Best Books To Give As Gifts – My Top 10 Recommendations

Would you like to gift a book to someone special? Books are always welcome gifts in my house! They can be entertaining, inspiring and useful! I love to be entertained and to learn at the same time. Here’s my pick of books I’ve read recently which are sure to be enjoyed and to inspire!

Hagitude: Reimagining The Second Half Of Life

Rich with the combination of myth, landscape and eco-feminism that took her earlier work If Women Rose Rooted to cult status, Hagitude reclaims the mid years as a liberating, alchemical moment – from which to shift into your chosen, authentic and fulfilling future. Drawing inspiration from mythic figures and archetypes ranging from the Wise Woman and the Creatrix to the Henwife and the Trickster, as well as modern mentors, Sharon Blackie radically rewrites the future for women in their mid and elder years. This was such a new way of looking at our elderhood for me. I loved it!

Forgiveness: An Exploration

Marina Cantacuzino seeks to investigate, unpick and debate the limits and possibilities of forgiveness – in our relationships, for our physical and mental wellbeing, how it plays out in international politics and within the criminal justice system, and where it intersects with religious faith. Cantacuzino speaks to people across the globe who have considered forgiveness in different forms and circumstances. She talks to a survivor of Auschwitz; to someone who accidentally killed a friend; to people who have lost loved ones in acts of violence; to a former combatant in The Troubles as well as to the daughter of someone he murdered.

Magnificent Midlife: Transform Your Middle Years, Menopause And Beyond 

I couldn’t not include my book! This is certain to inspire any woman in midlife (and beyond). I unpick the accepted status quo and negative stereotypes associated with women’s midlife and aging. I offer a radical research-based rebranding of midlife and menopause, highlighting the possibilities inherent in this transformational time in a woman’s life.

Unwell Women: A Journey Through Medicine And Myth In A Man-Made World

In this ground-breaking history Elinor Cleghorn unpacks the roots of the perpetual misunderstanding, mystification and misdiagnosis of women’s bodies, illness and pain. From the ‘wandering womb’ of ancient Greece to today’s shifting understanding of hormones, menstruation and menopause, Unwell Women is the revolutionary story of women who have suffered, challenged and rewritten medical misogyny. This a powerful and timely exposé of the medical world and woman’s place within it. This book is fascinating and really makes it plain how women have been short-changed when it comes to their health.

Walking with Nomads: One Woman’s Adventures Through A Hidden World From The Sahara To The Atlas Mountains 

I discovered this book because I interviewed the author Alice on my podcast and I’m so glad I did! Accompanied only by three Amazigh Muslim men and their camels, Scottish explorer Alice Morrison set off to find a hidden world. During her journey along the Draa river, she encountered dinosaur footprints and discovered a lost city, as well as what looked like a map of an ancient spaceship, all the while trying to avoid landmines, quicksand and the deadly horned viper. For armchair and real adventurers everywhere!

Being Mortal: Illness, Medicine And What Matters In The End

For most of human history, death was a common, ever-present possibility. But now, as medical advances push the boundaries of survival further each year, we have become increasingly detached from the reality of being mortal. So here is a book about the modern experience of mortality – about what it’s like to get old and die, how medicine has changed this and how it hasn’t, where our ideas about death have gone wrong. This book was recommended to me and I was transformed by it. We’ve got getting older and death wrong in so many ways in modern Western society especially. This is an attempt to rethink how we can age and die well. This book is remarkably uplifting considering the topic!

Dalvi: Six Years In The Arctic Tundra

Another book from a podcast guest and how great is this! Dálvi is the story of Laura’s time in a reindeer-herding village in the Arctic, forging a solitary existence as she struggled to learn the language and make her way in a remote community for which there were no guidebooks or manuals for how to fit in. Her time in the North opened her to a new world. And it brought something else as well: reconciliation and peace with the traumatic events that had previously defined her – the sudden death of her mother when she was three, a difficult childhood and her lifelong search for connection and a sense of home. This book is profound, moving and beautiful.

If Women Rose Rooted: A Life-Changing Journey To Authenticity And Belonging

Another great book from Sharon Blackie (soon to be a podcast guest). If Women Rose Rooted has been described as both transformative and essential. Sharon Blackie leads the reader on a quest to find their place in the world, drawing inspiration from the wise and powerful women in native mythology, and guidance from contemporary role models who have re-rooted themselves in land and community and taken responsibility for shaping the future.

Second Spring: The Self-Care Guide To Menopause

Second Spring is the more earthy and grounded version of my book, I reckon. It’s wonderful! It offers a new vision for menopause, mapping the psychological phases and showing how this period in your life can be a time of personal growth. Whether you choose a natural route, HRT or a combination of both, there’s a wealth of self-care practices available here to soothe your symptoms, and soulful enquiries to find real-life solutions for managing symptoms with kindness, helping you to become the person you always longed to be. Listen to Kate on my podcast here.

The Burning Light Of Two Stars: A Mother-Daughter Story

This riveting memoir by Laura Davis, the author of The Courage to Heal, examines the endurance of mother-daughter love, how memory protects and betrays us, and the determination it takes to fulfill a promise when ghosts from the past come knocking. You can listen to this amazing story direct from Laura on my podcast.

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An Easy Overnight Hike From London

Walking is my therapy. If I need to clear my head, I go for a walk. It can be just round the block or a bit further – it depends how much therapy I need! There’s something about walking in nature that is just so restorative. 

Recently, I decided to go for an overnight hike from London – solo. I’d been wanting to do it for ages but it just never really happened. Years ago, I did a five day overnight hike through the desert of Wadi Rum in Jordan. That was with a group but I joined them solo. We had lots of support so it wasn’t me by myself, but it was amazing. You can see pictures from that trip here.

hike from London

If you want to jump straight to my top tips, scroll to the bottom. Here’s some info on where I went and what I got up to!

I decided to get myself a ticket to somewhere I knew there would be some good walking, book a couple of places to stay and no return ticket because I didn’t know where exactly I would end up. I wasn’t going anywhere particularly adventurous – it needed to be close to home in London. I decided to go to Kent on Saturday, organized it all online and left Sunday morning!

My first destination was Rochester which I’d driven through in the past – such a beautiful town. It took just 40 minutes from Kings Cross St Pancras International to Rochester on the high-speed train – amazing! Within five minutes of getting off the train, I was outside the castle. 

hike from London

My destination for the evening was the Priory at Aylesford. I was going to spend the night in a friary! I’d vaguely researched the route and hoped to follow a number of different trails. I arrived in Rochester at two in the afternoon and set off past the castle following a route south on the ridge above the Medway river. Eventually, I came to a signpost for the North Downs Way, decided to chance it and soon encountered some spectacular scenery. 

hike from London

I knew I had to come off the North Downs Way at some point to get to the Priory and it would likely take me towards an old pilgrims route. Google maps was useful for telling me roughly when to begin my descent but I think I left it a bit late because I ended up doubling back on myself to get to the Priory. But I did discover the Augustine Camino, that ancient pilgrims route which coincided at times with the North Downs Way. 

I’d never heard of the Camino, but it has a whole website and it goes from Rochester all the way to Ramsgate on the coast. When I realized what it was, I started seeing little stickers on lamp posts and posts, telling me I was on the Camino, so I followed those and navigation became a bit easier for a while.

hike from London

But I was getting later and later to meet my friend who was coming to the Priory to say hello. We’d never met before, having only talked online, so it was rather exciting to be meeting in real life. Fortunately, she was able to pick me up about 2 km from my final destination, as I seemed to be getting further away rather than closer!

We went to a local village restaurant, the Hengist, for dinner because the pub was no longer doing food, then I collapsed into my austere friar’s cell after my vigorous afternoon’s walk. It was very basic but perfectly adequate and so atmospheric! The Priory is absolutely spectacular and I would recommend a visit to anyone. It is so beautiful and serene. 

The next morning, I had breakfast in the Pilgrims’ hall which is the most spectacular place you could possibly imagine having breakfast!

I went round the grounds before I left, checked out the relic in the chapel and visited the beautiful peace garden where the word for peace is inlaid in the floor tiles from every language in the world. Really lovely. 

I could’ve happily stayed all day and I’m certain that I’ll return. At about 9.30, I set off to find the Augustine Camino again, following the website directions – it was a bit further away from the Priory than I expected! Once I found it, it was a lovely route and I was full of the joys of spring as my city tensions melted away!

I’d checked out my itinerary on a walking website, but decided their suggested day two destination wasn’t going to be far enough for me. I wanted to go further. On reflection, I think choosing Lenham for my final destination was a little over-optimistic. I ended up walking 29 km in one day! I’d have been better off stopping at Hollingbourne instead but I wasn’t to know that then! 

Without the Camino website, finding that route and staying on it would’ve been impossible. I discovered there are people in Kent who don’t like having public rights of way going down the side of their house or through their vineyards! 

Certain places were completely devoid of any way-markers. At one stage, I went into the bushes to have a wee and found some markers left in the bushes. Tut tut. But with my instructions from the excellent Camino website, I was able to find my way to the Black Horse Pub in Thurnham where I had the most delicious lunch. I recommend the Black Horse Burger!

I then tried to carry on along the Camino route, but I went the wrong way and ended up at the North Downs Way again. The Camino wouldn’t get me all the way to Lenham anyway, but the North Downs Way would. So I followed that instead! 

This section of the walk was at times really hard work.  Especially with a backpack. I was going up and down steeply three times before it started to level out a bit. I met a very nice man with three lovely dogs who kept me company for a while and told me I’d already done the hardest bit of the route, so that was reassuring!

Later on, I was sitting waiting to go over a style to a field with a sign saying beware of the bull and another man with a dog turned up. I asked him if there was really a bull in the field and he said yes, so I asked, can I tag along behind you!  So that’s what I did!  We didn’t see the bull!  

Eventually, we went down off the downs and I then followed a very muddy bridle path – the official Pilgrims Way from Hollingbourne to Lenham, my final destination.

I was pretty exhausted by this stage and the bridle path was very muddy. At times I literally had to wade through water to get along it. So I was very very pleased that my boots are waterproof!

hike from London

At the end of both days, my Google Maps seemed to start playing up. Either that or I was just too tired to get it to work properly! As I headed towards the Priory on the first day, the distance seemed to get further rather than shorter!

As I approached Lenham on the second, I put the hotel where I was staying into Google Maps to be sure I was on the shortest route. But I then went off on a long detour and as I was heading back towards town, I saw the road I’d been on, the Pilgrims Way, coming out right by the entrance to the village. So that was a bit depressing! 

I walked over 29 km! Bit bonkers really. I was so happy to find my room had a bath. They also had hot chocolate and some shortbread biscuits. I had a lovely wallow in the bath and then collapsed into bed. 

The following day, I’d planned to walk to Ashford International before heading home, but I decided my legs had had enough and I took the local train from Lenham to Ashford instead, then the high-speed train from Ashtead back to St Pancras. All in all, it took just over an hour to get back to Saint Pancras which I thought was pretty incredible. A really easy hike from London!

This was the most wonderful mini adventure! When preparing this post I found this site which has lots of places to stay along walking routes. A great resource for my future trips! I’ll definitely do a longer one next time – it was so much fun!

Here are some practical tips for an easy overnight hiking:

  • Make sure your rucksack is super light and comfortable before you set out. I wasn’t actually aclimatised to my rucksack and it took a bit of getting used to because it had a ventilation system and seemed to be rubbing my shoulder blades. But I soon got used to it and all was fine. Make sure it has good waist straps. I can carry weight on my hips but not on my shoulders anymore. Use all the straps available – they’re there for a reason! 35 litres was big enough for me and could’ve lasted a week I reckon. Here’s a similar rucksack.

  • Take snacks. I had a couple of protein bars and some fruit and nut homemade selection, useful for when there were no shops around and I needed some extra sugar to keep me going.
  • Take enough water. I took one small bottle of water with me each day and that was actually enough because the weather wasn’t hot, and I was able to fill it up at the pub at lunchtime on the second day. But if it had been warmer, I would’ve needed to carry more with me. I had this backup collapsible water container in case I needed more – useful also for festivals!
  • Take a waterproof jacket and trousers, and layers for warmth. I was lucky that it didn’t rain, the whole time I was away, but it could’ve so easily been different. You’ll get warm while you’re walking but possibly cold when you stop. You may be cold at night. So make sure you have both waterproof and warm layers to accommodate changeable temperatures depending on where you are and the season. If you’re walking in the UK, you’ll likely always need waterproof clothing! Being wet and cold is miserable when you’re hiking
  • Invest in good kit – it will make you more confident. My rucksack and clothing were great. Good walking trousers make life easier – here’s an example of a good walking trouser. Mine were North Face and I have jungle ones for when it’s hotter from Craghoppers. Specialist walking trousers are quick to dry if they do get wet, making them easier to clean at night too. I swear by Vivo Barefoot shoes. 29km and my legs ached terribly but my feet were fine – the next day too. And these boots are waterproof. Expensive (I wish they weren’t so) but worth it and they last forever! You can usually get 20% off your first direct purchase with Vivo which is well worth it. Here’s a link to my walking boots, pictured below.

  • Put your clothing in a plastic bag inside your rucksack. My rucksack came with a cover but to be doubly careful, I put everything inside a black bin liner inside the rucksack. Being wet and cold is really miserable when you’re hiking.
  • Plan your route but be flexible about finding a better one. The combination of way markers, a website outlining the route and Google Maps proved to be incredibly effective – most of the time!
  • Don’t be afraid to ask for help. I asked for help and directions a few times and ended up having really nice chats with locals.

This turned into a magnificent mini adventure for me. As I wrote on the day, I could feel nature rejuvenating me with every step I took. It was so lovely to pace gently by myself and have no one else’s needs to consider. I like my own company and spending time with myself was very cool. I started off this article saying I needed to clear my head and it really help me do that. Are you inspired to go for an overnight hike from London? Go for it!

You may also like: How To Cope With An Empty Nest

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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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How To Overcome Menopause Brain Fog

Adapted from Rachel’s book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

Menopause brain fog is an issue for many women, often made worse by fear and stress. When we find ourselves forgetting things or getting a bit muddled and we don’t know why, our first thought can be that it’s early onset Alzheimer’s. But it usually isn’t!

There is such fear of dementia, particularly in the West, that many women fear this is what’s happening to them when they can’t remember the word they need. Shame kicks in too making everything worse. That’s another reason to raise awareness about this common menopause issue.

I wonder if you’ve had this experience? Experiencing it at work can be especially alarming. But fear not! When our hormones start fluctuating, they affect many things, including our ability to think as clearly as before. And getting stressed about it will add to any confusion!

menopause brain fog

Hopefully, post menopause, this will settle down. In fact post menopause, you get a brain upgrade and will hopefully find yourself more able to focus than ever before. Check out Dr Louann Brizendine on my podcast talking about How Women’s Brains Get Stronger And Better With Age.

But during the perimenopause years, we need to sort our hormonal balance as much as we can and develop coping strategies for when we suffer some brain fog. See the section at the bottom on Hormonal Balance for the quick guide to hormonal balance. That will give your brain and body the best chance of thriving through menopause.

You probably don’t need me to tell you that if you’re suffering from insomnia due to hormonal fluctuations, you’re also likely to suffer from foggy brain. Make sure you’re getting enough good, deep sleep. Click here for tips on how to get good sleep in midlife.

If brain fog is still an issue, consider coping strategies like a bit of humor to take away the anxiety. Try not to take it too seriously; we all forget things. And certainly don’t feel shame about it! For most of us, forgetfulness won’t indicate a deeper issue, but if you’re especially worried or have a family history of brain issues, do get yourself checked out by a doctor.

Sleep, stress, nutrition, and exercise will all have an impact on menopause brain fog. Beating Brain Fog: Your 30-Day Plan to Think Faster, Sharper, Better by Dr. Sabina Brennan has lots more research-based tips if you’re struggling.

I sometimes get a bit muddled still, but I think I’ve always been a bit like that. If you try not to let it upset you, it will have less impact. If you fear brain fog is impacting your performance at work, consider talking about it with a manager if that’s possible.

If you have a good relationship with colleagues, perhaps you can tell them menopause brain fog is just something that happens. It all helps raise awareness. Ask them to help you with a forgotten word and move swiftly on. Not being able to remember something or feeling a bit muddled doesn’t make you any less of the highly capable woman you’ve always been.

Click here for the ultimate guide to brain health in later life with Susan Saunders, co-author of The Age-Well Project and author of The Age Well Plan.

Hormonal Balance

I’ve written extensively elsewhere about how to achieve better overall hormonal balance. Here’s the quick guide.

1. Balance your blood sugar and sort out your diet. Fluctuations in your blood sugar levels are going to exacerbate the hormonal fluctuations of perimenopause so helping your body out with the right food and not putting in under extra stress makes sense. Stress can be external or what we create in our bodies with how we live, 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. For example, caffeine, alcohol, sugar and refined foods can all cause our blood sugar to spike and then plummet when their effects wears off. Natural plant-based phytoestrogens in the form of flaxseed or soya are also great for balancing out hormonal fluctuations. Jackie Lynch’s book The Happy Menopause is a brilliant guide to nutrition in menopause.

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?

4. Try to lower your stress or improve how you deal with it. Hormone fluctuations are exacerbated by stress and stress makes brain fog much worse. 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. Up your exercise. As we age we need more exercise not less and many women swear by exercise to help them manage menopause symptoms. Exercise helps manage stress which helps with brain fog. Click here to learn why lifting weights becomes so important as we age.

You may also like: Top Tips For Dealing With Perimenopause Anxiety and Menopause And Depression – Giving Context To Statistics

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Depression In Menopause

Adapted from Rachel’s book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

Depression in menopause is sadly not uncommon. That and anxiety can often raise their nervous heads during the menopause transition. It may be just greater overall sadness, but that can also tip over into depression. Especially if you don’t take steps to rectify it.

If you think of premenstrual syndrome (PMS), it’s only natural that as hormones fluctuate more in perimenopause, our nerves may be more on edge. Women can become suffer low mood around this time and are often offered antidepressants by their doctor, when what they really need is help balancing their hormones.

depression in menopause

But don’t automatically blame menopause! There’s potentially a ton of other causes that may be making you sadder than usual. You may be suffering the effects of ageism and sexism and all those negative narratives about who you are now, not to mention the global pandemic and the economic and political instability we’ve all been coping with.

How about dealing with teenagers and older parents at the same time? Or the end of your dreams of fertility or an empty nest? There’s so much going on! There’s also the U-curve of happiness which shows midlife as the dip in our lifetime happiness – it generally gets better after this time, I promise!

Antidepressants may help you through a difficult patch, but often, in midlife, it’s more about balancing our hormones and dealing with some of the emotional issues that surface around this time. Like hormone therapy, antidepressants can enable us to function, but they may mask symptoms we need to deal with, whether or not we take medication. Obviously, for some women, antidepressants are essential, but jumping straight to prescribing them for a midlife woman is not really giving her the duty of care required, in my opinion.

Statistics on menopause and mental health can also appear alarming. For example, there’s an unfortunate correlation which keeps being raised in the UK media, between menopause and the age at which there is the highest rate of suicide for women. It’s true that women aged 50-54 exhibit the highest rate of suicide in the UK, but the actual rate is only 7.4 women per 100,000 population. This rate compares with 6.9 women per 100,000 in the 45-49 age range and 6.5 in the 55-59 age range.

Of course, any rate of suicide is awful. But this is a tiny increase between age ranges, and the rate of male suicide is greater than that of women in every age group except 15-19. I think conflating the age at which there is the highest rate of female suicide with menopause is irresponsible, especially without context, and plays on women’s fears about this time. I’ve written more about this and how correlation does not equal causation. I asked the UK Samaritans for their view on these media narratives.

I believe there are many other factors that build up for women in midlife that impact our mental well-being. Sometimes I feel like the great menopause defender: “It’s not her fault!” If you’re experiencing low mood and or anxiety, I encourage you to be curious about what’s going on underneath and how you can deal with it.

There are plenty of things that can help, whatever the root cause. Here are some:

  1. Try any or all of the general hormonal balance tips you’ll find at the bottom of this article relating to diet and lifestyle.
  2. Remember, if you’re a drinker, alcohol is a depressant, and your body may may not be able to cope with it as well as it once did. I recently took an extended break from alcohol and my mood and anxiety levels both improved significantly.
  3. Try Cognitive Behavioral Therapy (CBT) and or a regular meditation/mindfulness practice. This will help ground you and bring you back to living in the moment. Good mindfulness/meditation apps to try are Calm, Headspace, Buddify, and Insight Timer (which is free). CBT is great for getting a handle on runaway thought patterns. Leafyard is a powerful online self-help program for mental health.
  4. Exercise and being outdoors are great for low mood and anxiety. Go for a walk in the park (or in a forest, if
    you can find one). Look around yourself and enjoy a bit of nature. Get your heart rate up and enjoy some post-exercise endorphins.
  5. Breathe! Box breathing is a great technique to slow things down if your mind is racing. With box breathing, you breathe in for four seconds, hold for four seconds, breathe out for four seconds, and hold for four seconds, all while visualizing moving round the sides of a square.
  6. EFT (Emotional Freedom Technique), otherwise known as tapping meditation, can also be very helpful for depression and anxiety. It has been found to be particularly effective for veterans suffering from PTSD. I really like The Tapping Solution app.
  7. I discovered essential oils and am finding them very powerful for changing my mood. I’ve been experimenting with blends in a diffuser to help me focus, boost my energy, balance emotions, and calm me down. Click here for some of my favorite blends.
  8. 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.
  9. If you’re really struggling with depression in menopause and think HRT will help, then ask the doctor about that. But don’t forget you still need to have a healthy diet and lifestyle to thrive in menopause and beyond. You’ll likely also need to deal with any underlying and unresolved emotional issues eventually!
  10. If anxiety and low mood have tipped over into depression, be sure to visit your doctor and get whatever help you need. The longer you leave it, the worse it may get.

Hormonal Balance

I’ve written extensively elsewhere about how to achieve better overall hormonal balance. Here’s the quick guide.

1. Balance your blood sugar and sort out your diet. Fluctuations in your blood sugar levels are going to exacerbate the hormonal fluctuations of perimenopause so helping your body out with the right food and not putting in under extra stress makes sense. Stress can be external or what we create in our bodies with how we live, 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. For example, caffeine, alcohol, sugar and refined foods can all cause our blood sugar to spike and then plummet when their effects wears off. Natural plant-based phytoestrogens in the form of flaxseed or soya are also great for balancing out hormonal fluctuations. Jackie Lynch’s book The Happy Menopause is a brilliant guide to nutrition in menopause.

2. It’s expensive, but eat organic if you can for most 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?

4. Try to lower your stress or improve how you deal with it. Hormone fluctuations are exacerbated by stress and stress makes low mood much worse. Reduce levels of stress in your life, maybe adopt a meditation practice as above, or do some restorative yoga. Both of these will help you lower stress levels overall and potentially reduce menopause symptoms, especially the sadness that seems to affect many of us around this time.

5. Up your exercise. As we age we need more exercise not less and many women swear by exercise to help them manage menopause symptoms. Exercise can immediately improve our mood. Click here to learn why lifting weights becomes so important as we age.

Don’t let depression in menopause ruin your life. Get the help you need!

You may also like: Menopause And Depression – Giving Context To Statistics and Top Tips For Dealing With Perimenopause Anxiety

depression in menopause
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How To Do 100 Days Sober

I can’t quite believe it, but I’ve just celebrated 100 days without a single drop of alcohol passing my lips. Shortly before my birthday in June 2022, I decided enough was enough. My body deserved a break from the booze.

I’d listened to a podcast by Dr Rangan Chatterjee with Andy Ramage, co-founder of One Year No Beer. There was one phrase that he used, that really stood out for me. He’s a former financial trader and I used to work in the financial world also. Perhaps that’s why this phrase particularly resonated with me. It was: the trade is no longer worth it. What he meant was that what he got from alcohol was no longer worth what he suffered as a result of it.

100 days sober

I’m always talking about how as women go through menopause and our hormones change, alcohol is no longer our friend (here’s a podcast about that). I’ve talked about how when I came off HRT, having been on it for my early menopause diagnosis, there were two things that caused me to have an immediate hot flash, chocolate and alcohol. These became less of an issue as my body settled down after the HRT, but if I had a few glasses of wine of an evening, the following morning I’d wake up in a big hot flash. not to mention having very disturbed sleep too.

I had long been aware that I was drinking too much. I don’t do moderation very well. One drink becomes two becomes three. I rarely if ever go beyond three but as I get older, the impact the following day is just not worth it. I won’t sleep well, I’ll wake up groggy, I need more time to get going the following day, and I just feel pretty rubbish. I’ve got lots of things I want to do and I don’t have time to cope with the hangovers that come when I drink.

Another issue has been my mental health. The last couple of years, with the Covid pandemic, have been very tough for everyone. Anxiety and depression raised their ugly heads for me and I became aware that I was using alcohol to self medicate. The problem was, the alcohol was actually making things worse. So that was another reason for taking a break.

Thirdly, with my favourite tipple being white wine, I was consuming a ridiculous amount of my daily calories in alcohol. I was running and doing exercise, and gradually I became aware that I was doing those things so that I could drink. If I had drunk and not done the exercise, I would be much heavier than I currently am.

Even just one glass of wine would impact my ability to do yoga the following morning. I like to do a vigorous form of yoga called Ashtanga and if I have any alcohol, I cannot do that yoga the following day without feeling sick. Eventually I started to listen to my body in this area of my life as much as I have learnt to in every other. So that was a third reason for having a break.

I’ve tried to have a break from alcohol in the past. I’ve done dry January and Sober October. But at the end of each month I’ve always gone back to drinking, sometimes more than I did before I stopped. It was this one phrase, the trade is no longer worth it, that has enabled me to keep going to 100 days this time.

I want to look after myself. I want to invest in me. There are so many things I want to do with my life, I don’t have time to drink! The recovery takes too long. I’ve avoided occasions where alcohol is prevalent to help me stay on track. But as time has gone on, I’ve been super impressed with how easy I’ve found it to just not want a drink.

Historically for me, long plane journeys have been a chance to try out free and quite expensive alcohol. I’m recently back from a 3 week trip to Peru and I didn’t have any alcohol on any of the plane journeys, and, something that truly amazes me, I had no desire to try the national Peruvian drink, a Pisco Sour. I just didn’t want it. I’ve also been to receptions where there’s been free booze on offer and I’ve reached for tonic water instead.

One thing that was more difficult while we were in Peru was that, while there were a lot of sugar heavy fruit juices, and an amazing maize drink called Chicha Morada, there were no alcohol free drinks. (Although I had some lovely juice drinks that often looked a bit like the image above!) Alcohol free drinks have been my savior here in the UK. I’ve long preferred alcohol free beer to the real thing and have stocks of it at home. Gordon’s does an excellent zero alcohol gin which I now make with tonic water so I have my own version of gin and tonic without the hangover the following day. I think it tastes great.

I’m also a fan of alcohol free wines. I joke that I’ve always had a cheap palate when it comes to wine, so the alcohol free ones don’t bother me at all. The Tesco’s and Sainsbury’s alcohol free bubblies are also pretty good from my perspective. It’s enough for a celebration!

But it really is the alcohol free beer and alcohol free gin and tonic which have enabled me to keep moving forward. I definitely saw alcohol as a reward early evening, as a treat at the end of the day. Now I’m happy to have a cup of tea, but if I do feel the need for something a bit more, to mark the end of the day, I can reach for my alcohol free drinks.

So I hope you’ll join me in celebrating my 100 days without alcohol. I’m not saying I’ll never drink again, but currently I have absolutely no desire to drink, something which is completely new to me. I feel fitter, happier, less stressed, more focused and I believe my relationships have improved also. I think my skin is better and my eye bags are definitely less pronounced! I’m not damaging my liver and my bones on a daily basis. I’ve likely reduced my risk of breast cancer. I’m slimmer too, despite my efforts to replace booze with dark chocolate. My husband says he’s got a new wife and he prefers this iteration. He said that after menopause too, so I guess I just keep reinventing myself!

As I hit publish on this post, we’re about to start Sober October. Club Soda is a brilliant community if you’d like some support changing your relationship with alcohol. Why not take this opportunity to take a break from the booze too? You never know where it might lead you!

Top tips for taking a break from alcohol

Here are my six top tips for making a success of a break from alcohol:

  1. Listen to this Feel Better, Live More podcast with Andy Ramage on taking a tactical break from alcohol.
  2. When you want a drink, consider whether the trade is worth it. How will you feel the following day? What will you be unable to do as well as you could later/tomorrow if you’ve drunk today?
  3. Read some ‘quit lit’ from the list below to understand better your relationship with alcohol – I recommend This Naked Mind, The Unexpected Joy Of Being Sober and Drinking: A Love Story.
  4. Buy some alcohol free drinks. I really like Lidl’s Perlenbacher 0.0. I drink Stowford Press Low Alcohol Cider (it says low but it’s almost zero), Gordon’s Zero Gin is very good and I buy alcohol free rosé, white, red and sparkling wine from Tesco’s and Sainsbury’s.
  5. When you’re out with friends who’re drinking booze and you don’t want to, think about what you’re going to drink in advance – tonic water perhaps or alcohol free beer which many pubs now stock, if not restaurants yet. Don’t be afraid to explain that you don’t want to drink – you don’t need to give a reason and if they complain that you’re boring not drinking, that’s their problem not yours.
  6. Give yourself a huge pat on the back each day that you don’t drink. It’s another day where you’ve given your body a head start in the health stakes.

Good luck!

You may also like: Lessons From A Month Off Alcohol! and What Happens When You Mix Menopause And Alcohol?

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Breast Cancer, Menopause And HRT

This is a summary transcription of our podcast interview with Dr Liz O’Riordan, an international speaker, broadcaster and award-winning co-author of ‘The Complete Guide to Breast Cancer’. In 2015 (aged 40) she was diagnosed with Stage 3 breast cancer whilst working as a Consultant Breast Surgeon. Her life changed dramatically. She’s passionate about helping people and especially breast cancer patients. Click here to listen to the full interview.

Taking away the blame about breast cancer

We know from statistics that have looked at studies of women that if you are overweight, if you drink a lot, if you have an unhealthy lifestyle, your risk of getting cancer is higher. I drank like a fish in medical school like most junior doctors did, but it’s very hard to say the reason I got breast cancer was because I drank a lot. Often, it is just a combination of changes that happen at some time in your life and people feel awful when they think it’s their fault. 

You can’t say it’s one thing that you did that caused this. Your lifestyle may have made it more likely to happen but skinny people still get cancer. Teetotalers still get cancer and I just want to take that blame away and say, having cancer is bad enough. You don’t need to blame yourself for that. Let’s just try and help you move on.

Estrogen receptor breast cancer

As a consultant breast surgeon, I never dealt with the menopausal side effects of Tamoxifen or the Aromatase inhibitors which lower the amount of estrogen in the body. I’d read the leaflets on breast cancer and I’d say you get a bit of vaginal dryness and hot flushes. It normally settles down in time, off you go. 

We had a great GP who sat in our clinics who ran a menopausal symptom clinic. I didn’t have the time to sit in with her. I assumed the GP dealt with it. I didn’t get any training in it. I didn’t know other drugs were available to help women with the symptoms. But I could never imagine any woman having extra estrogen. Estrogen receptor positive cancer is kind of the one that’s often left out. 

There are lots of new drugs coming for other cancers but for estrogen receptor cancers, when they come back, we still have the same old drugs, Tamoxifen and Anastrozole and it develops resistance and it can kill.  I wouldn’t want to give my patients anything that might increase the risk of a recurrence happening. Estrogen doesn’t cause breast cancer but it encourages those cells to grow. 

Coping with an instant menopause

Then I got breast cancer myself.  I was put into an instant menopause with chemotherapy and when my cancer came back, I had my ovaries removed. An overnight menopause and I thought I’d wet myself because there was sweat trickling down my bum cheek. I thought, Oh my God, that’s a night sweat. I’m never going to have a full night’s sleep again.

The flushing and the stripping off, the vaginal dryness, and sex and intimacy issues overnight. I thought, how on earth am I meant to cope for the next 10 or 15 years? An  incredible oncologist called Richard Simcock tweeted me to say, here’s a whole list of other drugs we can get you to help with the symptoms. I had no idea they existed. 

That’s one of the reasons I wrote my book – to tell women that there are options available. You don’t need to put up and shut up. With vaginal estrogen, when I was diagnosed, most doctors said no extra estrogen at all. There was a study looking at the amount that is absorbed vaginally, and it is tiny and vaginal estrogen is now 10 micrograms. We used to give 25. 

I thought, I need this as a cyclist. I was getting labia skin tears, riding 100 miles on a bike. It wasn’t just sex and intimacy. I thought even if there is a tiny risk, it will increase my risk of recurrence, my quality of life is so bad that I want to take that risk. I know it might increase the risk but I’m going to exercise, I don’t drink so for me, I thought that was fine. But I had to find a doctor who thought it was safe to prescribe it. 

My GP was fantastic but a lot of people get batted back and forth. I knew it was a tiny dose and I knew that risk. A lot of women don’t have educated GPs or breast surgeons like me. They don’t know this help is available. They don’t know where to go. They don’t know what websites to go on. It’s a minefield and most of us will go to social media for information. 

Dr Liz O’Riordan

Understanding the risks of HRT

There is a narrative that HRT could be safe after breast cancer. We can talk about the details of the research and trials, but my concern is a lot of women are hearing it might be safe and it’s good for you and it will stop you dying of heart disease and dementia and it’s fantastic. And then not being told that there are studies that say it has shown an increase in recurrence. 

None of the studies are great but women need to know, we don’t know whether it’s safe or not, so you can take that decision. Because if your breast cancer comes back and you took HRT, are you okay to live with that guilt that you or your family might experience? I don’t care if every woman takes it but I want her to know about all the alternatives and benefits of improving your lifestyle. If she’s willing to accept that real risk of an early death, that’s fine but I don’t think that message is getting across.

Staying curious about research

When I did my PhD looking into thyroid cancer, if I was using a scientific article, I had to read it and critique it and explain why I was using it to back up my theory and what was good and what was bad about it. If you write a book or you write an article, you don’t have to read all the papers that you reference. There’s no law. You may have seen one person said it and that was repeated and repeated and repeated. So I’ll just rewrite what they said about the study and put it in the book. And when journalists report on a new paper in the Lancet saying HRT is great, they don’t have to read the full study, they can just take the press PR spin. 

Just because someone has quoted a study doesn’t mean they’ve read it or they believe it. There’s no way of knowing that and most of us will think, oh wow, there’s loads of papers in this. It must be true. Look at all the evidence. There’s one book written by an American oncologist, Avrum Bluming, called Estrogen Matters and it’s promoted a lot in the menopause online space. About why HRT cures everything. Estrogen is the saviour, you have to have it. And I’ve had so many women send me awful messages feeling they’re being forced to have it. They don’t want it, why is it being forced on them? So I look at this data.  

Dr. Bluming says there are 25 studies that have been done looking at HRT, there aren’t many. But he says most of them show it’s neutral or safe. And I went back and they’re often done in the 1950s 60s 70s 80s 90s, 20-60 years old. And a lot of them aren’t done to actually look at HRT, they’re looking at the treatment of breast cancer. A lot of them only use women who are already two or three years down the line after treatment. 

And this is really important, because breast cancer is going to come back. So the first couple of years, or it’s 10, 20, 30 years later, like Olivia Newton John. But if you make it to five years, your chance of making it for 10, 20, 30 is much, much better. So by only picking women who’ve been treated for two or three years, you’ve got rid of everyone who had an early recurrence. So the women you’re looking at are less likely to have a bad outcome. And most trials only followed women up for a couple of years. But we know like Olivia Newton John, it can come back 30 years later. And a lot of the trials didn’t tell us whether those women had estrogen sensitive cancers or not. So you can’t say HRT was OK, if they’re all triple negative, because those cancers aren’t driven by estrogen. And when you delve down, we don’t have good data to show that HRT might be safe.

Evaluating whether HRT is safe for breast cancer patients

Now, on the other side, there are a couple of trials and I’ve not done my deep dive in them, so I’m not hot on the stats, that showed HRT could increase the risk of recurrence. And again, they weren’t long follow ups. One trial was stopped early, because they were concerned about this. And the people like Dr. Bluming poopoo this study, say it only showed local recurrence. And that’s not the same as death, or metastases. 

I had an early local recurrence. And yes, local recurrence can be cured, it can be cut out, it doesn’t mean my cancer is going to come back. But if you have an early local recurrence, you’re almost four times more likely, I think that’s right, definitely much more likely to get metastatic disease and die in the future. It’s always a marker that your cancer is worse than someone else. 

So the fact that it didn’t show an increase in death doesn’t matter, the increase in a local recurrence is more likely to lead to an increase in death. Does that make sense? So they can’t say, oh, it’s just a local recurrence. It doesn’t mean anything. Those women are more likely to get metastatic disease in the future. And honestly, you can interpret the evidence any way you like to make it fit your hypothesis, your opinion, your story. I don’t think there’s ever going to be a good trial to compare a group of 1000 women with positive breast cancer and say, half of you are having HRT for five years, half of you aren’t, and we’re going to follow that for 10 years; it’s never going to happen. So we may never have accurate data at all, we have bad trials. But women need to know that there were trials that showed it was good, and some didn’t. And some trials showed it was bad.

Making informed decisions and understanding risk

Every woman has the right to take what she wants. It’s her body and doctors have to realise that’s okay. We are not the ones living with that risk, the fear of recurrence, which I did as a breast cancer surgeon. And I think my fear would be worse than any woman I’ve ever seen as a doctor because I’ve looked after young women who have died of metastatic breast cancer. Most of my patients will have never seen anybody go through that and they can’t imagine what it’s like. But as long as the woman knows that. 

The position statement from the Royal Colleges of Obstetricians and Gynaecologists, Association of Breast Surgeons, the British Menopause Society, the Society of Endocrinologists says that HRT should not be routinely recommended for women with breast cancer, unless it’s exceptional circumstances. Because we believe it can increase the risk of recurrence. If women have tried all the other alternative drugs available. They’ve done lifestyle measures, exercise, cutting back on alcohol, and their quality of life is so bad, that they’re willing to take a risk of recurrence, then I think it’s fine if they have HRT, but we just need to make sure women have been told all of that first.

Everything is complicated. If you had a bit of DCIS, non invasive breast cancer, and you’re 65, the chance of that becoming metastatic in the future is very, very small. But a young woman who’s 35 with a large stage three ER positive breast cancer with positive lymph nodes, her risk of metastasis is much, much higher. And I’d be really concerned if women who’d had chemo were being recommended HRT because their risk of recurrence is so much higher. So I think it’s really important, your private menopause specialist, whoever you’re seeing fully understands your own risks of recurrence for your individual breast cancer.

It can be difficult because oncologists are probably going to say, no, you shouldn’t take HRT. Because we’ve looked after women where it’s come back, we are very, very risk averse. Whereas the menopause specialist may be saying, no, no, it’s fine. Trust me, you’ll be fine. And you’re left in the middle, and you don’t know who to believe. And that’s where it’s really, really hard for women. And there is no easy answer. But I think women need to know why the doctors are not recommending HRT, the cancer specialists on the whole are not recommending it.

I’m just trying to explain the evidence that women can understand. I used to tell my patients, don’t go on Google. I’ll give you a load of information. It’s bullshit, pardon my French, because it’s the first place I went. I bought 10 books written by breast cancer patients to understand what it was like and that’s me being a consultant breast surgeon.

Sources of information

The first place we go for information is often Instagram or Twitter.  It’s very easy to believe what you see and it’s crazy how if someone has 100,000 followers, you’re more likely to think they’re telling the truth. You’re more likely to believe them rather than a doctor who’s got 2,000 followers who’s putting out incredible content but because they’re not famous, people don’t listen to them and it’s really hard how your expertise is based on how popular you are, not your qualifications.  I don’t know the way around that. It’s really hard.

I’m not paid to do this. I do this in my free time because I just want to help people and think if I can explain research and help someone understand then that’s great. They don’t have to listen to me. It’s nice if they do but it’s a really strange world where social media is changing how patients are treated. They have access. It’s amazing as a patient you can follow conferences all over the world telling you the latest updates about your individual cancer, your illness. You have access to so much information now that was always kept behind locked doors with the doctors on this. It is opening things up.

Balancing the prevailing narratives about menopause and HRT

Most women with menopause actually cope quite well. The symptoms do get better in time, that’s the same for women taking Tamoxifen. It’s a bit like TripAdvisor. The people who are raging the most about a bad restaurant are the ones who go on and complain. I got letters of complaint, people trying to sue me. There are a handful but they really hurt.

The vast majority of people treated couldn’t be bothered to tell me anything and a couple send a card. It’s the same with the menopause. I believe most women, they know it’s not great, but they get through it, but there are some who really struggle and they are the ones making the noise and making it out to be much bigger than it is – just a thought.

The guidelines from the Royal Colleges all say that HRT should not be prescribed to prevent disease. It’s not designed for that but there’s a new narrative coming through that HRT will stop you getting dementia, heart disease, osteoporosis, diabetes, or all these kinds of things. It’s not designed for that. This is because women who are old get Alzheimers, therefore, it must be the menopause. Therefore, HRT can stop that. 

That’s like saying, women with breasts get breast cancer and women who have breasts, wear bras, therefore, bras cause breast cancer. There are so many other factors. But people who follow me with breast cancer who don’t want to take HRT are terrified they are going to die of Alzheimer’s and heart disease because they’re not taking HRT. 

The message from all the medical societies is you give HRT to help with menopausal symptoms, not to prevent disease. It may be a tiny bonus of taking it but you don’t prescribe it for that reason. What’s the biggest thing you can do to reduce your risk of dementia, Alzheimer’s, heart disease and osteoporosis? Exercise. Healthy lifestyle changes that are free and have no side effects.

Protecting health long-term

To improve the strength of your bones, you need calcium and vitamin D in your diet. You need weight-bearing exercise. Cycling, swimming and yoga don’t really count. You need to put force through the bones. You need to be ideally doing some weight training as well, to help build up the muscles to keep the bones strong. Estrogen delays osteoporosis. It will help a little bit if you’re on HRT but the biggest thing you can do is weight bearing exercise. 

How much are you paying to see someone to give you this medication? I’m really scared at the narrative that people are now saying it’s a deficiency syndrome. It’s not. The Royal Colleges say that menopause is not a deficiency. It’s a natural state when women’s bodies stop being able to have children. We don’t call midlife crises for men a testosterone deficiency syndrome, they just get on with it. 

There are still menopause specialists who are plugging the issue that it’s a deficiency. It’s natural. Your ovaries stopped working. When your body can’t cope with you being pregnant. It happens naturally like men naturally produce less testosterone. It’s called ageing. It happens to us all. 

For most women, it’s simple, healthy, boring lifestyle measures that will just help you cope whilst your body gets used to it, but then settles down into your postmenopausal state. Because if you go on HRT, you’re gonna have to stop it at some point and then you’re gonna go through the symptoms. You’re going to have to go through this anyway because it’s not safe to be on it until you’re 80 or 90. 

You’re delaying the inevitable. You’re going to be more able to cope with the symptoms of the menopause, if they’re bad in your 50s compared to your 70s or 80s. It’s just become this huge issue and it really shouldn’t be. People are making money. People are coming out making money off the menopause.  It’s the latest thing to cash in on. 

The importance of exercise when it comes to breast cancer

We now know that exercise improves all the symptoms of breast cancer treatment, physical and mental, and halves the risk of recurrence and it improves your bone health. Ideally, we should be doing aerobic and weightlifting two or three times a week and most of us don’t do it. Most doctors don’t do it. I have weeks where I fall off the wagon but it’s just that sense of, I’m looking after me, you get the endorphins ready, I feel better.

But it’s hard, and it’s easy for people to think, but look at her, she’s tall and slim. It’s easy for her. I have a busy job. I can’t do it. I get how hard it is. It’s like a dirty word, exercise. It sounds like hard work. It’s really hard to put on a pair of trainers and put a podcast in and get out the door and move. It is really hard to take the first step.

What Liz most wants women to know

I want you to question everything you’re being taught and think about the person who’s giving you information. There’s a test by a guy called Skyler Johnson called the CRAP test. Is the claim too good to be true? If it was true then every single doctor would be telling you it. Is the research unbiased? Is the research done by pharma companies who have an agenda?.  Are they making money off whatever they’re selling you? Just take that into account and remember, just because someone’s a doctor, doesn’t mean they are a specialist in the area they’re talking about and trust your gut.

Listen to Dr Liz on the Magnificent Midlife Podcast

Find out more about Dr Liz O’Riordan:

Dr Liz’s website:

Twitter | Instagram | YouTube

Dr Liz’s books: The Complete Guide to Breast Cancer and Under the Knife (For Pre-order)

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How To Embrace Middle Age

Middle age is a stage of life that can strike fear into the hearts of millions. Many of us dread reaching middle age because we equate it with being old. But middle age is exactly that, the middle of life. But what age is middle age? When does it start? How long does it last?

How do we define middle age?

I think that depends on how old you are as well as where you live in the world. Younger people seem to think middle age starts and ends earlier. Older people tend to think middle age starts later and ends later. Different cultures have different ideas of youth, middle age and older age. I’ve also noticed that middle age seems to start and end earlier in the UK, for example, than in the US. I’ve noticed that women in the US still consider themselves middle-aged in their 60s.

(I should have got more clarity before on this and also the extent to which women especially do not want to admit they are middle aged. I’ve spent the last six years trying to market services to women in a stage of life with which they have no desire to identify!)

How does the dictionary define middle age?

Most dictionaries reckon middle age is the stage of life from 45 to 65. I was rather surprised by that. I’d always thought it was from 40 to 60 and that 60 demarcated the beginning of my third or older age, or as I like to say elderhood. A British survey found that Britons saw middle age starting at the age of 55. If that’s the case, I’ve only just begun to be middle-aged rather than already approaching the youth of my elderhood as I actually believe.

The Merriam-Webster dictionary defines middle age as the period of life from about 45 to about 64 years of age. So according to that, I have another eight years to go… The Encyclopaedia Britannica defines middle age as being between the ages of 40 and 60, but also that it immediately precedes the onset of old age. So by 61, in 5 years’ time, I will be old aged. Not sure about that! There seems to be a lot of flexing of boundaries going on…

Why are we so binary when it comes to age?

Here’s where I really struggle with terminology and the binary nature of how we talk about age. There’s more on that in my elderhood article, but I question why, when we are moving away from the binary in other areas of our lives, we are still so binary when it comes to talking about age?

We go from young, often straight to old. Middle age is a kind of wasteland in the middle. But if the Encyclopaedia Britannica has me as old at 61, what am I going to be at 91, another 40 years hence? 61 might have been old 200 years ago. It certainly is no longer that now. When we classify everyone from 60 to death as old, it’s a really lazy age categorization to be doing. Someone of 61 is a whole lifetime younger than someone of 101!

What about the generations?

But we love to label people, especially when it comes to age. How about the generations? We dump loads of people together who may have so little in common, other than that they happen to be born within a certain time period. But at least this shows there is a little more variety in population ages, than simply young, then old.

Here are the generations I found:

  • Gen Alpha: born after 2012 (roughly)
  • Gen Z: born between 1997–2012
  • Millennials: born between 1981 and 1996
  • Gen X: born between 1965–1980 – that’s me but I’m a positively ancient Gen x-er
  • Baby Boomers I: born between 1955–1964
  • Baby Boomers II: born between 1946–1954
  • The Silent Generation (Post War): 1928 to 1945
  • The Greatest Generation: born between 1901–1927

I’d never heard of the Alpha, Silent and Greatest generations before doing my research for this article! The boomers sometimes get split into two because the span is so large – another example of lazy age categorization after a certain age!

Does midlife always mean a crisis?

Middle age is often referred to these days as midlife. I created a business called Magnificent Midlife because I wanted to redress some of the negative connotations associated with this stage of life, especially for women. The world has a terrible problem with ageism, but gendered ageism makes that far worse for women.

Midlife sounds a bit better than middle age to me. But I think, if I’m honest, that’s just me not liking the term because I’m being ageist against the phrase middle age!  Would middle adulthood be any better? There are so many terms around and so many labels with which to put ourselves in boxes. But the older we get, the more unhelpful those labels become.

Whether or not we work with middle age or midlife, there’s no doubt that when you search in Google on these terms, it’s not long before crisis comes up, especially for midlife. It seems impossible to have midlife without a crisis. We’re still so wedded to the silly notion that it’s a downward slope from midlife on. In fact, we get better with age not worse!

The crisis seems to hit both men and women but the added bonus of menopause does make midlife rather more challenging/difficult/exciting/infuriating/empowering for women. I’ve written extensively about how I actually see menopause as a catalyst for a new and very magnificent next chapter for women – I wrote a whole book about it – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

Moving beyond the crisis

Brené Brown describes midlife less as a crisis and more of an unravelling. Like Brené, I believe that rather than being a crisis, midlife is much more a time of reckoning and re-evaluation. It’s when we need to take time to reflect, unpack who we are now, and re-connect with who we’re becoming.

Big birthdays can add to the inclination towards introspection in midlife. We reassess what we’ve done with our life so far, and ponder where to go next.  Midlife is the ultimate reckoning point for many, but it can be an opportunity, rather than a crisis.

There’s also the U-curve of happiness – it’s been scientifically proven that we’re happiest at the beginnings and ends of our lives with a big dip in the middle like a letter U. Research shows that 47 is our unhappiest age, the depths of midlife malaise. There may be nothing in particular making you unhappy; it’s just a natural phase of life. Hoorah!

It’s the middle that can get us down simply because it’s the middle. If your 40s are a bit gloomy, there’s every chance that around 50, the fog will begin to lift. There are clearly other factors that may prevent that outcome, but all things being equal, that’s the normal trajectory of life. The U-curve holds.

Feeling good about middle age (and what’s to come)

Ultimately, the better we feel about ageing, the more healthily we will age. There’s scientific proof for that. It may just be that if we feel better about ageing, we take better care of ourselves, but ultimately the less we fear getting middle-aged or older-aged, the better will be our experience of both.

That’s not to say age is just a number and that denial is a good idea. I believe age is a very important number and I celebrate every year I’ve been on this planet. Each year makes me more magnificent! The more we can embrace the gifts that age brings, the less we will be consumed by the negative narratives and ageist stereotypes that dominate our youth-obsessed Western culture.

So let’s embrace middle age, midlife, elderhood, older age, all these rich stages of life that come after youth. And never let a label stop you living the very best life you can, in any one particular moment.

Listen to Dr Louann Brizendine talking about how women’s brains get stronger and better with age on the Magnificent Midlife Podcast

You may also like: Beauty Is Ageless and Are You Feeling Sad About Getting Older? Don’t!

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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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Thoughts On Approaching My Elderhood

When I started my Mutton Club e-zine in 2016, one of my first writers was the very lovely Lynnda Pollio who wrote an article about turning 60 and how very strange that experience had been. Lynnda described getting older and particularly turning 60, as entering the youth of her old age.

I’m not about to turn 60, but have just turned 56. This means I am officially closer to 60 than I am to 50. My husband, being ever precise about these things said, you’ve been closer to 60 since you turned 55, a year ago. That’s splitting hairs I reckon.

At least until now I was still officially 55 which was in the middle between 50 and 60. But now I’m 56, which is officially closer to 60 than to 50. That feels quite momentous, even for me.

If you’ve read my work or listened to my podcast, you’ll know I’m very pro aging. We’re all aging from the day we’re born and getting past 50, 60, 70, 80 is a privilege denied to many in this world.

So I don’t see aging as anything bad and I certainly don’t attribute any shame to it. That wasn’t always the case, but it’s something I’ve learned as I’ve gone on my magnificent midlife journey. 

I like the silver highlights coming into my fringe. I appreciate the wrinkles around my eyes and the frown lines between my eyebrows. The wrinkles mean I’ve smiled a lot. The frown lines… ah well!

But it still feels significant to be getting ever closer to 60, even for me. I’m sure the next four years will pass in a flash and I’ll be celebrating my actual 60th birthday before I know it.

I’ve already decided, unlike Lynnda, I’m not going to think of it as the youth of my old age. There’s a new term I’ve come across recently and I really like it as a way of describing the next stage of my life. It comes without the negative connotations which sadly are still deeply associated with older and old age.

That word is elderhood and I really like it. So I feel happy to be getting ever closer to the youth of my elderhood. I like the idea that I’m becoming an elder.  Being an elder carries all sorts of positive connotations for me. In history, and still in many places around the world, to be an elder means you’ve reached the top of the tree.

Since about 45, I’ve not minded getting older, but I do still mind if anybody thinks of me as old, simply because that is such a finite term. In our modern world, where we increasingly distance ourselves from the binary to appreciating more of a spectrum, age is one area in which we don’t do that.

We still seem to go from young to old with very little space for nuance or variation along what is actually a very long timespan. We forget that even when we’re 60, we’re young compared to a 90-year-old. An 18-year-old is positively ancient compared to a two-year-old. The binary definitions of young and old just don’t make sense!

We also lump great swathes of population into categories without differentiating between them. The European Union still talks about the silver economy as being everyone over the age of 50. That strikes me as such a lazy and damaging categorization.

How can you possibly lump a 50-year-old into a statistical grouping with a 70-year old or 90-year-old? The needs of those different ages are so very different. We wouldn’t dream of putting a 10-year-old, a 20-year-old and a 30-year-old in the same age category, even though there are only 20 years between them, in the same way there are 20 years difference between 50 and 70.

We need to stop being binary about age and believing that as we get older, we turn into one big amorphous, undifferentiated mass which no longer requires the subtlety (or respect) of differentiation.

Yes I am older, but don’t call me old. Don’t put me in a box. I don’t think I’ll be old until I’m at least 90, and even at 90, I’ll be young compared to a 100-year-old. You can call me older and you can even call me an elder. I like being an elder. 

Listen to this podcast episode where I talk about how we get better with age on the Magnificent Midlife Podcast

So what am I noticing as I turn 56? I care even less what other people think about what I say or do. I’m more willing to stand up and express my opinion when it goes counter to the prevailing ones and often gets me into trouble.

I’m getting better at appreciating the moment. Whenever I can, I try and slow things down because generally the world spins round at light speed.

I care about people and experiences, not things. So long as I have a roof over my head, I really don’t care what’s under that roof (so long as it’s tidy!)

My body aches when I get up in the morning, but I know that’s its way of telling me I need to go and stretch and do some yoga. And increasingly that yoga has to be done every day.

I’m interested in finding out why my body aches more and I’ve identified that I have very tight hips, so I’m working on opening those up as I get older. Yoga is one of those delightful practices you can get better at the older you get.

The more I learn, the more I realize I don’t know. And the more I want to make a difference.

Gratitude is something I try to practice regularly. I don’t always remember, and I often get swept away in the minutiae of the day. But getting myself grounded in the moment with a bit of mindfulness and gratitude is always a good thing to do.

So these are my ponderings around my 56th birthday. I’m getting closer to my elderhood, but I’m not worried about that. I’m just very very grateful to be here and I’m still busy trying to change the world.

This article first appeared on The Mutton Club.

You may also like: Women Over 50 – 7 Things To Remember and Are You Feeling Sad About Getting Older? Don’t!

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What Happens When You Mix Menopause And Alcohol?

Menopause and alcohol – there’s an interesting topic! Are they a good combination? Here’s what I discovered: when I stopped taking HRT, having taken it from 45-51, because of an early menopause diagnosis at 41, there were two things that triggered an immediate hot flush for me, chocolate and alcohol. This happened within the first week of stopping HRT. And if I drank too much in the evening, when I woke the following morning I would have a hot flush.

Alcohol and menopause symptoms

I’ve written extensively about how I believe the symptoms we experience as we go through the perimenopause years are the body’s way of telling us that it wants us to change the way we look after it. Alcohol can exacerbate several of these menopause symptoms. The impact alcohol has on us, especially during the perimenopause years, is something we’d be wise to consider.

Most of us know that alcohol is not particularly good for us, even though we may like to kid ourselves that it is. We may get excited when there’s a survey that says red wine is thought to be good for the heart. But even these surveys are suspect and when you dig into them, it’s one small glass of red wine a week that’s thought to do anything at all, so what’s the point? But I’ve read enough books about alcohol to know that however much we may like to pretend it’s not bad for us (and believe me, I’ve done that), fundamentally it is.

I feel I’ve always had a complicated relationship with alcohol. It was very much part of my family upbringing. There was always alcohol in my childhood home and it was a normal part of socializing, celebrating and also stress release. It also fueled a lot of arguments. Alcohol is a massive part of British culture. Almost every village has a church or chapel and a pub.

I’ve used alcohol as a stress release for years. Increasingly, going through midlife and menopause, I’ve used alcohol to anaesthetize myself from the stresses and strains of everyday life which have been compounded by midlife and menopause. But I know that’s not a good strategy!

I’m also aware that alcohol has exacerbated issues as well as soothing me. Alcohol can cause our blood sugar levels to be imbalanced and this can bring on hot flushes and night sweats. Alcohol interrupts our sleep which we need at all times, but especially in menopause when hormonal changes may also be having an impact. It can also exacerbate perimenopausal mood swings, anxiety and depression.

Alcohol may lift us up or soothe us temporarily, but it is a known depressant. I know for sure that alcohol has both depressed me and made me more anxious as I have gone through the menopause transition. Alcohol can make us more stressed over time, which can impact menopausal brain fog, so it stands to reason that alcohol isn’t going to help with that either.

Alcohol is also a big source of empty calories, calories that don’t give us any nutrition, but still add to the daily quota. As our metabolism decreases as we age, if we’re not making efforts to maintain our metabolism through exercise, we can start to put on weight. Alcohol could be contributing to that trend and you may find you’re exercising just so you can continue drinking! In menopause we can also tend to put on weight, especially around the belly, so that’s another reason why menopause and alcohol isn’t a very good combo!

I know a lot of women take hormone therapy to manage their symptoms and they carry on drinking. I don’t think this is a very wise course of action. You may be lessening the impact of the drinking during your menopause transition with the hormone therapy, but you’re not doing your long-term health any favors if you continue to drink too much during menopause.

Drinking more than your body could comfortably sustain during menopause, without the help of hormone therapy, can increase your risk of breast and other cancers, for example. And you’re not dealing with the underlying health issues that hormonal changes are now highlighting.

Alcohol and later life health

Women are less tolerant of alcohol than men and our intolerance increases as we age. But increasingly women are more likely to use it to manage stress, even though it’s going to make the stress worse in the long run. Older women are drinking more now than ever before, especially in the UK. But by doing that, we’re actively damaging our health. Alcohol can cause liver and other organ damage, put us at greater risk of dementia and be terrible for our bone health.

For years I have run a lot to protect and strengthen my bones (after the early menopause diagnosis at 41), but also drunk rather too much, thereby probably negating the good I was doing with the running! All the things that we’re thought to be at greater risk of post menopause are impacted by alcohol – Alzheimer’s, heart disease, cancer etc. We just like to ignore that fact because alcohol can be fun!

As we age, our bodies hold less water to dilute alcohol and more fat, so we hold onto alcohol for longer. We may feel the impact of just a little alcohol over night, long into the next day and even the day after. Enzymes in the liver responsible for breaking down alcohol can also diminish as we age, which is why hangovers get worse as we get older. It’s less about the hormones and more about the ageing process itself. We don’t bounce back as we once did. I suspect that’s the body trying to tell us that alcohol isn’t as good for us or as fun as we once thought.

I also know that when I’ve had a drink I can be more arsy than normal. When my adult son told me he didn’t much like me when I’d had a drink, I really had to evaluate how I changed when I had some booze. Young people today are drinking a lot less and that seems like a good way to be. They may do more recreational drugs but I’m very aware that alcohol has been my drug of choice. I reckon it’s no less of a drug than cannabis, for example.

Taking a break from alcohol

I’m writing this when I’ve just completed a dry month. I done lots of dry months in the past, lots of dry Januarys and Stoptobers. I managed 9 dry months when I was pregnant. But in the past when I got to the end of the month, I’d be celebrating that I could now have a drink! But this month is different. I completed four weeks yesterday and went to a reception last night where there was lots of free alcohol on offer. For the first time, I didn’t want any booze.

It’s early days yet but something seems to have shifted for me. Just over a month ago I listened to a podcast that made me realize something quite profound. I’m a big fan of Dr Rangan Chatterjee’s Feel Better, Live More podcast and on this re-released episode his guest was Andy Ramage, one of the founders of One Year No Beer, a habit-changing program that invites people to try 28, 90 or 365 days alcohol free – and see what it does for them.

Andy used to work in the financial City of London as a trader and said something that really shifted my understanding of alcohol. He said that for him, when thinking now about drinking alcohol, the trade was no longer worth it. What he got as a result of drinking wasn’t worth the cost to him.

I think this is massive when it comes to midlife and menopausal women especially. But while I’ve known this for a long time, it’s taken me ages to take action accordingly. As we’ve seen, as we go through the menopause transition, our body can’t process alcohol in the same way it used to.

It takes longer to recover. The various impacts of alcohol are greater, the hot flashes, night sweats, anxiety, interrupted sleep and sluggishness the following day even after only one or two glasses of wine, for example. Many women find that wine is in fact now a real no no. They just can’t process it anymore. Gin becomes a bit more palatable – no wonder it’s known as mothers ruin!

What I’ve realized is that the half an hour of feeling nice after having a drink, and for me it’s never one drink because I’ve never been very good at moderating, is simply not worth the disturbed sleep, the sluggishness the following day etc. etc. For me now too, the trade is no longer worth it. This has been a revolutionary shift for me.

I’ve wanted to get better at drinking for years. I’ve interviewed alcoholics on my podcast and been aware that my relationship with alcohol has been less than ideal. For me to get to the end of a dry month and not want an immediate glass of wine is really quite remarkable.

I do a fair amount of exercise and now I can run further, more consistently and with less muscle pain. I like to do Ashtanga yoga and if I’ve had any alcohol the night before, the intensity of the initial sun salutation sequence makes me feel sick, which stops me doing it. But now I can do my Ashtanga yoga whenever I like, because I’m not drinking.

Listen to Vicky Midwood talking about emotional eating and drinking on my podcast

Not only have I interviewed alcoholics on my podcast but I’ve listened to other podcasts about alcohol and I’ve read a lot of ‘quit lit’. Some of the books I’ve read are below and I really recommend them. But it’s interesting that none of them made me stop or even really cut back that much or consistently.

It was this one phrase, the trade is no longer worth it, that had the biggest impact on me. We all need to be ready to make changes, they can’t be forced. I feel I’ve been ready for a long time, but clearly something just wasn’t quite there yet.

You may not feel like giving up alcohol altogether and why would you? But having read this, you may feel it’s worthwhile cutting back or even having a break for a while. A detox. A reset. Whatever you want to think of it as. So how best to go about that?

Top tips for taking a break from alcohol

Here are my six top tips for making a success of a break from alcohol (remembering of course that I’m still early days in my new not drinking journey!)

  1. Listen to this Feel Better, Live More podcast with Andy Ramage on taking a tactical break from alcohol.
  2. When you want a drink, consider whether the trade is worth it. How will you feel the following day? What will you be unable to do as well as you could later/tomorrow if you’ve drunk today?
  3. Read some ‘quit lit’ from the list below to understand better your relationship with alcohol – I recommend This Naked Mind, The Unexpected Joy Of Being Sober and Drinking: A Love Story.
  4. Buy some alcohol free drinks. I love these and they’ve really helped me. I have long preferred alcohol free beer to the real thing – I really like Lidl’s Perlenbacher 0.0. I drink Stowford Press Low Alcohol Cider (it says low but it’s almost zero), Gordon’s Zero Gin is very good and I buy alcohol free rosé, white, red and sparkling wine from Tesco’s and Sainsbury’s. I’ve always preferred light cheap wine so I have a simple palate!
  5. When you’re out with friends who’re drinking booze and you don’t want to, think about what you’re going to drink in advance – tonic water perhaps or alcohol free beer which many pubs now stock, if not restaurants yet. Don’t be afraid to explain that you don’t want to drink – you don’t need to give a reason and if they complain that you’re boring not drinking, that’s their problem not yours.
  6. Give yourself a huge pat on the back each day that you don’t drink. It’s another day where you’ve given your menopausal body a head start on coping better with the transition.

Good luck!

Good books to read about alcohol

You may also like: Lessons From A Month Off Alcohol!

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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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