The Dr Louise Newson Podcast

138 - Explaining what the evidence shows to offer choice to women after breast cancer, with Avrum Bluming

Medical oncologist, Dr Avrum Bluming makes a welcome return to the podcast this week to re-visit the hot topic of menopause hormone therapy after breast cancer. Avrum has spent decades studying the research on the benefits and risks of HRT in women with a history of breast cancer and is passionate about giving women clear, evidence-based information that dispels myths and combats the misinformation that has unnecessarily frightened women and clinicians for over 20 years.

In discussion with Dr Louise Newson, Avrum clearly explains what his recent review of the literature reveals about the safety of HRT and the benefits it brings for your future health. The experts highlight the gender disparities that are commonplace in how women with cancer are treated with regard to their hormones compared to men, and they also discuss the importance of patient-centred medicine and giving women choice.

Avrum’s 3 tips for women interested in exploring their menopause treatment options after breast cancer:

1. Speak to your oncologist. Tell them about your menopause symptoms, ask to discuss the possibility of starting HRT and have a conversation about the benefits and risk for you individually.
2. When it is available, take Avrum’s article that will be published in the ‘Cancer’ journal in May/June 2022, and show it to your oncologist and GP. Don’t accept a dismissal of your views – engage them in discussion.
3. ‘Oestrogen Matters’ (2018, published by Little Brown) is a book co-authored by Avrum that is for women and clinicians, including a chapter on HRT after breast cancer, and it is heavily referenced to show all the evidence behind the information given.

Links to Avrum Bluming’s upcoming journal article will be published on the balance-menopause.com website when it is released.

137 - The challenges and importance of eating healthily with Dr Rupy Aujla

Dr Rupy Aujla was in his mid-20s and beginning his career as a doctor when heart problems caused him to re-evaluate what he thought he knew about health, nutrition and medicine. Having previously rejected his parents’ influences of traditional Indian medicine, Dr Rupy began delving deeper into some of those concepts and the science of nutrition that he wasn’t taught at medical school.

In this episode, he talks to Dr Louise Newson about the principles of healthy eating, how a busy lifestyle and your environment often make it challenging to find and choose healthy, affordable foods, and the experts share their concerns around childhood obesity, anxiety around food, and the particular metabolic changes faced by those going through peri/menopause due to a lack of estrogen.

Dr Rupy’s 3 tips for improving your nutrition:

1. Start with making a small change to your diet by adding just one more fruit, vegetable, nut or seed, at every meal if possible.
2. Have a back-up healthy meal that’s easy to prepare, or stored in the freezer, for those times when you are tired and lacking motivation.
3. Try to reflect what foods you really like but find a healthier version of it. For example, if you love pasta, add 3 different vegetables to any pasta recipe.

For details about Dr Rupy’s app, his books and recipe ideas, visit thedoctorskitchen.com

136 - ‘The lack of menopause research is a shocking medical injustice’, with Kate Muir

Kate Muir returns to the podcast to discuss her ground-breaking new book on the menopause, which she describes as the most difficult and complex subject she has investigated to date. Dr Louise Newson speaks to Kate about the shoddy science and lies that women have been told over the years and what Kate has learnt about past and current research from speaking to over 100 experts, and the real life impact on women from the conversations she has every week.

In this episode, discussion also turns to the ‘Davina effect’, referring to the impact of Kate’s Channel 4 documentary that was aired in May 2021, presented by Davina McCall, and has been a game-changer in raising the social and medical profile of menopause within primary care and in helping to inform and empower women to seek help.

Kate’s 3 wishes over the next 3 years:

1. A symptom list to be given out at your local GP practice
2. Good quality research into body identical estrogen and micronised progesterone
3. Research happening in the UK into Alzheimer’s and the role of estrogen and testosterone in women’s brains

Kate’s new book is titled ‘Everything you need to know about the menopause (but were too afraid to ask)’ and is published by Gallery UK. A second documentary about the menopause with Davina McCall will be released in May 2022.

135 - Tackling the Everest of menopause ignorance with Mariella Frostrup

Journalist and presenter, Mariella Frostrup, joins Dr Louise Newson for an energetic discussion and a whistle-stop tour through current insights and reflections on the way society approaches the menopause. Mariella talks about why she is ‘still banging on’ about the menopause, why you needn’t be afraid of HRT, and why it’s time to stop the silence and shame that surround it.

In 2018, Mariella presented one of the first documentaries on the menopause and broke the taboo of celebrities speaking honestly about their own experiences. Mariella’s recent book, ‘Cracking the Menopause: While Keeping Yourself Together’, separates the myths from the reality and offers expertise, hope and advice for all affected by the peri/menopause.

Mariella’s 4 hopes to improve the experience of menopausal women:

1. Knowledge is our armour; we each need be more informed individually so we can combat the myths and ignorance we will be faced with.
2. We need a trained menopause professional in every GP practice in the land and an invitation from the NHS for every woman to come for an appointment before the average onset of perimenopause, to let her know what will happen and how she can get help.
3. There should be menopause groups everywhere, so everyone can find support and we should all educate our daughters about it.
4. We need to ensure women are supported in the workplace so they can remain the valuable and experienced team members that they are.

Find out more about Mariella’s work at www.mariellafrostrup.co.uk

‘Cracking the Menopause: While Keeping Yourself Together’ is published by Bluebird.

134 - Advice from James Smith for exercise and nutrition in the perimenopause and menopause

Popular online personal trainer, James Smith, admits he only read Dr Louise Newson’s most recent book to check out the literary competition when their new books were released back-to-back. He bought a copy and read it on holiday and while he may have got some funny looks for his poolside choice of reading, James discovered many new insights about the perimenopause and menopause that he knew would really help his female clients in their quest to reach fitness and weight loss goals.

Louise and James discuss the common pitfalls many people go through when trying to exercise, perhaps out of obligation or to lose some of that midlife spread around the middle, and they warn against the plethora of misinformation on the internet about nutrition and training.

James’s 3 exercise tips for you:

1.  Ask yourself ‘how much do you want to train on a daily basis out of 10?’ If your answer is below a 5, don’t train but ask yourself ‘why?’ and tackle those things first, whether it be stress, lack of sleep or nutrition. Understand why you’re not motivated and fix that first.
2.   If you want to lose fat and/or manage your calorie intake, figure out your daily allowance and x7 for the week. You can overconsume on the weekend if you wish, but then divide what’s left by 5 for the days in the week and you’ll be surprised by how low it is. You will get a clear picture of how much you’re overeating on the weekend and it may make you think again about patterns of over-restricting then binging.
3.   Pick any exercise that you like and find rewarding, there isn’t a hierarchy of the ‘best’ ones, you have to enjoy it and want to do it.

 

For help with a personalised exercise programme and meal plans, check out James’ website at www.jamessmithacademy.com

James’ bestselling books, ‘Not a Diet Book’ and ‘Not a Life Coach’ are published by Harper Collins.

133 - Recognising and getting help for your perimenopause with Dr Rebecca Lewis

Dr Rebecca Lewis, Clinical Director at Newson Health, returns to the podcast for the first episode of 2022 to discuss the perimenopause with Dr Louise Newson. The experts explain what the term means, what’s happening to your hormones during this phase, and how it can be diagnosed. Rebecca offers practical advice on how to speak to your healthcare professional to convey the range of related perimenopausal symptoms and raise the issue of hormones.

Find out what your increased health risks are when your hormones change and what you can do to mitigate these risks. The perimenopause is discussed as an opportunity to take stock and consider introducing some small changes to your lifestyle that will improve both your physical and mental health.

Rebecca’s 3 top tips if you think you might be perimenopausal:

1. Take control and think about balancing your hormones and protecting your future health
2. Get a diagnosis earlier rather than later, download the free balance menopause support app and start tracking your periods and symptoms
3. Consider HRT to help your symptoms and feel better, and then you can look at making changes to your lifestyle that will benefit your future health and wellbeing.

132 - The benefits and pitfalls of evidence based medicine with Jonathan Underhill

Pharmacist, Jonathan Underhill is a consultant clinical advisor for the Medicines Optimisations team at the National Institute for Health and Care Excellence (NICE). His work is focussed on evidence-based medicine but, as he explains, this is more than simply telling people what to do. One of the particular focuses of Jonathan’s work is the process known as ‘shared decision making’ between the clinician and the patient and he’s interested in how you involve a person in choices and decisions about their own healthcare.

Jonathan outlines some of the reasons NICE was originally set up – to reduce uncertainty and variation in prescribing – and with Louise, he evaluates whether this has been the outcome 6 years down the line, after the release of the NICE guidelines on menopause diagnosis and management.

Jonathan’s tips for shared decision making as a patient:

1. It’s OK to ask questions.
2. If you need it, take someone with you that you trust who can listen and advocate for you

And for healthcare professionals:

3. David Haslam’s (former Chair of NICE) consultation skills advice for doctors were basically ‘shut up and listen, show empathy, and know something’. If you can do these 4 things well it will make a big difference
4. Practice your conversation skills as a clinician. You can learn to communicate better with your patients.

The NICE guidelines on menopause can be read in full here and more about shared decision making can be found here.

If you are a healthcare professional, the following link offers 4 hours of free online learning in shared decision making from NICE and Keele University:

https://www.nice.org.uk/guidance/ng197/resources/shared-decision-making-learning-package-9142488109

131 - Joining the dots through research and education with Lucy Chatwin

In this episode, Dr Louise Newson is joined by Lucy Chatwin, who is responsible for the not-for-profit organisation, Newson Health Research and Education. Lucy has had a portfolio career that has taken her through environmental science and operations, through human resources and management into health, in particular service improvement and transformation roles in the NHS. Her last role in the West Midlands Academic Health Science Network focussed on supporting the adoption of innovation into health services to improve health outcomes for people. Lucy is perfectly placed to bring together the often diverse worlds of industry, academia, and clinical organisations to drive improvements that will make a real difference to the lives of people in the perimenopause and menopause and those around them.

Lucy discusses the range of opportunities for innovation in menopause research, education and management and encourages those working in health and academia to ‘think hormones’ as an integral part of their practice. A key catalyst for this is the soon-to-be launched Newson Health Menopause Society that Lucy is leading on. The society will provide a global arena for integrating and energising research, driving education and upskilling professionals working in the field of menopause care.

Lucy’s tip for women is make time for yourself to unpick what is going on if you think you may be perimenopausal, don’t just assume it’s down to other things. Download the balance app at www.balance-menopause.com to help understand your hormones, the impact they’re having on you and how to get help for your symptoms.

Lucy’s tips for healthcare professionals:

1. Connect with other interested experts outside of your specialty, this is often the best way to expand your thinking
2. Make your mantra, ‘could it be hormones?’ If you treat women, don’t underestimate the influence of changing hormones in so many health conditions and presentations.

Register your interest in joining the Newson Health Menopause Society at www.nhmenopausesociety.org and follow them on Twitter at @NHMenoSociety or LinkedIn at Newson Health Menopause Society.

130 - ‘It‘s a scandal that more isn‘t known about the menopause‘ with Dr Richard Hull

Dr Richard Hull teaches philosophy at the National University of Ireland, Galway. Due to a coming together of work life and home life in lockdown and his wife’s experience, Richard began thinking and writing about the menopause from an ethical and philosophical perspective. As an issue under our noses all the time, he was astounded that more isn’t written about it, and he queries the lack of ethical concern for women regarding this time of life and the impact on those around them.

Richard discusses with Dr Louise Newson the importance of raising awareness of perimenopause and menopause, sharing accurate information, training healthcare professionals and empowering women with the right knowledge to recognise what is happening to them and to get the help they need through treatment.

Richard’s 3 hopes for change:

1. Personal and public awareness of the impact of the menopause is crucial
2. For everyone to have the confidence to seek support in all its forms and find out about HRT
3. Talk more and spread awareness and knowledge with others. The more people are aware, the less it can be ignored.

You can read Richard’s article on the menopause here. Richard’s wife, Jaany, has written about her experience here.

129 - Taking a mid-life career leap to help menopausal women with Gaele Lalahy

Gaele Lalahy had a successful career in consumer electronics as Board Member and Head of Brand Communications & Olympic marketing at Panasonic. Having been with the same company for two decades, Gaele became fearful of not having tried a different career, so she decided to take the leap and leave her job without a plan in place. When the opportunity came up to run Dr Louise Newson’s balance menopause support app, it didn’t immediately grab Gaele’s interest because, as she admits, she knew nothing about the menopause or the scale of the problem facing women.

After doing her own research and realising hundreds of thousands of women were suffering and struggling to get treatment, Gaele came on board as the Chief Operating Officer for balance at the start of 2021. Since then, the app has grown ten-fold and is really helping to change the narrative around perimenopause and menopause and empower women with the information they need to get help from their local GP practices. Gaele shares some of the remarkable statistics that show how the app helps women get a diagnosis and treatment more efficiently, and she discusses plans for the app’s future that will make even more of a difference to people’s lives.

Gaele’s 3 reasons to use the balance app:

1. The balance app is a safe space to share and get support from like-minded people who also going through the peri/menopause.
2. All the information on the app is very easy to digest, all medically approved and based on the latest evidence.
3. Come to the app to figure out what is going on with your body and mind and join the dots. You will learn more about the many changes you may be experiencing and can then use this insight in discussions with your doctor to get a diagnosis and treatment.

Find out more information about the balance app on the balance-menopause.com website here.

Read about balance for healthcare professionals (HPs) or share with your HP on their website here.

Look out for balance+ coming in early 2022!

 

You can follow the balance app on their social platforms at:

Facebook @balanceMenopause

Instagram @balancemenopause

Twitter @balanceMeno

LinkedIn @balance-app