Episode 3- Fannying Around with Rachel

Rachel was the woman who didn’t have time for menopause.

International marketing director, travelling the world, running a side hustle, and somehow still finding time to compete in ballroom dancing. Life was busy, exciting and very full.

So when the early signs of menopause crept in, Rachel did what many high-achieving women do — she powered through it.

She was wary of HRT, decided to go the “natural” route, and told herself she’d just get on with it.

Then life changed overnight.

Rachel suddenly lost her father, and grief collided with everything else already going on in her body. Headaches worsened, weight crept on, confidence dipped, and the energy she once had, both for work and the dance floor started to disappear.

The turning point didn’t come from a doctor. It came from a coffee with a friend who gently told her something she hadn’t quite admitted to herself yet:

“You’re not yourself anymore.”

In this episode Rachel talks honestly about career pressure, grief, weight gain, body confidence and the strange moment when the life you’ve carefully built suddenly feels harder to navigate.

And we also tackle a question many women quietly wonder about…

When does menopause actually end?

(Spoiler alert: it doesn’t exactly work like that.)

A candid conversation about pushing through, asking for help, and rediscovering confidence when your body and life, change at the same time.

Transcript

SPEAKER_02 0:01

This episode is supported by the Women's Health Clinic. At the Women's Health Clinic, you'll be seen by our accredited menopause specialists working to the latest international clinical guidance. We believe that knowledge is power. When you understand what's changing in your body and why, you can make decisions with clarity and confidence and feel back in control of your health. We really take the time to listen to your symptoms using evidence-based assessment and testing where appropriate and explain what's happening in a way that actually makes sense. From there, we support women to explore all effective treatment options, including prescriptions when needed. Our aim is simple to optimise women's health care wherever you are. No funnying around. Find out more at thewomen's Healthclinic.eu.

SPEAKER_01 0:57

Greetings, fanniers. Hope you're well. Episode three then of Fannying Around. Today then we're fannying around with Rachel. Rachel was what you might call a high flyer, an international marketing director, travelling the world, running a side hustle, and when she wasn't doing that, she was a competitive ballroom dancer. In other words, not someone who had time to sit around pondering menopause. In fact, Rachel will tell you herself she didn't think she needed help. She was a bit wary of HRT, so she decided she'd go the natural route. And well just get on with it. Which is exactly what a lot of us do. Until life throws something enormous at you. Rachel suddenly lost her father. Grief hit hard, her energy disappeared, the headache started, the weight crept on, and the confidence she'd always relied on began to wobble. And the moment that really changed things, well, it was a coffee with a friend who gently told her, Rachel, you're not quite yourself anymore. Rachel talks really candidly in this episode then about career pressure, grief, weight gain, body confidence, and the moment you realise that menopause isn't something you can just power through. And we also tackle a question a lot of women quietly wonder about. When does menopause actually end? Spoiler alert, it doesn't. Right then, let's fanny around with Rachel. Rachel, how are you looking extremely glamorous, might I add? So start us off then, Rachel. Tell us a little bit about you and your story. And I've got a feeling you're not holding back in this episode, are you?

SPEAKER_03 2:49

Well, there isn't a you can't ask me. Um I'm quite happy to be asked anything and I'll give a truthful answer. Um I'm 55 now. I'm I was all over and out at 47. Don't have kids. Led to believe that ladies that don't have kids go earlier, and that roughly you go the same age as your mother. Now my mother went at 51 all over and out. So I think probably fairly early in the scheme of things. Um like a lot of women, I think I'd heard all the you know scaremongering and horror stories about HRT and breast cancer, and that just made me go, no, I'm not doing that. I'm going to go through it naturally. Um, I started having perimendum pausal symptoms at 37. Very bad headaches. I've never, I'd only ever had one migraine in my life, which was stress-induced, and then I was having four-day horror migraine.

SPEAKER_01 3:44

Yeah, I think we were speaking before, it took out nearly four days a month, didn't it, for you?

SPEAKER_03 3:49

Yeah, yeah, it was horrific. Basically, on the day before my period would be due to start, it would start and then it would last for four days. And I I had a fairly high-powered marketing job at the time. So there wasn't an option to go to bed. There was an option to strap on a hot water bottle front and back and crack on. So, and and you know, turn all the lights off because I'm gonna be working in the dark.

SPEAKER_01 4:13

So that was the point then, the headaches when you realised something wasn't quite right.

SPEAKER_03 4:18

Yeah, I think so. The the headaches was really the first symptom, and that started when I was like 37. Then my father died very suddenly, uh, six weeks after I turned 40. And that was the first night. The night he died was the first night that I had what can only be described as the mother of all night sweats. Um, and I literally soaked through the bed, had to get up in the middle of the night, have a shower, lay towels down, uh, and all the rest of it. So that was a that was a rather rude awakening, shall we say, and then from that point forward, the night before my period was due, it would be towels down because we know I'm gonna have a huge sweat. Uh, and that that carried on the the night sweats carried on more or less from 40 to 47 when I finished. The minute I finished, they disappeared.

SPEAKER_02 5:06

And that that kind of I think that leads us nicely, actually, Rachel, into what did life look like for you before before you identify or you looking back retrospectively can say, Yeah, I think my hormones started to change then. What how old were you? What were you doing? Where were you?

SPEAKER_03 5:24

Tell us about Rachel then. Okay, so I was an international marketing director working in the health and beauty industry. I was flying around the world two and three times a week. Um, I had to just keep going because that's what the job demanded. And when I started to notice I'm getting headachey, you know, you know, my periods are going a bit haywire and what have you. It wasn't an option to just take to the sofa with a hot water bottle. I didn't have the time for that, and neither did the people that were depending upon me. So I think with women generally, there is a lot of I've just got to get on with it. I've just got to crack on. Um, you know, and although I was starting to feel my energy levels doing this, and the way that manifested was really, I just couldn't seem to do what I did a year ago. I didn't seem to be able to focus my mind in the same way, I didn't have the same level of energy. You know, yes, I worked very long hours, and I know that will have been a factor, but it was just that feeling of I need to nap, I need to lie down more, I need to not be doing stuff, but the pressure to do stuff was so intense, I just did stuff.

SPEAKER_02 6:40

So did you find that? So I think that the way this all begins is quite insidious, actually, Rachel. I think that what tends to happen is, you know, we think, well, you know, yeah, I am really tired, but I am working hard, and you know, I I am putting on weight, but you know, I'm probably not eating the best, and I am, you know, struggling with my brain fog, but I've got a lot on. And I think you know, it creeps in, and I think before we know it, then actually, you know, this is starting to impact our daily life. So when do you think that this started becoming something that you found unmanageable?

SPEAKER_03 7:21

I think probably um around about 38, 39, so maybe two years after I consciously thought things are going a bit. Um, and I think there were a number of factors in that. I think at that time I'd made a decision that I wanted out of marketing. I was sick of flying around the world, I was sick of working, you know, 16-hour days, and I needed an exit strategy. And at that point, I started up what I suppose people now would call a side hustle. Um, but I started a beauty clinic where I did evening weekends. Yeah. Side hustle. Well, just to digress for a moment, I think we have generally become a society where I don't know too many people that only have one job. I think a lot of people are doing a lot of things to try and keep a lot of plates spinning. Um, and that's just kind of the way our generation is. Um, but to go back to what I was saying, I think that knowing that I wanted to get out, that was one kind of pressure. Knowing that I needed something else to do because it wasn't an option to, you know, I'm not a trust fund baby, that wasn't an option. Um, so I started up this other business, but the other business had to run parallel with my day job. So I started cutting down on the travel in my day job by actually saying, Well, do you know what? I know how to do this, but my team members don't know how to do this. So they can come with me once, learn how to do it, and then they can do it so that I don't have to do it.

SPEAKER_01 8:55

Um Yeah, I think as well, we make ourselves indispensable, don't we, in our jobs and careers sometimes.

SPEAKER_03 9:03

Yeah, I think so. And I think, you know, it's a bit of a lightning moment, isn't it, when you realise actually you're really not indispensable in any case. I run my own business and I'm not indispensable. So, you know, at that point I started running the other business. If I look back sensibly, I probably shouldn't have done it the way I did it because I was still working, you know, nine to six in an office job, but then at seven o'clock, I'd open the clinic and I'd do seven till ten, and I'd do that four nights a week and I'd do it one full day of the weekend. So actually, I was working a hell of a lot more hours in order to try and build a customer base to be able to step away fully from the marketing. So that sort of build-up period was probably three years, and that coincided um with me turning 40, and then six weeks later, uh my dad dropping dead very, very, very suddenly. And I think that sort of sent things stratospheric because you have the normal stress load, or the normal stress load, of two jobs, and then you have grief to deal with, which is something else, and then you have other people's grief to deal with. So I think that heady mixture probably tipped the balance for me.

SPEAKER_01 10:26

Do you know what, Rachel? I'm nodding along because at 41 I was running my own creative agency. And honestly, I fell out of love with marketing. Uh I lost my dad really suddenly. Okay. Although it was about 10 years ago now. Um so I'm sort of 10 years behind you on that timeline. But there's something about getting to this stage of life, and I'm not really sure it's recognised quite yet. You reach this point where everything sort of collides. And I I don't have children um like yourself. And sometimes I think that that for a lot of women there's this natural pause in life where you're almost designed to nurture and nest for a while, whether that's raising a child or building something, or just to have that period where you're allowed to focus on being a woman in that phase of life. And I I kind of feel like I've never really had that pause. You suddenly hit your forties, you're probably in perimenopause, whether you realise it or not, or want to deal with that. And then life throws these uh huge emotional things at you. Um and for me, it was losing my dad. And like you say, the there's the grief itself, but it's not about just your grief, is it? You're processing your own loss whilst dealing with everyone else's emotions, supporting other people, holding everyone together, and sometimes you just want to say, Hang on a minute, I'm just trying to deal with my own stuff here. So when you layer grief on top of hormonal changes, on top of stress and work and everything else, it's no wonder things start to feel completely overwhelming.

SPEAKER_03 12:03

When you I mean, going through paramenopause in my experience, and going through menopause is enough of a thing on its own without having other things layered on top of it. And I think when you get an unholy trinity of, you know, those kind of things going on together, it can make you feel bat bat boobar crazy, you know, for for moments there, because it's just like there aren't enough hours in the day to deal with your day job, your side hustle, your own grief, your mother's grief, your brother's grief, and everything else that's going on. It's almost like you're raising your hands to the side going, oh my god, anything else?

SPEAKER_02 12:46

Really? From a clinical point of view as well, what's really interesting about that is that you know, when we quite often women will say, I had this life event, and that seemed to be the catalyst for my symptoms or for my my menopause or perimenopause getting worse. And whether that be an illness or you know, a traumatic life event, or in quite a lot of cases, grief. And actually, what that does is it rises, you know, cortisol is a stress hormone, it's your body's response to trauma and stress. And your cortisol will then, you know, knock off the rest of your hormones and cause absolute chaos. And quite often, you know, this has happened your whole life, but you know, when you're in your 20s and your 30s, your body is very good at rebalancing, so everything will rebalance. Your hormones will rebalance. It's not something that we ever have to really think about, is balancing ourselves. But actually, what will happen is when your hormones are unstable, that cortisol really can, you know, I always say set the cat amongst the pigeons, actually. And it can really, you know, be the catalyst for these symptoms.

SPEAKER_03 14:03

I think that's true. I mean, I've been reading a lot about cortisol. When I started going through all this in my late 30s, I'd read somewhere that some American lady who was a gyneological nurse and had been for many, many years, and worked in a dedicated menopause type clinic in America, she wrote a book called Is It Me or My Hormones? And I thought to myself, do you know what? I really should get a hold of a copy of that book. So I trotted off to Dean's Gate, got myself a copy, read it. And the interesting thing about that book is there are lots of tick lists in it. It says, Are you feeling this, this, this, and this? Has your taste palette changed? Do you now drink things that you never drank before? What's your body craving? And I was just going through this book going ding ding ding ding ding ding. Yes, I'm somebody that never drank coffee before I went through menopause. I only started drinking coffee because I had terrible four-day cluster migraines. And my neurologist said to me, I know you hate coffee, but the best thing you can do for yourself is take an espresso, have a painkiller, wait 20 minutes, and nine times out of ten it'll knock you a headache on the head. That was very true. Hated coffee, piled the sugar in it to just neck it and get it done with. Peanut butter, peanut butter ice cream, peanut butter creme brulee.

SPEAKER_01 15:32

That's fascinating because we hear of ladies having cravings and similar experiences in pregnancy, don't we? Is that a similar thing then? Yeah.

SPEAKER_02 15:41

So if you think, you know, I I think we're so used to thinking and an old-fashioned way of thinking of it is really, you know, your estrogen, your progesterone, your testosterone begin and end in your pelvis. But that's not true. You know, we have estrogen, uh, progesterone, testosterone receptors in in cells all over your body. So, you know, when you're really thinking, could this be related to menopause? Could my my change of smell be related to my menopause? Could, you know, my tolerance levels be related to my menopause? Could the fact that my tongue, my tongue is burning or I've got really dry mouth, could it be related to menopause? Absolutely, yes to all of the above. Because really nobody would be in a position to say no, that's not related to your menopause, because we have these hormone receptors all over our body. So, you know, the change really from transitioning to a you know a reproductive woman to a post-reproductive woman, so menopause, is it's a huge transition.

SPEAKER_03 16:41

It's absolutely huge. I think the thing is, nobody actually prepares you for that. If you say, I mean, I I don't have kids, but if you think about it, preparation for pregnancy, you've got antenatal classes, you've got, you know, all this advice coming out of your ears at you from all sorts of different quarters, be it your grandmother, your mother, your auntie, whoever. Um, but with perimenopause, it's kind of it's all kept a bit silent. It's all like a bit of a mystery. It's just like it's almost like the saying, well, you know, when you get there, you'll know about it. Well, that's not entirely helpful, is it? I do actually very strongly think there could have been more preparation and advice going into this rather than not.

SPEAKER_01 17:27

Yeah, we've spoken about this before on the podcast. The practical side of things gets explained to us quite clearly. When we're younger, we're told you're going to start your periods. This is what happens to your body, here's a tampon, the demonstration with a glass of water or whatever. Yeah, here are the diagrams. But what we're really not prepared for is the emotional side of it. And I'd probably say the same is true for pregnancy in the postnatal period. We're we're starting to talk about it more now, but a lot of women still struggle emotionally through pregnancy, after having children, and then again during menopause. And there isn't really a guidebook for that part, is there? You know, for how your mood might change, how your energy might shift, or how your relationship with your body might change as you move through these different stages of life. And and going back to what we were talking about earlier in your story, Rachel, that shift in how you started to feel about your own body, that's just something a lot of women just aren't prepared for at all. And that's just your mind and your mood. The the physical changes can be quite drastic as well, can't they?

SPEAKER_03 18:34

I think it's human nature, isn't it, to want to present the best of yourself. So if you're not feeling your best for whatever reason, you know, it's like going to these school reunion things to be avoided like the plague, as far as I'm concerned. Because I don't want somebody to remember me from 20 years ago when I was about that thin. And you know, then I'm coming into the room about that wide, and you know, thinking, oh, these people must recognise me. It's just like, no, they really mustn't, because you don't look like you used to do. The only thing that looks the same is your hair, you know, and it gives you that, oh my god, everybody's gonna think I'm fat. I'll wear black, it's slimming. It doesn't suit me, but I'll wear black, you know, because I don't, god forbid, I should put something on that's jolly, because the word jolly in itself implies jolly rather than jolly, doesn't it? So, you know, it becomes a fight with your own mind to say, don't be so stupid, you know, these are still those people that you knew 20 years ago.

SPEAKER_02 19:38

What the you you know, you're you're painting your picture of yourself as a really sort of go-getter woman, you know, somebody that was really used to being able to accomplish all of the things that they wanted to do. And you know, and then menopause or perimenopause came along. And do you think that it impacted your confidence, you know, at throughout that journey?

SPEAKER_03 20:02

Yeah, very definitely, because there were physical factors at play. So, you know, brain fog is very real. People, you know, you say brain fog to a man, it'd be like, oh brain fog, that's your excuse, is it? You know, no, it's not an excuse, it's an actual living fact, you know, and I I went from being somebody I would have classed as relatively intelligent, fairly switched on, to being a space cadet. Because I would get up from the sofa, I would walk the two yards it is to the to the kitchen to get something, and I'd arrive in the kitchen going, I know I came in here for something, I've no idea what. I'll go back to the sofa. You go back to the sofa, you'll have the lightning moment, you'll get back up, you'll go to the kitchen, and it happens again because in that two yards that you've travelled, you've genuinely can't remember what you went there for. And I think the mental impact of that has been shocking and appalling because you feel like your mental faculties must be, you know, diminishing, and it's not a comfortable feeling. I I don't think it's a comfortable feeling for anybody. It was particularly not a comfortable feeling for me because I had these plates spinning in the air of day job, side hustle, and everything else that was going on in the background. So I think affecting your confidence shows itself in many forms. You know, that that's just brain fog. You've then got to deal with the fact that your body is physically changing shape, which you probably don't want it to. I I certainly didn't want it to. Um, and then the aftermath of that change, where you go into the resentment period of, you know, I really I've not I've not thrown out some of my old clothes. I'm probably like many women because I see the signal of throwing out the clothes to mean defeat.

SPEAKER_01 21:55

Bless you, Rachel, and I think that's a really honest thing to. say. And I suspect a lot of women listening will recognise that because when you spent years of being capable, high performing, spinning all the plates, running businesses, careers, families, whatever it is, your confidence is tied up in that. And that identity of being someone who can pretty much handle everything. Then suddenly your brain isn't quite as sharp, your energy isn't the same, and your body starts changing in ways that you didn't ask for. And you literally just have a bit of a wobble, don't you? Yeah. And you know I'm the same. That body confidence side of it is huge, isn't it? Because it's not the physical change. Yeah. It's what that represents. Like you say, the clothes in the wardrobe, they become almost symbolic. Throwing them out feels like admitting something has shifted permanently. But I think a lot of women sit in that space for quite a while that slightly resentful stage of thinking hang on, I didn't sign up for this. And the irony is when you're dealing with all of that internally, life doesn't slow down. You know, work still expects the same version of you. Family still expects the same version of you and you're just you know silently just trying to figure out you know who that new version is. Let's go back to so you've hit 40 you are in menopause. Um you started at 38? Yeah with the perimenopause. And based on our chat previous um when would you say you were through menopause?

SPEAKER_03 23:30

Well Katie'll tell me off for saying that but when did your periods stop let's say well the actual stopping of the periods was 47 and I felt like God was shaking his fist at me because I'd I'd not had a holiday in a couple of years and we booked a holiday and what happened? I come on on the flight great fantastic and then on for the whole 10 days of my holiday and then that's it. I'm over and out no more periods. It's just like are you really really are you kidding me? So that was that was that in terms of the physical cessation of the periods as for being through menopause I was still having hot flushes after I'd finished the periods and in fact I would say my hot flushes rather than my night sweats were worse after I'd finished having periods than they were before. The night sweats were definitely worse while I was in peri but the actual hot flushes were worse after I'd finished my periods.

SPEAKER_01 24:29

And you'd made the decision to to go through menopause naturally and when we say naturally we mean with without the help of HRT.

SPEAKER_03 24:39

Yes I like many women had you know heard all the scaremongering about breast cancer and you know likelihood of that increasing if you go on HRT and I've just decided you know what that's not something I want to put myself through you know this increased risk because whilst it might help here I might get something awful there. And you know I did try every I tried everything that you know everybody wrote about red clover you know ginseng I tried these and I can't remember what the brand name was but they were like lady magnet things you were supposed to wear them clipped inside your knickers underneath your belly button well the only thing it did for me was set off alarms at airports which was embarrassing so I ditched that fairly quickly.

SPEAKER_01 25:25

Looking back then Rachel do you think you had access to the right information to be able to make those decisions?

SPEAKER_03 25:30

Not at all. Not at all. I don't think my neurologist had a clue about why the sudden onset of the migraines and that it was in all likelihood the changing of the hormones that brought this about. And I you know even now even I'm not medically qualified but I can tell you this which is those four-day cluster migraines finished the minute I had my last period. So fairly conclusive proof for me.

SPEAKER_01 26:00

Whilst we wait for Katie to rejoin the call um her internet keeps getting knocked out she's having wind issues um just to clarify she's having wind issues with the weather not her own wind. That's not knocking the internet out I'll throw a factoid at you actually off the top of the head. There is this huge uh gender gap in medical research and if you're female you are 50% more likely to be misdiagnosed. And this is purely because the medical research that's gone before has has been done on males predominantly. Right. So there is this huge lack of information out there particularly for women which drives me bonkers because even nowadays when you open up a packet of paracetamol there's war and peace in there isn't there I think also that that that a lot of I think doctors fall into two camps in my experience they're either pro-HRT or they're against HRT and the interesting perspective on that is in England I went to my own doctor who's my own age and is going through it and she was personally very good.

SPEAKER_03 27:10

In Spain no that there seems to be a general reluctance at general practitioner level to prescribe HRT.

SPEAKER_01 27:19

So I bring my HRT in from the UK otherwise I wouldn't be getting it I don't think so when was it you made the decision to go and see a doctor then Rachel because you'd initially made the decision to go through menopause naturally because you'd gathered all this information whether it be accurate or not what was a turning point when you said enough is enough I can't go on like this I'm gonna go and get some professional medical help.

SPEAKER_03 27:45

It was that conversation with my friend over coffee because she said to me about not being yourself you know I've known you a long time and you feel you you you seem very very flat she said you don't seem depressed you just seem flat and then she told me that she'd started taking HRT and actually my friend's family have the history of is it the BCRA2 gene the one that makes you higher propensity for breast cancer and she said for the same reason she held off going on HRT but what we were both dancers and she said you know look I went and sat down with my doctor and even though my family have the gene my doctor said let's start on the patch and take a small oral supplement at low dose and see how you get on and we'll monitor you. And at that point I thought well do you know what if my friend who has that gene in her family has started on HRT and she's informed herself through the conversations with her doctors then realistically I should be able to do it too. So it was that woman to woman link of sitting down and talking about it and thinking well do you know what actually I've got nothing to lose by trying it if I don't like it I can always come off it and that's that's what made me do it.

SPEAKER_01 29:14

And how was that moment then Rachel was it a light bulb moment?

SPEAKER_03 29:19

Did you start taking your HRT and feel like you'd been reborn or no so I started taking the patches I'm dutifully slapping them on my backside twice a week different cheeks end of month one I'm like well I don't feel any different you know I don't feel less tired I don't feel more energetic yeah now that's a bit of a downer so I thought well okay bear with it I had a chat with my friend and she said yeah she said I didn't really feel any difference until the end of month two and she said I wasn't bouncing around like Tigger at that stage but she said I did feel a difference. So at the end of month two I reassessed and I was like I do feel slightly less tired I'm not not napping in the afternoon I can get through a full day without a nap um you know which at 51 should be getting through a full day without a nap. And then at the end of month three I actually started to come round a bit and feel like yeah I could probably go and do a dance class. Wouldn't be full on but I could get out of my chair get in my car drive to my dance class do my dance class and come back again and then take to the sofa as opposed to just taking to the sofa.

SPEAKER_01 30:35

So yeah no it didn't it didn't really bounce in until we until month three and honestly I kind of think it got better up to month six so there'll probably be a lot of ladies listening now that have been putting off taking HRT for the same reasons as yourself. Or even just going to see the doctor never mind taking HRT because of the risks or the risks they think there are or because of the horror stories they've heard so if there's anyone listening to this now what advice would you give to them Rachel?

SPEAKER_03 31:10

I would say one size does not fit all and that just because you know this research came into the marketplace and was was later proven to be a scare rather than based in fact that just get yourself assessed as an individual and take some time to write down your symptoms before you get in a room with a doctor because at the end of the day you only get seven minutes on an NHS appointment these days to go and talk about your symptoms so have them down in front of you because if you've got brain fog at the time you can't remember them it's not very helpful. Whereas if you've actually taken 10 minutes, written a list of I feel a bit flat, I'm putting weight on I'm having terrible headaches, my skin's gone like a spotty teenager these are key things that the doctor if they're at all interested in their patient should be saying do you know what it's time for us to have a health review and I think that issue of health review is key at certain milestones so you you mentioned before you have all these milestones to meet when you're a baby you have milestones at puberty you have milestones at pregnancy but then it's like it's all bets are off until you get to be a pensioner and then suddenly they're a bit more interested and you know they're inviting you for poo tests and you know all the rest of it. So why not have something that's designed for a midlife woman that's like a midlife MOT it's almost like in Spain they have the well woman appointments. Now I'm well well aware that in the UK sometimes that's a feature of a private medical package. It's certainly not a feature of an NHS treatment and I'm gonna challenge it and say maybe it should be because you know we're all getting older and we're all going to go through it.

SPEAKER_02 33:07

Do you so I I think in in my experience Rachel is that the women that I meet and the women that we see in clinic actually aren't aware you know they know they want to feel better and that's why they want to take HRT but they're not aware of the impact it can have on your future health. And so many women you know don't realize that actually perimenopause and postmenopause is you know perimenopause is a is a critical health window. And what that means is the things that we do in this time can shape our future health and you know from a healthcare point of view it's very short-sighted isn't it if we look at you know treating all of the things that happen to women cardiovascular disease diabetes osteoporosis and if you look at what HRT can do then actually you know it really does reduce your risk of those three things and other things um you know in in midlife and and realistically you know why are they not shouting this from the rooftops?

SPEAKER_03 34:11

Why are the NHS and various governments around the world not saying well actually take action now?

SPEAKER_02 34:18

Well I think it's changing it's changing it depends where you are and I think you know it it's hard to tell but I think as women you know we're the voice we're the voice and the louder we shout then the the more people that will listen because as women we deserve to be given the right information to be able to make the right decisions for us. Nobody's saying that everyone has to take HRT but what we're saying is goodness you know we're clever enough and old enough that if you give us the information I'm pretty sure we can make up our own mind carry on.

SPEAKER_03 34:58

I was about to say I think it's the provision of the information in the first place it's completely and utterly lacking.

SPEAKER_02 35:05

And I think yeah and it's you know and a lot of the time it's it's opinion based you know I I don't I I'm not I'm not particularly interested in my doctor's opinion you know I I I'm interested in the facts I'm interested in what is this going to do for me? What are the benefits and what are the risks? And it certainly sounds like throughout your journey Rachel you know you've really had to fight hard to get the right information and and I I wonder if I wonder if you would how you would assess the situation now do you you know do you feel like you've got the right information do you feel like you're able to make the right decisions for your for your health now how old are you do you mind me asking no I'm 55.

SPEAKER_03 35:47

55 so at 55 do you feel like you've got the right information you need no I feel like I've got part of the information that I need I think the part that is lacking for me now is that okay I've got the HRT so certain of the symptoms have died off and improved. However you know things like the weight gain associated with HRT and the propensity to do I know whether I'm heading towards diabetes? No I don't do I know whether my blood sugar is too high? No I don't do I know whether my cholesterol is too high? Well I know it was too high last time it was tested but the last time it was tested in the UK it was marginally too high and I was told that you know it's going to be at least six months before you can come back and have it retested. And and the reality of it changing in that time was probably not that great.

SPEAKER_02 36:44

I think it's also you know and and you say about knowing all of these things about your body and how your body works I think the the fundamental bit there that you haven't included is why? You know why why has this happened? Why did I go from being a very healthy 35 year old with low cholesterol and a good blood pressure and able to do all these things and why now as the result a 55 year old with higher cholesterol or you know maybe not in your case but higher blood pressure or uh you know a widening waistline and all of these things that contribute to a higher you know a higher risk of poorer health and and that's the question that we should be asking because you know could these risks have been mitigated and and absolutely you know I think we would all argue yes wouldn't we if we knew why these things are going to change then we would then know what we could do about them rather than you know being a sitting duck.

SPEAKER_03 37:42

Yeah I I also think that there's step A and step B. Step A is exactly what you've just described but a lot of women will leapfro from step zero to step B because B is their reality currently I know I'm overweight I know I need to do something about it. Don't know what to do. You know all I can tell all I can tell you is that no matter how clean you eat, no matter how much sugar you deprive yourself of the waistline is still widening. So it's almost like that's the more I don't know if it's for every woman but for me that would be a pressing imperative because I'd like to know that the waistline is going to stop widening and actually that it might decrease.

SPEAKER_02 38:24

And so I'm you know this is probably an entirely uh a separate episode because I feel like we could really go to town on this but for for our listeners I know and you know for you I know that there's going to be people interested as to why that happens so why is your waistline widening because you know it's not what you know for the vast majority of women your food your diet hasn't changed dramatically and you know I think we all are aware of what we have to do and we know that. And actually what happens is when we look at your the estrogen effect or estrogenic effect on your body so usually things like insulin resistance will increase in perimenopause and menopause. And that means that women say you know I don't understand I've been doing the same thing my whole life and now I'm 10 kilograms heavier. Yeah and and and that's and that they've got their answer in the question is you know because you've been doing the same thing you know your whole life and your body is not the same. So we have to really be given the tools how do we how do we eat for optimal health in perimetopause and how do we move you know because spinning and running that's not the option anymore and it's confusing. It used to be when you were 25 but you know at 45 and 55 and 65 is not the answer. No and you know we also know that actually estrogen is a protective hormone and your body makes it in your ovaries but when your ovaries aren't making enough of it and this is in the simplest terms you know your body will try and generate more estrogen from your fat cells so it it retains your fat cells or holds onto fat more aggressively. And I I think 99% of women don't know that no of course they don't of course they don't and so what happens is we walk around you know feeling shamed and being shamed by our GPs that say move more and eat less and I have lost count of the amount of women that I meet that will say you know I don't eat breakfast I barely eat and then I'll have something at lunchtime and then you know it gets to the end of the day. And absolutely what that is is sabotage. Because if you're if you're insulin resistant yeah then you know there are things that are going to make your waistline bigger that you know isn't the food that you're eating it's it's more to be a lack of so yeah you know it's just information that we could really do with it 35 isn't it absolutely but also I think that you know my marketeer's brain even though I've left that behind me is saying now somebody needs to come up with a program how to move the needle.

SPEAKER_03 41:06

The needle's already over there we'd like it to be here preferably or there although I don't think that's realistic.

SPEAKER_01 41:14

And I think the world we live in as well there's a lot of misinformation out there. Oh totally so the information and we talked about social media and Katie's talked about the opinions of people the opinions of doctors even so a lot of the information that we come across as women and I'm inundated you are Katie is I'm I'm sure we all are we're inundated with information what do we eat how do we exercise and we we take little different parts of the jigsaw different parts of different people's opinions and we put it all together and it's wrong.

SPEAKER_02 41:48

I think also on social media that that they've a lot to answer for with all these take this quiz things Health Insider and you know shrink media and all the rest of it about cortisol detoxes take this powdered supplement it'll change your life take this pill it'll make you lose weight all that do you know Rachel I would argue actually and this is one of my favorite topics because it's probably my biggest passion is I would argue you know there is always going to be and there always will be someone trying to sell you something and and I'm okay with that I really am you know I really am but I would argue that what makes us vulnerable is a lack of the right information. Because if you knew what your body was doing then you would be able to know that actually you know doing a cortisol detox you might as well you know it it's just not going to do anything because a waste of your time and money. But you do know that taking a good B12 is going to help you. And we don't have to be you know brain surgeons we just have to and I feel very passionately about this as a clinician we have to make sure that the right information is out there for women to access because once we do that and once we let women know what's happening to their bodies and how their bodies are changing and how this is going to impact them then we give you the tools to be able to you know carefully select what what you think is going to help you not blind because at the moment I think you know most women I meet are in a blind panic you know how can I and exactly how you talked about when you were in your late 30s early 40s my life is not going to stop I have you know a busy job I have demands on me how can I fulfill that and I need to feel better so when we look at Instagram or Facebook or you know whatever else and we see these supplements or these powders or tinctures or courses or whatever the hell else is out there then then We will say, Well, God, you know, I'm desperate. I'm desperate. But why should we be desperate? Because menopause and perimenopause is natural, it's an entirely natural part of life. But that doesn't mean it should be suffered through, for goodness sake.

SPEAKER_03 44:15

No, and I think that suffering thing is a really good analogy because I think as you know, received wisdom, inverted commas from grandparents, mothers, whoever, you know, things change over. I mean, if you just take a look at midwifery, how has that changed over the years? How a woman has a baby now is completely different from how a woman had a baby in the 50s, and all that knowledge has been applied and people are aware of it. Well, if only they'd taken the same time, care, and attention and put it into the next stage of a woman's life, which is perimenopause and then obviously menopause and post-menopause. You know, there are a huge number of us post-menopause and increasingly going to be numbers of post-menopause. And how do we manage that?

SPEAKER_02 45:04

Can I um also just and I wanted to do this earlier, but it seems like a good time now just to circle back or draw a draw a circle, should I say, around postmenopause. And and you you mentioned it earlier when you said through the menopause. So what does that mean? And I think this is a big myth, is that you know you're gonna have perimenopause, which is transitional, you're then gonna stop having your periods, and then one day, who knows when, you're gonna wake up and say, Oh, thank God that's over. I feel fabulous now. And but you'll be waiting a very long time, Rachel, because it doesn't happen. You know, really, you are perimenopause until you're menopausal, and then you are menopausal for the rest of your life. And that doesn't mean that you're gonna have the same set of symptoms and they're gonna plague you until you're 95. And the amount of women that I meet in clinic who are in their 60s and 70s and have really missed the boat for the biggest amount of cardiovascular protection with HRT, and are saying, I feel robbed because I've been waiting for the last 15 years to this to for this to finish, and I still feel rubbish, and and now I want HRT, and you're telling me if I'd have taken it 10 years ago, you know, my outcome would have been more favorable. And you know, that's that's a really big deal. It's a really big deal. So, you know, if if people don't take anything else from this, it's that you know, menopause is not just gonna finish. It's not gonna magically end.

SPEAKER_01 46:54

No, there's no end point. Yeah, and I think that's really important. You're never too old to ask for help. And I know certainly from my work with Katie, uh, one of your patients, you know, bringing a mum in, you know, was in her late 70s, and and and people getting help in their 70s, even my mum's in her 80s, you know, and it doesn't like we just reiterate the point, it doesn't suddenly stop. So if there's ladies listening to this in their 70s and 80s, and I hope they are, you know, it's not too late, you know.

SPEAKER_02 47:25

Absolutely.

SPEAKER_03 47:26

That's that's interesting because I don't think a lot of people know that. I know my own mother doesn't know that. Yeah, my own mother, you know, made a statement not so long ago about I wish I'd have done HRT because you know, I'm in my 80s now, my skin is shot, this is shot, yeah.

SPEAKER_02 47:41

And you know, don't get me wrong, it it is it a sensible idea to go around prescribing every 89-year-old HRT? Probably not. I mean, I know that there are practitioners that would argue argue that also. But really, HRT should be given a risk-benefit analysis. And I have a handful of patients in their 80s who or you know, late 70s, who actually, when we look at what their what their menopause or their menopausal symptoms are doing, so they're not sleeping, you know, they're uh getting hot flushes, night sweats, they've got a dry vagina, they get constantly got UTIs. Actually, if we give them a bit of HRT, are we going to be able to you know prolong their life? Probably not, but are we gonna be able to improve the life that they've got? I I would say yes. And you know, we we have to be sensible. And again, going back, is HRT for everyone? No. But should we all be given the choice, regardless of whether you're 85 or 35?

SPEAKER_03 48:47

Absolutely we should. Absolutely we should. Yeah, definitely, and I think it's a really interesting point about, you know, it's not necessarily too late once you just finish starting your sorry, once you've start, can't get my teeth in, once you've finished your periods, it's not too late to start HRT then.

SPEAKER_02 49:05

No, and I think, you know, on the other hand, as well, Rachel, is you don't have to wait to stop your periods before you access help. And you know, if you as women, we know our bodies better than anyone else. And so I I say, you know, I say on all of the social media we do, I say it all day long. If you are a woman and if you think that your symptoms might be because of your hormones and their new symptoms, then you know, really make sure that you educate yourself and go and see a good practitioner because because you know, uh life is really short. And it's really important that, you know, with all the plates that we're spinning as women, we we live a good one, you know.

SPEAKER_03 49:52

I think um, you know, the one thing I would say to people who are listening who are younger, who haven't hit this stage of life yet, is you know, going through it naturally is not necessarily the best way to do it. Uh, had I had my choices again and had better information, I would not have left it as long as I did before I got help. Because it's not necessary to struggle, it's not necessary to go through the feelings of you know, isolation and oh god, and the the exit, the excess fatigue and all the rest of it, because there is help available. And so if I was talking to my younger self, it would be get yourself out there earlier.

SPEAKER_02 50:36

This episode of Fannying Around is supported by ClearBoost, a women's health supplement range I created after years of working in clinic and seeing how confused and overwhelmed women felt by supplements. Each product is designed to support the symptoms that I see most often: hormone changes, low energy, poor sleep, low mood, and stress. Using ingredients chosen for their specific roles in hormone regulation, energy production, and nervous system support. The idea was to replace long random supplement lists with a small number of targeted formulas so women know what they're taking and why. Find out more at clearboost.eu.

SPEAKER_01 51:31

So funnying around with Rachel, um a lot came out of that episode I wasn't expecting actually.

SPEAKER_02 51:37

Oh, I loved it. I loved it. I think there were so many conversations, you know. I I have conversations like that with so many of my patients, and the same themes come up, you know, that complete lack of body confidence, and really feeling lost, you know, going from being somebody that's incredibly confident and self-assured, and then kind of entering this no man's land where all of the rules have changed, and you know, you don't know your up from your downs.

SPEAKER_01 52:04

I think the three biggest takeaways from Rachel's episode for me were this fantastic career she had, and the Rachel before she hit menopause. She had her fantastic career and a side hustle, and then she was thrown this huge spanner of losing her father, which completely threw her off balance. Um, I think she'd already sort of entered certainly perimenopause, possibly even menopause. And even speaking to her now, I don't think she's fully got a handle on her symptoms and still isn't particularly confident in her own body or how she feels.

SPEAKER_02 52:45

Yeah, yeah. I I think you know, uh the without the information as to what does this trajectory look like, and you know, if you're just sitting around waiting for menopause to finish, then it Well, that was going to be my third point.

SPEAKER_01 53:01

She and a lot of ladies, and that kind of struck me, they go, Oh, yeah, I was all over and done, Rachel's words, or when I finish menopause, and I kind of saw your face, and you were like, finish menopause?

SPEAKER_02 53:15

I know, I know. I had a lady in clinic today, and she actually she said her starting sentence was, you know, I I started this at 42, I'm 63 now, like surely enough's enough. And I completely agree, but only if you're not managing it, you know, and I say you're not managing it, that responsibility is not on the woman. I'm just gonna absolutely add that only if your symptoms are not optimized or your hormones are not optimized, and absolutely enough is enough, you know. And I think when you've spent that that long period of time feeling, and I kind of got this from Rachel, that she felt a bit lesser, you know, that her menopause and her weight gain, and you know, it lessened her somehow. And and that that that I don't like. That I think you know, if if if we can empower, and certainly in my clinic, if if if I could empower one woman, you know, to realise that actually it doesn't have to be lesser, you know, lesser, absolutely bloody not. It's you know, it's about being more and and kind of harnessing that information to to work out how you can be.

SPEAKER_01 54:30

I think Rachel was a great example of sort of our traditional um opinions and thoughts and attitudes towards menopause because when we first started the conversation with her, she was adamant that her journey, she was gonna go through, and I use sort of inverted comments here, she was gonna go through menopause naturally. And this we hear this a lot, don't we? What does that mean? Is that just without drugs?

SPEAKER_02 54:58

Is that you know I I really I so I you know you know me, Rosie. I am so pro-choice, absolutely. Whatever floats your boat, if you wanna, you know, put on a purple hat and you know sail down the freaking Thames, and that's what you think makes your menopause better, do it, you know, do it, but but do it knowing everything that you need to know. And I I really feel like that when women say I want to do it naturally, that is loaded. And it seems to be because it's something that we've been told that that is the better thing to do.

SPEAKER_01 55:38

Yeah, that is almost like a badge of honour.

SPEAKER_02 55:41

Only, only we it's a bit like how people used to feel about antidepressants, or maybe still do, but you know, if you're weak or if you can't handle it, then then you'll take HRT. And I think the narrative is changing, but yeah, it that I want to do menopause naturally really sticks in my throat. And not because, as I said, I and I can't, you know, I can't reiterate it enough, not because I'm you know banging on the drum of HRT all day long, but because I think that most women, given the right information, would not say that.

SPEAKER_01 56:18

Well, you you're absolutely right in Rachel's case, because she decided to take this natural route because of the scare stories she'd heard based around cancer and and the risks attached to it, which when she spoke to a friend of hers who was at much higher risk, having had it in the family, she had a word with herself, didn't she? And go, well, if she's got HRT and it's really helping her, then maybe it could help me. It's again back to this information, and you know, we can bang the drum as loud as we like, but often it comes, and and that's the whole point of this podcast, from having a conversation with a friend or from overhearing it from a group of ladies you know.

SPEAKER_02 56:56

But also, do you think I think there was so much of Rachel and I could have spoken to her for forever because I think there was so much about her, and she reminded me of lot a lot of the patients I see in clinic that have been started on HRT and felt like a slight improvement in their symptoms, and it's like, okay, well, you know, I don't feel as bad as I did. So that's great. And you know, I'm just kind of waiting for it to finish, and they kind of feel embarrassed about being in my clinic, you know, they're like they're taking up my time, and there's probably nothing else I can do. And my answer always is like, what are your expectations? Because actually, if you're 50, 60, 70, 80, you your expectations to feel as good as you want to feel and achieve all of the things that you want to achieve are very valid. And you know, until we're sure that we've optimized your estrogen, your testosterone, your progesterone, your supplements, your lifestyle, all of these things that we we have as tools, then let's not stop. You know, let's keep going.

SPEAKER_01 58:04

Yeah, and do you know what, Katie? It's the way we've been marketed to, isn't it? Because our our mums and and and that generation, and and even certainly, I suppose, ours. Uh, menopause was always marketed to us as a something that happens to old ladies, and the imagery that was um put out there and all the connotations attached to it, it was kind of these old ladies that oh, we're at the end of their lives anyway, and they just kind of disappeared and died, you know. But thankfully, we've got some stronger ambassadors now, and we're talking to each other, and it's certainly not represented as end of life.

SPEAKER_02 58:45

Absolutely bloody lutely.

SPEAKER_01 58:47

You know, you look at these ladies and you think, oh, that's what menopause looks like.

SPEAKER_02 58:52

Uh yeah, absolutely. And I I think you know, if if anyone is listening to this and is thinking, well, you know, I've been on HRT for a while, and yeah, I'm still aching and still not sleeping, I'm still gaining weight, and I I hope that they pick up the bloody phone and make an appointment with someone. I don't care whether it's me, I don't care who it is, but make an appointment and say, you know, oh, actually, I don't feel great, and I feel like I could be better, I feel like I could, I could achieve more. And you know, I I suppose I'm going off on a bit of a tangent, but it literally just popped into my head. The thing that I hate more than anything is when people say, in some countries, there isn't even a word for menopause. In some in some countries, women aren't allowed to speak. So, you know, that's stupid. There should be a word for menopause. There should be a thousand words for menopause. We should be talking about it all the goddamn time. And you know, second spring, second spring, my ass. Because I just, you know, I just think, yeah, absolutely, it is a time for opportunity. But don't bloody second spring women, when they can't sleep, they're feeling like they've put on 10 kilograms, they don't have uh, you know, the relationship that they want with their kids or their friends or their husband, don't tell them that they're in their second spring and that in some countries there's no word for menopause because it's frankly unhelpful.

SPEAKER_01 1:00:27

And I think we'll end on Katie's Jim Royal styly outbursts, second spring, my arse. If you need help, get it. We'll be back with episode four, Fannying Around with Katie. No, not that one. Katie is an absolute joy, and she will be talking about her positive menopause and how she sees it as a rebirth. We'd love for you to fanny around with us. So if you've got a story you can share, head over to Instagram, Fannying Around Podcast, or you can email us fannyingaroundpod at outlook.com. Fannying Around was brought to you by Everything's Rosie, presented by me, Rosie Frost, and Katie Pitt Allen, and sponsored by Clear Boost Supplements and the Women's Health Clinic Europe.