:56.360 be a hormonal change happening? 0:05:56.600 --> 0:05:59.040 Yeah, and that's a really important question. And even if 0:05:59.080 --> 0:06:00.640 we did go for blood test, do you know what, 0:06:00.880 --> 0:06:03.240 I did some blood tests on a patient ten times 0:06:03.279 --> 0:06:06.760 in a day and they were completely different every single time. Wow, 0:06:07.160 --> 0:06:09.880 And so our hormones fluctuate all the time. But the 0:06:09.960 --> 0:06:12.360 other thing is when you do a blood test, what 0:06:12.520 --> 0:06:14.480 hormone is in the level of woman in my blood 0:06:14.560 --> 0:06:16.640 is not the same that's in my brain or my tissues. 0:06:17.120 --> 0:06:19.440 And so there's a lot of wasted money on blood 0:06:19.440 --> 0:06:21.599 tests where people are just going, oh, no, my blood 0:06:21.600 --> 0:06:24.080 test is normal, But I'm waking up eight times in 0:06:24.120 --> 0:06:26.760 the night, and I've got night sweats, and i can't concentrate, 0:06:26.839 --> 0:06:29.000 and my blood is shot to pieces, but you know, 0:06:29.040 --> 0:06:31.160 my heart. So we have to be really careful. But 0:06:31.200 --> 0:06:34.559 we also have to remember in medicine, not everything needs 0:06:34.839 --> 0:06:38.920 a test. Like I have migrain. I don't need a 0:06:38.920 --> 0:06:41.320 brain scan or a blood test to diagnose migrain. I 0:06:41.360 --> 0:06:44.800 need somebody who's an expert, and me as an expert 0:06:44.920 --> 0:06:48.720 patient to make that diagnosis. If I've got the right information, 0:06:49.440 --> 0:06:53.960 if there's certain classic symptoms of migrain which enabled me 0:06:54.000 --> 0:06:56.719 to make the diagnosis myself actually as a patient, but 0:06:56.839 --> 0:06:59.360 also as a doctor, if I'm seeing women with migraine, 0:06:59.680 --> 0:07:02.840 exactly the same with hormonal changes. And what we have 0:07:02.920 --> 0:07:05.320 to do is, which is what's forgotten for many years, 0:07:05.440 --> 0:07:10.119 actually is talk to women properly, ask them to help 0:07:10.200 --> 0:07:14.000 with the decision making about the diagnosis. And often when 0:07:14.040 --> 0:07:16.360 people have the right information, and that's one of the 0:07:16.360 --> 0:07:19.560 reasons I develop the Free Balance app. That people can 0:07:19.640 --> 0:07:22.560 have information, they can look at symptoms, and there are 0:07:22.640 --> 0:07:25.520 lots of symptoms we can talk about, and then it's 0:07:25.520 --> 0:07:28.800 that light bulb moment going, oh, yeah, actually I'm getting 0:07:28.800 --> 0:07:31.560 those symptoms and they're worse before my periods, when my 0:07:31.600 --> 0:07:35.600 hormone levels are at their lowest. That must be somehow 0:07:35.640 --> 0:07:39.160 related to my hormones. Might not be everything, but it 0:07:39.240 --> 0:07:42.240 might be ten percent or eighty percent related to my hormones. 0:07:42.720 --> 0:07:45.400 But actually, if it is related to my hormones, do 0:07:45.440 --> 0:07:48.200 I need an antidepressant or a painkiller or a sleeping 0:07:48.240 --> 0:07:51.560 tablet or do I just need some natural hormones? And 0:07:51.600 --> 0:07:54.080 then you're changing that whole conversation. But you've got to 0:07:54.120 --> 0:07:56.560 put you know, I went into medicine to help people 0:07:56.600 --> 0:07:59.760 feel better, but also to have my consultations where the 0:07:59.760 --> 0:08:02.720 payats are in the center. So if a patient's coming 0:08:02.760 --> 0:08:04.680 in to me and saying, do you know what, I 0:08:04.720 --> 0:08:07.680 think this is related to my hormones? Ninety nine point 0:08:07.760 --> 0:08:10.920 nine percent of the time that lady is right, and 0:08:10.960 --> 0:08:13.760 the problem is so many times every day in my 0:08:13.800 --> 0:08:16.320 clinic people have said, but I'm not listened to. Doctor. 0:08:16.440 --> 0:08:18.440 I've tried to explain and I've not listened to. And 0:08:18.440 --> 0:08:20.800 that's in all countries, not just in the UK. 0:08:21.000 --> 0:08:23.440 Doctor Louise, this is something that I've been diagnosed with 0:08:23.440 --> 0:08:27.120 peacos nearly two years ago. I had seen three different GPS. 0:08:27.520 --> 0:08:30.280 For anyone listening who doesn't know polycystic avariance inndrome, it's 0:08:30.280 --> 0:08:34.080 a hormone in balance. I have fluctuating hormones of all 0:08:34.160 --> 0:08:36.520 different kinds of levels. And like you said, I've had 0:08:36.520 --> 0:08:38.800 blood tests that showed things were normal. I've had blood 0:08:38.800 --> 0:08:42.840 tests that showed that things were excessively abnormal. I saw 0:08:42.920 --> 0:08:46.040 so many doctors I presented with so many of the symptoms. 0:08:46.160 --> 0:08:48.800 I was fatigued, I had brain fog. I had a 0:08:48.880 --> 0:08:51.480 feeling within my body that something wasn't right, and I 0:08:51.720 --> 0:08:56.320 constantly felt invalidated. And it took for me to actually 0:08:56.760 --> 0:08:59.719 go and get roacotane. I went and saw a dermatologist 0:09:00.040 --> 0:09:01.480 and she was the one who led me to an 0:09:01.520 --> 0:09:04.360 endocrinologist who ended up saying, we need to get to 0:09:04.400 --> 0:09:06.480 the bottom of what's going on with your hormones. So 0:09:07.320 --> 0:09:09.840 for me, that was a really frustrating experience. And I 0:09:09.880 --> 0:09:13.880 can only imagine that women going through the period of 0:09:13.920 --> 0:09:17.080 being maybe forty into their fifties, you know, this either 0:09:17.120 --> 0:09:21.080 perimenopausal or menopausal state. Because of how many of us 0:09:21.120 --> 0:09:24.520 are going to experience this, I would have hoped that 0:09:24.640 --> 0:09:27.600 doctors would be a lot more receptive to these concerns 0:09:27.679 --> 0:09:30.280 and these symptoms that so many of us are going 0:09:30.280 --> 0:09:31.000 to present with. 0:09:31.520 --> 0:09:34.680 Is that the case, Yeah, you'd hope, But I think 0:09:34.880 --> 0:09:38.280 one of the problems, many problems in traditional medicine. Actually 0:09:38.840 --> 0:09:41.000 one of it is that we've been trained and we 0:09:41.080 --> 0:09:45.480 still are, to treat disease rather than prevent. We also 0:09:45.800 --> 0:09:48.679 have become more and more siloed, so that if I 0:09:48.800 --> 0:09:51.480 was a cardiologist, I would only be looking at the heart, 0:09:52.000 --> 0:09:54.080 If I was a neurologist, I would only be looking 0:09:54.160 --> 0:09:57.319 at the brain. And you know, I'm a general physician, 0:09:57.559 --> 0:09:59.559 so I have been trained to look at every organ. 0:09:59.760 --> 0:10:02.640 Because they're called sex hormones, it's almost like they're an 0:10:02.640 --> 0:10:06.200 optional extra, but they're not about sex, they're not about gender. 0:10:06.320 --> 0:10:09.960 Men have estrogen and progesterone. Testosterone is the most biologically 0:10:09.960 --> 0:10:14.559 active hormone we have, so they're heterosexual hormones, they're health hormones, 0:10:15.000 --> 0:10:17.200 but they've almost been put to the bottom of the pile. 0:10:17.840 --> 0:10:21.400 And the other thing. In medicine, we're often so busy 0:10:21.440 --> 0:10:25.400 thinking about how to prescribe a medication that we are 0:10:25.440 --> 0:10:30.240 also not thinking holistically about treatment options because hormones often 0:10:30.240 --> 0:10:33.800 are really important, but so is everything else as well. 0:10:33.920 --> 0:10:37.440 So it's not just take the hormones and go away 0:10:37.440 --> 0:10:40.360 and enjoy your life. It's like, let's rebalance your hormones. 0:10:40.440 --> 0:10:43.559 When I see you again, let's then talk about your lifestyle, 0:10:43.640 --> 0:10:47.160 your exercise, your sleep, your stress, everything else. And that's 0:10:47.320 --> 0:10:50.120 often forgotten because in medicine it's quite a conveyor belt. 0:10:50.240 --> 0:10:52.280 You know, you're in and out. You deal with one problem, 0:10:52.360 --> 0:10:56.600 one consultation, but actually, if you spend time helping people 0:10:57.320 --> 0:10:59.960 as soon as they start to have symptoms, you know, 0:11:00.000 --> 0:11:03.360 so we're investing in future health and people that I 0:11:03.400 --> 0:11:07.680 see in the clinic, it's transformational medicine because with hormones, 0:11:08.000 --> 0:11:12.080 if their symptoms are due to hormonal changes, the symptoms improve, 0:11:12.120 --> 0:11:15.520 they feel better, which is wonderful, but more importantly, they 0:11:15.600 --> 0:11:18.880 are improving their future health. They're reducing risk of disease, 0:11:19.440 --> 0:11:22.600 keeping away from doctors and enjoying their lives, and that's 0:11:22.640 --> 0:11:24.840 what we all should be working towards as doctors. 0:11:25.280 --> 0:11:28.719 Doctor Louise, what was it that made you so passionate 0:11:28.800 --> 0:11:33.240 about hormones and this research that you're now conducting with 0:11:33.280 --> 0:11:36.880 perimenopause and menopause as a GP? What was it that 0:11:37.000 --> 0:11:38.400 made you go down this path? 0:11:38.720 --> 0:11:41.000 It's mainly I was working part time as a GP, 0:11:41.160 --> 0:11:43.240 but I was also a medical writer for many years, 0:11:43.400 --> 0:11:47.800 unstripping sort of evidence, looking at all diseases and conditions 0:11:47.800 --> 0:11:52.120 and writing about them so that doctors and patients could 0:11:52.200 --> 0:11:55.280 understand more. And I was asked to write a review 0:11:55.280 --> 0:11:58.160 on the guidelines for menopause that came out in twenty fifty. 0:11:58.679 --> 0:12:02.520 So I reread all the evidence and I was shocked 0:12:02.760 --> 0:12:05.720 by how it's been misinterpreted by so many people, and 0:12:05.760 --> 0:12:08.480 I thought, this is outrageous. And then I started to 0:12:08.520 --> 0:12:12.679 experience symptoms that didn't realize. I spent six months shouting 0:12:12.679 --> 0:12:16.600 at my husband, having unretracted infections, worsting my brain, putting 0:12:16.640 --> 0:12:19.200 on weight, it just feeling miserable that thought I couldn't 0:12:19.200 --> 0:12:22.079 cope with my third child, at my job and everything else. 0:12:22.440 --> 0:12:24.920 But the biggest thing that drives me is that I 0:12:24.960 --> 0:12:29.400 decided as an individual to take hormones, including testosterone, but 0:12:29.440 --> 0:12:32.960 I can't get them from my NHS doctor the dose 0:12:33.040 --> 0:12:35.720 and type I'm on, So if I can't get them like, 0:12:36.080 --> 0:12:39.200 that's really hard for others. And so every day I 0:12:39.400 --> 0:12:42.000 speak to women who don't come to the clinic. You know, 0:12:42.040 --> 0:12:46.200 women who are very disadvantaged, and they're being sidelined in society. 0:12:46.280 --> 0:12:51.240 They've been given these other drugs, is cocktail of antidepressants, antipsychotics, 0:12:51.679 --> 0:12:54.800 pain killers. They know it's their hormones, but they can't 0:12:54.840 --> 0:12:56.760 access it in the way that I can't access it. 0:12:56.800 --> 0:12:59.560 So I'm determined not to stop and tell every woman 0:12:59.600 --> 0:13:02.320 who wants to get the treatment that's right for her 0:13:02.679 --> 0:13:05.480 is able to because it's such an injustice to women. 0:13:05.800 --> 0:13:09.319 As a GP. Were you specifically, like when you went 0:13:09.320 --> 0:13:11.760 through med school and I guess even when you were practicing. 0:13:12.280 --> 0:13:15.160 Are there things in place to educate gps that this 0:13:15.320 --> 0:13:18.319 is something that half the population are likely to experience? 0:13:18.960 --> 0:13:21.680 No, not properly. I certainly I didn't get any education 0:13:21.720 --> 0:13:24.400 as an undergraduate or a postgraduate, and I did a 0:13:24.440 --> 0:13:28.160 lot of hospital medicine before general practice, So I did psychiatry, 0:13:28.200 --> 0:13:31.720 I did cardiology, I did rheumatology, I did gastro entrology, 0:13:31.800 --> 0:13:34.280 I did cancer medicine. Jobs no one to speak about 0:13:34.280 --> 0:13:37.320 hormones at all, then, no. I mean, we've created a 0:13:37.440 --> 0:13:40.280 Confidence in the Menopause Education Program, which is a remote 0:13:40.320 --> 0:13:44.440 program where we've videoed ourselves doing consultations with actresses. We've 0:13:44.960 --> 0:13:47.560 got links to the available evidence, and you know that's 0:13:47.559 --> 0:13:50.520 head over thirty three thousand downloads. So it's a really 0:13:50.559 --> 0:13:54.199 sort of different course that's available to people in Australia, 0:13:54.280 --> 0:13:58.200 to people in any country to learn from because you 0:13:58.320 --> 0:14:00.760 have to learn the evidence, but you also have to 0:14:00.800 --> 0:14:03.240 be able to put the evidence into clinical practice. And 0:14:03.280 --> 0:14:07.560 that's the art of medicine is individualizing care. So education 0:14:07.679 --> 0:14:10.880 has to be completely transformed for everybody, not just gps, 0:14:11.000 --> 0:14:15.080 not just nurses, not just pharmacists. Every single healthcare practitioner 0:14:15.240 --> 0:14:17.240 needs to know about hormones. 0:14:17.080 --> 0:14:19.840 Which is absolutely wild to think that something that affects 0:14:20.400 --> 0:14:23.480 fifty one percent actually of the population is something that's 0:14:23.480 --> 0:14:26.520 not even taught to you guys when you're practicing. I 0:14:26.520 --> 0:14:29.560 think people underestimate the impact of hormones. And I'm glad 0:14:29.600 --> 0:14:31.480 you said what you said. Before, because I didn't know 0:14:31.520 --> 0:14:33.800 that that you tested one patient ten times in a 0:14:33.880 --> 0:14:37.240 day and the hormones fluctuated the entire day. How much 0:14:37.520 --> 0:14:42.280 scientifically speaking, how does the pill work in suppressing hormones? 0:14:42.480 --> 0:14:44.640 And I guess i'd love to know your expert opinion 0:14:44.800 --> 0:14:46.200 on the contraceptive pill. 0:14:46.600 --> 0:14:49.160 Yeah, it's a really interesting question. And again, I feel 0:14:49.200 --> 0:14:52.480 doing a lot of reading about history of contraception for 0:14:52.520 --> 0:14:55.400 this tour that I'm doing, but I've also got a 0:14:55.440 --> 0:14:58.160 pathology degree, so I'm really interested in science how things 0:14:58.280 --> 0:15:00.880 work in our bodies and how things don't work when 0:15:00.880 --> 0:15:06.120 we have conditions and illnesses. But our hormones estrogen progesterone, 0:15:06.160 --> 0:15:10.600 testosterone are structurally we know the molecular structure, so the 0:15:10.600 --> 0:15:15.560 biochemical structure, and all the hormones that are prescribed as contraceptives, 0:15:15.920 --> 0:15:21.360 they're called estrogen progesterone, but they're synthetically made, so they're 0:15:21.480 --> 0:15:24.920 chemically altered. So if you think about a lock and 0:15:24.960 --> 0:15:29.160 a key, we have, like the lock, the receptor on 0:15:29.200 --> 0:15:31.640 every single cell, and if you think of the hormone 0:15:31.640 --> 0:15:34.240 as the key, it goes in, it fits nicely, and 0:15:34.280 --> 0:15:36.960 then you've got these lovely chemical reactions occurring in every 0:15:37.000 --> 0:15:39.640 cell that are really beneficial for our body. And that's 0:15:39.680 --> 0:15:42.760 what estrogen, progester in, testosterone we produce, as well as 0:15:42.800 --> 0:15:46.360 insulin and thyroxin and adrenaline and quarters are all these 0:15:46.360 --> 0:15:49.520 other hormones. They all have the lock where the key 0:15:49.560 --> 0:15:51.560 can go in and then you know, our bodies are 0:15:51.600 --> 0:15:54.680 amazing when they work properly. Now, these hormones have been 0:15:54.760 --> 0:15:58.400 chemically altered, so they might fit the lock, but they're 0:15:58.400 --> 0:16:00.360 not going to unlock. They're not going to have this 0:16:00.480 --> 0:16:04.240 lovely cascade of reactions. But also when they're in that lock, 0:16:04.800 --> 0:16:08.160 they're blocking another key coming in, so they're blocking the 0:16:08.240 --> 0:16:11.160 natural hormones coming in. So it's almost a double whamme, 0:16:11.280 --> 0:16:15.400 officer when people are on hormones as contraception, in that 0:16:15.440 --> 0:16:18.480 they're sort of blocking their natural processes occurring and they're 0:16:18.480 --> 0:16:21.480 blocking the natural hormones working. Now, some of them are 0:16:21.480 --> 0:16:24.000 different to others, so some of them will have like 0:16:24.080 --> 0:16:27.000 a partial turning of that lock, so they might have 0:16:27.160 --> 0:16:31.000 some chemical reaction that's beneficial, but a lot of people 0:16:31.360 --> 0:16:34.120 have side effects. We know to the contraceptis like you 0:16:34.200 --> 0:16:36.320 felt numb, you felt flash. You know, a lot of 0:16:36.360 --> 0:16:38.640 my teenage children friends are just put on the pill, 0:16:38.680 --> 0:16:42.080 and then they're put on antidepressants without anyone thinking, oh, 0:16:42.240 --> 0:16:46.560 what's happening, Why is this happening. And when contraceptions were 0:16:46.600 --> 0:16:50.000 first brought out in the sixties, they had done no 0:16:50.160 --> 0:16:53.080 studies on contraception. They just did studies on the womb 0:16:53.160 --> 0:16:56.640 and saw that periods became lighter and thought, great, women 0:16:56.640 --> 0:16:59.280 don't like heavy periods. Let's give it. Then after a 0:16:59.320 --> 0:17:02.880 year they said, let's market there's contraception. But no one 0:17:02.920 --> 0:17:05.919 did any studies on the metabolism in the body. They 0:17:05.960 --> 0:17:09.600 didn't do any studies on heart or inflammation or the 0:17:09.720 --> 0:17:13.240 brain function. There were some studies where they gave women 0:17:13.400 --> 0:17:15.320 like a hundred times the dose they do now and 0:17:15.359 --> 0:17:17.919 women were vomiting, have blood cuts, But they dis ignored 0:17:17.960 --> 0:17:20.480 some of those studies because they wanted to get it 0:17:20.520 --> 0:17:23.240 out to market because there was a massive market. Obviously, 0:17:23.240 --> 0:17:26.480 we all want contraception when we don't want to be pregnant, 0:17:27.160 --> 0:17:29.000 and this is part of the problem. Now there's a 0:17:29.040 --> 0:17:33.520 myriad of contraceptives, and obviously I'm not saying we can't 0:17:33.520 --> 0:17:36.240 have them, but there are ones that have different effects 0:17:36.280 --> 0:17:39.400 on different people, and we need to be really careful 0:17:39.720 --> 0:17:42.280 what we give and listen again to women. 0:17:43.760 --> 0:17:48.040 What is the general age guidelines of when women usually 0:17:48.119 --> 0:17:50.119 stop their period in going to minipause. And I know 0:17:50.200 --> 0:17:52.320 that's not a cut number. 0:17:52.400 --> 0:17:55.040 Yeah, so I mean it's a great question. But on 0:17:55.080 --> 0:17:58.320 average it's about the age of fifty in the UK, 0:17:58.480 --> 0:18:01.360 probably in Australia as well. India it's lower, it's about 0:18:01.400 --> 0:18:05.760 forty five. And this is a really important but about 0:18:05.800 --> 0:18:08.480 one in thirty women under the age of forty will 0:18:08.520 --> 0:18:11.919 have an earlier menopause. So I've seen in my clinic 0:18:11.960 --> 0:18:15.239 this week two women who have never had periods, so 0:18:15.320 --> 0:18:17.919 their ovaries didn't develop properly, so they were menopause at 0:18:17.960 --> 0:18:21.080 age fourteen. They were bugged on the contraceptive pill, never 0:18:21.119 --> 0:18:24.720 felt great, so they just need proper natural hormones. One 0:18:24.760 --> 0:18:28.359 of them has now got osteoporosis aged thirty eight. So 0:18:28.880 --> 0:18:32.320 lots of women will become menopausal at an earlier age. 0:18:32.320 --> 0:18:34.600 And sometimes it might be because their ovaries are removed 0:18:34.600 --> 0:18:37.320 in an operation, or they've had a hysterectomy, or they've 0:18:37.359 --> 0:18:41.120 had some chemotherapy or drug treatment for cancer that's affected 0:18:41.160 --> 0:18:44.879 their ovaries working. But a lot more women will have 0:18:44.960 --> 0:18:48.480 hormonal changes, so about ninety percent of us have PMS, 0:18:48.880 --> 0:18:50.920 but like you just, oh, it's only two or three 0:18:51.000 --> 0:18:53.760 days a month, but actually that's about a month a 0:18:53.880 --> 0:18:56.680 year that you're not functioning properly and not performing properly. 0:18:57.400 --> 0:19:01.440 But about one in twenty I think probably more have PMDD, 0:19:02.040 --> 0:19:04.600 which is a more severe form of PMS. It's really 0:19:04.640 --> 0:19:09.040 flawing people and they are just given antidepressants, but that's 0:19:09.080 --> 0:19:10.479 not treating the underlying cause. 0:19:11.119 --> 0:19:14.080 Yeah, we've actually done an episode quite recently on PMDD 0:19:14.359 --> 0:19:16.800 that if anyone is thinking that that could be something 0:19:16.800 --> 0:19:19.080 that they're experiencing, will link it. In the show notes 0:19:19.119 --> 0:19:23.120 that was with an endochronologist, Luis. You spoke briefly about 0:19:23.240 --> 0:19:26.720 these changes in function, saying that at these time when 0:19:26.720 --> 0:19:30.760 our hormones are acting differently, we can be not functioning. 0:19:30.920 --> 0:19:33.159 What does that look like in day to day life, Like, 0:19:33.160 --> 0:19:37.040 how would someone identify that's a symptom? Maybe there's something 0:19:37.080 --> 0:19:38.119 going on inside. 0:19:38.640 --> 0:19:41.359 Yeah, so there's a myriad of symptoms and you'll be 0:19:41.400 --> 0:19:44.560 pleased to hit not everybody gets every symptom, but symptoms 0:19:44.600 --> 0:19:47.720 can come and go, they can change between people, but 0:19:47.800 --> 0:19:50.760 also between time as well. The commonest symptoms and we've 0:19:50.760 --> 0:19:54.000 done a survey of six thousand women. But we hear 0:19:54.040 --> 0:19:55.679 it all the time in the clinic too. But the 0:19:55.720 --> 0:19:59.840 commonest symptoms are symptoms affecting our brain, so brain fog ma, 0:20:00.000 --> 0:20:06.800 memory problems, fatigue, low mood, anxiety, inability to concentrate, irritability, 0:20:06.880 --> 0:20:11.560 this iridescent rage that just comes from nowhere. But also 0:20:12.040 --> 0:20:16.440 just feeling more withdrawn, not feeling quite so engaged with people, 0:20:17.040 --> 0:20:21.399 feeling just quite flat, quite joyless, having very little motivation. 0:20:22.160 --> 0:20:24.920 A lot of people just feel like they're just existing 0:20:25.080 --> 0:20:28.600 rather than living. And then people can get headaches, and 0:20:28.640 --> 0:20:30.520 then you know, if you work down the body, people 0:20:30.560 --> 0:20:33.119 can get dry eyes, they can get changes in smell, 0:20:33.200 --> 0:20:36.439 they can get sore mouth, they can get changes in taste, 0:20:36.480 --> 0:20:41.000 they can get tinatus in their ears, hearing problems, breathing problems. 0:20:41.040 --> 0:20:46.200 People can get palpitations, irritable bounds type symptoms. People can 0:20:46.280 --> 0:20:50.320 get dry skin, itchy skin. They can get worsening xma. 0:20:50.640 --> 0:20:53.119 They can get this formication, this sort of feeling of 0:20:53.200 --> 0:20:56.840 spiders crawling over their skin. They can get pins and needles, 0:20:56.840 --> 0:20:59.359 they can get nerve pain, they can get muscle and 0:20:59.440 --> 0:21:03.080 joint pain. And as I'm working down the body, Hopefully 0:21:03.080 --> 0:21:06.440 you'll realize it's no surprise because I said at the 0:21:06.480 --> 0:21:09.400 beginning of this show that our hormones affect every single cell, 0:21:09.800 --> 0:21:13.080 therefore every single organ in our body. So if if 0:21:13.119 --> 0:21:16.879 that beautiful key and lock lovely chemical reaction isn't occurring, 0:21:17.359 --> 0:21:20.560 then our bodies don't work properly, and especially a lot 0:21:20.640 --> 0:21:24.560