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Uncloaking the Menopause

Earlier this week we ran a webinar dedicated to ‘Uncloaking the Menopause’ with our fantastic experts Emma Bardwell, Dr Chloe Mitchell and Dr Shahzadi Harper. This was such an insightful afternoon jam packed with helpful tips, information and advice from our wonderful panel.

To catch up on the full recording, simply input your details here

I was really keen to share some of our key findings and takeaways with you. A brief intro to our panelists:

Emma Bardwell: The menopause nutritionist. As a registered nutritional therapist and women’s health specialist, Emma offers evidence based advice you can trust. No matter what you’re going through, from seismic mood swings to bone crushing fatigue – Emma has you covered.

Dr Chloe Mitchell: Chartered psychologist and mental health consultant. Dr Chloe is passionate about promoting mental health and sharing her expertise to help people reduce the negative charge of difficult emotions and overcome adversity.

Dr Shahzadi Harper: The menopause doctor, Dr Shahzadi Harper is a dynamic doctor interested in optimising women’s wellbeing and health empowering them to look and feel their best. Dr Harper believes in the early management of symptoms of the peri menopause and menopause to stay youthful and healthy.

You might have noticed we have been running a survey surrounding women’s thoughts and feelings towards the menopause. The first thing that really shocked me was the fact that 75% of women were actually nervous about heading into this stage of their lives. Following on from this 60% were feeling very anxious about this stage and 75% of women actually currently going through the menopause had reported a negative impact on their mental health. As a mental health specialist and someone who sees hundreds of women facing challenges and struggles during this life stage Dr Chloe gave us a deeper understanding…..

‘ Dr Chloe: I do see this a  lot, one of the highlights I want to normalize is that  menopause is both physical and mental. There are so many aspects going on during this stage of life; hormone changes, life changes, body image awareness, worry of infertility, again, relationship worries – all these things can come crashing down on you at once which of course in turn impact your sense of wellbeing. One thing I think can definitely help is building awareness for others and ourselves. Actually noticing what is going on with ourselves, what are the current life stresses that I am dealing with, what should I expect and so on. What I have noticed is that every woman has their own unique menopause journey and the worry seems to be a lot to do with how they will make sense of this journey. It is here where it is so important to learn about ourselves and the worries that we are facing. From this we can start to practice the necessary self – care to reduce stress and anxiety. I want to stress that feeling nervous during this time is totally normal, taking time for self – care and reflection is a really important preventative measure’. 

It was incredibly reassuring to touch base on the fact that we are all nervous and really it is very normal and we are all going through this together.

Another key finding from our study was that 74% of women in the peri – menopause experience mood swings, weight gain and hot flushes. I was keen to find out more from nutritionist Emma Bardwell on any key changes or measures we can adapt to our diet during this stage of our lives.

‘Emma: during the peri – menopause and menopause women suddenly start to feel changes in their bodies, particularly body shape and composition. In turn this causes women to generally not recognize themselves and can cause them to feel uncomfortable in their own skin. While there is no specific food or nutrient that can combat feelings of anxiety itself, there is definitely a way of eating that can be beneficial. Largely a whole foods diet full of colour, diversity, fibre and omega 3 which is essential for brain health. An interesting study ‘the smiles trial’ took participants with clinical depression and split them into 2 groups. 1 group of participants were given the Mediterranean diet as described above while the other group were prescribed counselling. Findings showed that the biggest reduction in depressive symptoms were from the group eating the Mediterranean diet. This diet is largely made up of lots of fibre, omega 3 as mentioned, oily fish, some lean meats and is predominantly focused around fresh, unprocessed food.  This diet does include some alcohol but follows the idea of everything to be consumed in moderation. It is an anti – inflammatory diet packed with lots of herbs and spices.’

I was also intrigued to see how big an impact cutting back on sugar, alcohol and processed foods had on this stage of our lives….

‘Emma: In terms of cutting back on sugar, adrenals take over for estrogen production and therefore it really is essential to nurture them as much as possible. This can include self –care, recovery, exercise, and eliminating triggers. Some people for example will find caffeine to be a trigger making them very anxious however others it won’t even touch the sides. We are all completely different, if you find you are very flawed by symptoms you will find cutting down on alcohol to be hugely beneficial to how you feel’.

‘Dr Chloe: just adding to this, if you do add sugar to your stress levels you are very likely to make negative symptoms worse, your sugar intake is something to keep an eye on it especially if you are struggling to cope with anxiety and stress.’

‘Dr Shahzadi: yes maintaining sugar levels is very important. The shift in hormones impact insulin levels, it Is important to understand that lot’s of physical hormonal changes are happening within our body during this time so good quality sleep and diet is essential.’

‘Emma: while it can be difficult as those sugary snacks are often the things we reach for when are energy levels start to drop, eating fewer refined carbs, sugar, chocolate is a really quick and simple fix though difficult to begin with, but definitely worth changing.’

Another finding that came from our research was that 60% of peri – menopausal women suffered from sleep deprivation. I was interested in hearing more from Dr Shahzadi on the common symptoms she experiences in her private clinic…

Dr Shahzadi: while every woman has own journey the symptoms are actually very similar. One that catches women unaware is the difficulties with sleep and insomnia. There is a lot of external pressures going on at this point; life, work, home, finances and particularly now with Covid adding to this stress. A lot of women find they fall asleep ok but wake up between 3 – 5am with difficulty getting back to sleep.  This of course has a negative impact on the rest of the day. Other factors such as weight gain due to  hunger hormones being in overdrive, ovaries no longer producing the same hormones as they used to, insomnia … all these things chip away at self- esteem levels. Brain fog is another particularly common symptom. More and more of us working and therefore women experiencing these symptoms are more aware of not being able to focus, not able to find their words, lose what they were going to talk about, worry about their own ability.  I had a lady visit my practice the other day who has been married for 25 years and all of a sudden felt suffocated in her relationship. It is these psychological symptoms such as the mood swings, tiredness, flatness that have the bigger impact. Aging can be a real tipping point. I had another patient look in the mirror and feel she had just aged and lost her sense of youth. During this time a woman can lose her sense of identity, her glow and sparkle’.

Something I found so concerning from our study was that 76% of women didn’t prepare for menopause at all. While it is great to see it is being talked about and taught in schools, I feel I didn’t give it a second thought during my late thirties and early forties. It seems crazy that it is such a taboo topic which we pretend never happens when the reality is it happens to all of us and it is something we all should be talking about more openly….

‘Dr Shahzadi: when I was a doctor in my 30s menopause seemed so far off, there is almost an element of denial as we think of menopause to be associated with a much older person. As a GP you don’t necessarily know much about it, one reason I decided to specialize in womens health and the menopause was because I wanted to know more. It is great to see it start to become more normalized’.

Another topic we touched upon was supplements and whether they are necessary during the peri – menopause and menopause. I turned to Emma for some advice….

‘Emma: while I am not totally anti supplements I believe you just have to be very careful particularly regarding blanket statements suggesting you will really benefit from this that and the other, because the reality is it is not always true. Women have come to see me with carrier bags full of supplements, not even sure why they are taking them, not sure if they are working. Everyone is individual and their dietary needs should be personalised to them. What often happens, because we are not prepared symptoms suddenly creep up all of a sudden and cause women to take a scattergun approach grabbing all these things, lots of supplements that stick the word meno on the front of them. I will say you need to be a complete detective in this situation. Question why you are taking something and does it work with other things your taking. There is a common ethos that supplements are all natural, but what people do not realise is that high dosage of of herbal supplements have been linked to liver damage, Talk to a registered health care practitioner and find out what is best for you. Having said all that  I am an advocate for vitamin d, omega 3, and b12 supplements particularly if you are vegan or vegetarian. ‘

I was also interested to know whether as women there should be an optimum time that we start to think about the menopause and how we can help best prepare our bodies when the time comes….

‘Dr Shahzadi:  I think as women we should be more in tune with our bodies, hormones are part of us play a huge part of our day to day life. It is good to think about addressing deficiencies and needs during our late 30’s  and early 40s. Start to think about exercise, mental health, your hormonal cycle. Your periods might start to be a bit shorter and  you may not even notice along with everything else ticking along until 2 periods come and go in a month. It is good to keep on top of these things and be aware. Lots of women see the menopause negative but if you are prepared, while it can be challenging, it can also be liberating, positive and something we share as women – not all doom and gloom.’

Dr Chloe: you’re spot on, raising awareness and understanding what we need to do to help us be a positive experience and see it as an incredible stage of our lives is something we definitely need to be better at.’

From our findings we noted that 65% of women are unsure that they will receive the support they require from their GP and 37% didn’t even see their GP with the symptoms they were experiencing. It seems more and more obvious that during this stage of our lives when we need more support than ever, the reality is we are actually left to feel like we are facing this struggle alone. I was interested as to whether Dr Shahzadi thought it would be appropriate and necessary for women to seek regular support during the menopause as they would when they are pregnant..

Dr Shahzadi:  this is absolutely right. There is so much support at the beginning of the reproductive line and the maternity programme, but often there is just nothing left at the other end when we need it the most.  For example, in the workplace a pregnant woman knows she is secure, she is entitled to the support she needs. While the peri- menopause and menopause can go on for some years, it should be essential for women to know they have the support they need. 10 minutes with your GP is not an appropriate form of support. It is actually unfair to expect that much of a GP for 10 minutes and in fact an insult to women going through this stage of their lives. This is a primary reason why I decided to do what I do.

A lot of my friends who I know have been through or going through the menopause have actually been misdiagnosed and prescribed anti – depressants. Mental health specialist and chartered psychologist Chloe shared her insight

‘Dr Chloe:  mental health is very subjective. What you think impacts how you feel and how you behave. The more we leave unprocessed, the more we just brush off the fact we are not coping and leave it for another day and consequently the more it builds, the more stressed we become. The thing is with feelings is that unless you give them space and time they will just keep brewing and building up. Mental health is a spectrum that fluctuates all different experiences; affection, receiving empathy, joy, happiness. There is a way we can take care of ourselves. I will do my emotional clearing out, personal de cluttering session and say to myself ‘right Chloe, where are we at today’ – just 10 minutes. If you like journaling you can accept it this is what I can control, what I can’t control, what do I need I need; to feel joy, to take care, connect with friends all really simple things that can become difficult when build up and ignored. Take care of yourself, exercise, eat well, seek medical support, practice good wellbeing and self – care every single day’. We are really good at being hard on ourselves and often seeing the negative. Take an emotional snapshot everyday of where you are at and what do you need to balance yourself’.

Another key finding was based around sex and relationships. 46% of women think their sex life is going to improve however as expected the majority said that wasn’t the case. This can cause real problems and put enormous pressure and stress on our relationships. As expected the majority of women explained that feeling fitter, healthier, improving their body image would encourage them to be more physical. It makes a lot of sense as it is surely easier to be physical when we are feeling great.

‘Dr Shahzadi: it does make a lot of sense, weight gain is such a common symptom of the menopause and let’s face it it is a symptom that doesn’t make you feel very sexy. Along with mood swings, tiredness, flatness it is very common for women to find it difficult to keep themselves going let alone find the energy to have sex. I often see patients for the first time who really say they cannot find the energy but after some time this will just to lift and improve. There are so many things going on in our bodies during this time. During lockdown it has become probably even more difficult while the children and family are at home but it is a great idea where possible to keep sex away from the bedroom!’

It is definitely the case that the fitter and healthier you are, the more positive you feel about your body. It is really important through this stage of our life to adapt our exercise routine to incorporate more weighted, resistance exercises to encourage muscle growth and to protect our bones. In my opinion exercise should be all about creating a habit. There is no need to spend hours in the gym Focus on 10, 20, 30 minutes of good quality, feel good exercise with a focus on technique. I always tell my clients that it is much better to do 10 minutes of effective, good quality exercise rather than an hour constantly feeling like you cannot complete it. More of our research suggested that 50% of women find motivation to be a real struggle when it comes to exercising. Furthermore women in our study revealed a real lack of support in gyms when it comes to supporting them in this stage of our lives.

‘Dr Shahzadi: I have actually walked into an exercise class before and walked straight out because I found it so intimidating.’

Our panelists all agreed that keeping a diary and scheduling in exercise as you would an appointment or important meeting is a very effective tool to keep you accountable and take some time for yourself to exercise.

‘Emma: it doesn’t happen by accident, you have to be prepared’.

Dr Chloe: it is so important to take a whole personal approach through the menopause, incorporating exercise, nutrition, good quality sleep keeping your mental health in check. I often see patients who are great with exercise but hate themselves, or who eat really healthy but still full of stress. It is vital to take a whole personal approach to find an appropriate balance.’

What was really interesting and encouraging to note was that women from our study wanted to seek more communities and groups to get talking more about the menopause and start to normalize this time in our lives that we all are going through. I know personally that I do not really discuss the peri – menopause or menopause with my friends even though we are very close or some of us potentially even there. It would be great to speak more openly about our symptoms.

‘ Dr Shahzadi: the community aspect is so important for a wellbeing point of view, there are more and more community groups out there now on Facebook and Instagram. I was actually only introduced to Instagram a year ago and I have been amazed at how open and helpful the conversations on there. It is also great to see celebrities such as Jo Wiley open up and talk about her experiences.

‘Emma: there are lot’s of forums on facebook which have really insightful. Community based conversation lead by real people on the same journey as you.’

Nutritionist Emma also had some really helpful tips on super simple and easy ways we can give ourselves the best chance with our diet and food preparation

‘Emma: simple is key. Have a few staple breakfasts for example yoghurt with berries, the next day might be eggs and so on. It’s important to start your day with protein to set you up for the day ahead. If you do have the time batch cooking can be really helpful to get your fundamentals sorted for the week. Build your plate around protein, add some veg, some whole grains with fresh herbs and spices and as much colour as possible’.

I was really keen to find out from our incredible panel of just one thing they would each recommend we could do today to help us prepare..

‘Dr Shahzadi: be a bit selfish. We have dedicated our lives to our partner and children, this is an amazing time to start to think about YOU. Put yourself and your needs first. Find something that makes you happy, a hobby or interest, get yourself a health check up and invest in your future.’

‘Dr Chloe: Because of stress and pressures we so often try to do everything at once. Break it down into what you can do today, what is manageable. Be sure to find pockets of joy throughout your day that are important to you. Take a moment to hover over yourself and establish where you have lost your balance and what you can do to get it back on track’.

‘Emma: check your calcium levels and work out what sources you are obtaining your calcium from, particularly if you are vegan it is key to be mindful on how close you are to your target’.

My own advice would be to really think about what exercise you are doing and how this might need to adapt in the next stage  of your life; i.e. strength, weight and resistance training. Try to concentrate on making exercise a habit, focus on 10 – 30 minutes of quality exercise a day where you can really make improvements to your bone health and muscle mass. Do not beat yourself up if you miss a day, focus on breaking it down and making it part of your everyday routine. Before you know it you will get to the point where you cannot imagine your life without it.

I really hope you enjoyed this webinar and took away some key insights and advice for you and your friends/ family approaching this next stage in your journey. I have really enjoyed chatting with like minded women who are on the same mission as myself to keep raising the awareness and importance of the peri – menopause and menopause so it becomes a completely normalized topic – after all it will happen to all of us women at one stage in our lives and it is far better we are prepared so we can make it a really positive, liberating, happy and healthy time.

A big thank you to our panelists, please be sure to keep up with them on social media to follow all the amazing work they are doing throughout world menopause month:

@drchloe_mitchell

@emma.bardwell

@drshahzadiharper

We are offering a 50% discount to all of you who caught our webinar to help put your new exercise habits into practice. Head to niix.fit and enter code: WEBINAR50 where you will receive any subscription half price.

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