The Dr Louise Newson Podcast

Clinical Director of Newson Health, Dr Rebecca Lewis, returns to the podcast this week for a special end of year episode with Dr Louise Newson. The business partners and friends reflect on some of the positives over the last 12 months and discuss the continued challenges in trying to help more women with their experience of perimenopause and menopause. Rebecca’s three hopes for 2023: Testosterone needs to be licensed for women (and not just for low libido) Treatment for significant and severe menopausal symptoms in the workplace to help keep women in work Education about the perimenopause and menopause reaching out to other medical specialties so more healthcare professionals understand how it affects the patients they see.  Follow Rebecca on Instagram at @dr.rebecca.lewis

Professor Chris Harding is a Consultant Urologist working at the Freeman Hospital in Newcastle upon Tyne and at Newcastle University. He has a particular interest in bladder dysfunction, continence and urinary tract infections (UTIs). In recent years, his research has focused on non-antibiotic treatments for recurrent UTIs and developing targeted treatments for specific patient groups. In this episode, Professor Chris talks to Dr Louise about the challenges of diagnosing UTIs accurately, the severe impact recurrent UTIs can have on your life, how antibiotics can be used appropriately, and how to prevent UTIs occurring. The experts share some of their plans to study the effects of systemic HRT and vaginal hormone treatments on UTIs in women. Chris’s advice if you have recurrent UTIs: You don’t need to put up with UTIs in the perimenopause and menopause; there are many proven treatments available Acknowledge that current tests for UTIs are not 100% accurate. If you think you have a UTI, you probably have, even if your test was negative - the diagnosis can always be questioned Discuss with your doctor how you can prevent infections if you have had 2 episodes within 6 months, or 3 within a year Hormone replacement, particularly vaginal treatments, are significantly protective and preventative against UTIs. Follow Prof Chris Harding on social media at @chrisharding123

This episode contains reference to suicide Professor Jayashri Kulkarni is a psychiatrist working in Melbourne, Australia, specialising in women’s mental health and researching the role of estradiol in mental illnesses such as schizophrenia and depression. She founded and directs the Monash Alfred Psychiatry Research Centre, a large clinical research group in Melbourne.  In 2022, Professor Kulkarni launched and directs HER Centre Australia – a Monash University Centre delivering Health, Education and Research in women’s mental health - dedicated to improving the quality of care for women with mental illnesses by developing specific treatments tailored to suit women’s needs. In this episode, the experts discuss the different ways estradiol influences brain health and function, what this means for healthy brain aging and longevity, and they share some of their experiences when helping women with mental health changes during the perimenopause and menopause. Prof. Kulkarni’s tips for women experiencing mental health changes: Trust your instinct – you know you best. If you think it might be hormones, help is available. Look at your background history. If you had premenstrual mood changes or postnatal depression in the past, this may mean you are particularly sensitive to hormonal changes. Early life trauma (e.g. neglect or emotional/physical/sexual abuse) can disrupt hormone signals and brain chemistry and this may make you more vulnerable to mental illness. Whatever your past history, there is help available in the form of HRT. See your local healthcare provider or a menopause specialist if needed. You can find the Meno-D questionnaire here. This tool identifies the specific mood changes that are more typically present in perimenopause and menopause related depression. For more information on Professor Kulkarni’s work and research, visit www.maprc.org.au

Dr Samantha Newman is a British doctor working in Hawkes Bay, New Zealand. After training in obstetrics and gynaecology, a moving encounter with a patient led her to re-train as a GP and develop an interest in supporting women’s health and wellbeing. Samantha’s clinic, FemaleGP, was established in 2016 to improve access to focused healthcare for women including gynaecological and sexual health and treatments for perimenopause and menopause. In this episode, the experts discuss shared decision making with their patients, symptom improvements with HRT, and supporting women to ‘listen’ to their hormones. Samantha also shares some of her experiences working with women from the Māori community and culture. Dr Samantha’s three tips: See your hormones as a journey and not as separate, distinct phases of life. Find support along the way – wherever in the journey you find yourself. For healthcare providers: see your patients as a whole person and as part of their families and find out their true thoughts and desires. Be honest with your patients and encourage them to be honest with you. If they haven’t taken your advice, revisit things and find out what didn’t align with their values rather than viewing it as a negative. For more information about Samantha’s work, visit www.femalegp.co.nz Follow Samantha on social media at https://www.facebook.com/FemaleGP and https://www.linkedin.com/in/samantha-newman-34223b230

Dr Laurena Law is a general practitioner working in Hong Kong who has a special interest in nutrition and lifestyle medicine to improve healthy aging and prevent chronic illness. When Laurena gained personal experience of perimenopause and saw the impact it was having on her own life, she decided to learn more about hormone health and evidence-based treatments for the menopause so she could help herself and her patients. In this episode, Louise and Laurena discuss cultural differences and similarities between British and Chinese approaches to menopause from both an individual and healthcare perspective. Laurena emphasises the importance of educating women so they know how to recognise their perimenopause or menopause and to empower them to make their own health needs a priority. She educates healthcare professionals in Hong Kong and further afield to ask women the right questions in consultations and to know how to prescribe body identical HRT. Dr Laurena’s three tips for women: Complete a menopause symptom questionnaire and repeat it every few months. This can form the basis of a conversation with your healthcare provider Find a healthcare provider that is educated and updated in menopause care Find a support group of women also going through the menopause to talk about the problems and challenges you’re going through – you’re not alone.

GP and menopause specialist, Dr Sarah Glynne, joins Dr Louise Newson on the podcast this week to discuss menopause care after breast cancer.  The experts share more about the breast cancer steering group established as part of the Newson Health Menopause Society that is working towards producing a consensus statement to support clinicians and improve the quality of life for menopausal women who have had breast cancer. Dr Sarah Glynne discusses the importance of individualising the risk-benefit ratio for every woman when making decisions around treating the cancer and weighing this up with treating menopausal symptoms. Sarah emphasises the importance of talking through the implications of each of these considerations using a shared decision making process. Sarah’s three tips for women after breast cancer: Understand the risks and benefits of the drugs used to treat your breast cancer and what this means for you personally. Ask your oncologist for more information about your own breast cancer, if you are not sure. You can then use the PREDICT tool online for understanding more about your own cancer risks and what additional benefits any treatments may offer. Read about non-hormonal options to help your menopause symptoms and cancer recovery such as diet, yoga, or acupuncture. Try various approaches to find the ones that may bring some benefit to you. Vaginal moisturisers and lubricants may also help and these do not contain hormones, and there are other medications your GP may be able to prescribe for some of your symptoms such as hot flushes. If your menopause symptoms are severe and your quality of life is suffering, ask your clinician to explain the risks for you regarding your cancer prognosis if you decide to take HRT, versus the risks to your quality of life and long-term health if you choose not to take HRT. If you have genitourinary symptoms of soreness and dryness, vaginal hormones are very safe for improving these symptoms. Read information on the balance website and the book ‘Oestrogen Matters’ by Avrum Bluming, and make a choice that is right for you through discussion with your clinician using a shared decision making process.

In this episode, Sam shares her moving account of the journey she has been on for the last five years when, after a miscarriage and losing her father, things started to unravel and her mental health suffered. A difficult few years followed spent navigating depression, trialling several antidepressants and anti-anxiety medications, and seeking help from psychiatrists to try and understand what was going on. At the time, Sam believed she was years away from becoming menopausal and through her own research sought treatment privately in the form of ketamine due to her desperation to feel better and function again. Through learning more about hormones and their effects on the brain and mental health, Sam has recently begun to take HRT and feels she has started on a more positive path to health and stability. Sam’s three tips for those struggling with mental health: Try and be assessed by a menopause specialist before accepting a diagnosis, medication or treatment from a psychiatrist – it may save you a lot of unnecessary suffering. If you do start taking HRT, be patient. It can take time and the dose and type may need tweaking before you feel the beneficial effects. Become as well informed as you can about your hormones and the menopause from good sources online. And talk to other women – you’re not alone.

Human beings are hard wired to adapt to unexpected life events but how do we manage this process alongside our natural need to control? Psychotherapist, Julia Samuel MBE has been interested in this question throughout her 30 year career supporting families with grief and bereavement. Julia founded the charity Child Bereavement UK and has worked extensively with families in the NHS and private sector as well as writing books on grief, family, and change. In this episode, the experts discuss human nature and our response to adverse life events and times of transition. Julia speaks of the importance of love and connection with others and about the impact menopause can have on relationships, family life and work. Julia’s tips for helping your relationship: Be aware of how you’re communicating in your relationship and look at what has changed Try and form a regular habit like going for a walk together to talk and listen to each other and make time to reflect Be aware of your own inner critical voices and turn down the volume on those. Turn up the volume of self-compassionate voices and practice being kinder to yourself Remember connection with others is key throughout our lives For more information about Julia Samuel and her books, visit juliasamuel.co.uk For support and information if you have experienced the loss of a child or care for a grieving child, visit www.childbereavementuk.org

Newson Health has recently appointed a Chief Medical Director to ultimately help more women improve their health. In this episode, Dr Magnus Harrison shares a whistlestop tour through his professional life so far as a Consultant in Emergency Medicine via New Zealand, Australia, and Manchester and his experiences in leadership at Stoke on Trent in the wake of the Mid Staffordshire NHS Trust’s ‘adverse mortality’ investigation. Via Harvard, USA and India, Magnus then oversaw the merger of Burton upon Trent and Derby NHS Trusts before the hardest time of his career to date – the COVID 19 pandemic where 8 staff members from his organisation lost their lives. Magnus discusses with Louise what he hopes to bring to the medical leadership and management of Newson Health and the key values that underpin his mission. Magnus’s aims for his leadership at Newson Health: I will be humble and led by professional curiosity to learn how to help more women I aspire to be a compassionate leader, will listen to understand, empathise and ask how I can help Kindness is essential and should underpin all that we do.

The focus of this year’s World Menopause Day is cognition and mood. In this episode, Dr Louise Newson talks to Dr Clair Crockett, a GP and menopause specialist with an interest in mood, mental health and hormones. Clair’s interest in the topic stems from her own experience of escalating anxiety, low mood and intrusive thoughts in the premenstrual phase of her cycle during her mid-to-late 30s. Through her own research, she looked for ways to help her symptoms including through lifestyle changes, supplements and antidepressants. While these all helped some aspects of her mental health, it wasn’t until she began taking HRT that the premenstrual mental health symptoms eased. The experts discuss the importance of considering hormones when helping women experiencing mental health problems and outline some of the ways they are working to improve education about menopause and mental health amongst healthcare professionals. Clair’s tips to women with mental health symptoms in perimenopause and menopause: Track your symptoms and periods, the balance app is a good way to do this. This will make it easier to relay to your healthcare professional when you see them. Ask who has an interest in women’s health in your GP practice so you can see the most appropriate person. Tackling mental health in perimenopause and menopause is multi-faceted, it can take a while to get it right through a combination of taking HRT, your food choices, exercise, and doing work that inspires you. Make peace with your body image and don’t let it stop your progress. If you’d like to read more about Clair’s personal experience of mental health and hormones, you can read her story here.