"Don't Think You Just Have To Deal With It, Because You Don't" - Menopause with Dr Annice Mukherjee & Amanda Thebe

Host Louise Minchin speaks to Dr Annice Mukherjee, top UK hormone specialist & Endocrinologist, Amanda Thebe, Fitness & Menopause Expert & Best-Selling Author: Menopocalypse, Sam Walker, Journalist, Broadcaster, Podcaster & Her Spirit Community Member and Mel Berry, Her Spirit Co-founder. 

In this episode you will learn:

• Common symptoms of the menopause.
• How alcohol affects menopause symptoms.
• Why lifestyle is so important.
• You are not alone.

Click here to listen to our last podcast about menopause with Dr Stacy Sims.

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Transcript

Her Spirit - S5 E7 - Menopause Mental Health

Louise Minchin:

Hello and welcome to the Her Spirit podcast. I'm Louise Minchin, every month we sit down and talk about small changes we can all make to our lives that can lead to big results. If you're new to the podcast, a very warm welcome, Her Spirit to let you know is a community of women just like you nd we come together to help and encourage each other to get more active and feel stronger, happier, healthier. Come and join us at herspirit.co.uk. If you are already active, you'll find lots of resources and plans to get you to the next level. But if you haven't got the bike out of the garage for years and years, or perhaps you've only just started walking or running, it doesn't matter because once you're part of our community at herspirit.co.uk, you will find your tribe. Lots of women of lots of different ages and abilities wherever you live, can help you feel stronger and healthier. So do come and say hello. Now, today we are talking about menopause. And I know that some of you may be aware we did a whole podcast about menopause a few months ago. There was so much response to that and so many more questions. We are here again, and today is very much about positive responses to menopause, what it means for us, how we can make things easier for ourselves. And we really want to dig into this particular podcast, how it affects mental health, how we can make ourselves feel happier, and perhaps alcohol as well. Does it make it worse? What should we be drinking slash/drinking and sleep? That is my perennial question. How do I sleep better? So we're gonna talk about that, lots of other things as well, and we've reached out to you. Thank you very much indeed for everybody who's got in touch. We'll include your stories on the podcast as well. Right? So let's crack on. Mel Berry is here as usual. She is of course one of the Her Spirit founders has had her own menopause journey. Would that be fair enough, Mel?

Mel Berry:

Very much so. Louise, and for me, definitely sleep, being active and losing muscle, which again, is something that I know is really important to kind of be active. So yeah, I have my menopause journey to share, warts and all with you, Louise.

Louise Minchin:

And last time we really particularly focused on muscle and strength. So we won't do too much on that this time. You can go back and listen to that podcast if you, if you want to, we'll put the details in the notes. But it was with Dr. Stacy Sims, right? Let's talk to you today. On today's podcast, we have Dr. Annice Mukherjee. Thank you so much. She's also known as the hormone doc, a leading UK hormone specialist. Thank you so much for coming up today, and you're very much I'll follow you on Instagram. Your sort of messaging is about, this does not have to be bad, does it?

Dr Annice Mukherjee:

Absolutely. I mean, I started doing, posts on social media only two or three years ago, and the reason was to try and empower women. And what I don't want to see is just women fearing menopause, because actually it's an incredibly, it's got so many positives, it's an incredibly positive stage of life if you can just get over this, the sort of the rollercoaster in the bit where the hormones are really changing, and I think that's what, we're trying to do on, on Her Spirit as well.

Louise Minchin:

Yeah, I sometimes refer to it as my superpower because it enables me to say things that 10 years ago I probably wouldn't have dared. So there are definite, Sam's laughing, I'll explain you. Sam is, Sam Walker is also, she's member of the community. She actually produces this podcast. You've known me for many years, Sam. I love that you laugh at that.

Sam Walker:

Because I completely agree with you as well. And you know, I've been talk about a rollercoaster. I've been on an absolutely massive, massive rollercoaster, which coincided with me leaving the BBC, leaving England, leaving all my friends and family behind and moving halfway across the world to Arizona. So that was a great little intersection of madness going on in my life that that led to me having a really, really horrible time for, I'd say a good 18 months. So I wish Dr. Annice, I had known about your social posts at that point, because I really needed you.

Louise Minchin:

And let's also introduce our other guests as well, Amanda Thebe and I follow you. I've been looking at some of your stuff on Instagram, Amanda, and you are best selling author. And we’re going try and get this right. Come on, I can do this, meno….. I've done it wrong. I did it right before. Go for it. Tell me what it’s called.

Amanda Thebe:

Menapocalypse. It's like the apocalypse only it’s not! You know, when I picked the book title, I actually wasn't gonna use that, even though I thought it was fun and catchy because I didn't want it to have a negative connotation. Actually, the subtitle is, “and how I learned to thrive during menopause and how you can too”. But actually when I was living in the thick of it, it didn't feel like it was gonna get any better. And I'm very aligned with Annice. In fact, we do a lot of stuff together purely because we 1) wanna get menopause on the radar because that's usually the biggest problem. You've no idea what the hell's going on. So getting it on the radar, giving practical advice to women that's very balanced and inclusive, and then 2) talking about solutions and, and then adding the radical idea that, you know, it isn't always gonna be like this.

Louise Minchin:

Yeah, absolutely. Okay, so let's talk about, let's sort of dive in, shall we? With you know, there's lots of hard things to talk about here, but let's dive in with, with mental health because it did have a big impact on me. It made me feel very anxious about all sorts of things, and very negative in a way that I was really not. I'm a glass half full kind of person. And that's, that was the really deepest change for me. So who would like to talk? Sam, I see you nodding there. I'm gonna go to you first about how it affected you and this is not all negative by the way, cause there will be people who are fine.

Sam Walker:

Yeah, I think that's really important to say that that, that this isn't everyone's experience, but I wish I had been more aware of other people having similar experiences to me because I genuinely didn't understand what was going on. I mean, as I said, I just moved to the other side of the world, I was dealing with, with two girls who were becoming teenagers. I was dealing with parents who weren't very well, who were a very long way away from me.  COVID happened, I didn't really have any friends where I'd moved to, it takes a long time to build friends, especially when you're in your forties. And yet I would stand and look in the mirror and not recognise the person in front of me. And that really started to freak me out because I didn't know who I was anymore. My body had changed so much, my weight had gone up so much, I couldn't seem to lose any weight at all. My skin was so dry, it was like sandpaper. I would literally put moisturiser on and it would just suck it up and feel just so unpleasant. But it was that sense of self, which is really hard to kind of explain how that feels. But when you look at yourself in the mirror and you don't recognise who that person is, it's really, I mean, I'm using disconcerting, that’s an understatement of the year. But I knew that I felt anxious. I would, the thought of having to call up a dentist or a doctor to book an appointment was completely overwhelming to me. I could barely bring myself to pick up the phone and Louise, you and I have broadcast together, you know, that this is what I did. I spoke to people for 20 years and yet I was finding it impossible to call my daughter’s school to say she'll be late tomorrow. She's got a dentist appointment in case I got it wrong in case I got it wrong. I mean, it was crippling, it was horrendous. And I finally plucked up the courage to go to my, what's called here, primary care physician, my GP not understanding the healthcare system, not really understanding what to do, which was another hurdle. And I walked in and explained everything to him as I've just said to you. And he said to me, yes, I'll give you some antidepressants.

Louise Minchin:

Which is again, is something we've heard before and we've talked about before, haven't we?

Sam Walker:

Time and time and time again. And I knew therefore that this wasn't the right thing for me and I argued against it and he did not like that at all. And basically told me that he wasn't gonna give me anything else and to go and get a second opinion if that's what I wanted. And good day to you. It was a real sort of shake your hands, please leave. It was a horrible, horrible experience and it took me a year to go back and find another doctor and get the proper help and support I needed, which was then. And I'm sure we'll talk about it later though. It was transformational.

Louise Minchin:

Gosh, Sam, I'm so sorry. First of all, cause I've, as I known, you know, anybody listening to your story, and I've known you personally for many years, I mean so much of you, what you said I can relate to. And I had that thing where I, I didn't feel comfortable in my own skin. Dr. Annice, we’ll kind of come to you in a second, but Amanda, I could see you kind of nodding along to that and sort of feeling, was it similar thoughts as well?

Amanda Thebe:

You know, I remember I'd been not feeling great for about two years and it was very frustrating being in the health and wellness industry for the decades that I'd been doing it. Something wasn't right. And I was in Canada at the time, really great healthcare system, seeing neurologists, ear, nose, throat doctors, you know, I had all of these different tests and nothing was ever conclusive and I was not getting answers. And I remember waking up one morning and looking in the mirror and saying to myself, I don't think I can do this. I don't think I can turn up every day feeling like this. Not knowing what it's gonna be like in the future. Is this essentially how I'm gonna be? Am I gonna be this like miserable cow for the rest of my life when I used to light up the room when I went anywhere? And I just didn't think I could continue. And it got quite serious to the point where my husband was wondering whether to take me to hospital, like to go and get like a mental health checkup. And actually, you know, what happened is a couple of months after that, I did see a gynaecologist who said hey, these are perimenopausal symptoms and you've got depression and I can help you and you've got migraines with aura. I can help you. And it sort of gave me enough hope that I was like, okay, so there's this, there's an answer to this at least. But then I was just furious, furious for ages afterwards, then. I won't swear here, but you know, I went, I left the appointment and I was kicking bins in the street thinking, why, why didn't I know this?

Louise Minchin:

Gosh I can I just, I feel your pain actually both of you. So let's answer that. Why and hopefully this is, you know, what I spoke about this on BBC Breakfast three, three years ago now and this is why we talk about it. Dr. Annice is to help people join all of those dots. And they are not, as we've just heard from both Amanda and Sam, just physical, are they?

Dr Annice Mukherjee:

No, and I mean, Sam's story is pretty traumatic just to listen to really. And there's so many threads there because the problem, and I see it very much today cause I've been in this field for 30 years or so. So I've seen women going through menopause for a long time and you know, we've got many more women today going through menopause with a lot of other things going on in their lives in, in midlife. And of course for the last 20 years, I mean I've spoken about menopause, I've treated women for menopause holistically with HRT et cetera over the last 20 years. But of course many doctors have been very fearful of the word menopause because of research that was undertaken many years ago. So, you know, Sam talks about the total wipe out course of her life at the same time as, as as going through menopause, then being fobbed off, then being told she's depressed. And you know, I think we all know our bodies to some extent and know if things don't add up when we're fobbed off by doctors and not knowing what's going on in all of that, it's a real messy, messy situation. And the positive notes are, I think, over the last two to three years in terms of GPS and sort of general sort of practitioners, nurses, et cetera, the awareness that HRT isn't a big bad wolf. And actually, if you've got a woman having experiencing multiple symptoms in midlife of a perimenopausal age, talk about menopause. You know, not every woman will necessarily want to have medication, whether it's antidepressants or whether it's HRT. Every woman needs to have, a toolkit of lifestyle focus because actually lifestyle is the bit that's non-negotiable. Cause that really is a key to long term health. In the short term, when you are really struggling. I describe the sort of symptoms as crescendo, if it all comes on and you've got other things going on in your life. So any support that's going to help should be offered during that time. It really is needed and things are changing. But it is always quite heartbreaking to hear people who've had stories of really severe symptoms and they're told either there's nothing wrong with them, or here you go, here's a pill, which is an antidepressant and it'll solve everything. And you know, sometimes antidepressants can help with anxiety and mood but I think if you've got multiple physical symptoms as well as anxiety and other symptoms, you wanna treat the underlying cause as much as possible. And please be aware. And I want your community to be aware, I treat many, many women with HRT. And if you take HRT and you sit on the sofa and watch TV all day and eat junk food, you won't feel better. You have to use the whole sort of holistic approach. But you know, if you are not aware of what you need to do and all of those things, how do you, how do you find your solutions?

Louise Minchin:

Go Sam.

Sam Walker:

I was just, I was just gonna add to what Dr. Annice said there, cause that was really true to me. The thought of not having a drink every night was impossible. The thought of going to an exercise class was impossible. The thought of taking control over my eating was impossible. I just, I just couldn't see a way through. And I think for me, finally seeing a medical professional who understood me and responded to the symptoms I had since, for me, HRT has worked. I know that's not for everyone, but that was the key because then I didn't want to sit on the sofa every night. I didn't want to have a glass of wine every night. I wanted to go out and exercise. I wanted to eat really healthily. And in the last three months, everything's completely transformed three, four months. And I think sometimes when you are in that awful funk, you go, “I know I should be doing this, but I can't do it”. And it's having that key available to you that can help you unlock everything else. You go, “oh, here I am again. I am the person who loves bike rides. I am the person who loves Pilates”. You know, that's what's been amazing.

Louise Minchin:

And that's, so I hope that, you know, I hope that some of this can be the key for some of the Her Spirit community or anybody listening to this. Kate Wilger, thank you for getting, getting in touch. I'm so glad it's been talked about more. She says, “I suffered for many years before anyone would acknowledge anything was wrong and I was told I was too young. I just presumed I was too young. I was 45. I'd never thought it would happen to me then.” Okay, so let's talk about you mentioned alcohol. That's kind of, sometimes I think the elephant in the room actually, Sam, it's not something that I have really talked about on any of the stuff I've done. So tell us Dr. Annice alcohol, should we not be having any, how does it affect us? What's going on?

Dr Annice Mukherjee:

Well the short answer is alcohol is an unhelpful coping strategy to treat menopause symptoms. It's a short term anxiety reducer. When I say short term, you know, over a couple of hours. Okay. so it, it reduces that, that's why people reach for a glass of wine in the evening, or a gin and tonic. But the problem is, it's a completely unhelpful coping strategy because actually it reduces your sleep quality. So it makes you more tired the next day and alcohol begets alcohol. So you have one glass and then it ends up being two and then it ends up being three. And then, you know, many of my patients, it can be a bottle, a bottle of wine just like that. And it, it absolutely does not help anything to do with the long will make you more tired, you won't want to exercise. It can trigger migraines in women who are in perimenopause with, with fluctuating oestrogen levels, et cetera. And apart from anything else, you know, excessive alcohol is really bad for long-term health in terms of many different diseases, chronic diseases and morbidities. So it's not a good coping strategy that is very different from having a glass of wine socially with friends, you know, not excessively when you are relaxed. I don't, I would never say never to anyone about alcohol. I wouldn't say don't, nobody should ever drink. But it's a commonly bad coping strategy and it doesn't work.

Amanda Thebe:

I also think, you know, that it comes from a cultural side. It's so different now. I'm living in Canada and I bet Sam sees the same thing in the us you know, when I go home, everyone still goes out on a Friday, Saturday night, it's like a ma a girl's night out on a Friday and then a couples night out on a Saturday and everyone's drinking and I literally can't keep up anymore. And I feel like when I speak to my friends in the UK that the cultural side is sort of still there. I feel like drinking's maybe a little bit more acceptable on the cultural side. But it, it really, I just tagging onto what Annice said, one of the things we know about alcohol as well is the body wants to metabolise it quicker. It's a toxin, right? We need it out of our bodies quicker so that everyone will wake up at two and three o'clock in the morning when they start drinking. And, and when you start messing with your sleep schedule, then the knock on effects of that for our overall health are, that's what's detrimental. So it just, it cascades unfortunately.

Louise Minchin:

Okay. I wanna say a few things. First of all, Dr. Annice, thank you for saying, you know, it is okay as well because, you know, I just actually, I mean I have, I have found that if I cut down alcohol, like you say Amanda, I just sleep a whole lot better. I really do. But you know, I think there's a really good message there that a drink is okay if that's what you are doing, but you know, perhaps not on those levels. Mel, I know lots of people from the community have been in touch specifically about alcohol, haven’t they?

Mel Berry:

It's a really important point and I was talking to Annice earlier and last night I had a beer, slept really badly, don't wanna exercise today. So I echo everything that you've just said. But two wonderful comments from the community at Her Spirit. Chris Onion said “the fuelling is definitely helping alongside ditching alcohol, but I wish I could find stable ground time and stress are the biggest barriers in brain fog and stress, which feeds my brain fog.” And the second which echoing the whole alcohol piece is from Theresa, from our shout out on Instagram, @HerSpiritUK is “cutting out alcohol completely has dramatically reduced my anxiety even though I wasn't a big drinker but had noticed anxiety was much worse the day after just one glass of wine”. So I think we're all nodding our heads very much. This is a big conversation.

Louise Minchin:

I'm really interested by that because you know, we've kind of, I've certainly found it in my own personal way and actually Dr. Annice in some ways, you know, this could be one of the first things that people could do if, like Sam, you know, Sam, I know I understand it's difficult to do, but it could be one of those things people just genuinely could try very quickly.

Dr Annice Mukherjee:

I would never tell somebody no one should ever drink. Cause some people can drink moderately, occasionally and and be fine with that. But the Amanda is exactly right. And certainly in the UK and some certain countries more than others, there is a drinking culture where people will drink several glasses every night of whatever they're drinking, which it doesn't seem a lot at the time, but it's probably chronically quite a lot of units per week or binge drinking. And both those are unhelpful and unhealthy and it's absolutely true that, as I said, an alcohol, if you have a glass you might feel relaxed for, for that hour or something, but the next day often you can get more rebound anxiety. So if, you know, cutting out alcohol altogether is a very reasonable thing to do if you feel, if you feel that it is not agreeing with you. And I always say every single woman is different, we’ve all got to make our own decisions.

Amanda Thebe:

I would just add onto that as well. I think we should normalise not ordering alcohol as well. So when you go out with friends, I mean it's, it's always hard being the one that says, I'll have a line and soda or I'll have a slim line tonic. But there shouldn't be like the questions around that. And, and I think that, I think things are changing and now there's so many non-alcoholic alternatives that it's quite easy to do in a group setting if you feel in that peer pressure. So but I'm all about moderation as well for most women. Yeah.

Louise Minchin:

I've been doing a sort of long experiment and I finally found the answer and I wish I, I might have to put it in the notes, I found a wonderful non-alcoholic sort of like what you call gin or vodka alternative. And I've done quite a lot of work on it and it's absolutely scrumptious cause for me, at the end of the day, there's something about that moment when you sort of check, you know, I drink water all day, I drink tea, coffee and water. That's it. And for me, there's something about that signalling at the end of the day where I drink something a little bit different and actually I'm finding it doesn't have to be alcoholic. So there we go. There are alternatives out there if anybody wants to talk about it and, and offer suggestions. I know for example, Gordon's gin have non-alcoholic gin, for example. So there, you know, I think maybe things are changing. Should we talk about lifestyle because that's so much part of what Her Spirit does Mel and about trying to encourage all of us to sort of lead healthier lifestyle. Dr Annice, there is no quick fix, but what should we be thinking about?

Dr Annice Mukherjee:

Well, again, this, this links with what Sam was saying before you go to your doctor and you're feeling exhausted and you get no solutions. You get no advice about lifestyle and you just get offered an antidepressant. And, and I do not subscribe to that approach at all. And I think if, if a woman goes to a doctor for help, she should be offered reasonable strategies. And strategies can be medical and they can also be lifestyle and lifestyle is crucial. But to say go and do exercise to somebody who's got awful aches and pains, who's feeling utterly exhausted is just not a helpful comment. It's like saying, well, your blood tests are normal, so there's nothing wrong with you and you're 45 and you know, you are perimenopausal, but nothing's on the blood test. It's not helpful for doctors to say that. And I'm all about trying to educate doctors about that. I spent the whole of last week at, at one of our national conferences talking about that. So it's about lifestyle is important, but microdosing lifestyle is, is a term that I use making tiny changes when you are really struggling because the thought of going for even for a half an hour walk to some women, if they are, their symptoms have really accelerated and they're feeling exhausted. It's, it's a real struggle. And that is because we have protective instincts that come from our genes and our ancestors that want to protect us. So if we're tired, we don't want to move, we don't want to go. If we've got aches and pains, we don't want to go out and exercise. So you have to kind of override the instincts and you can't do that. And if you go for a run when you've not been doing any exercise and then you injure yourself, you know, you're gonna reinforce the negative, the negative strategies that you're using. So if you do do tiny changes, they are usually more sustainable. And that's what I mean, Amanda and I are very, very aligned on, on, on lifestyles, you know, strategy approaches because they work, we know they work and you know, it doesn't matter where you are, whether you're a marathon runner, you know, a yoga instructor or somebody who's been sitting on the sofa for the last 30 years, building up poor lifestyle approaches. You can, you know, get through menopause without necessarily having terrible injuries or ups and downs you know, trying to do things that don't work. So small changes. Louise sorry, I'm, I'm talking for too long.

Louise Minchin:

You're not, Sam, what happened when they told you, you know, what about exercise? Cause I think you, you really went off it for some time, didn't you? And you and you liked your Pilates, for example.

Sam Walker:

Yeah, I did and I used to always used to cycle and I used to run as well. I mean, kind of run walk, but get out there. And I really used to enjoy doing that. You know, I've got two enormous dogs. It's like having marauding bears around my house they’re so big. And I live right on a mountain here in Phoenix, Arizona. And until about 18 months ago, I'd walk up that mountain pretty much every day and then everything just shut down, I think. And it was really led from the mental health side of things and then looking in the mirror and not recognising who I was and not being able to fit into those workout gear or anything. But then in fact, I was on Instagram one day and I saw this reformed Pilate studio where you're on this reformer, it's bit like a rack, a torture rack that you sit on. And it had opened up and I, I pretty much forced myself to go. And I walked in the door and it was, it was your worst nightmare. It was wall to wall Instagram models, everyone was 20 wearing sort of gorgeous little bra tops. I sort of, you know, bumble in a lumpy old bag as I felt inside. And I just thought I had that moment, Louise, a bit like you said, when you get to a stage in your life and you just don't care what people think anymore. And I thought, do you know what? Let this be a warning to you Instagram model beautiful 20 year olds. If you don't keep up your exercise, this is what it's gonna be. And I kind of had to get over myself and get in there and for a year I forced myself to go and nothing changed in my body. Nothing changed that I could see. And then once my HRT started and I didn't wanna drink alcohol every day and I wanted to go out and walk my dogs more and I wanted just to be physically active. I've got a pool, I'm so lucky and I wanted my pool apart to sit there and drink a beer in it, you know, it was ridiculous. But suddenly I found that I wanted to move my body again. And then now the magic of the Pilates was a year on, you know, in the last three or so months I've lost three stone. It's fallen off me with, I have changed my lifestyle, but I haven't done something absolutely ridiculously dramatic. But it's that my hormones have gone, oh no, this is who you are, we remember you. Hello, welcome back.

Louise Minchin:

Gosh, that's amazing story Sam.

Sam Walker:

Yeah. And as I've started to lose the way I've gone, oh hang on, I can feel my muscles that were there hiding under my little armour that I was wearing from doing that Pilates. And that's what's been amazing cause now I feel physically so much stronger. So even if you're doing something you don't see a difference, just keep going

Louise Minchin:

Amanda, I wanted to pick up with you about and, and, and also you Mel too about physic, about being stronger Amanda, because that can make such a difference to the way you feel, can't it?

Amanda Thebe:

Well I was just gonna comment on Sam’s story. And so even though you were doing it for a year Sam, and you felt like you were making no progress, you were. And so one of the things I like to say to like women, especially through midlife and if they're struggling with perimenopause, is that everything you do, that's a positive step forward for your health matters. And it doesn't matter if it doesn't feel like it. So the fitness snacking, the doing, the small behavioural changes are ultimately what's gonna help with your overall health moving forward. And I get it right cause I get exactly how you felt, Sam. I didn't recognise myself, I didn't wanna move and if anyone told me to go and do 10 pushups that could go and screw themselves cause I didn't even wanna make a cup of tea, right? So, and I'm a fitness instructor, right? So I get it right. But sometimes you know that we know the transition can be terrible and for some women that HRT can be the thing that opens the door to them taking control of their other lifestyle things again. And so the fact that you'd already been doing your Pilates for a year, what happened then is it just sort of cascaded like I said, you know, then you were like, oh, well now I'm feeling a little bit more human again and I recognise Sam again. I might not wanna sort of like grab the crisps every night or have a drink of wine and, and you know, maybe I'll have some kombucha watching the telly tonight. And, and these small tiny behavioural things we know are the most impactful for our overall health. And so I'm just tagging onto it and Annice said there's not many of us out there are good at the all or nothing, not many of us. There's human nature, we're so much better remembering to floss every night cause eventually we'll just floss without thinking of it. And so I really just beg women to who are in the situation where they feel they, they can start taking control again. Please don't go for that: I'm gonna over exercise. I'm not gonna eat. I'm gonna go extreme, extreme, extreme and just go, you know what? I'm gonna commit to going outside and walking every day for 15 minutes and that's all I'm gonna look at this week. Just start, start doing something.

Louise Minchin:

Amanda, and thank you so much for saying that because I think Mel, this is what, you know, you and Holly have done so well and anybody who is a member of the community you give people women opportunities to make those small steps. Whether it's, I mean I've done so many with you and I'm doing right now, I'm doing the winter swim challenge, thank you very much Mel by the way. But you know, feet first February where we all committed to walk every day for February and do you know what, that will have changed people's lives. So it's very, you know, there's so much available on the community Mel, and just give people an idea of what they might find out there because I just think it's incredibly helpful to sort of have a community or friend, whoever it is, Her Spirit holding your hand along these journeys.

Mel Berry:

One of our community members in the week talked about, it's the hug, you know, it's the arm that goes around that woman to make them feel supported and picking up on Annice your point, that whole micro-dosing we're currently doing the 30 day stronger challenge, which is about do a few press ups, do a few crunches, do something that is very easy to do when you're boiling the kettle and others. And you know, the next thing is community 5K challenge. This is about just moving, this isn't just about having to go at a certain speed and it's around, “Right, how can I get to a goal?” And picking up on your point, Amanda, behaviour change, we built Her Spirit on understanding what behaviour change means and for women at the outset that's about confidence. We are all people that I'm sure the outside world says, wow, they're super confident people, but we all have our times of struggle. And I posted within the community at Her Spirit yesterday that I had zero motivation and I needed them to lift me up. And they all posted and said, come on, go just do it because you, you can. And look, Louise, it's, it's that, it's about finding what's right for you because the whole behaviour point is choice. One day Louise likes to be a swimmer the next day she likes to, you know, cycle and do other kind of crazy things with me. And, and I'm hopeful that, that Sam is gonna find a new running love in the foreseeable future. But hey, together we've got this ladies and and that's why we built Her Spirit because it's about passion and purpose.

Louise Minchin:

One of the things though I'm doing at the moment, the winter challenge, and Mel on the last podcast we talked about, its a swim challenge, isn't it? You can sign up to whatever you want to do every, any week. And I swim, you know, I swim anyway. But what I have committed to do, I haven't, haven't put it in there yet, but I am, I'm, I've been doing it for the last four weeks or so, is that two minutes in freezing cold water in the river. And I've found, there's so much in the passion in the community about open water swimming and I love open water swimming, but I do not like swimming in cold water. But I know now that if I get in the river for two minutes, any little sniff of a bad mood, bang gone. It's like a magic medicine. So I might even go to more than two days a week, but one day I'm doing one day a week. But, but you know, there is something for everybody and I think Dr. Annice, that that, you know, it echoes your thoughts, isn't it? We can just, you know, if you change your perception, do something that becomes a habit then, then that really can make like Sam has a real difference.

Dr Annice Mukherjee:

Yeah, I mean it's a little bit like the reverse of the alcohol story cause alcohol is becomes a habit and it's a terrible habit. It's not good to use that as a coping strategy as a habit. But if you switch that habit for, you know, regular movement or small changes to your lifestyle, then you know, it's transformational in the longer term. And as Sam described, you know, she was doing all the the right things. She didn't feel better for a year and then she added something in which made the huge difference to her, which was for, for Sam the HRT. And then it all fell into place. It's like it might not have fallen into place if you hadn't been doing all those things already, you know, cause it's a combination of the different strategies. But that the, the Whim Hoff sort of cold water thing is, is a very interesting concept as well because there are some significant effects I think that the scientists are researching on immune function and, and the stress response that that that has a positive impact on.

Mel Berry:

Yeah, I mean community as we talk about is obviously the heart. And Sarah Porter was on the last podcast and I wanna read out to you what she says about swimming. “Swimming in the outdoors has helped me and the women I swim with in so many ways. Firstly, community and talking about how we feel honestly and openly with no judgment. And secondly, it helped me with hot flushes and the mood. But the important link in is it helped me with confidence that I could see that I could get in the sea in January. I could, whatever the challenge is, I know that I can do it.” It's that confidence piece and it's so powerful isn't it? I don't worry about my former self, my, my future self and my current self can be phenomenal and that camaraderie is really powerful.

Louise Minchin:

I promised at the beginning of this podcast that I talk about sleep and we've talked about lots of things but not sleep. So we haven't got long left. So have we, shall we quickly go around the room and I want solutions. I know it's not easy <laugh>, but I want any solutions for people who are listening. How do we make it easier? Who wants to go first?

Amanda Thebe:

I'll go quickly. I don't actually, didn't struggle with a lot, lot of sleep issues, but then I did all of a sudden, right? So I'm like a bear sleeper. But I wanna, I wanna tell you that I also sleep well again now. I'm four years post-menopause and I sort of wanted to start the conversation by saying that a lot of the time the sleep issues are in the peri menopause menopause transition and they resolve themselves. So I wanna give some hope there and Annice will tag onto this. I also wanna say that any sleep things that you try take a long time to actually work. So don't just do some sleep habits for a week or two and go, oh, they don't work then. Your, circadian rhythm can take months and months and months to sort of like resolve itself. My thing is, I don't have any screens after I turn the TV off at say 9.30pm/10pm I go to bed and I read a book for half an hour. I like try and pull away from all of the screens. That was a big thing for me and I still do it.

Louise Minchin:

Good. Great. Thank you. Very positive. I love that. Dr. Annice you can go next.

Dr Annice Mukherjee:

Yeah, well I you'll have difficulty stopping me because I'm a lifelong insomniac. So I really, I've, I managed a lot of my patients with sleep issues and I do consider myself quite an expert in, in difficult sleep problems because of that. And when I went into menopause, which was quite a sudden menopause for me cause it was medically induced, I noticed the difference. But actually being a lifelong insomniac, I didn't make that much difference. I just accepted that I'd be awake for longer. But its complicated cause there's menopause, perimenopause related issues around vasomotor symptoms and anxiety and, you know, the, the hormone changes and then there are the modern world sleep disruptors. So as Amanda alluded to the devices that we're on at night, which not only is simulating in terms of the content, but the blue light that shines at us that delays melatonin release, which is one of the important sleep inducing hormones, stress amongst women. And Sam talked about it at the beginning, you know, all these things going on in midlife, you're getting your hormones messing, messing around and then you've got lots of stress. And if your stress is disregulated, your cortisol response, which is normally quite predictable through the day and it's higher in the morning, the cortisol and it's, it's very low at bedtime, that's very reliable in a healthy person. It starts to just disregulate. So you can wake up and refresh, go to bed, tired and wired and that's part of the stress side rather than specifically hormones. But they all interact and, and Mel mentioned, you know, you can have one beer and feel awful the next day and you can have a few, a few, you know, drinks of alcohol and sometimes be absolutely fine. And that's because there are so many different systems interacting. So back to basics, like Amanda said, you know, having a good sleep routine, getting rid of the devices late at night, managing stress through the day, exercise through the day is a really, it's really good for sleep quality. And, and you know, I I don't say that, you know, trying to upset somebody who isn't doing any exercise, any movement, is better than no movement. So that you know that there's so many different things you can do to help with sleep other than medication. I've not even mentioned the word, neither has Amanda, but there are generally, apart from HRT medications are sort of short term solutions rather than longer term solutions.

Louise Minchin:

Thank you Dr. Annice. Just quickly, just while we just mentioned that my main disruptor was very, very overwhelming night sweats and actually once they stopped they were waking me up, you know, and probably having to get outta bed and you know, get dry and start all over again. Those were very problematic. And actually I'm really very lucky because the HRT did sort those out for me and my sleep has been so much better since. Sam, word from you?

Sam Walker:

Mine was 3:00 AM waking up and then second that my brain switched on the massive kind of crushing anxiety and just hideousness in my brain, which meant, I just used to go in the spare room and read a book or watch something or just try and do anything cause I knew at that point it wouldn't go back to sleep. But then I also knew my whole day would be disrupted cause I felt so awful cause I was exhausted. For me, you know, the magic TicTacs as I call them, the TicTacs, which I have for my HRT pellets. I remember getting them and just thinking, please, please, please, please, please work. And it took two weeks for me, for my HRT and I remember one morning waking up after about two weeks after I'd had them and I thought, oh it's, it's 6.30am, I haven't woken up at three. This is amazing. And then I thought, hang on, I don't wanna burst into tears. And that for me was the moment when I realised things were changing cause I actually woke up and thought I don't wanna cry. And I'd realised then I'd wanted to cry when I woke up for about a year and a half. So whatever works for you all, all that advice is amazing. But yeah, don't just sit there and think this is what you have to deal with because you don't.

Louise Minchin:

And also Amanda, I like particularly what you've said and I'm gonna, cause I'm trying to deal with my sleep again cause I've left, I'm left post breakfast now, so my sleep happens are very different. But I like what you said and I'll remember that, that it's not a quick fix. It's not gonna get mended in a week. Which is really interesting. And that goes back to your point about the Pilates as well. It's brilliant. Mel, final point from you.

Mel Berry:

For me I love sleeping and Annice probably the person that you would love to be, but for me it is, it's, it's alcohol, but what the thing that I know that works so perfectly be active through Lakes to London. I mean I had no problem with, with sleeping. Definitely the stress piece. Try and think about what is helping you to, to relax and solutions. You know, we've got an amazing small group of women that we're doing a bit of tests and learn on at Her Spirit to say, if you educate women on understand how to fuel yourself better, how to use physical act exercise for you and I think Annice you picked on, everybody's different. How do you find your way? So please come and be part of the Her Spirit community. We have a menopause group that helps you. We've got all of those exercises that again can help you. And yeah, be open and honest like I think we have done today. I think it's really important conversation to have.

Louise Minchin:

Thank you so much everybody. I've, I've really enjoyed this conversation. I've learned lots of little things that I'll take away. Mostly that thing about nothing is a quick fix. I think small things are good, Dr. Annice and nothing is a quick fix and thank you very much indeed, Annice, Amanda Sam and Mel for taking the time for talking to me today. Don't forget to head to Her Spirit.co.uk. Lots of absolutely brilliant tips, pieces of advice and I really recommend those challenges because you never know that feet first February, for example, I absolutely loved. I'm sure Mel will be doing that again. Join us on the Winter Swim Challenge. You can definitely still sign up. There are so many different things to do. Just find your tribe wherever it is in the Her Spirit community. And come and join in our conversations as well on Facebook and Instagram? Find us at Her Spirit UK. We'll post the links in the episode notes and we'll also add a link of where you can reach a full transcription cause Sam will have to do it, won’t you Sam? You're all fantastic. I've really enjoyed it. I’ve mentioned the next episode of the Her Spirit podcast will be arriving in the new year. And why don't you put in the notes what you'd like to hear us talk about. I'm sure we'll have some brilliant ideas as ever, but do tell us what you want to talk about. Tell us what you want us to discuss. If you want a particular guest suggest it as well. Together, we've got this. Have a really great Christmas. See you soon.