The Dr Louise Newson Podcast

158 - Pushing against social and political constraints on women’s health with Dr Heather Hirsch

Dr Heather Hirsch makes a welcomed return to the podcast this week. Heather is an internal medicine physician, specialising in women’s health and menopause care at the Brigham and Women’s Hospital in Boston Massachusetts, USA. Her clinical work and research centres on inequalities or unanswered questions in the field of women’s health, specifically in menopause education.

In this episode the menopause experts discuss the bigger picture of menopause care as a gender issue, women’s role in society and in the workplace, perceptions of women’s suffering and the menopause as a medical specialty. Louise and Heather share the challenges they each continue to face to educate and inform the public and healthcare professionals on the perimenopause and menopause and the benefits and safety of HRT.

Heather’s 3 tips:

1. Know what’s going on in your body by keeping a journal and tracking your symptoms. I recommend the free balance app to my patients for this.
2. List your own priorities and what matters most to you, whether that is your sexual health, your hair or skin, your sleep and so on.
3. Understand the three strands of menopause management: lifestyle changes, non-hormonal treatments and HRT, and know the pros and cons for all to realise what choices are best for you.

Follow Heather at:

Instagram @hormone.health.doc

Website: heatherhirschmd.com

YouTube: Health by Heather Hirsch

Podcast: Women’s Health by Heather Hirsch

157 - Science based weight reduction that lasts with Dr Saira Hameed

Dr Saira Hameed is a consultant endocrinologist working at the Imperial Weight Centre and at Imperial College London. Her work focusses on researching the drivers for appetite, obesity, and regulation of body weight to develop science-based interventions that help people manage their weight and lead healthier lives.

In this episode the experts discuss the impact of obesity on individuals’ health, on the NHS and wider society, and the science behind sugar, fats, and processed foods. Dr Hameed’s book, ‘The Full Diet’, explains the weight loss programme that is used in the NHS by clinicians and patients and was developed and trialled at Imperial College.

Saira’s 3 tips:

1. Short term – do everything you can to remove ultra-processed foods from your environment
2. Medium term – look at all the factors that contribute to your weight such as your stress levels, sleep, activity levels and seek to address those too
3. Longer term – be your own biggest fan. Feeling good about yourself will have a positive ripple effect on other areas of your life.

‘The Full Diet’ book is available now and published by Michael Joseph.

Find her on her social channels on Instagram https://www.instagram.com/drsairahameed/ and Facebook https://www.facebook.com/thefulldietbook 

156 - Educating women, improving access to treatment and influencing those in power with Dr Sharon Malone

Dr Sharon Malone is an eminent American physician who has worked as an obstetrician and gynaecologist for over 30 years in Washington DC. After 15 years of working mostly as an obstetrician, Sharon changed to specialise in menopause care around the time of her own perimenopause. She is passionate about educating women to understand their own hormone journey and empower them with evidence based information about hormone treatments.

The experts discuss the challenges of influencing and persuading medical colleagues on the benefits of hormone replacement, the importance of patient choice and agency, and the lack of menopause research and need for government funding.

Dr Malone’s advice to women:

1. Find your community of women who will support you and understand what you’re going through
2. Be active, keep exercising regularly
3. Maintain a healthy diet and eating habits; processed foods negatively affect so many aspects of your health

To read or listen to Dr Malone’s Washington Post op ed, visit https://www.washingtonpost.com/opinions/2022/04/28/menopause-hormone-therapy-nih-went-wrong/

Dr Malone is the Chief Medical Officer at US based menopause company Alloy, to find out more visit www.myalloy.com

155 - Weight loss, diabetes and menopause with Dr Clare Bailey and Dr Michael Mosley

Dr Clare Bailey is a GP and health columnist with extensive experience in helping people lose weight and improve their health. Dr Michael Mosley is a science presenter, journalist and executive television producer. Together, they have authored several bestselling books on weight loss, diet and diabetes and created the popular 5:2 and fast 800 diets.

In this episode, the guests describe the evidence showing the positive effects of incorporating principles such as the Mediterranean style diet and time-restricted eating into your lifestyle and how the fast 800 diet can dramatically improve your health outcomes, particularly in reversing type 2 diabetes. The ‘metabolic car crash’ of poor sleep, low hormones, poor diet and weight gain for women during the perimenopause and menopause are also discussed.

Clare and Michel’s top tips:

1. Enjoy olive oil. You don’t have to be stingy with it – it’s good for you!
2. Eat oily fish – remember SMASH: Sardines, Mackerel, Anchovies, Salmon, Herring.
3. Avoid snacks (especially in the evenings) or if you have to, reach for a few nuts.

For more information on Clare and Michael’s diet books and the fast 800 diet, visit thefast800.com

Follow Clare’s recipes on Instagram @drclarebailey

154 - How pharmacists can improve menopause care in your GP practice and community with Rupa Lyall

Rupa Lyall is a clinical pharmacist who works in a GP practice in Buckinghamshire seeing patients with minor illnesses and prescribing medications. In this episode she tells Dr Louise Newson how she became interested in the perimenopause and menopause and how, through the training on fourteenfish.com and resources on the balance website, Rupa now supports and educates other clinicians in HRT prescribing.

Their conversation covers raising awareness among professionals, working with patients from BAME communities, the importance of empowering women to improve their quality of life and the transformational effects of hormone replacement.

Rupa’s 3 tips for pharmacists interested in the menopause:

1. Go to fourteenfish.com and do the ‘Confidence in the Menopause’ course
2. Don’t be frightened of the menopause, learn more and talk to others
3. Speak to patients about their HRT, ask them how they’re doing, especially in the community. You will learn a lot by doing this.

153 - Learning how to prescribe HRT as a GP trainee with Dr Thulasi Naveenan

In this episode, Dr Thulasi Naveenan talks to Dr Louise Newson about her experiences as a 3^rd year GP trainee working in a central Manchester practice and learning on the job when it comes to HRT prescribing. The conversation covers working with patients from different cultures and with interpreters or family members, challenging misinformation, health risks after menopause and gender differences, and introducing the topic of hormones at 40-year health checks. Thulasi gives an honest and reflective account of what she has learnt about women’s health and hormones in her last 7 years of practising as a doctor.

Thulasi’s advice to clinicians learning about menopause:

1. Always have hormones in the back of your mind and there is no younger age limit cut off. Don’t be afraid to ask patients about their periods, vaginas and symptoms.
2. Don’t be afraid to ask about what you don’t know, use resources like the balance app and NHMS to find out more information. Find your local expert and seek out their knowledge and experience.
3. If you’re ‘junior’, don’t be afraid to challenge more senior clinicians – they may not be as up-to-date on the latest practice.

You can follow Dr Thulasi Naveenan on Instagram at @tnaveenan and on Twitter at @ThulasiNaveenan

 

Since the recording of this podcast, there has been further discussions with Cancer Research UK.

152 - Irritable bowel, bloating and digestive health with The Gut Experts

Consultant Gastroenterologist Professor Barbara Ryan and Clinical Dietitian Elaine McGowan are The Gut Experts, passionate about digestive health and helping women with debilitating bloating and irritable bowel symptoms.

In this episode, the experts discuss why more women are troubled by gut related symptoms compared to men, how gut and bowel problems have a very real impact on women’s lives, and why eating the right type, amount and variety of foods is so important for your gut health and overall wellbeing. The Gut Experts also talk about their new book written for women of all reproductive ages experiencing gut and bowel related symptoms.

Barbara’s tips for improving your future digestive health:

1. If you’re having digestive symptoms seek a correct diagnosis rather than self-diagnosing
2. Don’t look at your gut and digestive health in isolation, take a whole-body approach. Remember TEAMS: Total gut and body health, Exercise, Alcohol (reduce/cut out), Mental health, S

Elaine’s tips for improving your diet:

1. Fibre is a superfood for your gut microbiome – find the right amount of fibre intake for your own gut as everyone is different
2. Variety and diversity of foods is crucial, eat the rainbow, following a Mediterranean style diet.

Visit the Gut Experts website at https://thegutexperts.com/

The Gut Experts book, ‘What every woman needs to know about her gut’, contains solutions for bloating, IBS, and digestive symptoms and is out now, published by Sheldon Press.

Follow Barbara and Elaine on instagram @thegutexperts

151 - Unpicking UTIs and the role of hormones with Dr Rajvinder Khasriya

Dr Rajvinder Khasriya is a urogynaecologist who leads the Lower Urinary Tract Symptoms clinic at the NHS Whittington Hospital in North London, and is also involved in research work at University College London.

In this episode, the experts discuss urinary tract infections (UTIs) and the role a lack of hormones play in their occurrence and ongoing recurrence. Dr Khasriya explains how common and debilitating UTIs can be for women in the peri/menopause, why traditional methods of testing and treatment are often unsuccessful, and she outlines the benefits of using vaginal hormonal treatments as part of a holistic approach for managing UTIs.

Dr Khasriya’s tips for women with UTIs:

1. As always, do your own research and find patient groups for support and information.
2. Understand all the factors that can contribute to UTIs such as weight gain, your general health, your diet and stress levels, as these are also important.
3. Be generous when using your vaginal estrogen, it is completely safe to use and in the long term.
4. Trust yourself, you know your body best.

The patient groups:

Embedded/Chronic UTI Support Group

Do you suffer from reoccurring UTIs? Many of us have been previously incorrectly diagnosed with Interstitial Cystitis (IC) and have come to learn our condition is actually an embedded or chronic UTI...

Home - CUTIC

1 in 3. women will have a UTI by the age of 24 1. 90%. of chronic urinary tract infections are missed by the standard MSU culture test 2. 70%. the risk of recurrence within a year 3.

Bladder Health UK

Women asked if bladder drug should be available to buy. A pill to help treat an overactive bladder - which affects millions of women - could soon be available to buy in the UK without prescription.

150 - The effects of trauma, gender bias and the peri/menopause with Dr Jan Smith

Dr Jan Smith is a chartered psychologist, executive coach, author, campaigner and the director of Healthy You Ltd. She has over 15 years’ experience providing psychological support to those affected by injury and clinical negligence. In 2014, Jan developed a birth trauma service and campaigns to improve safety in maternity services for families and staff and provides training in the UK and internationally to maternity students and healthcare professionals on birth trauma and its impact.

In this episode, Jan describes to Dr Louise Newson how women can feel after a difficult birth or medical experience, and how trauma related emotions can resurface many years later at peri/menopause when psychological and genitourinary changes occur, often affecting relationships and intimacy.

Jan’s 3 pieces of advice:

1. If you had a difficult birth or healthcare related experience that affects how you feel about your genitals and intimacy, it is never too late to get help, even if it is years down the line.
2. Workplaces need to view women’s health as a continuum, not separate stand-alone events like pregnancy or menopause.
3. Think about ‘reaching in’ to help other women going through it – to listen, to validate and let them know they are heard and seen. This can be hugely beneficial for everyone’s mental health.

For more about Jan and Healthy You, visit https://healthyyoultd.co.uk/

149 - What I have learnt since falling in love with menopause care with Dr Abbie Laing

In this episode, Dr Louise Newson speaks to Dr Abbie Laing about why she now specialises in menopause care and what she has learnt through her research and writing on the subject. Together the experts discuss clinical hot topics where misinformation and misunderstandings are rife such as what the evidence shows about the risk of clots and breast cancer with HRT, and treating symptoms of genitourinary syndrome of menopause (GSM) with vaginal estrogen.

Abbie’s 3 tips for women with symptoms of GSM:

1. Seek help early and use vaginal estrogen; persist with treatment options if the first one doesn’t suit you. The benefits are huge, and treatment should be long term.
2. If you have recurrent UTIs, consider vaginal estrogen treatments .
3. For elderly, frail, or very busy women, the vaginal estrogen ring (Estring) is a very effective and safe option.
4. Vaginal estrogen treatments are very safe and do not have any associated risks, including for people who have had cancer.

To access the treatment pathways discussed in this episode, become an associate of the Newson Health Menopause Society at www.nhmenopausesociety.org

For more information on any of the treatments discussed, visit the balance website at www.balance-menopause.com