How Riding A Bike Indoors Strengthened My Bad Knee!

Recently I’ve had to completely rethink my exercise regime. Because of a knee injury I had to stop running and look at more low-impact exercise options. I discovered that riding a bike indoors is good for bad knees and I’m here to tell you what I’ve done to integrate this great form of exercise into my daily routine. 

riding a bike indoors

I’d long been a runner. I was never a very fast one, more of a slow jogger, but I loved it and it was very much part of my identity – I was a runner. I was even a half-marathon runner having completed my first and only half marathon at the tender age of 50. My goodness I felt proud of myself when I completed that. But at age 57 I was getting niggles in my knee joint and I stopped running and consulted a physical therapist. I was doing lots of physio to improve my knee health and strength, and everything seemed to be going quite well. 

But then on one day in Midsummer, a combination of a slight knee niggle when doing my morning yoga, a long walk which perhaps wasn’t very sensible given that niggle, and some breaststroke in a swimming pool in the afternoon, resulted in a trip to the emergency department of my nearest hospital in the evening! I could no longer bear weight on my leg and it was very alarming.

I then proceeded to have six months of waiting to find out exactly what was wrong with my knee! Nothing was broken but I had three different diagnoses on 2 MRI scans, all of which seem to be impacting my knee in different ways. The upshot was eventually that while I didn’t (yet) need surgery, I was told by the consultant that if it was his knee, he wouldn’t be running on it. I was pretty devastated to be honest.

My key priorities were getting back to some form of cardio exercise and weight-bearing exercise too so that I could maintain my bone density as I age. I’m now able to walk much longer distances than I was and that’s good for my bone density, but I wanted something more intense. I had also become a recent fan of my jump rope. This is such an easy and fun form of cardio exercise. But I will never know whether that led to the problems with my knee and it doesn’t seem to be a very good option for me at the moment. Boo hoo. 

Initially I wasn’t confident of maintaining balance and weight on the injured leg, so outdoor cycling didn’t seem like a very good idea to build up muscle strength. I have a tendency to fall off my bike at the best of times, and I didn’t want to have my knee giving way again when I was in the middle of a road! But I certainly needed to build up muscle strength to rehab my knee problems and strengthen my patellofemoral joint (the kneecap joint effectively). 

Indoor cycling has become my new passion and I want to share with you how brilliant it’s been as a low-impact form of exercise that enables me to feel that I’ve really made some effort. Another thing that running did for me was release my stress and I’ve been very grumpy not being able to to run! Now I can get on my bike for 15 to 20 minutes and cycle away my cares.

So how did I do this? First of all I checked that indoor bikes were a good and safe form of aerobic exercise for me. It turns out that with a bad knee, an exercise bike is one of the best tools in the arsenal. You can pretty much exercise the entire body although obviously the focus is on the leg muscles. You can quickly raise your heart rate and go through a full range of motion in your lower body maintaining flexibility. And moving our bodies is what it’s all about, even when they’re damaged. We need to move. 

Riding a bike indoors or outdoors is a great exercise routine for cardiovascular health and muscle strengthening. You need to ensure that you always have some resistance on the bike to protect your knees. But unless you go silly with the resistance and overdo it, the repetitive motion of cycling shouldn’t lead to more knee damage. 

Obviously with any form exercise, you need to listen to your body. This is why I stopped running long before I had the actual problem that landed me in hospital. I knew something wasn’t right, but I didn’t know what. It also helps to get good advice on how to do any form of exercise safely. This can sometimes appear daunting when exercising at home, but there are some fantastic resources online now that can help you get the proper form, so you can stay safe while doing your exercise program. 

I bought this exercise bike from Decathlon (image below – at time of writing it’s on special offer at £199) having googled best exercise bikes UK (just google for your country to get local results). It was actually almost the cheapest upright stationary bike I found, but I think it is absolutely brilliant and more than sufficient for most people’s needs. I also bought this tablet holder stand for my bike which enables me to read or watch videos while I’m cycling. When I first got the bike, I was having to read a lot of research papers and was able to do that on my iPad while cycling away. I love to multi-task efficiently!

I then discovered Kaleigh Cohen on Youtube who has an entire channel devoted to indoor cycling sessions. She has playlists for beginners, lots of alternatives for different levels, and an all-important cool-down stretch routine, which I do after every workout to sort out any sore muscles. She also has a video all about how to set up your bike – which is incredibly important to watch to avoid injury – getting the saddle height and handlebars correctly positioned so you have the correct body position is key. 

She’s super motivational without being annoying, gives out easy to follow resistance instructions (it really helps if you have a computer with RPMs on your bike which mine came with) and constant reminders about maintaining good form. You can easily adapt the intensity of your ride to suit your fitness or rehab goals. I quickly feel like I’ve done a really great workout to start my day well.

With this combination, I see absolutely no reason for anything more expensive and certainly not a Pelaton – unless of course you have money to burn! While I have now joined my local community gym so I can swim and sauna at my leisure, I also see no need to go to a spin class, as I have everything I need in the comfort of my own home, saving me time and money in the long run.

A recumbent bike is also an excellent way to maintain movement and flexibility, as well being good for cardio strength. But you won’t be able to do the same movements (what Kaleigh describes as position 2 and 3) standing up, for example, on a recumbent bike, like in a spin class. But do be careful with these positions too, as anything out of the saddle will increase the pressure on your knees.

Listen to your body and only do what feels good. It all depends on your fitness levels and the extent to which you need to maintain low impact on your joints. Recumbent exercise bikes are very good for older people where any risk of injury is of even greater concern. They also provide a more comfortable and supportive riding position.

I am absolutely delighted with my indoor bike. My overall health feels so much better since I got it. I reckon it will help with weight management too – and I need help with that since I stopped running! My knee range of motion and strength are improving all the time. It turns out riding a bike is good for bad knees after all. 

An indoor stationary bike can be a great way to rehab from knee injuries, as well as being great for low impact aerobic exercise. I think I’m probably at risk of knee osteoarthritis too in the future. Cycling is also good for that, so it’s win win. 

My bike doesn’t take up much room either. It sits in a corner of the bedroom and is a great clothes hanger when not in use! If you’re looking for a great, efficient form of low impact exercise, it can’t be beat, I reckon. 

So why not get on your bike! 

You may also like: An Easy Overnight Hike From London

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Menopause And Disability – Need They Be Linked?

Guidance from the Equality and Human Rights Commission (EHRC) has clarified employers’ legal obligations towards women experiencing menopausal symptoms that may be interfering with their work. This isn’t new law. Rather, the guidance has reiterated and elevated existing legislation, bringing greater awareness of the protections in place for menopausal women in the workplace. In the past, if women wanted to make discrimination claims because of menopause, they could only do this by making a claim for menopause being a disability. This is still the case. 

Generally I think the new guidance is a welcome move. I’m happy to see efforts to generate greater awareness around menopause and that women will be supported more and also protected. I’m pleased that employment law does enable women to push back against unfavourable treatment and that more and more organisations are putting in place a menopause policy.

However, I struggle with any association made between menopause and disability, because I consider menopause to be a natural stage of life and even when women have severe menopause symptoms, I don’t think that pushes them towards disability. But before I talk more about that, first let’s take a look at what exactly the EHRC has said.

Employers legal obligations are set out thus:

“Under the Equality Act 2010, workers are protected from discrimination, harassment and victimisation on the basis of protected characteristics including disabilityage and sex.

If menopause symptoms have a long term and substantial impact on a woman’s ability to carry out normal day-to-day activities, these symptoms could be considered a disability. If menopause symptoms amount to a disability, an employer will be under a legal obligation to make reasonable adjustments. They will also be under a legal obligation to not directly or indirectly discriminate because of the disability or subject the woman to discrimination arising from disability.

Women experiencing menopause symptoms may also be protected from direct and indirect discrimination, as well as harassment and victimisation, on the grounds of age and sex.

Under health and safety legislation, employers also have a legal obligation to conduct an assessment of their workplace risks.”

The reasonable adjustments to working conditions that the EHRC recommends for menopausal employees are better ventilation and cooling devices to accommodate hot flushes for example, the provision of quiet rooms and relaxing uniform policies or allowing women to wear cooler clothing if needed.  The guidance also recommends facilitating flexible working and changing shift patterns, for example, to accommodate women experiencing symptoms of menopause, such as difficulty sleeping, hot flashes and brain fog.

If employers fail to make these accommodations, they could potentially be sued under disability legislation. The guidance also sets out how taking disciplinary action because of menopause-related absence could be unlawful discrimination unless it is justified. Similarly, using language that ridicules a worker in relation to their menopausal symptoms could be considered harassment on the basis of age, sex, or disability. This last point, I love!

This all seems to be good news and it’s important to get more guidance on best practices. Just being able to wear natural fabrics and not synthetics can make a radical change to a menopausal woman’s comfort levels at work. But she also needs multiple sets of uniform to accommodate frequent changes and especially in case she suffers from menstrual flooding during her menopause transition.

These are all important ways to accommodate women at work. We also need to think about toilet facilities which are often woefully inadequate. If a woman is flooding during menopause and she has no access to a wash basin in the toilet stall, how can she possibly take care of herself in the workplace. It’s important that employers also provide toilet facilities that enable women to practice good personal hygiene without making any embarrassing issues obvious to everybody at work!

It’s interesting to consider that pregnancy is a protected characteristic but menopause is not. The guidance talks about harassment or discrimination on the basis of age, sex, or disability, but women cannot currently bring a claim for discrimination on the basis of two of these protected characteristics, only one. I believe that is why, in the past, when anybody wanted to make a claim in connection with menopause, it had to be done on the basis of disability. But pregnancy isn’t a disability and neither is puberty. Why does menopause take us into disability territory? 

Is a menopausal woman a disabled person? The guidance talks in terms of when there are long-term severe symptoms that can impact a woman’s work, the symptoms could then be considered a disability. So, technically, it’s not menopause itself that is the disability, rather it is the menopause symptoms, if they are severe. But is this just semantics? It still puts menopause in the disability camp, I think. It still seems to me, to be an unfortunate use of terminology.

Natural hormonal changes are something that happen to all women in midlife, and I believe with more knowledge, support and understanding, most women should be able to transition through this period without having to call on the disabilities act. If, in fact, we were able to call on two protected characteristics to make a claim, then menopause would fit neatly in age and sex. We go through menopause because we are older and female. 

Another element of the guidance is that menopause-related leave needs to be classified as menopause-related leave. This strikes me as a very grey area. How are women and managers to classify what is related to menopause and what isn’t? Will a doctors note and medical evidence be needed? There is no test for natural menopause, unlike for pregnancy.

If a woman is suffering from sleepless nights, that could be menopause-related or it could be stress related to life in general. There can be so much going on in a midlife woman’s life! She may be grappling with an empty nest, she may be stuck in the sandwich generation, caring for children and elderly parents, she may be experiencing her first real dose of gendered ageism, which could be knocking her confidence even further. 

If a woman suffers from joint pain, how do we know that is specifically menopause and not another reason? Do we look at the average age of menopause and if the employee fits that profile, then we put everything down to menopause? There is much disagreement about what exactly is caused by menopause and the extent to which it has a significant impact on women. And every woman has a different menopause.

Could menopause now be used as an excuse for poor performance standards with employers fearful to say anything in case they get sued? What time period will be used to accommodate women needing support during the menopause transition? We know all women have their own individual experience and deserve to be accommodated on a case-by-case basis. There is no one-size-fits-all, but it does make it all quite complicated. But menopause and women’s health in general is complicated. We need to work with that.

There are certainly positive steps being taken to support women at work and hopefully improve the employment rates of older women, so they don’t feel the workplace no longer works for them. If women are leaving work because it can’t support and accommodate them during their menopause, that’s not a good thing! We need to ensure we keep older women at work – society needs them! 

But it’s not just about ticking the menopause box either. It’s also about considering the impact of age discrimination and sex discrimination, and how we can also tackle those. Both have a big impact on how women experience menopause, as well as just being an older woman in general. There’s lots more to be done to combat the often unfair treatment of older women at work, and stop the need for any woman to attend an employment tribunal!

You can hear me talking about the new menopause guidance on Times Radio.

You may also like: Government Policy On Menopause – What Exactly Is It?

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Books I Read Last Year – 2023

I was inspired to write this post about the books I read in 2023 by the very fabulous Kate Codrington who stunned me with her fabulous review of her own books read last year. And she’s been doing it for five years. So I feel I have to catch up! Not that I’m at all competitive of course!

She’s also an inspiration to me in that she borrows books from the library instead of feeding the Amazon machine. I’m a sucker for a Kindle book and I need to wean myself off that addiction most probably!

Looking back at the books I’ve read this year, it’s been a real hodgepodge. I’ve clearly been doing a lot of soul-searching, definitely looking for healing, analyzing relationships, reading about how we can age well and occasionally dipping into some great fiction, which I’ve mostly neglected for years.

My Kindle says I’ve read 36 titles, but occasionally there’s a hard copy and there have been academic books too for my gerontology master’s. Kindle also counted some books I marked as read in 2023, but actually finished earlier. But I’m averaging around three a month which is pretty cool ‘in my book’.

I’ve increased my reading speed exponentially in recent years. Sometimes I get the Audible version of the book and move between that and the Kindle version. That all speeds up how much I read. And trying to always read books written by my podcast guests, I need to be able to get through them fast! (My podcast was nominated in the book category of the Independent Podcast Awards.) Not to mention all the research papers I need to read for my master’s!

So here we go, a gander through the books I’ve read and mostly enjoyed last year. There are quite a few others I’ve dipped into but not actually completed. I’ve made a pledge to myself that this year I will try to write a short note about each book when I finish it, as I so often forget what I have read very quickly.

The Four Winds – Kristen Hannah

Starting with fiction, which I don’t often read! I’m not sure how I found this book, but I really loved it. Perhaps on a podcast I listened to? When there’s a strong female character, I’m immediately hooked and the story is very powerful. One woman’s epic fight to survive in the American Midwest. Fabulous!

Hagitude: Reimagining The Second Half of Life – Sharon Blackie

I was lucky enough to interview Sharon on my podcast which you can listen to here. This book opened up a whole new world for me about women in non-patriarchal history, mythology and folklore, and how we can look to these strong, feisty role models of older women to help us redefine and reimagine the second half of life. I learned so much from this book, which reinforced my excitement about the post-menopausal phase of life. Enlightening.

The Wiser Women’s Guide To Perimenopause And Menopause – Tania Elfersy

I’ve long loved the work of Tania Elfersy and quote her extensively in my book. I was very excited when I discovered she has recently published her own book. This is such a revolutionary look at perimenopause and menopause. It’s empowering and reassuring, revolutionary and back to basics wisdom. Tania’s also been on my podcast. Highly recommended.

Unwell Women: A Journey Through Medicine And Myth in a Man-Made World – Elinor Cleghorn

This is a fascinating look at how medicine has been designed for men in a man-made world. It looks at how women have been treated medically through history and exposes the truth of our medical world and women’s place within it. This is the book to read to understand why women’s health has either been mythologized based on nonsense or overlooked as irrelevant. It unpacks the roots of the perpetual misunderstanding, mystification and misdiagnosis of women’s bodies. Excellent.

The XX Brain: The Groundbreaking Science Empowering Women to Prevent Dementia – Lisa Moscone

This is a fascinating look how women’s brains evolve through life and how we can protect ourselves against dementia, which so often strikes women more than men. While estrogen decline plays a significant part in brain changes, there is so much else we can be doing to protect our brains in later life. Informative.

Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living – Liz O’Donnell

Another of my podcast guests, Liz O’Donnell runs a community online for women combining work with caring for their aging parents. A topic very close to my heart and I was delighted to welcome Liz to talk at length about her book and personal experience. It’s a very powerful book and a very powerful podcast. It’s always reassuring to see one’s own life experience reflected in other people’s. And know that we’re never actually alone. Empowering.

Seven and a Half Lessons About the Brain – Lisa Feldman Barrett

A fascinating and easily readable book about the brain – what it is, what it does and why. Turns out there’s no such thing as the ‘lizard brain’. It’s short, entertaining and accessible, explaining the basics of current neuroscience research. Cool.

The Invisible Life of Addie LaRue – VE Schwab

This novel was recommended to me by an online contact. It wasn’t really the sort of book I would normally read and it was a bit long, but it was a engrossing story about a woman who is unable to be forgotten and also damned to live forever. Fascinating to see how her life played out. I realized it was really young adult fiction, but fun none the less. Once started I wanted to find out what happened to Addie and the Audible version helped my get through the whole story! Engaging.

Who Cares: The Hidden Crisis of Caregiving, and How We Solve It – Emily Kenway

Another awesome podcast guest. A lot of the books I read are by guests on my podcast. This book was utterly brilliant and I recommend it to everyone. Inspired by Emily‘s own tragic caring journey with her terminally ill mother, this book shines a light on the hidden and ignored world of caring and carers. It calls for a radical rethink of how we approach care, which we’re all going to encounter at some stage in our lives, either giving it or receiving it. You can listen to the awe-inspiring podcast here. Challenging, revolutionary and inspiring.

The Change – Kirsten Miller

I’m nervous about reading fiction about menopause as I like a different topic to the one that often fills my days and I don’t want it to be a winge fest. This was absolutely glorious and really celebrated the magnificence of the menopausal transition and the magical powers it can bring us. It was a brilliant read, fast paced and lots of fun. Rollicking.

The Overstory – Richard Powers

This again wasn’t a book I would naturally have picked up, but my other half was raving about it, so I thought I’d give it a go. I found it rather long and heavy but also fascinating. It’s a novel about trees and the people who learn to love them. That may sound bizarre, but it was incredible and as Barack Obama says, it changed my thoughts about the Earth and my own place in it. Compelling.

The Power Decade: How To Thrive After Menopause – Susan Saunders

I love everything Susan Saunders writes and she’s been on my podcast twice talking about how we can age well and keep our brains healthy. I love this latest book which explores the power inherent in menopause and how to make the most of life after it. I’m featured in it too which was absolutely delightful! Highly recommended.

Yellowface – Rebecca Kang

If you’ve been in my world for a while, you may know I studied Chinese and am fascinated by Chinese culture. Finding this novel by an acclaimed Chinese writer about someone pretending to write a China themed novel as a white woman was particularly fun for me as a white Chinese speaker. I didn’t think it was quite as good as some of the critics have said and the ending was perhaps slightly disappointing, but as an enlightening dive into the literary world and clashes between cultures, it was fascinating. Quirky.

What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities and You – Heather Corinna

I try and read a variety of menopause books so I have a complete picture (unless I know I will be tearing my hair out after reading the blurb and the first page, then I tend to avoid it!). Having written my own book, I’m aware it wasn’t the most inclusive. I was keen to read this one written by an author who identifies as non-binary. At the beginning and given the title, I feared it was going to be a negative winge fest but it actually turned out to be pretty positive and I recommend it as a well-rounded look at menopause. But I kept wanting to say to the author, please stop smoking and your menopause experience will be that much better! Inclusive.

Breaking The Age Code – Dr. Becca Levy

This book has been on my Kindle for ages, recommended by many including Ashton Applewhite. It is absolutely brilliant, looking in detail at how we age, what we can do to age as well as we possibly can and all the myths and assumptions that contribute to the negativity around aging. As Anna Maxted said, less self-help manual than a manifesto for a revolution. Dr Levy is the source of the research that found that positive age beliefs can add 7.5 years to your life. I loved this. Fantastic.

Hold Me Tight: Your Guide To The Most Successful Approach To Building Loving Relationships – Sue Johnson

Despite years of therapy I’ve never really explored attachment theory. This book opened my eyes to the crucial importance of how we attach early in life and explains a lot about my own life. It’s a phenomenal tool set for understanding hiccups in relationships especially when you haven’t got a clue why things keep going wrong. It provides a completely new lens with which to explore issues. Even if you understand reactions and feelings intellectually, it will be your experience of attachment and that of whoever you’re in relationship with, that dictates how you both behave. Life-changing.

Queen Bee – Ciara Geraghty

I decided to read this because I was sent it by the publisher, as a novel about menopause. It wasn’t the sort of book I would normally read and not really my cup of tea, but it was entertaining. It felt slightly as if it was jumping on the menopause bankwagon (you read that term here first!). I wanted to shout several times where menopause facts were misleading and had clearly being gleaned by a superficial media search. Regular readers and listeners to my work will know I’m a stickler for the true truth when it comes to menopause! If you like chick-lit, I think this one will be a fun read for you. Amusing.

A Smoke And A Song – Sherry Sidoti

Another podcast guest and you can listen to the interview here. Sherry is a yogi and writer living on Martha’s Vineyard (which is very much a character in her book). I didn’t know what to expect from the book but I loved it. It’s a memoir about Sherry’s personal healing journey through revisiting and excavating episodes in her life. I found it really powerful and beautifully written. She describes these episodes in the present tense and it’s highly evocative. I’ve been on my own healing journey this year, so I found it very moving. Cathartic.

Bourneville – Jonathan Coe

This was a very random book for me but I had to read it, because I grew up 5 miles from Bourneville in Birmingham. And I wanted to check it out before buying it for my mum. It was a lovely novel following a family through major events of the 20th century and was incredibly evocative for me as a Brummie. My own suburb of Hall Green even got a mention towards the end. This is a real delight to read. Highly recommended.

Fault Lines: Fractured Families And How to Mend Them – Dr Karl Pillemer

Families are complicated. I love to hear from people who’ve done research in interpersonal issues and I always find something of use to help me, often just by reframing things from a more objective standpoint! This was a really interesting read and certainly helped me reevaluate my own complicated family. Full of interviews and strategies to repair rifts or live in peace when nothing can be done. Reassuring.

Lessons In Chemistry – Bonnie Garmus

I absolutely love this book and was sad to finish it. It deserves all the accolades it has had and the TV series available on Apple TV is also sublime. I just loved everything about it, so if you haven’t read it yet go and do that! Brilliant.

The Myth of Normal: Trauma, Illness And Healing In A Toxic Culture – Gabor Maté & Daniel Maté

If you read one book in 2024, make it this one! Another book I part listened to, part read- it is very long. This is Gabor Maté’s latest work and my goodness I will be recommending it to everyone. Absolutely life-changing. So powerful. Gabor analyses the mind-body connection and applies it to individuals, communities, societies and the world as a whole. It’s a truly brilliant book and incredibly ambitious. It feels like the amalgamation of his life’s work. The audiobook is read by his son who also contributed to the book and (apart from the dodgy British accents he likes to do) it’s excellent. A MUST READ.

Remarkably Bright Creatures – Shelby Van Pelt

I was desperately seeking another novel to grab my attention like Lessons in Chemistry and this one was beautiful. It was such fun and I’m very grateful to the woman in a Facebook group who recommended it to me. Such a lovely story and a real page turner too. If you liked Lessons in Chemistry, I think you’ll like this one too. I need more books like this! Gorgeous.

The Slow Moon Climbs: The Science, History, And Meaning Of Menopause – Susan P Mattern

A history of menopause written by an eminent historian. This book reflected many of my views about menopause but gave me the concrete historical evidence I had previously been lacking. Of course we are designed to go through menopause. Of course there is an evolutionary reason for why we do. Of course we have a massive role to play in society post menopause as older women. I love, love, love this book and keep trying to persuade the author to come on my podcast. Fantastic.

Brothers, Sisters, Strangers: Sibling Estrangement And The Road To Reconciliation – Fern Schumer Chapman

Another book I read trying to make sense of the world this year. Part memoir and part warm, empathetic guide. This was a very useful read and enabled me to shift my perspective and see things with more compassion. Empowering.

A Monk’s Guide to Happiness: Meditation in the 21st Century – Gelong Thubten

I heard the author speak on Dr. Rangan Chatterjee’s podcast and was inspired to buy his first book. This is a highly accessible book about the power of meditation and how it can help with the stresses of modern day life. Highly recommended.

Handbook For Hard Times: A Monk’s Guide To Fearless Living – Gelong Thubten

I was so impressed with the first book I just had to buy the second! This takes meditation to a deeper level and has inspired me to both revisit and revamp my own meditation practice. It has lots of easy tips on how to make this a fundamental part of how you live and the power it can provide for dealing with the hard stuff. This is another very accessible book and I highly recommend it too. Enlightening.

Wise Power: Discover The Liberating Power of Menopause To Awaken Authority, Purpose And Belonging – Alexandra Pope & Sjanie Hugo Wurlitzer

I wish I’d discovered these clever women while I was still menstruating! I’ve also read their pre-menopause book about menstruation, Wild Power, and really wish I’d known about the power of our menstrual cycle when I was still cycling. This book shows how menopause is a time of positive transformation in a woman’s life and while it may be difficult as we go through it, it brings great bounty. I interviewed the authors on the podcast before the book was published and in fact before it was even completed. You can listen to that podcast here.

The Power of Now: A Guide To Spiritual Enlightenment – Eckhart Tolle

I’ve been on quite a spiritual journey this year, exploring new ideas and trying to get closer to what really matters in life. This book has been on my Kindle for years but I hadn’t read it. I finally made the time to read it and thoroughly enjoyed it. I particularly appreciated the reminder that it’s my ego that lies behind so much of life and that letting go of things that don’t serve you can be a positive thing. Staying in the moment is the power of now. Enlightening.

A New Earth: Awakening Your Life’s Purpose – Eckhart Tolle

Having finally read the life-changing Power of Now, I decided to follow up with this book which Oprah Winfrey says is a wake up call for the entire planet. It really is a life-changing book. I part read, part listened to both these books and it was very good to be able to do that. That is how I manage to consume so many books often by listening to them while walking or just moving around! A global shift in consciousness can be the balm we need in these troubled times. Empowering.

The 100-Year Life: Living And Working In An Age Of Longevity – Linda Gratton & Andrew Scott

As a student of gerontology I’m fascinated with how we age, how our life expectancy is increasing and how changes may impact our lives and lifespan. This is a fascinating book that looks at the specific implications for life when we’re living to 100. How we’ll need completely new systems and to reconfigure the arc of our lives. My one criticism of it was that care wasn’t mentioned once in the entire book. If we’re all going to live to 100, we’re going to need so much more care, and it wasn’t even raised. Thought-provoking.

And my book of the year, of all the books I read in 2023? It has to be The Myth Of Normal – if everyone read that, we would live in a very different and much better world! It’s an amazing book! Get it!

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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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