Government Policy On Menopause – What Exactly Is It?

There have been a lot of indignant women in the UK this week. The government rejected suggestions from the Women and Equalities Committee, including to introduce ‘menopause leave’ and make menopause a protected characteristic under the Equality Act.

government policy on menopause

A lot of women feel very let down and I get that.

The wording used for rejecting menopause as a protected characteristic was unfortunate. The government said such a move could have “unintended consequences which may inadvertently create new forms of discrimination, for example, discrimination risks towards men suffering from long term medical conditions or eroding existing protections.”

So of course the headlines were all about the protected characteristic proposal being rejected because it could hurt men. Not good. In fact, we can still fight menopause discrimination under three other protected characteristics – age, sex and disability. So there are ways around any such discrimination. We can fight it! All is not lost.

While I don’t like this government, I looked at their report and it’s very comprehensive. There were actually 12 recommendations and the government rejected 5. That means they accepted 7 wholly or in part. That doesn’t get covered in the media though.

The cost of HRT is set to plummet and doctors are getting better informed, even if on-going training is not being made compulsory. It is already a part of the UK medical curriculum – perhaps it is the older doctors who are less well informed? There are already lots of initiatives to raise awareness including making menopause part of the curriculum at school and encouraging employers to be more supportive.

There’s going to be a Menopause Employment Champion appointed and the NHS England National Menopause Care Improvement Programme, launched in 2021, is working to improve clinical care for menopause in England (shame that’s devolved). The campaigners have done great work to get things to change. Women are speaking up and being heard more.

The government wording I quoted above, highlights for me that menopause is viewed as a medical condition, when it is in fact a natural transition in a woman’s life, puberty in reverse. Medical conditions need medication, hence why all we hear about with menopause is HRT, when in reality it is lifestyle factors that often influence how bad natural (non surgical or illness related) menopause can be.

I just hope with all this awareness raising and championing, that the focus isn’t solely on HRT, but on how we can use menopause symptoms as the impetus to sort out our lifestyle, to give us great midlife health and set us up well for the long term.

I personally can’t see how menopause leave could work. Menopause isn’t like pregnancy with a fixed time limit. It can go on for years. If a woman is still having hot flushes in her 60s, having had them in her 40s, would she still be entitled to meno leave? It would be very difficult to manage. I also don’t want another easy reason for organisations not to want to employ older women.

But we could definitely benefit from more workplace understanding and flexible working! And that recommendation was accepted too – to make flexible working an option from day 1 of employment.

If you’re interested in the detail of this, I really recommend reading the actual government report rather than relying on the sensationalist media. Maybe I’ve just bought in to the propaganda. But it does make a lot of sense to me. And I always like to go back to the source. Click here for the report.  

You may also like Is It True 900,000 Women Left Work Because Of Menopause?

government policy on menopause
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Sex And Menopause – Keeping You Sexy

But it doesn’t have to be contentious nor taboo! Menopause means your body’s changing and so may your sex life. But not necessarily for the worse. It may even be an exciting new beginning!

But if you’re suffering from menopause symptoms (or actually perimenopause symptoms), experiencing decreased desire, and vaginal dryness is an issue, how do you keep sex a joy, not a chore?  If you’ve been with the same partner for a long time, how do you keep things fresh and exciting, especially if menopause symptoms have dented your self-esteem?

What if you’re just not feeling sexy any more? It’s a truism that in a great relationship, sex isn’t so important, but in a bad one, it usually is! And what if you don’t have a partner to keep the wheels on the road? Then what?

Sex and the menopause may call for extra creativity. Here are some ideas to help keep you and your sex life sexy.

Changing hormones

Many women struggle with the changes menopause brings, particularly when it comes to changing hormones and the dreaded prospect of vaginal atrophy.

A little known fact is that as oestrogen and testosterone both decline, testosterone hangs around in the body more. So years after menopause, women can have as much testosterone in their system as they did in their twenties! This means your interest in sex doesn’t necessarily decline even if the body doesn’t respond quite as it used to. Here’s a great article that talks about sex actually getting better with age and the difference between one’s genital prime and one’s sexual prime.

An issue for many women is vaginal dryness. Things can change down there and it can take many women longer to get aroused after menopause than when younger. Penetration can also be painful. I’ve been told that it can also be more of a problem for women who have not given birth vaginally.

Sea buckthorn oil, taken as a food supplement, can help with intimate dryness, as well as giving a boost to skin, so they say. HRT should help and vaginal pessaries in the form of Vagifem (available on prescription in the UK), used either alone or in addition to standard HRT, can really help keep things moist. Just a couple a week may be all you need.

Then there are some great lubricants out there.  The best of the commercial ones I’ve found is Pjur silicone lubricant as recommended by our Pleasure Workshop expert in the Members Club Becky Price. I chose Pjur Woman on Amazon and it’s really good.  It’s not cheap but it lasts! Because it’s silicon, it stays on the skin and doesn’t get absorbed. Before I found that I used organic Yes natural water-based vaginal lubricant, available on prescription in the UK. They also do an oil-based lube but now I really prefer Pjur. But their vaginal moisturizer is a useful addition to moisturizing routines. I wish Yes would do refillable dispensers for their moisturizer, so we can cut down on plastic while still getting the benefit! The same for the Vagifem pessaries which each come with a plastic dispenser – very wasteful. Reduce, reuse, recycle we say please!

But you may want to also try some wonderful organic coconut oil. It is really brilliant and moisturizers as well as lubricates. Organic coconut oil must be one of the most versatile products on the planet. As well as using it in the bedroom, for massage too, I wash my face and take my makeup off with it at night, I cook with it and it’s also a great general moisturizer.

Use it or lose it

Another theme is use it or lose it.  Your vagina isn’t going to shrivel up over night, but it pays to invest love and attention in its future health. If you’re a masturbation aficionado, keep up the good work and give your clitoris the attention it deserves. If you’re struggling to maintain previous levels of desire and sexual response, for whatever reason, vibrators might help both with a partner and without. But also don’t forget that desire can change from day to day, month to month. Don’t assume that because it’s dipped, it’s always going to be that way.

Also, don’t assume that heterosexual sex needs to always be penis in vagina. Maybe that’s just too sore or uncomfortable which it can be some women.  Just carrying on regardless because you don’t want to ‘lose it’ when it’s sore is a recipe for disaster. If that’s the case, take PIV sex off the menu for a while, reduce the associated stress about performance and have some intimate fun using other forms of sexual pleasure for both you and him.  But do keep up the vulval stimulation because getting  blood consistently to that area is what will help keep you going long term. Then bring back PIV as and when it feels right to do so.

Not only can vibrators make orgasms a forgone conclusion (hooray!), but they are also useful during a dry spell to maintain sexual function and blood supply to the necessary area. And of course have fun!  Vibrators can also be great for lighting that first spark of desire if it’s taking a while to get aroused with a partner, which may be a bit soul destroying for both of you.

My favourite vibrator supplier is Sh!, a women-run real-life and on-line store which is a veritable women’s erotic emporium. Everything you might have ever fantasied about, you can find at Sh!. Time Out describes it as the ‘best sex shop for women’ and there are hundreds of  products for all sexual persuasions to tickle your fancy.

There’s loads of advice on their website, as well as classes in store if you live in London, UK.  They also have plenty of erotica that might just wake you up in ways you thought were long since gone. Try out their egg vibrators if you haven’t already experienced these delightful little toys. They’re great for getting the juices going when you’re struggling to get in the mood. Sh! has given our sister site, The Mutton Club. their advice for having great orgasms here.

Orgasms galore

Finally, for the orgasmically challenged or just sexually ambitious, decide to spend some time with Betty Dodson.  Betty has made it her life’s mission to educate women on sexuality and masturbation, and to ensure that every woman achieves amazing and consistent orgasms. She teamed up with Carlin Ross, another sex educator, to amplify their collective voice and change more women’s lives. Their website is a mine of great information and their work constantly inspiring.

Have fun! If you want some more help with both intimacy and pleasure and re-igniting your intimate relationship check out the workshops on these in our Membership.

Check out my podcast with midlife sex therapist Dr Sonia Wright.

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Natural Treatment For Menopause – All You Need To Know

Recently I’ve been delighted to see much more talk about menopause. It seems we really may be seeing the end of it being a taboo subject, which is fantastic. As we raise awareness, though, I’ve noticed the majority of talk around helping women cope centers on HRT.

Since my early menopause at 41, I’ve spent a decade researching all the ways in which women can be helped to vibrantly transition through menopause. I’ve researched differences in menopause experiences across cultures and looked at reasons why in the West, especially the UK, we seem to suffer worst. I’ve learnt a lot! It’s important we have the full picture so we understand our options for natural treatment for menopause.

There are many diet, lifestyle and mindset changes we can proactively make that allow us to have a different experience of menopause and often a vastly improved one. I’m not anti-HRT, far from it. I was advised to take HRT after an early menopause at least until normal menopause age of 51.

This was to protect my bones and heart from 10 years or less of estrogen than normal. You can read more about my early menopause experience here.

natural treatment for menopause

Back then the advice was to stay on HRT only until ‘average’ menopause age of 51, if I was feeling OK then and I took this to heart. I have an inherent dislike of taking medication unless I absolutely have to. High blood pressure didn’t go away after pregnancy and I was advised to go on BP medication because of family history. But my father was obese and immobile for much of his life.

I took my BP meds at first but subsequently tried lifestyle changes to keep my BP normal. I take a similar approach to menopause. Only time will tell if I’ve been successful in my efforts avoiding medication!

When it comes to HRT, I chose to come off it at the age of 51 and have managed any symptoms since entirely naturally. (Click here to read about how I weaned myself off HRT.) There is plenty of natural treatment for the menopause. In this article I’m going to tell you everything I know about that.

Menopause Symptoms

So what are the main symptoms women struggle with most in menopause? Many women sail through without noticing anything more than the end of their periods. For others, symptoms often attributed to the menopause can include the following:

  • Hot flushes (flashes)
  • Sweating
  • Irregular periods
  • Trouble sleeping
  • Headaches
  • Aching joints, muscles and feet
  • Restless legs
  • Breast tenderness
  • Weight gain
  • Urinary incontinence
  • Changes in skin and hair
  • Irritability and forgetfulness
  • Anxiety and feelings of insecurity
  • Diminished sex drive
  • Vaginal dryness

There are actually reported to be 34 symptoms in all that can be attributed to the hormonal changes of menopause! But these are the main ones.

So what can you do if you prefer natural treatment for menopause rather than reaching for drugs to manage it, or you’ve been advised against HRT? Ultimately however natural and ‘safe’ HRT may be shown to be, it’s still a drug. It’s still manufactured from its natural source.

It comes in sachet, patch or pill format which means the ‘natural’ element of it is highly processed. HRT is touted as the cure-all for the whole range of menopause symptoms because it restores the same hormonal balance you had before perimenopause hit. But we’re designed to go through menopause and live the latter part of our lives with less estrogen.

How To Balance Hormones Naturally

Let’s start with how to achieve better hormonal balance naturally and then I’ll also give some ideas on what you can do for specific symptoms.

1. Balance your blood sugar and sort out your diet. Start with what and how you eat. As Jackie Lynch writes in her book The Happy Menopause, the most fundamental component of good hormonal balance in midlife and beyond is making sure your blood sugar levels are as stable as they can be.  As we go through the perimenopause years, estrogen decreases. But it doesn’t go away completely.

The ovaries stop producing it, but it’s still made in our adipose tissue and by our adrenal glands. It’s a weaker form of estrogen but still estrogen. The problem is that if we’re stressed and our bodies go into fight or flight mode, the adrenal glands prioritize production of our stress hormones in favor of estrogen. Then we get into trouble with menopause symptoms.

Stress can come in the form of bog standard emotional stress. Or it can be stress we put on our bodies, making them think they need to go into fight or flight mode by causing our blood sugar levels to be imbalanced. This happens either because we haven’t eaten when we should have, and blood sugar has dropped, or we’ve consumed the wrong thing that makes our blood sugar level spike.

So eating (and drinking) regularly and the right things becomes ever more important. Caffeine, alcohol, sugar and refined foods can all cause our blood sugar to spike and then plummet when their effects wears off.

All kinds of stress are bad. So we need to start with reducing stress and eating/drinking in such a way that our blood sugar levels are balanced. A little and often, and eating protein and complex carbohydrates (such as beans, whole grains, and starchy vegetables), which are high in fiber, with every meal is a good way to go.

Now is the perfect time to make your diet healthier overall and include lots of fresh vegetables. Cut out processed food as much as you can. Refined carbohydrates, in particular, are known to mess with our hormones generally, quite apart from the blood sugar spiking effect.

Eat plenty of fruit and vegetables, reduce your alcohol, sugar, and caffeine intake, all of which mess with hormones and cause hot flushes, and eat natural phytoestrogens to replace the estrogen your body no longer produces with foodstuffs like flaxseeds, lentils, tofu and soy. Here’s a comprehensive list of foodstuffs that can help.

Daily ground flaxseeds on my breakfast cereal as well as organic soya milk instead of dairy have massively helped me.

2. It’s expensive, but eat organic if you can for all food types. Pesticides used in agriculture are known to impact our hormones negatively as well as generally not being very good for you. Certain fruit and vegetables have higher proportions of pesticide residues on them than others. So some you don’t need to worry about so much if they’re not organic and others you may want to avoid unless organic.

I’m still grappling with this but have printed out the lists of the worst offenders for reference. You can get these lists for the UK at Pesticide Action Network or in the US at the EWG.

3. Consider also what toxins are in your home environment and whether you can cut back on those. Household cleaning products are full of chemicals, some of which are thought to interfere with hormones. Personal products like deodorant, moisturizers, shampoos etc. often come laden with potentially suspect ingredients (there’s still controversy about parabens) – can you identify everything in the ingredients list of your favorite product?

I’ve followed advice over the years to try to cut back on these both for myself and the environment. I now use less toxic cleaning and laundry products when I can and try to keep cosmetics as natural as possible. I use organic coconut oil to clean my face and take off makeup, and make my own facial oil to moisturize.

I buy organic sunscreen when it’s available. Plain old vinegar makes an excellent household cleaner. All this helps to keep any hormone influencing toxins as limited as I feasibly can.

4. Try to lower your overall stress or improve how you deal with it. Hormone fluctuations are exacerbated by stress, both emotional and the dietary kind that we’ve discussed above. Reduce levels of stress in your life, maybe adopt a meditation practice or do some restorative yoga. Both of these will help you lower stress levels overall and potentially reduce menopause symptoms, especially the anxiety that seems to affect many of us around this time.

5. Get a handle on your weight, if you think it’s an issue. If you’re significantly overweight in midlife, that will cause problems down the line. And women who are overweight are known to have more of an issue with hot flushes in particular. Yes, you can take a supplement or try other things here that will help.

But if you are, hand on heart, overweight and suffering badly with menopause symptoms, consider trying to do something about it rather than just accepting it as a natural aspect of getting older. It’s not.

6. Up your exercise. As we age we need more exercise not less and many women swear by exercise to help them manage menopause symptoms. I know regular yoga and running certainly help me. Running is also excellent for building and maintaining bone density.

Any weight-bearing exercise helps to maintain strong bones. Also actually lifting weights helps to maintain our muscle mass which naturally decreases as we age, slowing our metabolism which then leads to weight-gain. Midlife muffin top? Not necessarily menopause. Lift weights and do lots of cardio exercise!

7. Try acupuncture. Acupuncture is great for restoring balance to the body so it makes sense that it can help us during menopause when we are out of balance. I tried it for a nasty facial scar but also for general balance and I felt amazing afterwards.

natural treatment for menopause

Hot Flushes/Flashes and Night Sweats

The most common of menopause symptoms is hot flushes/flashes and their night-time equivalent night sweats. What natural treatment is there specifically for these?

1. First, think of them as power surges! If you think of them like that, rather than seeing them as a problem or something shameful, they become less of an issue. They’re great when it’s chilly! This may sound simplistic and naïve, especially if you’re coping with being drenched in sweat, but it’s worth a go.

Mindset can be very powerful. A BBC documentary on menopause found that when women used CBT techniques to lessen feelings of shame around hot flushes, their hot flushes became fewer and less intense.

2. Keep a diary of when you have hot flushes and the triggers for them. Is stress bringing them on? Caffeine? Sugar? Alcohol? Chilli? All these are known to exacerbate hot flushes. If you know the triggers, you can tackle the symptoms. Keep an eye on your weight too. If you’re significantly overweight you’re likely to suffer worse from hot flushes.

3. Try avoiding or reducing caffeine. For many women caffeine brings on a hot flush. Personally I haven’t had any caffeine since I went through early menopause at 41 which is over a decade ago. I

was advised by Dr Marilyn Glenville to give up caffeine and I haven’t missed it in years. I love not being dependent on caffeine to get myself going in the morning or after lunch.

4. Cut back on sugar especially refined. I was also advised by Dr Glenville to give up sugar or at least reduce my consumption of it. Refined sugar products, in particular, are known to cause hot flushes.

I try not to overdo it on the sugar front but I do love my chocolate. The mini hot flush I occasionally get after I’ve had some chocolate is worth it. It’s just my little power surge!

5. If you find alcohol a trigger for hot flushes, consider reducing your intake of that also. Unfortunately it’s many of the things we love that contribute to our power surges. But you may consider it a price worth paying.

That’s up to you. But better to be informed so you can make that decision. Again, remember it may be your body telling you what you’ve done in the past, may not be what you need for long term future health. Bummer!

6. Learn to regulate your temperature with ease. Wear layers and if you’re a fan of polo necks and sweaters, consider alternatives. I’ve given up wearing polo necks because I don’t want to run the risk of being caught having a hot flush and then being unable to do anything about it!

Instead I’ve become a committed wearer of scarves and I regulate my temperature by just taking them on and off. Similarly, although they may not be the most sophisticated item of clothing, I’m a big fan of the humble cardigan. I can wear a cardigan, jacket, or zip-up fleece either open or closed.

Unfortunately the same cannot be said for a sweater. So I think about the environment in which I’ll be wearing a sweater and whether I’d be comfortable taking it off! Avoid synthetic fibers and carry a pocket foldout fan especially in summer.

I’m also usually to be found with a hair band on my wrist. I have long hair and my hair band helps regulate my temperature. I actually really feel the cold and can’t imagine ever having my hair cut short now. I would just be too chilly! But being able to put it up in summer (or if flushing) is fab.

Drink plenty of water and check whether spicy food brings on a flush. If so, consider avoiding that curry or decide it’s a price worth paying!

7. Spirulina and maca powders, added to smoothies for example, may also help reduce hot flushes.

8. Finally, consider these natural remedies too:

  • Black cohosh
  • Sage – as a supplement of just as a tea
  • Evening primrose
  • Camomile tea
  • Dong Quai – a Chinese herb
  • Foods rich in vitamin E like sweet potatoes, hazelnuts, almonds and avocados are thought to be able to help, particularly to decrease night sweats.


1. Try all or any of the above to get your hormones balanced better.

2. Try a regular meditation practice with some mindfulness. This really helps ground me and bring me back to the moment. Remember your thoughts are just your thoughts. Just because you think something doesn’t make it true. Good apps to try are Headspace, Buddify and Insight Timer which is free.

3. Exercise and being outdoors are great for anxiety. Go for a walk in the park (or a forest if you can find one) and take some calming deep breaths.

4. Take big belly breaths. Many of us breath very shallowly in our upper chest. This doesn’t help at all when we’re feeling anxious. So slow things down and breath deep down into your belly. Do it 10 times and assess whether you feel less anxious.

5. Remember that menopause doesn’t make you any less of who you are. You are still the fabulous woman you’ve always been. You know the same stuff and can do the same things. Believe in yourself and your power.


Sleeplessness can be an issue in the menopause years but remember it will get better once the hormonal fluctuations stop. If it continues after menopause then you need to seek help because it has become a habit. Start by trying everything above to get your hormones more in balance.

If restless legs are keeping you awake, try taking a magnesium supplement. Practice good sleep hygiene: make it dark and quiet where you sleep, no screens an hour before bed, a soothing routine to get you ready for bed (think bathtime for babies – we need routine too), if you’re lying awake, try using it as an opportunity to meditate or listen to a sleep meditation on your phone – try Insight Timer.

Try not to get up but stay resting in bed. If thoughts are keeping you awake, set yourself some boundaries about what you allow your mind to think about when it’s sleep time. You can choose to ignore your thoughts.

I’ve also recently been told about EFT (Emotional Freedom Technique) tapping to help with insomnia. Doing it regularly before you go to sleep can really help apparently (and this is from a woman who went through surgical menopause).

Here is the recommended free Tapping Solution app  and there are free meditations on it as well as paid.  (You may think it’s just a placebo effect but if it works, so what!)

Lack Of Libido And Vaginal Dryness

I’ve put these together as I think they’re very linked. If one isn’t working so well, the other probably won’t either!

1. Don’t assume it’s menopause! You might just be bored/resentful or generally unhappy!

2. Start investing in your relationship if you’ve let it slide. John Gottman’s 7 Principles For Making Marriage Work is brilliant for reconnecting with a distant partner. Do the exercises in the book and see if anything changes.

3. Take sex back to pleasure. We have a whole workshop in our Members Club on this (and on intimacy) and it’s so important. Take the pressure off. Sex doesn’t have to always be PIV (penis in vagina). Outercourse can be a lot of fun! Take turns to give non-sexual pleasure to each other. Make it about giving and see what happens. Try the 3 Minute Game

4. Invest in a good lubricant. My current favorite is Pjur silicon lubricant. I used to insist on organic and liked Yes products and even coconut oil which can be great. But because Pjur stays on the skin and isn’t absorbed, it’s great and lasts!

5. Invest in sex toys. If getting going is an issue, a small but powerful egg (or bullet) vibrator may get your bits responding if they’re not performing as you want them to. Similarly they can help us have fabulous orgasms. They’re fun with or without a partner. Not particularly natural? Well it’s not drugs huh!

6. Have fun and practice with yourself. Self-play is particularly important. It keeps blood flowing to the vulval area and keeps us able to respond sexually. There is some truth to use it or lose it. But that applies to the whole area rather than necessarily specifically penetration, which is not worth pursuing if it causes pain. So keep up your personal pleasure even if you don’t have a partner.

7. Sea buckthorn tablets taken as a supplement can be very helpful for maintaining the health of our vaginal tissue.

8. Moisturize your vagina as you would your face. Coconut oil can be very good for this.

9.  Not what I’d consider a natural solution but vaginal estrogen pessaries can be very helpful to get you over a painful hump and restore confidence and pleasure. I’ve used them in the past and probably will again when I get round to going back to the doctors. Clearly I don’t currently feel the need though as I haven’t yet! But even when using them I limit how often I do.

Urinary Incontinence

Lastly a brief word about incontinence. One in three women will suffer from stress incontinence – when we laugh, cough or sneeze – or bounce around on a trampoline, for example. Often this starts after childbirth. And it can start or get worse in menopause as estrogen levels drop, affecting the tissue in our vulval area.

But incontinence is common NOT normal. So go and see your doctor, get a referral to a pelvic physiotherapist and get treatment. 84% of women with stress incontinence are cured after just 6 sessions. And it all comes down to pelvic floor exercises.

So don’t suffer. Get help. Do the exercises religiously. And get better. Your orgasms will improve too! Double whammy! I recorded a fabulous podcast episode with the amazing pelvic physio and stand up comedian Elaine Miller which you can listen to here.

So that just about covers most things natural when it comes to menopause. There is so much to try. A word of caution though. Don’t assume any one of these is going to fix everything.

Often it is a package of things that will do the trick. For me it is soy, ground flaxseeds daily, no dairy milk, no caffeine, trying to limit sugar, alcohol and processed foods, running, yoga, meditation, a great lubricant and my friends.

Having good friends you can fall back on makes all the difference! It helps to remember none of us is alone! Women all go through menopause – if we’re lucky enough to live this long!

I’m so passionate about empowering women through their menopause transition that I wrote a book about it. If you liked this post, you’ll probably like my book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond. Feel free to reach out to me on here too if I can help. Good luck!

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Coming Off HRT – How I Did It

I came off HRT when most women are going on it, at ‘normal’ menopause age of 51. Coming off HRT at that age was always something I’d planned to do. Here I explain why and how I did that. You should always take medical advice but weaning yourself off HRT needn’t be hard or scary.

At 41 I found out I’d gone through early menopause. But I hadn’t experienced any signs of menopause! The doctor who told me was as shocked as me. At the time it was a devastating diagnosis because I was trying for another child. It was also very confusing as I thought everything was normal.

I suspect nowadays the diagnosis would be different. Or perhaps with a different doctor, the diagnosis might have been different. I think I was probably in perimenopause. Since it happened, I’ve learned the knowledge of doctors (GPs) in the UK, of menopause, is woefully inadequate. This is crazy considering menopause affects 50% of the population!

I was advised to take HRT at least until the average menopause age of 51. This was to protect my bones and heart from 10 fewer years of estrogen than ‘normal’. I wasn’t very keen on this particularly when all I was initially offered was Premarin which is made from pregnant mare’s urine (and yes mares are kept pregnant so they can produce this). But discovering I had borderline osteopenia in my hip after a bone scan 3 years later finally persuaded me to suck it up and take the HRT.

Knowing what I know now would I have made the same decision? I’m not sure. Then I followed the advice to go on hormone therapy, but only until average menopause age if I was feeling okay, and I took this advice to heart.

I decided to take the version that was as ‘natural’ as possible, coming from plants rather than horse’s urine. So I started taking Estradiol gel, and Utrogestan as my progesterone, as I needed that still having my womb. I also took vaginal estrogen pessaries in the form of Vagifem to combat issues with vaginal dryness.

Coming off HRT

I weaned myself off HRT at 51 as advised. I have an inherent dislike of taking medication unless I absolutely have to. High blood pressure didn’t go away after pregnancy, and I was advised to take medication because of family history. I took my BP meds at first, but subsequently tried lifestyle changes to keep my BP normal. I take a similar approach to menopause.

I don’t want to medicalize a natural transition in a woman’s life unless absolutely necessary. We don’t automatically medicate puberty, and I don’t believe hormone therapy should be the default option when it comes to menopause.

signs of early menopause

I was very confident of being able to wean myself off HRT without any adverse effects. I know a lot of women are worried. Why wasn’t I?

When I first got the early menopause diagnosis I consulted Dr Marilyn Glenville, a nutritionist who specializes in women’s health and particularly hormonal balance. Dr Glenville put me on a restricted diet, gave me a special tincture to take and within a month my periods had returned! This was quite miraculous for me and in retrospect shows how wrong the initial diagnosis was because of the hormonal fluctuation in the perimenopausal years.

What did I do in terms of changing my diet? I was told to cut out all caffeine, sugar, alcohol, processed food and have regular meals and snacks so my blood sugar level remained constant. I think I was also advised to cut out dairy but that’s a fuzzy (brain fog) memory! The herbal tincture I was given had some agnus castus in it.

The reversal didn’t last and within nine months I was back to my postmenopausal state. Maybe I didn’t keep up with the restricted diet, I can’t really remember. But this experience showed me that my lifestyle could have a direct impact on my hormonal balance (and that hormones can fluctuate wildly during perimenopause). I’ve continued with many of these ideas and learnt lots of new ones.

This is what I put in place before stopping the HRT. I tried to stop gradually, but it wasn’t really possible. I did reduce the estrogen gel, but as the progesterone was one pill nightly, and it couldn’t be cut in half, there wasn’t much I could do about reducing that gradually!

Here’s what I did when coming off HRT and what I continue to do now. Maintaining hormonal balance is a life-long thing!

  1. I eat healthy food regularly. I learnt the importance of balancing blood sugar levels so I try to limit sugar and processed foods as much as possible. I have not had any caffeine since my early menopause diagnosis and I know that I am better when I’m not drinking alcohol but I do still enjoy an alcohol beverage from time to time. It’s a choice you can make when you have the information you need. I also replaced dairy milk with organic soya milk though I do still eat cheese and occasionally yogurt.
  2. I added natural plant-based phytoestrogens to my diet in the form of soy, ground flaxseed and other seeds daily. I believe these have probably helped the most to keep my hormones stable. I find it fascinating that these foods are a major element of diets in countries where women appear to report less issues with menopause.
  3. I try to eat organic food as much as possible, especially for high risk food, to avoid any hormones or pesticides that might be in it and impact my hormones.
  4. My personal care products and cleaning products are also as natural as possible, to avoid anything getting easily through my skin that may impact my hormones.
  5. I found better ways to manage my stress including exercise, meditation and journaling. I have no doubt that the initial early menopause diagnosis was brought about because of the very stressful life that I lived.
  6. I was not overweight, but I have tried to maintain a healthy weight throughout this period, because I know that weight can have a big impact on hormonal balance and how well we cope with menopausal issues. A bit of extra midlife weight gain is not necessarily to be worried about. But there is much we can do if it starts to get out of hand and fat around the middle is not good for our long-term health.
  7. I increased my exercise and currently I try to do something every day. I think every midlife woman should be doing yoga because it is so good for achy joints and muscles. Running, being weight-bearing, helps maintain my bone density, and I also lift weights to further strengthen my bones and maintain muscle mass, and avoid the slowing of my metabolism which can lead to weight gain.

Immediately after coming off HRT, I was my own guinea pig. When I had an alcoholic drink or some chocolate I immediately had a hot flush, so I could see the impact these things had on me. This hasn’t meant that I have stopped drinking or eating chocolate. When I first came off HRT, I just thought of the hot flush as my little power surge and it was worth it! As time has gone on, these things don’t impact me anymore as they did when I first stopped the hormone treatment.

One hormone treatment I do still continue occasionally is vaginal estrogen as vaginal dryness can be an issue. But I only take this when I remember and it’s not a problem if I forget. I now prefer a vaginal estrogen cream, as the Vagifem pessaries, each with a plastic applicator, seem environmentally very unfriendly! I feel more comfortable with this as it is so localized and not impacting my whole hormone system.

I recommend a brilliant lubricant Pjur silicon lubricant. I’ve also talked elsewhere about the power of vibrators which can be particularly useful post menopause. If you haven’t indulged already now is seriously the time!

I’ve written extensively about the many natural ways to manage the menopause transition and remedies for specific issues too. You can find lots more information about things that will help here.

I believe how we feel about midlife, aging and menopause has a dramatic impact on our experience of each. I’m so passionate about giving women the information they need to thrive, not just survive through menopause, that I wrote a book: Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond. There is loads more in there about how to transition through the change and create your own magnificent next chapter. Good luck!

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Menopause And Suicide – Challenging The Narrative

This article discusses the sensitive topic of suicide. If any of the content impacts you and you would like to talk to someone, please either call the Samaritans any time for free from any UK phone on 116 123. This number is free to call and will not show up on your phone bill. Or contact the Samaritans online helpline at

I often see shocking menopause statistics or ‘facts’ quoted in the media that fail to provide a source for the figures. One of these ‘facts’ is the link between menopause and suicide. The general premise is that suicide rates significantly increase around menopause age, and that the highest rate of suicide amongst women is those around menopause age, thus demonstrating how awful menopause therefore is.

The extrapolated data used for many of the menopause suicide claims is from the Office for National Statistics. See the chart below.

The age range 45 to 54 is the highest peak. The Samaritans, “the only organisation that collates suicide statistics for the UK, its nations, and the Republic of Ireland” does not attribute these figures to menopause. Yet, do a search and you get comments like this:

“Diane Danzebrink, who runs Menopause Support, said it was “no coincidence” that figures published by the Samaritans showed the highest rate of suicide among women was between the ages of 45 to 54. “The vast majority of women will be peri-menopausal by the age of 45, the average age of menopause is 51. It’s become absolutely clear to those who work and campaign and advocate in this area that this is simply not a coincidence.” BBC 12 November 2021

Carolyn Harris MP and Penny Lancaster (paywall) wrote about the correlation they saw between menopause, depression and suicide. They quoted a 16-fold increase in depression in women aged 45-52 and a “staggering” 7-fold (700%) increase in suicide in women aged 40-50. As the ONS figures suggest a slightly less shocking increase of 48% when comparing women aged 45-49 (rate of 6.9 per 100,000 population) to women aged 20-24 (rate of 5.0 per 100,000 population), it is not clear how they obtained these figures and no sources were given.

Women (and men) want better information about menopause, not frightening headlines. These shocking claims may get reactions, and be more likely to increase web traffic, but misleading information can undermine the integrity of those associated with them and the discussion itself. As the old adage goes: correlation does not equal causation.

To use the correlation between menopause age and an increased rate of suicide to make a point without providing wider context, damages both the menopause discussion and the work of those dedicated to highlighting the social and economic factors relating to suicide and supporting those most at risk.

Just a simple glance at the above chart shows that men peak at the same age and their numbers are much higher. This alone suggests that other more significant factors may be influencing the changes in suicide rate. Eleanor Mills in the Observer noted: “Research from the Centre for Midlife in America finds that unhappiness peaks at the age of 47 because it is when we are hit with a tsunami of issues: divorce, bereavement, empty nests, elderly parents, our own health problems and redundancy.”

The Samaritans “monitor suicide statistics to make sure we reach those most at risk, and prevent suicide.” Their Dying From Equality report states “There is no single reason why people take their own lives. Suicide is a complex and multi-faceted behaviour, resulting from a wide range of psychological, social, economic and cultural risk factors which interact and increase an individual’s level of risk. Socioeconomic disadvantage is a key risk factor for suicidal behaviour…”

The report highlights:

“Individuals experiencing socioeconomic disadvantage and adverse experiences, such as unemployment and unmanageable debt, are at increased risk of suicidal behaviour, particularly during periods of economic recession.

The risk of suicidal behaviour increases when an individual faces negative life events, such as adversity, relationship breakdown, social isolation, or experiences stigma, emotional distress or poor mental health.

Socioeconomically disadvantaged individuals are more likely to experience ongoing stress and negative life events, thus increasing their risk of suicidal behaviour.

In the UK, socioeconomically disadvantaged individuals are less likely to seek help for mental health problems than the more affluent, and are less likely to be referred to specialist mental health services following self-harm by GPs located in deprived areas.”

Depression and feeling desperate during the menopause transition is not uncommon. I myself fell into a deep depression after I was told I’d gone through early menopause at 41. It’s a real issue for menopausal women. Sadly, there is certainly stigma still associated with menopause. But mispresenting, and effectively weaponizing, suicide data to hammer home a certain narrative, can undermine the integrity of any campaign to raise awareness of menopause and support women. More seriously, it has the potential to undermine the work of those dedicated to saving lives.

Women are bombarded from a very young age by the media, advertising and entertainment industries with the message that beauty equals youth, that our value lies in being young, looking a certain way and being fertile. In the marketing world, menopause screams old, irrelevant and over the hill. Is it any wonder we get anxious and depressed? Creating anxiety is a profitable business. We spend an estimated £46.5bn on anti-aging products.  

The same goes for the menopause business. In her article on ‘the great menopause gold rush’ in the Guardian, science correspondent Linda Geddes writes that one report found the menopause market to be a £450bn business opportunity. An industry which has a self-interested bias towards sales of products and services, which tilts ‘education’ towards fixing a ‘hormone deficiency’ and promotes the miracle drug HRT as the ‘cure’ needs to be scrutinized.

Getting the topic of menopause out in the open has been so liberating for very many women who’ve suffered in ignorance, silence and shame.  Pressuring the medical profession to get educated and take menopause and its impact seriously gets every woman’s vote. So why dramatize the data and make questionable claims?

Why are other factors that may give women better personal control over their menopause transition either left out or given only cursory mentions? Subjects such as the impact of balancing blood sugar levels, cutting alcohol, caffeine and sugar consumption, or the impact of regular exercise and keeping fit.

On my early menopause journey, I was advised to take HRT until average menopause age of 51 to protect my bones and heart from 10 years less of estrogen. I then weaned myself off. Taking decisive action to change my lifestyle and what I eat and drink, has turned out to be the most beneficial for my physical and mental health.

Menopause can be hard and it can also be wonderfully empowering. Some women may feel suicidal but there may be so much else also going on in their lives, not just menopause. Using shocking figures out of context can do more harm than good, scaring women rather than empowering them.

Let’s be curious about numbers that are used to make a point and conclusions reached. Educate and challenge those who are misusing information. In our cause we are undermined by bad information. I also dug into the 900,000 women have left work because of menopause narrative and found the research it came from just didn’t stand up to scrutiny. It’s shocking. So be curious about the source, particularly for claims that seem shocking, and check whether it’s reputable and trustworthy.

I want the world to stop blaming menopause by default for the majority of what can go wrong in midlife. Scaring women about menopause is only going to lead to further sadness and depression. That’s not doing women any favours and will not bring about the overall change that women and society so desperately need.

I forwarded this article to the Samaritans to get their feedback. This was their response: “We know that there has been increased interest in this area recently, but unfortunately there are a lot of unknowns due to limited evidence based on these particular issues. However, we do know that suicide is complex and is rarely the result of one thing. A combination of psychological, social and physical factors contribute to a person’s risk of suicide, and its important that we don’t oversimplify the reasons why somebody might take their life as it can impact vulnerable people.”

This article was first published on The Mutton Club online magazine.

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Maybe My Best Podcast Yet – As A Guest!

It was always a dream of mine to work for the BBC. Both my parents did, so it ran in the family.

My father was a TV and radio announcer, the first presenter of Midlands Today and latterly the music producer for Radio Birmingham. My mother was a studio manager for the BBC World Service at Bush House in London – how glamorous that sounds.

She did the good daughter thing, though, and returned to Birmingham to be closer to her mother when her own father died when she was still in her 20s. That choice of hers has influenced me massively – I have never wanted to make such a sacrifice – but that’s for another post, not this one!

I applied to the BBC after college but didn’t make the grade. I think it was radio I specifically applied to. But I made the classic mistake. I didn’t listen to the sort of radio for which I was applying.  

But the media still held a great allure. I applied to the Reuters graduate scheme and didn’t get into that either. What was wrong with me? I didn’t write back then – that may have had something to do with it!

Eventually I got the booby prize. Reuters was involved in real-time news but also in the creation of news abstracts from publications around the world. I had a degree in Chinese and Spanish, and was able to wrangle my way onto the Asia Desk of their news database service. Officially I was an indexer/abstracter. Unofficially I was a data processor. But it did teach me how to summarize quite well!

Little did I know that by the time I reached my 50s, I’d have my own magazine (The Mutton Club) and my very own radio show! OK, not exactly radio, but a podcast which is near as dammit. Radio on demand I like to think of it as. Netflix for your ears.  At time of writing, I’m fast approaching 100 episodes of the Magnificent Midlife podcast, which I can’t quite believe.

I’ve interviewed some incredible women and shared wonderful stories.  I love digging deep to help them share their wit and wisdom. I’ve never been one for small talk! Deep and meaningful conversations tick all my boxes.

My midlife mentoring, podcasting and now also book writing journey has allowed me to be a guest on some amazing podcasts too. And the nice thing is, I get better at both hosting a podcast and being a guest on one, the more times I do it. Writing the book has definitely helped me hone my message better too.

I want to share my latest podcast guest outing because I was truly on fire in this one! Clarissa Kristjansson’s Thriving Thu Menopause podcast is brilliant in my view and I was delighted to be invited on to talk about my book, Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

Clarissa and I are like two peas in a pod, I reckon, when it comes to menopause. We both get very annoyed by some of the silly myths being propagated about menopause and we’re concerned about how much money is often involved these days finding solutions for women. We agree women have been going through menopause for centuries and if we’re suffering lots now, we need to be curious about why that is and take action accordingly.

We had a lovely conversation which I think you’ll enjoy too. There were a lot of laughs. I was allowed to get up on my soapbox which I always love to do! It may make you think differently about quite a lot of issues.

Have a listen here. I’d love to know what you think of it!

You can check out my other podcast appearances here. There are some really good ones. It’s just that I think Clarissa’s is my very favorite so far.

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Writing A Book For The First Time – What I Learnt

I recently published my very first book. It took me two years to write. I wasn’t writing for two years, I couldn’t write for a year in the middle! I learnt a lot of lessons, both about the process and myself. Here’s what I learnt about writing a book for the first time.

My book is non-fiction with a bit of personal memoir thrown in. But I like to think that these general learnings are applicable to any kind of book, fiction or non-fiction, or anything in between.

Just keep going. You can’t write a book without writing a book! It won’t appear magically, without you sitting down on a regular basis and writing stuff. So find some system or process that will enable you to write regularly.

Be disciplined about it. Show up with pen to paper or fingers to keyboard or even, as I am writing this post, by dictating it straight onto a phone or computer.

Believe that you have a book worth writing. We all have stories to tell. We all have experiences to share. Never doubt that your story or what you want to write is in any way less valuable than anything anybody else has ever written.

If you see other books that look similar to yours, take what’s good about them and then carry on writing yours. Your voice will be different, your experiences are unique, what you need to say is what you need to say.

Have a plan/structure – probably. I don’t think I could have written my non-fiction book without having a plan. Not having a plan for what you’re going to write can sometimes work if you’re writing non-fiction and you want the story and characters to have a life of their own.

But if you’re telling a non-fiction story, I think it helps to have a rough idea in advance of what you’re going to say and where. Obviously, this may well change as mine did, but my original overall structure enabled me to get the book done and actually it didn’t change that much over the course of the project.

When you can’t write, just write anything. When you’re completely stuck for something to write, just write something, anything. The process of writing itself will generate writing. Morning Pages are a great example of just random writing that then can turn into something profound.

Morning Pages, as described by Julia Cameron in The Artist’s Way, is the process of writing three pages of about A4, each morning to empty one’s brain. It’s often by the third page that the true genius of our brains finally gets kick-started. So if you’re suffering from writer’s block, just write something totally random, keep going, and see what appears on the page.

Take a break. When you’ve finished your first draft, put it away for a while and try and get some headspace. Then go back and look over it again.

Look at it as if you are looking down from a helicopter and see how it all hangs together. Your first draft is exactly that, your first draft. There is a long way to go between the first draft and final book. Don’t be discouraged if your first draft is a pile of poo. That is sadly often the way!

Read your work out loud. When you have done several drafts and have edited as much as you feel comfortable with, try reading your book out loud.

This is one of the best ways to find problem areas in the language and ascertain whether your book really works. When authors record their own audiobooks, they often make lots of changes, because it’s the first time they’ve heard it out loud. I read my entire book out loud before I went anywhere near the audiobook, so in fact, any changes I made during that process were minimal.

Find yourself a developmental editor. I’ve heard writers say they no longer use developmental editors when they have written several books. But for a first-time writer I think a developmental editor is an absolute must have.

You need someone who will take an objective look at your book and be brutally honest about its potential and how good of a read it is. We can never be objective about our own work. My developmental editor made significant changes to my book and it is a much better one as a result. You can find Ricki Heller here.

You’ll need a copy editor and a proofreader. My developmental editor was also my copy editor but I made sure to have a different person to do the final proof read. It was important that somebody came to the text at that stage with completely fresh eyes to catch any last-minute errors. You can find Theresa Thorne here. You can find editors in author groups on Facebook, for example. Ask around for recommendations.

Don’t scrimp on design. When you’re finally ready to publish, unless you yourself are a designer or specialist in book layout, you will need someone to design your cover and your internal layout. I decided to invest in these and I feel it made a real difference to the quality of my book.

Cover design and internal layout have an impact on both the e-book version and hardcopy. When you have put so much work into the content of your book, don’t scrimp on the cover design or the internal layout. I found suppliers on Reedsy.

We all know the phrase, don’t judge a book by its cover, but everybody does. So make sure your cover is one that will stand out and attract the specific kind of readers you are looking to attract.

recording my audiobook

Read your own audiobook. This is a lot of fun. It also gives you a whole new appreciation for your own work. I’m very lucky in that my husband has his own recording studio! So I was able to record my book there. I also happen to like reading out loud and have experience of recording through doing my own podcast.

If your book is fiction, you probably want to find an actor or professional book reader to read it for you. But for non-fiction, if you can get some animation in your voice, and it won’t send your listener to sleep, I think it’s nice to hear the author reading their own work.

Don’t make marketing an afterthought. Try to think about marketing as you are publishing, especially if you are self-publishing. I was so focused on the self-publishing aspects and getting it all sorted – which is a mammoth undertaking all of its own – that I didn’t really think about marketing.

Ideally I’d have had a launch plan in advance, rather than playing catch up once the book was published. But I’ve also learnt that when you self-publish a book, marketing and the growth of that book is a very long game. It’s quite unlike the initial big launch you might get with a publisher. But you get a much higher percentage of any revenue from your book.

Be proud of what you’ve achieved. Even if you just write a book and never publish it, you have done far more than most of the population. If you actually publish your book, then you are in a tiny minority and really do need to be proud of your accomplishment.

So take some time to celebrate and pat yourself heavily on the back. Well done!

If you’d like to read my book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond you can find that here. It’s available in three formats: e-book, audiobook (narrated by me) and paperback.

Now go get writing! Your readers are waiting!

Good luck!

You may also like: Must-Read Books About Menopause, Making The Most Of Life And Ageing Well

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Has Covid Made You Ready For A Different Next Chapter?

Want To Create A New Chapter In Life? Here’s How.

next chapter in life

Midlife is often when we start thinking we want something different from our lives. Menopause reminds us that while we still have lots of time left, if we want to do something else, we better get our skates on! I started this process when early menopause at 41 prompted me to start questioning everything about myself and my future role in the world. I quickly realized this was a whole new chapter in life.

I reckon the potentially biggest impact of Covid-19 will be that our priorities have changed and we’re no longer so willing to accept the status quo. It’s certainly prompted me to start focusing on what’s truly important, rather than all the distracting less meaningful ‘stuff’ of ‘normal’ day-to-day life.

There’s nothing like a global pandemic to make you realize exactly what does and doesn’t matter! What you actually need. As well as reminding you daily of your own mortality!

I don’t find this depressing, I find it really exciting. Finally the world seems to be waking up to the possibilities of difference. I don’t want to go back to ‘normal’. I was already determined to make my life the best it could possibly be, but now I feel even more inspired to just get on with it! No more time wasting!

How about you? Are you feeling that itch to live differently going forward? Are you wondering what next? Has that annoying niggle in the back of your head that there must be more to life, become a stroppy roar? Do you want a significantly different new chapter in life?

If your niggle is getting louder, you’re not alone. We’re already seeing a huge increase in creativity since the world started coping with Covid and I don’t see that stopping any time soon. The restrictions on our daily lives have led to this explosion of creativity.

You may still be under pressure and feeling depleted, but that doesn’t need to restrict your next chapter planning and, depending on what you actually decide to do, putting that in place. Darwin proved long ago that it’s not how strong you are that determines your survival, but the extent to which you are able to adapt to change.

If ideas for your next chapter have already arrived fully formed in your head, congratulations! Your challenge will be how to make that a reality in a post Covid world. What I talk about below will still be of use to you to make sure you’re on the right track.

But what do you do if you know you want change, but you don’t know what?

1. A good place to start is with your values. Find a good extensive list, Brené Brown has a great one. Take some time to work out your top three. There’s no point in creating a sparkly new next chapter that isn’t aligned with your values. You’ll just feel like you’re treading water still.

2. Another useful thing to understand better is your strengths. We often go through life focused on improving our weaknesses. But if we can align what we do with what we’re best at, we’re likely to be much happier. I don’t mean specific strengths like being able to cook or paint. I’m talking about our innate strengths that form a fundamental part of who we are. The Clifton StrengthsFinder is fantastic for this. My own latest chapter has specifically focused on what I found to be my strengths: ideation, input, empathy, belief and connectedness. I love it!

3. Next, work out how you want to feel day to day. Danielle LaPorte’s Desire Map work is great for this. How do you want to feel in various areas of your life: career, money, home, sustainability, fitness, food, sensuality, interests, education, hobbies, romance, relationships, family, community, soul, faith, intuition etc.? Brainstorm feeling words that inspire and empower you. What feelings do you not want to feel? Find a journal and write down your thoughts. Let your subconscious mind take over and guide you. My core desired feelings which continue to motivate me are: inspire (to inspire and be inspired), vibrant, centred and authentically brilliant!

4. Hopefully by now you’re learning quite a lot more about yourself! Now you get to create your Chuck It List (the opposite of a Bucket List). What don’t you want? What do you never want to do ever again? What will you do to stop yourself having to do that ever again? Get out your journal again and just write whatever comes to mind.

5.The final step in this mini reinvention process is to start dreaming. Remember, you’re never too old and it’s never too late. You have so many life skills and the world needs you to use those just as much as you do.  Make an inventory of all the things you love doing and all the things you’re good at. What do people always ask you to do? What are you well known for doing? What did you used to love when you were younger but which you perhaps gave up as you progressed through a more structured and sensible life? Get out your journal and write everything down. You’ll find the gold for what will create a magnificent next chapter in the intersection between what you’re good at and what you love.

The Japanese have a wonderful word for exactly this – ikigai – the intersection of what you are good at and what you love doing. Your reason to jump out of bed every morning. It’s thought to be the secret to a long and happy life too, and centres on the central core of making life meaningful. If your ikigai is also what the world needs and you can be paid for it too, so much the better!

The secret to creating a next chapter that delights you is to find your ikigai and make it work for you. Whatever you do to create a sense of meaningfulness in your next chapter doesn’t have to be big. It could be something small or as big as you choose to make it. What matters is that it fulfils you and provides a sense of purpose. But connecting with that will enable you to create the magnificent new chapter in life that you crave.

So where are you going to start? That clock is ticking…

You may also like: Creating A New Normal, Pondering The Pandemic And Life After Coronavirus

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Menopause, HRT And The Importance Of Staying Curious

I want to share some thoughts on menopause, HRT (hormone replacement therapy) and a new narrative in the UK that most if not all women should be on HRT for menopause issues and long term health, because of HRT’s potential preventative impact on heart disease, osteoporosis and Alzheimer’s.

It’s evident that systemic and localized (vaginal) HRT can be enormously helpful for many women in managing their menopause, but I don’t believe, unless absolutely necessary, most women need to be on systemic HRT long term.

Davina McCall presented a ground-breaking documentary about menopause. In it she talked of having two episodes of shame around menopause, the first when she was initially diagnosed and the second when she took HRT. It’s tragic that she felt shame over either of these and I commend the program for exposing this as something which simply shouldn’t happen anymore. There is nothing shameful about menopause nor taking HRT to help with it!

menopause hrt Rachel Lankester
Author, Rachel Lankester

I too experienced these kinds of shame.  After failing to conceive a long hoped for second child, I was told I had gone through early menopause at 41. It was crushing.  I gave in to taking HRT at 44, because I was found to have borderline osteopenia in my hip. I felt I was succumbing to a narrative of downhill to the end.

At the time, menopause specialist, Dr Nick Panay, and his early menopause team were looking after me and had been advising me to go on HRT until average menopause age of 51, to give my bones and heart the extra 10 years of estrogen protection they’d missed out on because of early menopause. It took me three years to accept their advice.

I chose to come off systemic HRT as advised and at 53, another bone density scan showed no worsening in my bones. Now I occasionally take localized vaginal estrogen to help with vaginal dryness. I use a cream as vaginal pessaries come with individual plastic dispensers which I consider unnecessary plastic waste.

Women are rightly indignant they’re not getting the care they need from our National Health Service (NHS).  The documentary was a powerful reminder of the sad state of play and lack of awareness both within the medical profession and for women themselves. 

One thing about the documentary I do struggle with though, is that it failed to mention the obvious, that menopause is a natural and transformative life stage. To not highlight this reality underpins the emerging narrative that menopause is a bad thing and that HRT is the answer.

Peddling HRT as the ‘must have’ for all women in menopause, such are its life-saving properties, protecting against heart disease, osteoporosis and Alzheimer’s, AND that most women should be on it well beyond menopause, smacks of snake oil sales with bells on. Women are now even asking if they need to be on HRT to protect themselves from dementia!

This narrative is taken up by some leading menopause professionals who, to my mind seem to be as damaging as the doctors who prescribe anti-depressants for menopausal women. 

The narrative needs balance. Diet and life changes are probably more important for menopause issues and long-term health than defaulting to synthetic drugs. Sadly, the documentary was void of any discussion regarding the impact of diet or lifestyle on hormonal balance and only passing comment on lifestyle in terms of fitness.

One-sided narratives from the evangelical can have darker sides. ‘Champions’ and ‘goddesses’ deserve scrutiny and the simplest and probably the clearest form of scrutiny is the financial trail. HRT and hormonal insecurity is lucrative business. We are in a culture of wanting our cake and eating it. Excess without consequence. We will pay anything for a panacea.

How many of us swallowed the lies of the cosmetic industry and have felt reduced by body image, hair type, greying hair, wrinkles, spots, skin colour or felt guilt for eating the wrong things, drinking too much or being the weaker, fairer softer sex? 

Billions have been made by creating insecurities and ‘needs’, then exploiting them. We have been crushed, silenced, side-lined and lied to. Sadly, we do have a tendency to be shaped by the nonsense we are told.  I was.

From puberty women live on a hormonal and societal roller coaster. By our 50s many of us have had and raised children, tried to make safe homes, we’ve been undervalued, objectified, underpaid. We’ve juggled, loved, strived and known fear. Menopause is a gift that takes us off the rollercoaster. Perhaps HRT keeps us its slave?  

Menopause is a transition as major as puberty. It is not to be feared. It is not a permanent state. It is a gateway that takes us into deep calm waters where we can thrive in new ways.

Why am I passionate about diet and lifestyle changes? After my early menopause, I went to see a nutritional therapist who put me on a special diet. I was to have no alcohol, sugar, caffeine, dairy, processed foods, eat as organic as possible and eat a healthy source of protein every three hours to make sure my blood sugar levels were balanced.

Within five weeks of changing the way I ate and what I ate, I had a menstrual bleed, and a further hormone test showed I was back to being pre-menopausal. This only lasted another nine months, but it was a wake-up call that showed me the impact of diet.

I did not conceive and the effects didn’t last, I was just too late. Eventually I slipped back to a less healthy diet, although I’m still caffeine free, I eat better and exercise more. I don’t live an abstemious life! It was similar dietary and lifestyle changes that allowed me to transition off systemic HRT at 51 with no adverse side effects. I’m now post-menopausal and celebrating the liberation it brings. 

Hippocrates (460-370 BCE) is perhaps a thorn in the flesh for ‘modern medicine’ and the HRT industry, as his wisdom regarding health tends to mindfulness, which is free, as opposed to intervention, which is costly and profitable. If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” “Let food be your medicine and medicine be your food.”

Food for thought?

On reflection, my resistance to HRT was bound to resisting the negative sexist and ageist narratives about women and ageing.  Like most women, I was never taught about health, perimenopause, menopause and being post menopause. As a consequence, my work has now become sharing what I’m learning, being alongside other women experiencing menopause and living life beyond, and to help challenge the narratives that enslave us.

With HRT it is women with money who pay to go private and keep paying, if that is the only way they can access HRT. The more women can be persuaded HRT is the golden ticket, the more money can be made.

What about UK women who can’t afford to see a private doctor to get their (long term) supply of HRT? Why is menopause so difficult that many women need HRT to get through it? Why don’t we ask more questions about why British women reported having the worst experience of menopause?

HRT clearly has a crucial role in menopause care and should be more readily accessible in the UK, but why are we now told most women would benefit from taking it to keep us healthy into older age? We can do other things to keep ourselves healthy. What about women in countries without money for basic medical care let alone hormone therapy? Will women worldwide be lead to believe HRT is crucial for their long term health? That will lead to a lot of insecurity but also new untapped markets…

In her 2020 book, The XX Brain, The Groundbreaking Science Empowering Women to Prevent Dementia, Dr Laura Mosconi, PhD, Director of the Women’s Brain Initiative and Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College (WCMC)/NewYork-Presbyterian Hospital, says:

“Let me underline that the primary indication for MHT (HRT) remains relief of hot flashes, night sweats, and vaginal dryness. MHT is not recommended for prevention of heart disease, Alzheimer’s, cognitive decline, or any other conditions.”

Dr Mosconi goes on to say:

“I must reiterate that prescription medicines come with many potentially dangerous side effects of their own, and the last thing any of us needs is to accidentally exchange one negative side effect for another. Another reason to look beyond estrogen replacement is the fact that estrogen is not always a friendly and helpful substance—especially when it’s not your own. It doesn’t cost much to start with the safer strategies that focus on ameliorating hormonal levels by means of diet, exercise, and other natural therapies. These methods are known to boost hormonal production in the brain as well as in the body, while improving memory, sharpening our minds, and supporting resilience, all the while reducing risk of dementia for all women, no matter what stage of the game they’re at.”

After doing some research, I found evidence that HRT may help prevent and treat osteoporosis, for example, but even that research says:

“Therefore, in postmenopausal women at risk of fracture and younger than 60 years, or within 10 years of menopause, HRT can be considered as one of the first-line therapies for the prevention and treatment of osteoporosis-related fractures. Conversely, the initiation of standard HRT after the age of 60 years for the exclusive reason for fracture prevention is not recommended since the potential risk of long-term complications, namely breast cancer, can outweigh the benefits [24]. Thus, the extension of HRT after the age of 60 years must take into account potential long-term benefits and risks of the specific dose and route of administration, compared to other proven non-hormonal therapies [24].”

Marco Gambacciani and Marco Levancini  2014 Hormone replacement therapy and the prevention of postmenopausal osteoporosis

We now know the breast cancer risk is much less than previously reported and current forms of HRT are safer than early versions, but are still not without risk. Some practitioners say HRT breast cancer risk is no more than drinking alcohol or being overweight. But what if you’re on HRT, drinking too much and overweight? Your risk load could get quite high.

Some say women need HRT now because we didn’t live long past menopause in the past. In parts of the world, some women have lived past menopause for hundreds of years. In 1680, life expectancy for a woman at age 15 (having survived childhood) in England and Wales was 56.6 years, rising to 64.6 years by 1780.

Women in the Blue Zones, where people live the longest, don’t rely on HRT for their long healthspan. I believe it pays to be wary of big bold claims, stay curious and continue to ask questions. We are all guinea pigs when it comes to long term use of HRT. No one knows.  

Random guinea pig.

I’m increasingly skeptical about studies that make big claims about drugs and menopause. I want to know who conducted the research, who paid for it, was it published and peer-reviewed, and even whether it actually happened.

My recent research found a 2016 survey attributed to British broadcasting entity ITV, who claimed to have worked with women’s research charity Wellbeing of Women. The latter told me that survey never took place. There’s an article on the ITV website claiming that one in four women considered leaving work because of menopause symptoms, based on a non-existent survey.

That statistic has become fact and even been quoted by a member of the UK parliament. Why is that false fact still on the ITV website? Probably because it helped get viewers to their program then and helps bring advertising revenue now. They don’t care about setting the record straight. I’ve asked for this to be looked at but no response. I’ve asked to see the source of the statistics in the latest Channel 4 documentary too, but no one has responded on that yet either.

In her book, The New Hot, Meg Matthews includes the menopause experience of Buck Angel, a transgender man. He talks about how taking testosterone for 10 years atrophied his reproductive system…

“…causing my uterus to fuse with my cervix, creating an infection in my uterus. That was the cramping I had been experiencing all these years… After three months on intensive antibiotics to get rid of the infection, I then had a full laparoscopic vaginal hysterectomy… All of this could have been prevented if any one of my endocrinologist would have given me an estrogen supplement… How can doctors be giving a very powerful hormone like testosterone without understanding the need to balance this out… I almost died because of the lack of medical knowledge, yet the doctors give testosterone out with little concern about the long-term effects.”

I’m not suggesting that long-term use of systemic HRT for women could cause similar issues. Of course not. I am suggesting there’s not enough knowledge about the long term effects of any hormone therapy, for practitioners to be so confident telling women it’s okay to be on it long term or even forever. We won’t know whether that’s true, until I probably turn at least 75, in another 20 years.

The narrative that most, if not all women, will benefit from being on HRT long term, also presupposes that life with our pre-menopause hormonal profile is universally better than being off the estrogen rollercoaster as an older woman. I don’t want older women to be split into those who believe good health into older age can best be achieved if we have the same hormonal profile we had pre menopause, and those who don’t.

Some people believe we should be able to replace the hormones we’ve lost through menopause. But that suggests menopause is a disease that needs to be fixed (some want it rebranded as Female Hormone Deficiency) not embraced for the powerful changes it naturally brings.

This harks back to the misogynist book Feminine Forever written in 1966, which affirmed a narrative about women being subpar post menopause and that we need to be on estrogen long term ‘to stay agreeable and attractive for our husbands’. We’re not less anything post menopause and can be healthy without synthetic hormones. I don’t want older women (let alone younger ones) to believe they are in any way less because of menopause, or in danger healthwise without HRT.

There are abundant natural sources of plant hormones, amongst many other things, that we can add to our healthy diets to help achieve hormonal balance and long-term health. These work for many women and are often important traditional components of the diets of women in places like Japan and China, where menopause often appears to be less of an issue than it is for Western women.

And, she whispered… are we not just a little entitled and privileged demanding a drug long term whose effect can often be replicated for a large proportion of women by living a healthier lifestyle? When NHS resources are at their most stretched and we are already so lucky to have free healthcare in the UK.

Did you want to keep on with the 5 cups of coffee a day to keep you going, lots of sugary food, burning the candle at 6 ends, smoking, drinking too much booze to wind you down, using products laden with 100s of potentially hormone-disrupting ingredients, sitting down all day, not sleeping well because of the sugar, caffeine and booze, and not dealing with your stress, but take HRT to stop those your hormones screaming for attention?

I see many midlife women doing that and wondering why their body is rebelling. We’d rather demand a fix-all, than get curious about other ways to feel better, longer.

One too many?

Around 25% of women suffer badly with menopause. That’s bad enough, but you’d think it was more. I talk about that with Jackie Lynch author of The Happy Menopause on my podcast. The ones who suffer shout the loudest and often it’s celebrities in the public gaze, who are living stressful lives that can make menopause worse, who speak up about their experience.

I’m grateful to them for raising awareness, but I’d like a more balance, more discussion about other options and less reliance on HRT to mask symptoms, rather than sorting out underlying issues. I don’t want to terrify women coming up behind so that an awful menopause becomes a self-fulfilling prophecy. Be prepared not scared is my motto.

I think of menopause symptoms as the body’s early warning system, the canary in the coalmine, telling us we need to make changes if we want to live a long healthy life. We can take HRT and it may make us feel better. We may also miss the chance to make the changes our bodies are telling us to make, if we’d just start listening.

What is different about us or the way we live to make our menopause experience different to elsewhere or other women? To what extent does our society’s view of older women impact how we experience midlife and menopause? How is life different now to in the past? We need to talk about menopause more. And much earlier too.

The medical profession is woefully under-resourced for helping menopausal women. We need to increase medical and public education so doctors recognize perimenopause and women aren’t fobbed off with anti-depressants, or fear they have Alzheimer’s when it’s hormonal brain fog. Doctors in the UK need to understand the latest NICE guidelines for prescribing HRT and not withhold it unnecessarily from those in need.

I’d also like doctors to know about the role of diet, lifestyle, environmental toxins and stress when it comes to managing menopause. I want an holistic approach. I’d like women to see menopause as a chance to adopt a healthier lifestyle and embrace the different hormonal profile we’re supposed to have post menopause. Then we will find the true healing power and magic of menopause.

If you liked this post, you’ll probably like my book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

You may also like: Menopause Matters – Resources To Help

menopause hrt
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All You Need To Know About Symptoms Of Menopause

Think you might be in menopause? Are you sensing some weird stuff, making you wonder if by some remote chance you’re in menopause, but you can’t be really can you, cause you’re far too young!

Or just wondering what are the symptoms of menopause? And what is happening to your body! Who pinched it and what did they do with it?

Welcome! Relax. Here’s all you need to know about symptoms of menopause. It’s a tricky subject but we’re here to make it all that much more understandable and definitely way less worrying!

symptoms of menopause

First things first! Some definitions.  Menopause is that moment in time exactly one year after your last period. Usually around 51. Perimenopause is the period leading up to that menopause moment. But the world like to talk about menopause and the symptoms of menopause so rather than add to the confusion we’ll stick with menopause for now!

Second, quick reality check. Menopause happens to all women who are born female, IF we are lucky enough to reach the age at which menopause kicks in. You are no less of a woman because you are going through menopause. You are just as beautiful, vibrant, sexy, vivacious, gorgeous as you’ve ever been. DO NOT FORGET THAT!

You made it through puberty and menopause is just puberty in reverse. There’s a lot to be said for no more fear of pregnancy, hormonal fluctuations, PMT and just monthly bleeding for goodness sake! So take a deep breath. Menopause may just turn out to be the best thing that ever happened to you! When this is over you will be off the hormonal rollercoaster for good. Yippee!

Third knowledge point before we get into the detail of symptoms. There are two creatures that go through menopause. Ourselves and whales. When female whales go through menopause, they become the leaders of their pods often for up to 50 years. They’re the matriarchs of whale society which would not survive without them.

So if you’re a bit stuck in thinking menopause is the end of meaningful life, JUST STOP THAT RIGHT NOW! Be more whale. When we go through menopause, we become more valuable to our communities as leaders than as breeders. Find out more about this in Let’s Be More Whale.

Menopause happened to me at 41! That was a whole decade earlier than ‘normal’ menopause age. And a bit weird and certainly unexpected. I was trying for another child so it kinda knocked me for six. I ‘d had no symptoms other than a bonkers hormone test! I  hadn’t even noticed my periods must have been a bit off!

So don’t assume that symptoms won’t start till your 50s. And (peri)menopause can last for ages, so if you’re mid 40s and experiencing some weird stuff that might be menopause, fear not! That’s all fairly normal.

But how you live your life can impact both your symptoms and when it all kicks off for you so don’t panic if you’re nowhere near your 50s and still experiencing some weird stuff. We’ll get to how to manage it shortly.

Meanwhile what can you expect? There are apparently 34 potential symptoms of menopause. But why not just throw the kitchen sink in there for good measure! Everyone is different and some women may experience nothing at all, some a few and some lots.

STOP did you register that? You may not experience any symptoms. You may experience some or just a very few. There’s lots of reasons for the discrepancy between women but first off let’s look at what might happen.

The 34 potential symptoms of menopause

You may experience symptoms for a few months, several years, or NO TIME AT ALL! Here’s the full list – and I’ve starred* the most common ones.

  • Hot flushes/flashes*
  • Night sweats*
  • Irregular periods*
  • Mood swings*
  • Vaginal dryness*
  • Decreased libido*
  • Headaches
  • Breast soreness
  • Burning mouth
  • Joint pain
  • Digestive problems
  • Electric shocks
  • Muscle tension
  • Gum problems
  • Tingling extremities
  • Itchy skin
  • Fatigue*
  • Anxiety*
  • Disrupted sleep*
  • Hair loss
  • Memory lapses*
  • Difficulty concentrating*
  • Weight gain*
  • Dizzy spells
  • Bloating
  • Stress incontinence
  • Brittle nails
  • Allergies
  • Irregular heartbeat
  • Body odour
  • Irritability*
  • Depression*
  • Panic disorder
  • Osteoporosis

Really symptoms of menopause?

BUT STOP RIGHT THERE! Cos this is just the full scary list and you are UNLIKELY to suffer the majority of these. If you do, then it’s your body telling you something needs addressing. That could be something physical or emotional.

You see, the only actual symptom of menopause is the cessation of your menstrual cycle. All the others are symptoms ASSOCIATED with menopause.

These can all be triggered by changes in our hormones. But there is probably an underlying cause to the symptoms which is revealed once the protection of our reproductive hormones starts to drop. If they were symptoms OF menopause, most woman would likely get them, but we all go through menopause very differently.

If you’ve always been a bit anxious, you may find you are more so during menopause. If you’ve always had trouble sleeping, that may get worse.

These symptoms are common but not normal! Think of menopause symptoms as the canary in the coalmine, warning you that you need to make diet and lifestyle changes to stay healthy long term. Thank you menopause!

It’s also easy to attribute all these changes to menopause but actually it could just be because our bodies are getting older.  Or sadness might come because we’re languishing in the happiness U-curve which bottoms out in our 40s! Or we’re fed up with the life we have and relationships that no longer fulfill us and make us irritable.

Or we’ve bought into all the negative narratives about midlife, menopause and getting older as a woman (as I did at 41), and that’s causing us to be both anxious and depressed. Or we have an overload of unnatural toxic products in our lives that are causing our bodies to be hormonally challenged.

To find out more about all these potential other issues impacting our hormones, as well as the many products in our environment that can impact hormonal balance, for example, listen to my wonderful podcast with naturopath Angela Counsel, or read the transcription of that fabulously informative interview here.

Menopause gets blamed for a lot and it’s not necessarily to blame. Weight gain may speed up around menopause with hormonal changes, but fundamentally it happens because our metabolism slows down as our muscle mass naturally declines with age. If we make sure to do weight lifting to maintain our declining muscle mass, we can reverse that trend.

Often it’s a hot flush/flash that alerts women to changes happening in their bodies. Sometimes there’s an overwhelming feeling of sadness and many women are prescribed anti-depressants when what they really need is a bit more hormonal balance in their lives. Or those negative midlife narratives have taken hold, not to mention ageism kicking in.

Or maybe it’s a sudden inability to shift those extra pounds that alerts you to changes, but as we age if we continue consuming and behaving as we’ve always done, we’re bound to put on weight and find it more difficult to shift it.

Many women fear they have early onset Alzheimer’s because they feel they are getting a bit more forgetful or less able to concentrate. But no, it’s just hormonal changes. Good to know huh!

If you’ve had a child, think pregnancy brain. You may have had difficulty sleeping while pregnant and the same may happen during menopause. It’s all caused by hormonal changes.

It’s just that no one talks about menopause, it’s still taboo, we’re not prepared for it, we don’t know how to take better care of ourselves and it can all go on for rather a long time!

Just for clarity, I’m talking here about symptoms associated with a natural menopause. If yours has come very early or been caused by illness or surgery in particular, then the sudden change in your hormones may lead to more of these symptoms occurring – but also not necessarily.

One woman I know had a hysterectomy in her mid 50s and the only symptom she suffered afterwards was trouble sleeping which she fixed with tapping meditation.

Taking back control and helping yourself

If you go to the doctor complaining of menopause symptoms and have a blood test which confirms you are in (peri)menopause, you may be offered HRT. But HRT remains contentious for many and there are lots of natural ways to try to manage symptoms before resorting to HRT.

Menopause isn’t illness, so why not try other ways to help first? HRT can be a useful Band Aid for some women, but where will you be in 10 years time if you don’t fix the underlying issues? And if you mask those with HRT, you won’t have the chance to fix them either.

What you put in place now will also help set you up for good general health in the long term.

1. Balance your blood sugar and sort out your diet

A good diet will help with all menopause symptoms and maintaining consistent blood sugar levels will help to reduce stress levels in the body, thereby supporting hormonal balance. This will help you maintain more consistent energy levels and stop fatigue. It will also help to stop any night sweats that may be disrupting your rest.

Try to cut out sugar and processed food, eat plenty of different kinds of vegetables, eat protein with every meal, add in natural phytoestrogens and eat organic as much as you can to prevent chemicals and hormones that have entered the food chain from messing with your hormones. You can find out more about a good menopause diet here.

2. Get plenty of exercise

As we age, our metabolism slows down. It’s easy to blame menopause for middle-age spread but the natural ageing process is just as responsible. As estrogen leaves our body we need to work harder to maintain bone health. Regular exercise, both cardio and weight bearing will help in the long term as well as assisting through menopause. Exercise is also great for our mental health.

Yoga is wonderful for maintaining strong bones and flexibility. It may even help reduce hot flushes/flashes.  If you’re overweight you’re much more likely to suffer from hot flushes. The better you feel about yourself and your general health, the more likely you are to have a positive experience of the change. Don’t forget your Kegel exercises too to sort out any urinary leakage issues!

3. Try natural remedies

Herbs such as black cohosh, sage and red clover can all help with symptoms particularly hot flushes. Take a fish oil supplement to help protect your bones. Sea buckthorn oil, taken as a supplement can help with vaginal dryness.  Coconut oil can be eaten, used as a personal lubricant, cleanser and moisturizer.

The YES organic vaginal lubricant range is excellent and available on prescription in the UK.  Here’s some advice on how to stay sexy through menopause and beyond.  Pjur lubricant is my current favorite. It’s not the most natural but it’s very good! A regular mindfulness or general meditation practice can really help ease mood swings and anxiety.

Finally, when it comes to menopause, don’t expect the worst but also don’t suffer in silence. Get the help you need. If your symptoms are bad and natural remedies don’t work, there is also HRT.

Having gone through menopause at 41, I was advised to go on HRT to protect my bones and heart until I reached normal menopause age, when I chose to come off HRT. I chose the body-identical yam-based HRT rather than pregnant mare’s urine. These are also available on prescription in the UK though some doctors don’t seem to know this.

One natural remedy in isolation may not do much for you – but a package can really work.

My hormonal balance package

Since turning 51 (‘normal’ menopause age), I have managed any midlife hormonal challenges with a combination of: no caffeine; natural phytoestogens every day in the form of soya (instead of dairy) milk, ground flax seeds (on my mueslli) and chickpeas; limited sugar and processed foods; a relatively healthy diet with lots of vegetables; limiting (often unsuccessfully!) alcohol; meditation when I remember; running at least 3 times a week; yoga/stretching every day.

If you want lots more great ideas to help with specific symptoms check out Natural Treatment For Menopause – All You Need To Know

You can read more about my early menopause experience in How To Cope When The Change Comes Too Early.

The real trick is to embrace menopause as a natural process that actually empowers you. We’ve been working with our wombs all our lives. Midlife is not the time to start fighting them and the essence of our feminine power.

At Magnificent Midlife we’re challenging stereotypes and changing perceptions. We think of midlife and menopause as a time of re-evaluation and regeneration as we embark on the exciting second half of our lives.  I hope you agree.

If you want to hear more about the magic of menopause listen to my podcast interview with the amazing Darcy Steinke who was the first to alert me to whales becoming leaders post menopause.

Good luck! Don’t hesitate to get in touch if I can help you further.

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Menopause And Depression – Giving Context To Statistics

Please bear with me… I’m having a bit of a rant!

I’m often moved to write about menopause because I see a fact or statistic on social media and I question its validity, whether it’s been communicated with context, why it’s been mentioned at all and whether it’s true.

I watched a really great little video on Instagram about normalizing menopause. The video itself is really empowering and I thought, wow that’s great. Shame I’m not in it. But in the blurb that went alongside this video about menopause was the following comment:

“We can talk about empowerment all we want, but [a] lot of us are having a hard time, in our bodies as well as our minds.  Let’s not forget that according to the latest numbers from the UK Office for Statistics, the age group with the highest rate of suicide is women ages 50 to 54.”

menopause and depression sad woman

What do the statistics really tell us?

This is a statistic I often see connected to menopause. But the last statement is actually plain wrong. It’s true that amongst women the highest rate of suicide is the age group 50-54. But the age group with the highest rate of suicide overall is men 44-59 and the figure is three times that of women. In fact men in all age groups have a far higher rate of suicide than women.

So it’s simply not true to say that the age group with the highest rate of suicide is women ages 50-54. The rate of male suicide is greater than that of women in every age group except 15-19.  It is true to say that the group with the highest rate of suicide for women is ages 50-54.

Below is the chart from the Office of National Statistics in the UK where you can see that even in this group we’re only talking about 7.4 women per 100,000 of population in the 50-54 bracket compared to 25.5 men per 100,000 in the 45-49 bracket. This compares with 6.9 women per 100,000 in the 45-49 age range and 6.5 in the 55-59 age range.

Yes, any suicide number is awful but knowing the context, doesn’t it take away some of the sting of the statistic mentioned above? Even when the statistics are correct, context is still crucial.

What really upsets me, and which I keep seeing mentioned in the media and suggested by others, is this correlation between the higher rate of female suicide and menopause. I believe this is pure conjecture and not based in fact nor research. This article presents a case that not only are there errors in the facts we believe about menopause, but there are also so many other things going on to cause anxiety and depression during the menopause years.

Menopause may be a contributing factor to midlife malaise in women and if you are suffering from depression, please ask for help. But I believe it is irresponsible and verging on scaremongering to suggest that menopause is responsible for this highest rate of suicide in women figure.

I’ve sat on this for ages and the time has come to put fingers to keyboard! I feel a need to set the record straight on misrepresented menopause statistics that suit a particular agenda.

Women, menopause and work

I hate it when facts are taken out of context, or are just plain wrong, especially when it relates to menopause. Women so need truth about this topic! At time of writing I’m trying to speak to ITV to get a ‘fact’ corrected which has been on their website for five years and which has been quoted even by a UK Member of Parliament, but is actually false.

This ‘fact’ is that one in four women considers leaving work because of menopause issues. ITV claims this is based on a research survey they did with women’s health research charity Wellbeing of Women in 2016.

I have spoken to Wellbeing of Women who told me there was no such joint survey and also to Professor Myra Hunter, Emeritus professor of clinical health psychology at Kings College London, who did the menopause research for Wellbeing of Women, and who said “I am not aware of this survey being published nor who authored it.”

There was a research survey done on menopause in 2019 by Wellbeing of Women and Professor Hunter, but ITV was not involved and there was no finding that one in four women consider leaving work because of menopause issues.

The ITV claim is blatantly false. Some women may consider leaving work because of menopause but there is no published research or evidence of this. Professor Hunter also said, “In my reading of the research literature, the evidence of women’s work performance being adversely affected specifically by the menopause is inconclusive.”

I have complained on ITV’s website, I have emailed them and I have tried to speak to them on Twitter. They continue to ignore me. I’m not going to include the article link here because I don’t want to give it more credence, but if you search for women considering leaving work due to menopause in Google you will find it.

This false statistic has become truth and is quoted ad infinitum. It adds weight to negative narratives about menopause but is simply not true. It is not based on credible research. If the 2016 survey was done at all, it was done by ITV without Wellbeing of Women and it was neither published nor peer-reviewed.

Why does ITV quote this ‘statistic’ and leave it on their website five years after the program aired? Because it helped them originally get viewers for their program about menopause and continues to make them money from advertising now.

When it comes to how menopause, and aging in general for women, are regularly presented, I have found there is often money lurking somewhere in the background.

What else might be going on concerning menopause and depression?

So returning to the suicide statistic, what else might be going on for women aged 50-54 to make it when there are more suicides than at other times? I have lots of ideas about that!

  1. Women are taught from a very young age that we are only valuable when we are young and fertile. Girls are told that they become women when they go through puberty so what does that mean for us older women when we go through puberty in reverse? Do we stop being real women? I think many women actually fear this to be the case! It’s the ultimate confirmation that life is on a downward slope. I know when I went through early menopause at 41, my initial reaction was to see myself destined to a life as a shriveled up old prune sitting in the corner and of no value to anyone. Society taught me to view menopause in that way, because in the West we worship youth, the fertility that goes with it, and the beauty and value that we ascribe to it. So is it any wonder that we might be a bit anxious as we go through our 40s and into our 50s about what it all means? I would argue it’s not menopause to blame for this midlife malaise, but rather how we have been taught to feel about it.
  2. Have you heard of the U-curve of happiness? Yes it’s a real thing. It’s been scientifically proven (with actual research this time) that we’re happiest at the beginnings and ends of our lives. Research shows that 47 is our most unhappy age. There may actually be nothing in particular making you unhappy; it’s just a natural phase of life. And it affects men and women. It’s the middle that can get us down, simply because it’s the middle. Feelings of discontent, restlessness and even sometimes worthlessness are not unexpected. Plus the big birthday soul-searching can make it all the worse. Yes that’s a thing too and the big 50 is a pretty major milestone for most of us. We’re still tied to those outdated ideas of what we should have achieved by a particular age, forgetting as we are wont to do, that we all have different lives, are on different trajectories and that comparison is the thief of joy. We may suffer depression in the middle, but hopefully once we’re through that, the only way is up. If your 40s and 50s are gloomy, there’s every chance that later the fog will begin to lift. Clearly there are other factors that may prevent that, but all things being equal that’s the normal trajectory of life. The U-curve holds.
  3. We’ve been taught to perceive midlife (which is when menopause usually happens) as a crisis. Just search midlife in Google and all you get back is midlife crisis. But I prefer Brené Browns’ interpretation of midlife as an unravelling: “a series of painful nudges strung together by low-grade anxiety and depression, quiet desperation, and an insidious loss of control.” For women especially, it’s when we often start questioning who we really are and what we want from life. Hormonal changes can add to our sense of discombobulation. Menopause is a big life marker reminding us of how long we’ve already lived and highlighting what time we likely have left to do whatever it is we want to do in this world. So yes it’s a time of introspection and potential inner turmoil but again, it’s not the actual menopause transition that’s responsible, rather, various different elements all coming to a head and exacerbated by the fact that our hormones are impacting us as much as they do during puberty.
  4. Midlife is also a time when women in particular are subject to a whole litany of other stress and depression inducing circumstances. We may be coping with difficult teenagers or struggling to adapt to an impending or actual empty nest. We may be caring for older parents and shouldering the brunt of those responsibilities. We may be encountering ageism in the workplace, feeling side-lined and ignored when previously we were on an upwards trajectory, just like a man would be in his 40s and 50s. But the insidious combination of sexism and ageism makes it far more difficult for women to get visibly older than men. Men become silver foxes, women are accused of letting themselves go if they embrace their natural older hair color. Thank you patriarchy. Again follow the money: a lot of people get rich persuading us that actually looking like an older woman is bad, making us fight getting older. And when do we see the most accelerated signs of aging in women? It’s often in our 50s when our faces and bodies really begin to change if they haven’t already. Another contender for the midlife malaise.
  5. Women simply don’t have enough good information about how to manage their menopause so, as well as the distressing emotional impact already discussed, the physical symptoms can become debilitating. Doctors often aren’t much better equipped, prescribing drugs for depression rather than recognizing that hormones could be out of balance and the impact that can have. But this absolutely shouldn’t be the case. I was able to reverse my early menopause diagnosis by making dietary and lifestyle changes. My mission now is to ensure that women have the information they need, when they need it, which is often earlier than they think, so that they don’t need to struggle with menopause. Just sorting out their diet and balancing blood sugar levels can have a major impact on women’s experience of menopause, but the majority of discussion is still concentrated on trying to fix it, usually by taking hormone replacement therapy. I have written extensively about how I believe menopause symptoms are actually the body’s early warning system. It’s trying to tell us that there are things we need to change about how we live if we want to enjoy long-term health. This includes cutting back on things like caffeine, alcohol, processed food and sugar which we may have enjoyed in our youth, but which our menopausal bodies are less able to cope with. It can mean adding in things we didn’t necessarily consider before, like more vegetables and natural phytoestrogens in the form of flaxseed and organic soy, for example. It also includes cutting back on the toxins in our environment, whether that be in the food we eat by going more organic, or the personal and household cleaning products we use. It means perhaps losing some weight if we’re a bit too heavy, making sure we get enough exercise which has been proven to reduce menopause issues and working hard to optimize our mental health because if anything is going to cause us to suffer during menopause, it is stress. I have no doubt that it was stress that caused my early menopause diagnosis.

Please help me set the record straight

So please, let’s all stay curious about menopause statistics that are quoted as fact. Find out where they come from and whether it’s a reputable and trustworthy source. Follow the trail back to the actual research before assuming it is true. I had assumed ITV was reputable but they have had false menopause statistics sitting on their website for years!

If you hear these particular statistics being quoted, please direct people here or tell them that the information is false or inconclusive. I want the world to stop blaming menopause by default for the majority of what can go wrong in midlife, leading to sadness and even depression. Instead I want women to embrace it as the gift prompting us to get our lives sorted that it can be.

And let’s stop scaring women, both those in menopause and the ones coming up behind, by upholding a doom and gloom approach to this important and empowering transition in a woman’s life.  

Let’s instead start listening to our bodies, being curious about what else is going on and working to improve all of that rather than lumping the problems all on menopause and ignoring the rest. It’s working on all of it that will reduce suicide rates for women in midlife. Not just making menopause better.

Yes let’s talk lots more about menopause, but not in isolation. That’s not doing women any favors and will not bring about the overall change that women and society so desperately need.

You may also like: Top Tips For Dealing With Perimenopause Anxiety and Menopause Matters – Resources To Help

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Why I Want To Change The Menopause Narrative

This post is in response to a request from the editor of Goldie Magazine on Twitter asking what the ‘menopause awareness community’ thought about informing everyone in the workplace about menopause symptoms. This question was inspired by a discussion thread on Mumsnet which started with someone posting that an awareness email had gone out to staff in her workplace about menopause, and had listed symptoms, including vaginal dryness and reduced sex drive.

menopause narrative

A colleague had then apparently complained that mentioning vaginal dryness was inappropriate in a workplace email. The writer of the post disagreed saying that it’s a common symptom of menopause and therefore should be included. She went on to say that if one was raising awareness about prostate cancer, one would not leave out difficulty maintaining an erection from a list of symptoms.

I knew it would be difficult to explain my position in tweets but I tried to express I had mixed views on whether or not this was appropriate. Before I got into too much trouble with the community, I promised to write a longer piece, which this is, to explain my position.

I do have very mixed views on this. First some background on me. I’ve been talking and writing about menopause for the last four years, pretty much non-stop, since I set up my online magazine The Mutton Club. That was cited in the Huffington Post as being one of the top 10 websites where one could get help with menopause. I’m on podcasts talking about menopause and I’ve been on BBC Woman’s Hour talking about my experience of it. Women make a beeline for me at events to talk menopause.

I most certainly want to increase awareness, stop the taboo and change the narrative. But my menopause narrative is often very different to that of the majority. Perhaps it would be a good idea for me to start with my beliefs:

  • I do not believe menopause is a medical condition and that our first instinct should be to medicate for it.
  • I do not believe menopause is something that needs fixing. It may be challenging and women may need help to manage symptoms. But it’s a natural stage in every biological woman’s life, if we are lucky enough to live that long.
  • I believe menopause can be something very wonderful and that is a narrative I am keen to promote.
  • Menopause is not something to be fought against any more than puberty or pregnancy. We’ve been dealing with our wombs all our lives. Menopause is not the time to start fighting them. We would do better to embrace menopause!
  • There are lifestyle changes that can help the majority of women with their menopause experience and I want these to be given more airtime, rather than simply sticking Band-Aids on symptoms. I believe these changes should be tried first rather than automatically reaching for HRT when symptoms prove difficult. Education here is key and not enough is said about how we can help ourselves.
  • I think menopause symptoms are nature’s way of telling us how we live our lives may have to change if we want long term health. Of course it’s all about choice, but menopause gives us an opportunity to start listening more to our bodies and making positive changes.
  • Being post menopause is great for most women, myself included. When I asked in my private community on Facebook for reassuring words about life post menopause, the overwhelming themes were of liberation, calm and a renewed sense of energy and purpose (not to mention the second creative peak we apparently reach in our 50s).
  • I do not believe HRT is something women should be on forever nor that it’s good for a woman in her 80s to enjoy having ‘periods’ because she is still on HRT (a prominent private gynaecologist is the source of those ideas).
  • I believe the insidious combination of sexism and ageism also impacts women’s sense of well-being and ease at work. Stressful jobs and hormonal changes are not a happy combo. I think menopause gets a bad rap and it’s not always to blame.

So what’s my menopause story? I went through it early at 41. At the time it was devastating. I was trying for another child and it was only after a fertility test that I found out.  I hadn’t noticed! I had no symptoms and I thought I was right as rain. The doctor who told me was equally flabbergasted to discover my hormone profile was that of a postmenopausal woman.

I spent a long time coming to terms with this and initially got a lot of help from the Daisy Network. Through them I came across Dr Marilyn Glenville, a nutritionist and Dr Nick Panay who specializes in early menopause. I had consultations with both. With Dr Glenville’s help, a change in diet and lifestyle and a special tincture, I got my periods back for 9 months but not long enough to deliver the desired-for baby.

I resisted medical advice to take HRT to protect my bones and heart, but eventually went for a consultation with Dr Panay. I still didn’t have any noticeable symptoms but was referred by his team for a bone density scan because I didn’t want to take HRT. It was only after the scan showed borderline osteopenia in my hip, that I decided to finally suck it up and take the HRT.

Knowing what I know now about how to protect and improve bone density, I don’t think I would do that again. But I took HRT probably for about six years. I made sure I took the body identical version, made from yams rather than pregnant mares urine (which is still prescribed today). I’m always keen to make sure women in the UK know this is available on prescription and there is no need to get so-called bio-identical hormones from a private practitioner. I was even offered testosterone by Dr Panay’s team if I had wanted it. But you do need to know what to ask for.

When I was 51, ‘normal’ menopause age, I came off HRT as that had always been my plan. I weaned myself off using a variety of other ways to minimize any negative impacts from doing this. I needn’t really have worried as there were none. But I believe it’s because I’d put in place all the alternatives I now know are effective, that the easy transition occurred.

You might imagine I would have a negative view of menopause. But I absolutely do not. I wouldn’t be doing what I do now without it. I have a lot to thank it for! But I now believe my stressful career for the previous 15 years was at least partly responsible for it coming early. We can’t have it all. There is always a price to pay. We would do well to listen better to our bodies and respond to what they need.

I’ve learnt that menopause is just another transition in a woman’s life. It’s puberty in reverse. I know many women have a difficult experience with it. But many women don’t. But as is often the case, the negative voices shout the loudest. And the media loves a negative headline as we know. (I don’t actually believe headlines that say 1 in 4 women have symptoms so bad they consider giving up work even if research suggests that. Was it for a hormonal day or a serious consideration? We’ll never know. When I asked that question in my Facebook community of 2000+ women, it was a small minority that said yes.) I went on Woman’s Hour because I wanted to wave the flag for a positive menopause experience despite my secondary infertility.

There are many questions we need to be asking about menopause and one of them is why is it other cultures don’t seem to suffer as badly as us? Why does research show that women in the UK have a worse experience of menopause than other countries/cultures? What is it about our way of life that makes that the case? I want to know!

So finally, back to the all staff awareness email that talked about vaginal dryness. Very well-meaning I’m sure.

I’ve been trying to imagine how I’d feel if I received such an email at work. Clearly I don’t know the exact wording, nor have any other background, but I worry that when something like this is taken out of context and there’s no opportunity to explain and bring more information to the discussion, it can potentially do more harm than good. It seems to me a very good idea to have an awareness raising seminar to which people are invited and these issues are discussed.

But I still have a problem with listing vaginal dryness as a menopause symptom in an all staff email. Why is it relevant?  How will it affect our performance at work? For some women who have extreme vaginal atrophy, it may effect work. I’ve been reading My Menopausal Vagina and know this to be the case. But hopefully this is a very small minority of us.

I also don’t think the argument about including erectile dysfunction in a list of prostate cancer symptoms impacting what we include when talking about menopause, holds any water in this context either. It’s not possible to know a man is suffering from prostate cancer unless he shares that information with you. But all woman 50-55 (and much earlier in my case) will be either perimenopausal, or post menopause. It affects all of us. So there’s no hiding from anyone’s potentially misguided assumptions.

Unfortunately I also know enough about human nature to know, of all the things raised in this email, the ones that will jump out most are vaginal dryness and decreased sex drive. I’d be mortified to think 25 year old Paul in Accounts might be looking at me submitting my expenses and thinking about my dry vagina. Not to mention poor 30 year old Andrea in HR, who’s already feeling sensitive about turning 30, because of those commiseration birthday cards she received, and has just had it reinforced there’s not much to look forward to as an older woman.

These are some of the dangers of communicating things out of context. Each workplace is also different and a blanket approach will not work, no matter how well-intentioned. We want to raise awareness. We want women to feel able to raise menopause as an issue if they want to. But what we may end up doing, is increasing the endemic ageism in the workplace, adding in a nice dose of sexism, finding more reasons to question older women’s performance and getting an insidious and potentially humiliating combination.

So these are some of the reasons why I urge caution when raising awareness of menopause at work. The more we discuss menopause in the workplace, the more switched-on HR executives will want a menopause policy and awareness raising programs. This is a good thing, but it needs to be done sensitively and most certainly not as a box-ticking exercise, an issue raised by one of the Mumsnet commentators. In my view, sending out random emails without context is not being sensitive.

Including a list of symptoms and making it all sound dreadful is also not particularly helpful. Each woman’s menopause experience is different and many have little problem with their transition. I wince when I read sensationalist negative headlines about menopause and I will fight tooth and nail to stop younger women believing it is all doom and gloom ahead.

Deborah Garlick and her Menopause in the Workplace organisation is doing very good work in this area and she wrote recently about a new research paper published. Yes, women want awareness but they are also keen that menopause is not always seen in a negative light. They said managers should avoid drawing assumptions or generalizing, and never adopt a one size fits all approach. They want conversations to be kept strictly private. In fact, the research showed that it was seen as very important that employers do not draw any attention to a woman’s menopause or symptoms.

I believe exploring the underlying issues that may be making menopause difficult, is just as important as providing a work environment in which older women can function. Understanding and better ventilation are useful, but so also is awareness of the impact of changes in diet, exercise and mindset etc. For example, a BBC documentary found that CBT techniques could have a dramatic positive impact on both frequency and intensity of hot flushes.

Caffeine, sugar and alcohol are all known to exacerbate them. Natural phytoestrogens such as soy and flaxseed can help with hormonal balance. Exercise and meditation are beneficial probably for all of us. There are herbs like black cohosh and sage that can also help.  These alternatives are equally worthy of awareness-raising but all too often, the focus is on just coping or taking HRT.

It’s also worth considering that a once manageable high stress, but now unfulfilling and ageist work environment, may also be affecting women’s general sense of well-being and even their performance. I’d like us to look more holistically at older women at work, evaluating all issues that affect us and why we may struggle. There is a lot more going on, not just the menopause.

Awareness-raising needs to include positive statements to enable us to re-frame our menopause experience and narrative, for ourselves and the women who follow on. Many women love finally being off the oestrogen rollercoaster and do great things both during and after menopause. It can be a catalyst for positive change for many of us, as it turned out for me, and a time to embrace all that being a woman involves, as we transition to the next exciting stage of life. Whatever we do to end the taboo, let’s do it with sensitivity, balance and discretion so we bring everyone along with us.

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