8th April 2021
Following a very informative workshop on Women's Health for our virtual event in February, we invited Andie back as our guest blogger. The reassurance and education that ladies got from the Q&A workshop was overwhelming and highlighted the importance of speaking about this and getting as much education, guidance and advice around all aspects of women's health as possible. This include menopause, peri-menopause and your hormones journey. We hope this offers some help!
1. What's the biggest misconception regarding menopause in your opinion?
In my opinion the most common misconception is that the menopause is all about when you stop having periods. The peri-menopause (the years leading up to this) can be very difficult for a lot of women. For example one of the early symptoms can be anxiety and a sense of just not coping as well as you did before. This can occur years before your periods stop and leave a woman feeling inadequate when that is most definitely not the case!
The other misconception I hear a lot is that it is all about HRT. Some women have their lives changed with HRT. Others don’t need it, and many just need some lifestyle changes in order to feel well. The tricky part being that it is so individual and the changes that make a difference at this life stage are not the same as what we needed before.
2. Gabby Logan recently opened up about her peri-menopause journey and having some bloods done that divulged a lot of info about her hormones. Is it a good idea to have blood tests done if we feel slightly different or see changes in our bodies and moods?
It's certainly true that blood tests can make a big difference to knowing about our well-being. An example of this is that the menopause is a common time for thyroid issues to surface so checking these hormones can be useful. Conversely our female hormones can be just so varied during the peri-menopause that a snapshot blood test often doesn't really tell us anything if we are just looking at female hormones. One important thing though is that when we are going through the peri-menopause it's often a time of life when there's a lot of other things going on; family, work and other pressures. Sometimes because of these pressures we don't prioritise our own health and it would be unwise to assume that changes in our bodies ‘must’ be due to the menopause and miss other health complaints that may be happening. Sometimes a blood test can uncover an entirely different cause for our symptoms.
3. How important is it to get partners on board and what's the best way to do this?
The cynical answer to this is very straightforward - the menopause can affect libido and our sex life.
Sometimes, if we can help our partners to understand that careful management of the menopause would improve our sex life that in itself would get many on board!
The reality as always is more complicated but living with a sleep deprived potentially distressed woman may be quite difficult and it can be hard to see someone you love suffer in this way, so partners understanding the journey we are on is so important.
The best way to do this is with communication and understanding – if they understand why we are struggling as we are then they are likely to be more supportive of the journey to recovery.
4. How important are things like nutrition and sleep with regards to our hormones?
The more I learn about hormonal health the more I realise the impact of lifestyle. Sleep and nutrition have fundamental effects on hormonal balance and well-being. A simple example of this is the way we break down oestrogen – one of our most important female hormones. If your gut is not working efficiently then we can reabsorb toxic metabolites from the colon which can make us unwell. So improving gut health through good nutrition helps us to remove these breakdown products of oestrogen. There are many other examples and it's safe to say I could talk for hours on this subject! It's important though to bear in mind that what our body needs nutritionally varies over the years. There are phases of life when we need more carbohydrates, other times when more protein is required and sometimes the needs within a family vary between family members which can make it all very tricky!
6. How can exercise be affected during our cycle?
I think anybody who exercises knows that our cycle affects our abilities, our motivation and our injury risk. This is down to the hormonal changes that occur during the cycle. When your testosterone is naturally higher you can feel stronger and more motivated, when your progesterone is higher you can feel more sleepy and ligaments can become more at risk of injury. These changes can be more marked in some people but certainly listen to your body and push yourself on the days when your body feels able, on other days rest, or stretching may be enough.
7. What sort of training is best for women over 40's, should we be incorporating strength training?
When we hit the menopause our bone health and cardiovascular health can take a nosedive. Before this time it's therefore really important that we optimise our health and try to be in the best position we can to face the physical challenges ahead. Exercise overall therefore becomes even more important at this stage of life. It is true though that strength training is more important from our 40s. This helps you to keep your metabolic rate up and reduces the chance of weight gain as our oestrogen levels drop towards the menopause.
8. Surprisingly and sadly a lot of women feel shame in how their moods can be affected and sometimes feel they can't reach out or know where to find the help. In your opinion, what more can be done to open up the discussion about hormones/women's health and menopause.
I've seen a big improvement in this area in recent years. The menopause affects all women and broadening the conversation beyond HRT is incredibly important. I'm hoping that blogs like this will help people to realise that they are not alone. As mentioned, in my clinical practice I often see emotional issues being the first symptom of peri-menopause and people can feel like they've lost their strength of character and ability to cope long before they realise that this is related to hormonal health. Speaking with a healthcare practitioner or your GP about how you feel is so important. If you don't feel heard then don't just go quiet - speak to somebody else. Like all things in medicine, practitioners have strengths in different areas but there are plenty of us out there willing and keen to listen and help.
9. Are you working on any current projects that may help women (and partners) through this stage of their lives?
Funny you should ask that! I'm currently having a wonderful time creating a program for women reaching peri-menopause and menopause. This course is being put together by myself, a nutritionist, Fran Moore – who is well known locally in Dorset - along with a specialist exercise practitioner and a health coach. This will be a six week virtual course with huge amounts of information, webinars, food and exercise plans, live Q&A sessions and lots of support. We think this is so important as the more informed we are the better able we are to manage our own health - it's not just about the knowledge, it's about practical ways to feel better. Setting this up as a program should make it more accessible to the huge number of women out there going through this potentially challenging stage of life.
All four of us who are developing this course are "women of a certain age" and therefore really do know what you're going through! If anybody is interested in this please do get in touch. We don't yet have a launch date but are extremely excited about what is coming.
10. Finally, what is wellness to you?
When I was a young doctor I thought wellness was the lack of disease. The more experience I get the more I realise that this is a vast oversimplification. If we are walking along a tight rope with the disease on either side then that does not really feel like wellness. True wellness is when you are a long way from disease – so you can take a fall either literally or metaphorically and get up again with resilience.
Wellness is also about being able to enjoy the things that really matter to you. Hormonal health can sometimes make that difficult which is why it is an area I feel so strongly about.
Mosaic medical is a group of three doctors who work from Poole, London and Edinburgh combining conventional, lifestyle and functional medicine. Andie can be found working out of the Sandbanks Clinic in Poole or virtually as preferred.
If you're interested in the menopause program please see their website www.changethechange.co.uk