Dr Louise Newson: Anxiety! Joint pain! The perimenopause symptoms you’re ignoring

One in six women arriving at Dr Louise Newson's menopause clinic have suicidal thoughts. 92% see those thoughts reduce with natural hormones, so why are women still being prescribed antidepressants instead? In this chat with Fearne, Louise explains why women are being misdiagnosed with depression or anxiety when the root cause is hormonal. Fearne admits she's the woman with her head in the sand about perimenopause, so Louise walks her through what the many (many!) different symptoms could look like, and how to talk to a GP about how you’re feeling mentally and physically. Plus, is there any truth to the myth that HRT causes breast cancer? Why is testosterone the most misunderstood hormone in women's health? And would the contraceptive pill be approved if it was created today...? Louise’s new book, The Power of Hormones, is out now. If you liked this episode of Happy Place, you might also like: Liz Earle https://pod.fo/e/4049a9 Cally Beaton https://pod.fo/e/329307 Naomi Watts https://pod.fo/e/2a7df4 Hosted on Acast. See acast.com/privacy https://acast.com/privacy for more information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Fearne Cotton?

  Hello and massive welcome to Happy Place with me, Fern Cotton. This is the show that empowers you with knowledge so you can make the decisions that are right for you. Today, I'm chatting to Louise Newson.

• 0:14Speaker 01

  If we're getting any symptoms, the first thing as women we should do is think, right, could it be my hormones and could topping up my hormones in a very natural way help? They affect every cell in our body, so that means every organ. So you could literally list going from your head down, literally, obviously so many functions in the brain. Palpitations, very common. Muscle and joint pains, really, really common. A lot of people in their 40s get diagnosed with Irritable Bowel Syndrome, weak bladder, all of that can be related to hormones as well, restless legs. You know, so many women are having these symptoms and just putting up with them.

• 0:49Fearne Cotton?

  Hey, how are you all? I hope you are well. Look, this is a chat that I've needed to have for a very long time. Hands up, any women that are listening right now, that are of a certain age, that have got their heads buried firmly in the sand when it comes to perimenopause and menopause, because that is me. I am in complete denial. Whenever anyone mentions the menopause or perimenopause, I just think, oh my God, stop talking about it. I can't think about it. I don't want to think about it. And mainly that's because I've been so confused as to what the solutions are. And it shouldn't even be a solution. It should be like, how do I cope with this? What can I marry with everything else that

• 1:31Fearne Cotton?

  I'm doing in my life to feel okay? So I needed to face up to this whole subject head on and get stuck into it. And what better person to do that with than the brilliant Louise? So Louise is a GP, author, campaigner, and the menopause specialist in the UK. She's the founder of the Newson Health Menopause Clinics and Balance Menopause App. And her latest book, The Power of Hormones, is an absolutely vital read because there's so much in there that gives women the understanding of our own bodies that's been withheld for far too long. This chat could have gone on for weeks, but we managed to really crack on and condense

• 2:15Fearne Cotton?

  it into a listenable amount of time. And we cover subjects like the power of believing in women's experiences of their bodies. So basically going to the GP and properly being listened to. We also look at understanding the history of the pill. Maybe if you were again, similar age to me, back in the day, like in the 90s, the early noughties, you popped that contraceptive pill without giving it a thought as to what was in it, what the side effects might be. We talk about what hormones do in the body and the brain, the perimenopause symptoms to look out for, and debunking the fear around taking hormone replacement therapy. That for me is the big part of this conversation because that's

• 2:59Fearne Cotton?

  been the bit that has been keeping my head buried in the sand. So I really needed to ask all the questions, like just to give you a bit of behind the scenes. I do a lot of research for these conversations. I read books, I read news articles, I watch YouTube clips, I listen to podcast episodes. I did all of that with this one. But when I got to sit in front of Louise, I basically freestyled and just asked her all the questions that I have previously felt, I mean, too embarrassed to ask anybody. Like what happens when you go to the doctor to talk about menopause symptoms, like that basic. So if you're with me on that, this is the chat for you.

• 3:42Speaker 02

  Hello, I'm Joanna Fletcher.

• 3:44Speaker 03

  And I'm Marco Burchella.

• 3:45Speaker 02

  And this is Boots Off.

• 3:48Speaker 03

  We are friends who've spent a decade together, walking up mountains, across deserts, and along coastlines with some seriously awesome groups of humans.

• 3:56Speaker 02

  And something happens when you're out there, feet on the ground, surrounded by nature. The conversations just spill out of you.

• 4:03Speaker 03

  This series is about the adversities that lead to adventure.

• 4:06Speaker 02

  The adventures that lead to adversity.

• 4:08Speaker 03

  And how life can be one big adventure in itself.

• 4:11Speaker 02

  Listen every Thursday. Just search for Boots Off.

• 4:19Fearne Cotton?

  Right, here we go. This is the show.

• 4:42Fearne Cotton?

  Louise, I'm so thrilled to have you on the podcast.

• 4:44Speaker 01

  I'm very excited to be here in this lovely, lovely, I'm gonna sit here all day and straighten your chairs, they're lovely.

• 4:49Fearne Cotton?

  I wanted tactile chairs, just so I like to fiddle with textures and a pen and Miss Fidget. So I thought, yeah, these chairs are quite nice and comforting.

• 4:59Speaker 01

  I feel very calm.

• 5:00Fearne Cotton?

  We have got so much to talk about today, it is unbelievable. Now, of course, you are the doctor known for kickstarting the menopause, you're rolling your eyes, the menopause revolution. But my God, did we need it and do we still need it? And it seems like many women out there are really on board with having this conversation now and learning and being open minded. But is the medical world ready for this chat?

• 5:27Speaker 01

  It's not, and I'm really proud of being a doctor, really proud. No one in my family has been a medical doctor and I wanted to be a doctor since I was four. So, you know, it's something I feel very, very privileged to be a doctor. And I went into medicine to help everybody. I've worked in some really deprived areas, including in prisons, and I never judge my patients because they all have problems. But what I learnt really young as a doctor is to listen and believe your patients and put them in the centre of your consultations, which is what I do every day. And the biggest agenda with all of this, and I've written a chapter about it in my book actually, is women not being listened to and not being believed. And that is something that I'm really, really sad about.

• 6:10Speaker 01

  So we can talk about whether doctors are educated about hormones or not, which is a problem. But for me, the biggest problem is the stories that I hear every day for women not being listened to, not being believed, not being taken seriously. And in my clinic, you know, when I see new patients, before I finish the consultation, they thank me. That's before they've used any hormones, before they've had any treatment, because I've believed them and listened to them. And the stories that I hear, the way other doctors have spoken to them, just fills me with horror. Because as a doctor, I don't know everything, but I could say to you, Fern, I'm not really sure what's going on. Let me just have a little think or let's do some tests or I'm going to talk to a colleague. And you probably feel quite reassured.

• 6:55Speaker 01

  But if I cross my arms and say, I think you're just, it's all in your head. You will feel awful.

• 7:01Fearne Cotton?

  Yeah.

• 7:02Speaker 01

  And, you know, I've got a small family and my middle daughter had sepsis a few years ago and I, and Martha's law wasn't a thing then, but I had to demand for her to stay in the hospital. And I'm sure I saved her life that night, but I've got a lot of balls and I've got medical knowledge, but I realise how vulnerable patients are. And this is the bigger conversation really about hormonal care, health of women, all of that. It's just that side of it really irate me.

• 7:27Fearne Cotton?

  Well, I bet because, you know, we all know and I'm, we've touched on this in other episodes before, to a degree that we know that women's health is not taken seriously. When it comes to, you know, and we, if you think women, young girls start their period could be as young as 11.

• 7:43Speaker 01

  Yeah.

• 7:44Fearne Cotton?

  And then have to deal with, you know, fluctuating hormone levels and everything that comes with having a period, a menstrual cycle, pregnancy, perimenopause, menopause, until we're, you know, 40s, 50s. That's a big section of our lives that isn't really being taken seriously. So I'm sure that plays into a large part of it. Also, I'm imagining doctors being time poor, that you get these like five minute segments with people.

• 8:07Speaker 01

  Yeah, I don't think that's, it doesn't take long to be kind to people. You know, I've been a GP for many years, 10 minute consultations. And actually on a Monday morning, we used to do five minute, I can't believe we did it, just to try and get through some of the emergencies for the day. But you can really learn a lot in a short space of time if you listen, but also if you educate people. So as you hopefully know, I've worked really hard the last 10 years to try and educate women so they can make choices themselves. So what I feel almost guilty for now is that women are educated, like you say. So they might have, you know, downloaded Balance, got the symptom questionnaire, printed it off and say to their doctor, because it's always one problem, one consultation. I think it's my hormones because I've got this, this, this, this, this symptom. They're really empowered.

• 8:51Speaker 01

  So as a doctor who's educated, it's really easy because you go, right, I'm thinking hormones now. I'm not thinking palpitations, heart problem or joint pains, rheumatological problem. It's easy, the patient's giving you the diagnosis really. But then it's still people aren't joining the dots and that's what's really difficult. So it doesn't take long. You know, if you came to me saying, oh, I'm a bit tired and I'm crying a lot and I've got joint pain, da, da, da, da, that's going to take me 10 minutes to listen to your symptoms. But if you've prepared, you've got everything on a tick box and you're saying, Dr. Newsom, these are my symptoms. I would now like to talk to you about whether I can take hormones. I've got nine and a half minutes to talk to you about hormones.

• 9:30Fearne Cotton?

  Yeah.

• 9:31Speaker 01

  Quite a long time.

• 9:31Fearne Cotton?

  So it's really for the patient, taking back control to say, I've got a feeling as to what's up, rather than, oh, my God, I don't know what's going on with me, but I'm really struggling. I think the ripple effects of women not being informed previously, but also, as you say, the medical world not catching up with this conversation.

• 9:48Speaker 01

  Yeah.

• 9:48Fearne Cotton?

  Is many women, like me, have got their head buried in the sand. So in many ways, I'm the perfect person to interview you today, not only about your new book, which I fucking raced through because I was just like, I need this book right now, The Power of Hormones. We'll put all the details in the podcast copy. But I am that typical mid 40s woman who is totally and utterly in denial. My head's buried in the sand. I don't know. I think because I have found the conversation around perimenopause and menopause overwhelming at times and you're fed so many different pieces of advice. And, and also people like to regurgitate their own narrative to you.

• 10:30Speaker 01

  Yeah, which is worse.

• 10:30Fearne Cotton?

  Which then, you know, you could start thinking, oh, maybe I should go and talk to someone about this, or should I start hormones? Then someone else says, definitely don't because of this, or the fear mongering comes in. I am that person right now who is still slightly head in the sand. And I know I've got certain symptoms. My periods are certainly getting closer together. So the cycle is shorter. The periods can be shorter, but I can get a bad headache on day one and a heavy period on day one. And then it's kind of very light after that. So I know that there's changes. I know there's stuff going on, but I'm doing nothing about it. And I reckon there's a large portion of my listeners.

• 11:09Speaker 01

  Yeah.

• 11:09Fearne Cotton?

  Of my age, who feel exactly the same.

• 11:11Speaker 01

  They're confused. They're confused. I, I, I hate my Instagram. I mean, I love it and I hate it. So whenever I go on it, there's all this stuff like, oh, my God, what do I believe? Who do I trust? It's just awful. But can I ask you a question? If you, if you had like low iron, would you take an iron tablet?

• 11:27Fearne Cotton?

  Yeah.

• 11:28Speaker 01

  And if you had an underactive thyroid gland making you really tired, would you take thyroxine?

• 11:33Fearne Cotton?

  Yeah.

• 11:33Speaker 01

  Yeah. So it's, it's interesting, isn't it? Because. You know, that's why in the book I've written that I hate the word menopause, perimenopause, you know, PMS, PMDD, they're just labels for women. But if I said to you, I've done a blood test and you've got low, I mean, I haven't, by the way, just for your listeners, but you know, but you've got low testosterone and that's why you're feeling more tired, you're having headaches, whatever, would you like to try testosterone just for a short time, see if it's going to help your symptoms?

• 12:00Fearne Cotton?

  Yes.

• 12:01Speaker 01

  It makes the conversation then really easy.

• 12:03Fearne Cotton?

  Exactly. I guess what we need to do first is debunk some of the myths, perhaps all the fears that women have. So you, you say in your book, only 15% of women in England, or all the UK, sorry, are currently getting hormone therapy, the lowest in, in years and years.

• 12:18Speaker 01

  Madness, isn't it?

• 12:19Fearne Cotton?

  More likely because of these, these fears. One of the big ones being a story that we've seen in the news circulating, it goes, it comes back around the link between taking hormones and breast cancer. This is a big subject to dive into straight off the bat, but I think it's the one that we need to tackle.

• 12:34Speaker 01

  It's really important. So I think before I answer that, we need to just remember what hormones are because so many people think hormones are something we prescribe. They're not something we produce ourselves.

• 12:45Fearne Cotton?

  Yes.

• 12:46Speaker 01

  So we produce dozens of hormones. They're just chemical messengers that go into our bloodstream, made in different organs in our body. They all have defined actions, but they're really important for our cells, our organs to work properly. So the hormones we're talking about are only progesterone, estrogen, but I really talk about estradiol because that's the best form of estrogen and testosterone, to keep it really simple. But when I prescribe hormones or HRT, there's loads of different types. So there's the ones that I prescribe day in, day out, which are the same structure as estradiol, progesterone, testosterone, because they've all got their own chemical structure. So they are the body identical natural hormones.

• 13:26Speaker 01

  You're replacing like with like. But when HRT was first made, and that's where you've got that whole history of HRT in the book, it was made synthetically because one of the problems, which isn't really a problem, but when they made it more naturally, you could buy it over the counter. But the pharmaceutical companies wanted to clearly make money. They worked with gynecologists. And scientists and they made synthetic version. So they changed the chemical structure. Now, even if you don't know much about chemistry, most people know that water is H two O, two hydrogens with one oxygen atom. If you add one more oxygen and make H two O two, it's hydrogen peroxide, it's bleach. So just to highlight to you, a small change in a chemical structure can make a huge difference to properties.

• 14:11Speaker 01

  So they changed the chemical structure. So it's like estrogen, like progesterone. And even they made, they've made lots of synthetic testosterones. It's like testosterone, but it's not, doesn't work the same in the body. So you, you know, quite simply that putting something that's a chemical in your body is not going to have the same biological effects.

• 14:29Fearne Cotton?

  No.

• 14:29Speaker 01

  It's not going to bind to that receptor and unlock those lovely, beautiful cascades. You know, even Lizelle talking about mitochondrial function, right? I love mitochondria. We need, they're the powerhouse of all our, our cells. But we've got receptors for estrogen, progesterone, testosterone on our mitochondria, not for synthetic estrogen, not for synthetic progesterones, not for synthetic testosterone. So once you know that, that's really important because all the risks with HRT, including that big terrible study that came out in two thousand and two was using synthetic hormones. So you can almost discard it, other than the hormones they used are still similar to hormones in contraception.

• 15:10Speaker 01

  So it brings a whole new like complexity. And this is what I do tease out in my book as well. The whole history of contraception, because they're not hormones, they're synthetic.

• 15:19Fearne Cotton?

  And I took that without even thinking back in the day. I was like, I'll take whatever pill you've got, give it to me. I had, did no research. So it's weird that there's so much more focus on.

• 15:29Speaker 01

  Well, this is, this is what I find out. I wish I'd written this book 10 years ago, really, because 20 years ago, I was the same as you. I took the pill. I didn't actually know, no one taught me at medical school that it wasn't a hormone. It was only because I'm very scientific, evidence based. I've had a lot of blue sky thinking as a doctor because I've written, I've worked as a medical writer for so long and an educator. That I sort of sat down and just thought, what is the difference? That they're all called different. They can't be the same. And then once you. Understand them and you understand how they work differently in the body. It's suddenly this big wake up call and think, hang on, they're not hormones. We need to be really clear with our language. And women are being misguided, but so are doctors because the doctors that are scared of H R T.

• 16:13Speaker 01

  And merrily prescribing synthetic contraception for twelve year olds with acne.

• 16:18Fearne Cotton?

  Yeah.

• 16:18Speaker 01

  And I'm like, hang on, we don't know, we know that all synthetic hormones have a small risk of clot and heart attacks and stroke and cancers. We know that they probably get into the D N A. So whatever goes on might be transmitted to other generations. And we've known that with some other types of synthetic hormones. But no one's really looking at that. They're still trying to like stop women from having natural hormones, which improve symptoms, but also improve our future health.

• 16:46Fearne Cotton?

  Is there such a thing as a contraceptive pill that isn't synthetic?

• 16:49Speaker 01

  Wouldn't that be nice?

• 16:49Fearne Cotton?

  There isn't.

• 16:50Speaker 01

  So there is and there isn't. So there's one called Zoli, Z O E L Y, which contains estradiol, not ethanol estradiol. Now, we've known since nineteen seventy nine, the World Health Organisation put out a report to show that ethanol estradiol is carcinogenic, so causes cancer. But every combined oral contraceptive bar one contains ethanol estradiol. All of them contain a synthetic progesterone.

• 17:15Fearne Cotton?

  Right.

• 17:16Speaker 01

  But what's ironic is that when contraception came to market, it was just for periods. They didn't even test it properly as a contraception. Then they changed the marketing after a year because it was going so well and women weren't having periods. They thought, oh, it's probably fine for contraception. So sales like doubled, but they never did testing of the contraception on the bones, the brain, the heart and our other organs. So all the testing was done on the womb. A lot of it was done in the war actually as well in concentration camps. It's mind blowing when you read the history.

• 17:43Fearne Cotton?

  My god.

• 17:44Speaker 01

  Yeah.

• 17:45Fearne Cotton?

  I think because we were fed at a young age, the fear of getting pregnant as a teenager was so huge. You're like, I'll do anything.

• 17:52Speaker 01

  Anything precisely, yeah. And we were taught at medical school, you know, you have to worry about the risks of unwanted pregnancies and backstreet abortions and all of that. And and I'm not coming on to here to say that we can't use contraception. It's like, I sort of. Explain to people sometimes who don't understand like the difference between having roast chicken and chicken flavour crisps. Like chicken flavour crisps do not contain chicken, they might taste like chicken. Doesn't mean you can't eat crisps, but you just need to know they're probably not the healthiest thing to have.

• 18:22Fearne Cotton?

  Yeah.

• 18:22Speaker 01

  Do you see what I mean? And it's the same with, if, if it's the only option for you, then absolutely. But you've just got to know there are small risks associated with all these synthetic hormones. I mean, Zoli, like I say, the estradiol contains which is, which is better. Some people top up with other hormones as well. So someone might have a marina coiling, which is a synthetic hormone. And it can block the ovaries working, so it can lower estradiol, progesterone, testosterone. So then some people take those hormones as well.

• 18:52Fearne Cotton?

  Right.

• 18:52Speaker 01

  Which will improve their symptoms and future health too.

• 18:55Fearne Cotton?

  The, the thing that grates the most, I guess, is that all of this is on women and young girls, you know.

• 19:01Speaker 01

  I know.

• 19:01Fearne Cotton?

  Not only do we have no choice, if we're looking, yeah, first and foremost at the contraceptive pill. Okay, we've got no choice. We're like, I guess I'll take the synthetic one, but there's A, not much research seemingly into let's look at a natural alternative. But equally, nothing on the boy slash man.

• 19:19Speaker 01

  No, well, this is why contraception in men has never really taken off. Because if you say to a man, right, I'm going to give you a synthetic hormone that's like testosterone, but not. It will reduce your fertility, but it will probably block your hormone receptors in your brain. It might make you feel low and flat. It will increase your risk of clot and cancer and heart attacks. Quite rightly, they'll say no. And actually, to get a drug to market now is a lot harder. Perfect, because we've got, you know, more stringent rules, we have to do more studies. In the sixties, there was no ethical consent, they had no proper studies. And in fact, when you do read some of the studies, a lot of them, they disregarded some of the, the risks and the problems.

• 20:01Speaker 01

  Because they said that we can't prove it's a direct cause. So they had no real idea what they were doing. But these drugs were pushed by the pharmaceutical companies. Once it's got licensed, you don't have to do the same stringent studies. So I do wonder if the pill was being, or the contraception were brought to market now in 2026, would it get over the line?

• 20:24Speaker 01

  And I can't answer that question, but you know, it's just.

• 20:26Fearne Cotton?

  It's just also crazy. I mean, it's a minefield that I'm happy to dig into and like, let's, let's really dissect it and get into it. Because it's so, so important for women, I think, because so many women and young girls, even if they're, I wasn't cognizant of it as a young person, but we feel so out of control in terms of what our options are. I think that's why my head's been in the sand. So let's move on now to looking at, you know, women of my age, which will be a large portion of my audience will be women who will be perhaps thinking about this or women slightly younger thinking, oh, I should start to prepare for what that looks like down the line. When you go to your GP, thinking, yeah, I probably have got some symptoms here that are alluding to,

• 21:09Fearne Cotton?

  you know, hormonal changes in my body. Are you automatically offered the synthetic HRT initially? Is that how it works now?

• 21:16Speaker 01

  It really varies. It really varies. There's a, there's a big move to changing to the body identical hormones. 10 years ago, it was very much one size fits all and it was usually the synthetic hormones. So there, there is a choice and often people say the patches, the gel, if the patches are just the pure estradiol and it will stay on them. It's a bit like food. If you look at the ingredients, it will say if it says estradiol, that's fine. The tablets, micronized progesterone, usually you should just stand in the UK. And then sometimes we give it as pessaries or suppositories, the pure progesterone. Testosterone, the cream or gel is testosterone. It's not one of the synthetic hormones. But it's, it's important to know because it's not just perimenopause or menopause. So many women have PMS.

• 21:59Speaker 01

  95% probably of us have PMS. PMDD, premenstrual dysphoric disorder is a more severe form. Postnatal depression affects 85,000 women a year in the UK and it's all due to hormonal changes. And some women are more sensitive than others to these hormonal changes. And these hormones, as you know, are made in our brain. And I'm more concerned about the effect on our brains than anything else because mental health, we know is in a crisis. And we know that more women and children actually are prescribed antidepressants than they are.

• 22:33Speaker 01

  Hormones.

• 22:34Fearne Cotton?

  But they're misdiagnosed as having, you know, we had Calli Beaton on here, a comedian who's written a brilliant book about the changes in midlife. And one of the big fuckups for her was she went to the doctor and they said, you've got bipolar. And she was prescribed a ton of medication. And then she realised she was going through the menopause. And it hadn't even been on the doctor's radar to quiz her about that.

• 22:57Speaker 01

  I mean, I, you know, I'm doing my theatre tour at the moment, and I've called it breaking the cycle, the power of hormones, because people are locked in this cycle of mental health. Once you get diagnosed, usually with a mental health condition, that's it. You're on this trajectory with antidepressants, antipsychotics, lithium. I've seen people that have had ketamine infusions, eight thousand pound ketamine infusions, 45 year old woman, no one asked about her hormones. No one thought about her hormones. And this is really scary because we know, and we've known for decades, the importance of hormones in our brain to improve our mental health. And actually, 60 years ago, doctors were giving natural hormones for postnatal depression, postnatal psychosis, PMDD, natural progesterone. It's not rocket science.

• 23:41Fearne Cotton?

  No.

• 23:42Speaker 01

  And women improved. But, you know, we've got all these other chemicals that people have been given, whether it's synthetic hormones, or whether it's antidepressants, antipsychotics. And very few people are thinking about hormones. And it doesn't make sense.

• 23:58Fearne Cotton?

  Hello, this is Susie Ruffel.

• 24:00Speaker 04

  And Maisy Adams.

• 24:00Fearne Cotton?

  And together we host Big Kick Energy. Hey Mais, what is it?

• 24:03Speaker 04

  Only the best podcast ever.

• 24:05Fearne Cotton?

  Yeah.

• 24:06Speaker 04

  A comedy entertainment podcast with a focus on all things women's football, all things hilarious, all things friendship. It's a laugh is what it is, Ruffel.

• 24:16Fearne Cotton?

  Yeah, and a fair bit of gossiping, too.

• 24:17Speaker 04

  Oh, and a lovely bit of gossip. Chow down on the gossip.

• 24:20Fearne Cotton?

  Nom, nom, nom, nom, nom. You can listen wherever you get your podcasts. Just need to search Big Kick Energy.

• 24:25Speaker 04

  Grab a knife and fork and tuck in, baby.

• 24:31Fearne Cotton?

  So if we, like me, know very little about hormones, what are our hormones impacting physically, mentally? What are they doing?

• 24:41Speaker 01

  So they affect every cell in our body. So that means every organ. So you could literally list, you know, going from your head down, literally, obviously so many functions in the brain. So that's why memory problems, anxiety, low mood, poor concentration, sleep problems related to hormones changing in the brain. Eyes, dry eyes, mouth, burning mouth, sore mouth, teeth changes, even smell changes, you know, just going down the body. Palpitations, very common. Breathing changes can occur. Asthma increases without hormones, for example. Coughing, obstructive sleep apnea, where people have difficulty breathing at night. Muscle and joint pains, really, really common. Also gastrointestinal symptoms.

• 25:26Speaker 01

  A lot of people in their 40s get diagnosed with irritable bowel syndrome. A lot of that's related to our hormones.

• 25:32Fearne Cotton?

  Wow.

• 25:33Speaker 01

  Our hormones affect our gut microbiome in a positive way. So if we don't have them, bloating, heartburn, indigestion, very common symptoms, constipation, all of that can occur.

• 25:43Fearne Cotton?

  It's basically...

• 25:44Speaker 01

  It's everything.

• 25:45Fearne Cotton?

  Everything.

• 25:46Speaker 01

  Everything. E urinary symptoms, really common, UTIs, incontinence, you know, weak bladder. All of that can be related to hormones as well. Restless legs. I mean, we've got a symptom questionnaire that we use for all our patients, but it's also in Balance the APP. And it's got over 80 symptoms because I extended it. Well, you did use one that had 21 symptoms, but I extended it a year or so ago because I find it really useful as a doctor. So I can eyeball all those symptoms. But also patients do, and women, because they look and go, I didn't realise, I didn't realise my hair changes, my skin changes. All of this could be related. And that's really important because often, you know, when you ask women, they're quite intuitive.

• 26:25Fearne Cotton?

  Oh, yeah.

• 26:25Speaker 01

  And if the symptoms are similar to maybe how they've had those days before their periods, they're more likely to be tuned in and go, do you know what? I think there's some hormonal change.

• 26:34Fearne Cotton?

  Yeah.

• 26:35Speaker 01

  And it's just the suffering. You know, so many women are having these symptoms. Just putting up with them. Even PMS, for example, you know, my daughter has, my oldest daughter has PMDD and she's had a really difficult time and thankfully she's so much better because she takes natural hormones. But she's had some very, very dark times. And she said to me, but I mean, it's just not those three days that I feel awful. The rest of the month, I'm dreading those days coming.

• 27:00Fearne Cotton?

  Yes.

• 27:01Speaker 01

  She's a trombonist. So she said, what happens if I'm doing an audition or I'm, you know, I'm playing in a concert? Like, I can't function. She said, but the rest of the days when I'm feeling great, I just think surely I can't feel this bad. It must be, you know, it can't be because it's so black and white. And then it comes and I'm just like in this hole. And, and I see that so much with my patients and I see a lot of her friends as patients now. And a lot of them are great, really clever musicians, are quite neurodivergent, a lot going on. A lot of them have had some very difficult upbringings. So they've always been blamed for their trauma, their past or whatever. But I give them often just some natural progesterone for a few days when their mood dips of the cycle.

• 27:42Speaker 01

  And one of them said to me the other day, Louise, I'd just like to thank you because you've transformed my life. And are you sure it's legal to feel this good every day of the month? And it really made me think though, Fern, because yes, we should feel good every day of the month. Like, can you imagine saying to a man, like, once a month, you're gonna have a duvet day. You probably feel a bit shit. You won't want to go to work.

• 28:00Fearne Cotton?

  Not only that, you're gonna be paranoid that you're gonna be, I'm constantly like, can I wear that outfit at that time of the month? Because I'm gonna be checking the whole time, the paranoia, the worry, can I get to a loo quickly if I'm out in public?

• 28:14Speaker 01

  And then there's all this about, oh, you should change your exercise. So there's a few days before a month when your hormones are low, you could just like not do so much cardio and you should rest. And it's like, hang on, stop it. If we're getting any symptoms, the first thing as women we should do is think, right, could it be my hormones? And could topping up my hormones in a very natural way help? Because evolutionary, we have to remember, we are designed to have hormones in our body. And, you know, in the Victorian times, we were pregnant more than we weren't, you know, lots of pregnancies, really high levels of hormones actually in our body. But the average age of menopause was about fifty seven. Age of death was fifty nine. But we have to be thinking, actually, these hormones are really beneficial for our day to day functioning,

• 28:57Speaker 01

  but our future health. So women who don't take hormones have a higher risk of inflammatory diseases, heart disease, osteoporosis, diabetes, dementia, autoimmune diseases, multiple sclerosis, all those diseases of the increases we age but increase without hormones. And studies have even shown women with PMDD because they have half of their cycle or a weaker cycle. So, you know, a good chunk of their time without hormones, they have an increased risk of future diseases. So we have to sort of spin it on its head a bit and think, what are the risks of me not having hormones? Rather than what are the risks? Because taking natural body identical hormones, how do they have risks when they're our own hormones?

• 29:36Fearne Cotton?

  So is there any risk of, say, the big one that we keep getting fed in the press, breast cancer? Is there any risk of that with the body identical?

• 29:43Speaker 01

  So when we look at the study, that scary study.

• 29:46Fearne Cotton?

  Yeah.

• 29:46Speaker 01

  There were two groups of people. There were people that they only gave estrogen to, and that was the pregnant horse's urine. So it was a bit different to what we prescribe now, but it had estrogen in it.

• 29:55Fearne Cotton?

  Yeah.

• 29:55Speaker 01

  But there was also the people that had estrogen with a synthetic progestin called midoxiprogesterone acetate, which is still used in contraception now. But the risk of breast cancer was small, wasn't statistically significant, was only in the arm of the study that had the synthetic progestin.

• 30:12Fearne Cotton?

  Right.

• 30:13Speaker 01

  The ones who had estrogen had about a forty four percent lower incidence of breast cancer. So there's no evidence anywhere in the studies that estrogen causes breast cancer, which is really important for people to know.

• 30:25Fearne Cotton?

  So if you were to go to the doctor and they, and they took the symptoms seriously, and they said, right, we're going to prescribe you HRT, but it was the synthetic version. Do you have the autonomy at your local GP to say, I want body identical?

• 30:39Speaker 01

  Yeah. Firstly, but body identical is actually, depends on, on the region, but it's similar price or slightly cheaper than the synthetic. So they can't use cost as a thing. The guidelines that I think are the most important are shared decision making guidelines, which is for any condition. So if I'm your doctor and you come to me and say, I really don't want to take. Iron and I've got low iron and I'll say to you, well, Fern, you've got the risk that you're going to be more tired and, you know, you've you've got this low iron and unless you eat differently or take an on sup, it's going to carry on. You might say, well, that's fine. I want to carry on like that. You are allowed to be involved in that consultation and share the decision, even if your decision isn't what I would recommend as a doctor.

• 31:19Speaker 01

  So this is what's really important that people know. And it's really, that's why it's so sad that people do go to their doctors and say, I would really like to try hormones. I would like to try testosterone and then met with this no. I met somebody at the theatre tour a couple of days ago. She said to me, she felt so prepared for her consultation. She printed off some information from Balance App. She had the questionnaire. She went to her doctor. And her doctor said, this information is wrong. And Dr Louise Newsom, you don't trust, stood up and marched her out of the consultation room. So she was crying and said, I've just given up now. I'm sixty two. There's no point me even trying to go back to another doctor. She's got, she might have twenty, thirty years of her life without hormones,

• 32:01Speaker 01

  putting her life at risk. And she wanted to try them. You know, this is where I just, in my head, I get so sad because these stories are all the time.

• 32:10Fearne Cotton?

  And you, you know, not only are you trying to get this information out there and debunk, you know, myths that are putting women off getting the help that they need. You genuinely wanna help women, wanna stop the suffering of women in general. You personally have had a lot of backlash and had to, and I can't even imagine how that's felt. When you're passionate about something and you've spent your, your life's work is studying this. To be constantly pushing against that must be personally exhausting.

• 32:40Speaker 01

  It's horrible. I mean, you know, you've got children. It's, it's not just me. It has had a big impact on my whole family, you know, they, as a mum, you're the strong person. You get all the, everything together. For them to see me broken last year is really hard, like really difficult. But, you know, I've got three daughters and they won't let me start working. They're like, you get back out there because every day, you're helping these women, these women who have suicidal thoughts. You know, one in six of our patients have suicidal thoughts. You know, if I funded a PhD student in suicide. Prevention and we've got some amazing results. And you know, a lot of people, they can't, they've got nowhere else to go to. But last year I I was close to having to close my clinic because of the the financial impact that Panorama did to me.

• 33:22Speaker 01

  And it's like, if that goes, Balance App goes, my podcast goes, everything goes. But also, you know, I went into medicine to do the best and I've not done anything wrong. There are loads of doctors out there that have done things wrong and, you know, they should be sanctioned, but often they get off. So I feel like so strongly because I'm very fortunate. I'm on hormones and I know who to go to, you'll be pleased to know, to get good advice. But, you know, when I was doing some voluntary work in prisons, these women have no voice and no one's prescribing them hormones. You know, I said to the prison doctor, do you ever prescribe testosterone in the prison? They were like, no, why would we do that? Women don't need a libido in prison.

• 34:05Speaker 01

  I said, but they might be in a same sex relationship, but you don't always need a man and a penis to have a libido. I mean, the colour just drained from her face and then obviously they reported me for even going into the prisons and educating women. And this is where I feel like sad because I'm not here saying you have to take hormones, but you have to know. You have to know the benefits, you have to know the risks of not having them and it's about choice. And my role is really as an educator. Really, you know, people come to my clinic because they've decided they want hormones and they want the right dose and type for them. But my work is so much bigger than the clinic. It is just allowing people to have this knowledge that has sort of been hidden from us for so long.

• 34:46Speaker 01

  And I've spent a lot of time, you know, thinking and reflecting and I'm very evidence based. You know, I think it's about thirty pages of references in my book because I'm very clear that I am telling a story. I'm, people keep calling me controversial and I'm like, well, I'm not inventing a new drug.

• 35:02Fearne Cotton?

  Why do you think that is just because you're wanting to bust the myths?

• 35:04Speaker 01

  Yeah, I think so. I think sometimes the truth hurts and it's uncomfortable and I'm very. Well, I didn't say I'm happy because I'm not happy, but I wouldn't say, like, I don't mind admitting to you, Fern, that I was that doctor that used to give contraception for heavy periods. I was the doctor that used to give forty five year old women antidepressants because I didn't know about the effect of hormones. I was that doctor who, you know, gave biologic agents to people with rheumatological problems because I didn't know there was a option. I didn't ask the right questions. And I've done a lot of hospital medicine and I look back and I think, all those women I saw, all those women that we were admitting with all these different conditions, and I never thought about it.

• 35:46Speaker 01

  But, you know, it's like anything in life, you learn and then you say, okay, I'm going to change my practice. But it's this resistance for others to learn that is harming women and that's really sad.

• 35:59Fearne Cotton?

  And is that what, is that why you've been occasionally called controversial or you've had shit thrown your way? Because you want to do things differently and the medical world is a bit stuck in time?

• 36:08Speaker 01

  I think there's, there's, and I've written about it in the book. I mean, medicine is very patriarchal. My husband's a surgeon and obviously, you know, I courtesy to him every morning. I don't, but you know, um.

• 36:20Fearne Cotton?

  Mutual respect from both of you.

• 36:21Speaker 01

  But there is this thing that in, in medicine, there's the surgeons and there's the physicians and then there's the GPs really at the bottom, which I really challenged because, you know, I was doing hospital medicine. I only went into general practice so I could see my children and go part time and, and help, you know, bring them up really. Um, but I've, I've always worked as a medical writer. I've written books on evidence based medicine. I've, I've got pathology degrees, science degrees. So, you know, I, I am clever, but I'm very inquisitive. I like to know, like, but why, but why, you know, I'm one of those people. But in medicine, you often learn from your peers. So you learn from your senior doctor and if they tell you something and it's in a guideline, then, then you do it. We're quite robotic. But because I've written and summarized guidelines for the Royal College of GPs, I worked for them for twenty years.

• 37:07Speaker 01

  Um, I'm used to like looking at the guidelines, looking at all the references that have been used, the studies, looking at who's written them, what conflicts they might have, which pharma involvement they've had, for example, and then summarizing them properly for people. Lots of people don't have the luxury of that time. And I think what's happened is in the past. Menopause hormones has sort of been owned by gynecologists, if you like. I'm not a gynecologist. So some gynecologists have got quite rattled, and I know that because I've had a subject access request, I've got 350 pages of emails that they've written about me. And really frustrated that I'm doing work in unconventional ways as well, because women

• 37:48Speaker 01

  in the past, like Katrina Dalton, who prescribed a lot of progesterone for women with PMDD and postnatal depression, was really slated as well because she was only a GP and she could reach her patients. But you know what it's like with the podcast, with social media, you can reach people that you're never going to make money from, you're never going to know, but you're empowering them. And that's what I think a lot of them haven't liked, the way that I've gone about things. But also, and they have told me because inverted commas, I'm only a GP. And I find that really, really frustrating. And it's sad because it's other colleagues, like we've all got plenty of work to do. And patients can choose, we can agree to disagree, but not do it to the extent that

• 38:33Speaker 01

  you make a panorama documentary about me and try and ruin me professionally and personally.

• 38:38Fearne Cotton?

  Yeah, I mean, horrific for you, horrific. But also, like you say, for all the women that you desperately want to help. And you say in the book, you don't want menopause, premenopause to just be seen as a gynecological issue, because as you stated a moment ago, it's affecting literally every part of us physically and mentally. And maybe we're, we're being reductive in terms of this conversation and going, it's just this, the reproductive part of women's bodies and, and that's it. Whereas we know it's not that.

• 39:07Speaker 01

  It's just, but it's just stupid, isn't it really, to think that women are just their periods of fertility. It doesn't make any sense to me. And even the testosterone conversation, you know, some people, you just look in the media and all these experts are saying, we're so scared, there's over prescribing of testosterone, it's getting out of control. Somebody, a doctor even wrote that it was abusive, the amounts of women who are being prescribed testosterone in private clinics. She didn't kindly mention my name, but I'm sure that's where she was pointing her finger at. The stats, it's about zero point eight two percent, so less than one percent of women are being prescribed testosterone. That isn't out of control. What is out of control are all the drugs that people are being prescribed instead of testosterone.

• 39:50Speaker 01

  And we've published some data that women who are on testosterone, as well as progesterone and estradiol, we can reduce their antidepressants, their antipsychotics, their painkillers, their gabapentin, their pregabalin. You know, those drugs, I would lose sleep about prescribing for my patients. I don't lose sleep about prescribing natural hormones to to patients who feel better.

• 40:11Fearne Cotton?

  You say that testosterone is the most misunderstood hormone. Why is that?

• 40:15Speaker 01

  Well, look at the name, test it. It's come from the testicles. We don't have testicles. So that's really confusing.

• 40:21Fearne Cotton?

  Yeah.

• 40:22Speaker 01

  And then what happened is, as you know, the the history of it, once they discovered testosterone, they made synthetic testosterones, went to market, and then athletes got hold of it. So then they were pumping themselves with synthetic testosterone. So then there's this weird body shape. They know it's associated with heart disease, other problems. And so that's why it's a banned substance, even in sport. Women are not allowed any form of testosterone, which is crazy. But we prescribe the same chemical structure as our own testosterone. And testosterone is made in our ovaries, our adrenal glands, but also in our brains as well. And so it's the most biologically active hormone we have. Testosterone starts to decline in our late twenties, early thirties. So it's not a menopause related hormone.

• 41:06Fearne Cotton?

  Wow.

• 41:06Speaker 01

  It's it's.

• 41:07Fearne Cotton?

  And is that for men and women?

• 41:08Speaker 01

  That it starts to decline? Probably later, usually in the forties and fifties. Yeah, but it's a problem for men too. And and men struggle to get testosterone, but women especially. And then when you look at the guidelines, they say it's if women have reduced sexual desire. And then some menopause societies say women have to have this ridiculous disorder called hypoactive sexual desire disorder, which is H S D D for short. If you look at one of the criteria, it says that women have to be severely psychologically distressed with their reduced libido for at least six months.

• 41:39Fearne Cotton?

  Wow.

• 41:40Speaker 01

  So like, can you imagine?

• 41:41Fearne Cotton?

  That's a lovely amount of suffering.

• 41:42Speaker 01

  Yeah, of course. So if you've been suffering for five and a half months, I'd have to say no sorry for and come back in two. Like it's just, sorry, it's just bullshit. It's just ridiculous. But also, why does someone think that libido is just like, the testosterone is just a tiny bit of our libido part of our brain, when it affects every cell in our body? And we've known since the 1940s that testosterone helps with wellbeing, it helps with mood. They used to give it to people with period problems as a menopause treatment in the 40s. That's like 80 years ago.

• 42:13Fearne Cotton?

  So we've gone backwards with that one.

• 42:14Speaker 01

  We've completely gone backwards. Yeah.

• 42:16Fearne Cotton?

  Going back to something you said a moment ago, something just sparked in my head. If you are a woman who has an inkling that, you know, your hormones are changing, but you are on anti-anxiety medication, antidepressants, et cetera. Can you take hormones in the same way?

• 42:33Speaker 01

  Yeah, there's, there's nothing that will interfere with natural hormones because that's what they are. If you saw what I mean. Lots of people were told, someone contacted the clinic the other day and said, oh, I've had a meningioma. I've been told I can never have hormones. So meningioma is a benign brain tumor. It's like, well, of course you can. You know, there's very few conditions that you absolutely can't have natural hormones because that's what they are. The synthetic hormones, very different.

• 42:56Fearne Cotton?

  Okay. So that's a really good thing to clear up. Cause I think, again, some people are completely put off because someone has once said it to them and they're like.

• 43:02Speaker 01

  Yeah, absolutely. Lots of people are told if they've got a family history of any cancer, they can't take hormones. Someone last night, cause I do a live Q and A in the show as well, said that one of their family members had had a clot. They're worried about the clot risk. There's no clot risk in progesterone, estradiol or testosterone. So just because you've been told something, the chances are it's not right.

• 43:26Speaker 02

  Hello, I'm Joanna Fletcher.

• 43:28Speaker 03

  And I'm Marco Burchella.

• 43:29Speaker 02

  And this is Boots Off.

• 43:33Speaker 03

  We are friends who've spent a decade together, walking up mountains, across deserts and along coastlines with some seriously awesome groups of humans.

• 43:41Speaker 02

  And something happens when you're out there, feet on the ground, surrounded by nature. The conversations just spill out of you.

• 43:47Speaker 03

  This series is about the adversities that lead to adventure.

• 43:50Speaker 02

  The adventures that lead to adversity.

• 43:52Speaker 03

  And how life can be one big adventure in itself.

• 43:56Speaker 02

  Listen every Thursday. Just search for Boots Off.

• 44:03Fearne Cotton?

  There's also a terrifying fact in your book. You say that the suicide rates for women are the highest since 1994 in the age bracket forty to fifty nine, which as we know is quite clearly the hormonal change, perimenopause, menopause era of a woman's life. But there is little, if any, correlation to hormones when we look at how the medical world are viewing those really scary, very real suicide rates.

• 44:29Speaker 01

  Yeah.

• 44:30Fearne Cotton?

  How do you feel about that?

• 44:31Speaker 01

  Oh, it's terrible. It's one of the reasons that I work as hard as I do because I worry, I really worry about suicides, mental health. We know that about eighty four percent of women with PMDD have suicidal thoughts. I mean, that's huge. But like you say, suicide rate has increased in these women. And of course, there's lots of reasons why people might want to harm and end their lives. But we can't keep ignoring the role of hormones because we've known for many, many years that hormones can improve mental health, reduce suicidal thoughts. You know, we've just published data to show that ninety two percent of women with suicidal thoughts reduce their suicidal thoughts when they prescribe progesterone, esterol and testosterone. Ninety two percent reduction.

• 45:16Speaker 01

  I've already said one in six of our patients come to our clinic with suicidal thoughts. Like, why wasn't that in the front page of the papers? I don't know, and I might be wrong, but I'm sure your listeners will tell me. I don't know of any psychiatric drug that will reduce suicidality by ninety two percent that doesn't have long term effects. And, you know, I wrote a training module for the Royal College of GPs a few years ago. And it took me a few years to get it over the line because they kept pushing back on the data and saying, we don't have enough evidence. I said, you do, there's this, there's this, there's this. Anyway, got it, got it over the line. I actually paid my money, so it was free access for psychiatrists. And I got a prize because it was the most downloaded course. Lots of psychiatrists learnt for the first time about the role of hormones in the brain.

• 46:01Speaker 01

  Some of them started prescribing hormones to see, seeing the transformational effects. And then a few weeks ago, someone from the British Menopause Society contacted them to say that I over exaggerated the effects of hormones and they've taken the course down.

• 46:14Fearne Cotton?

  What?

• 46:14Speaker 01

  Um, and I've given them all evidence now because we've published since, you know, the course came out and they, they said it's under review at the minute. And I, I told them that I would, if you don't tell me what's going on, I'll tell people in the theatre tour. So I, I have done because I'm really sad and they said, you know, I know they've had complaints from psychiatrists about it. And it, it's just, it's harming women. Like, I'm not saying that all mental health can be cured by hormones. I'm not saying all suicides can be reduced by hormones, but I am saying, and I've seen it time and time again, you know, I've saved lives from women who are on hormones and they've tried everything else, you know. I'm, I'm in the theatre tour, I'm going with a, with a guy Jay who's 26 and his mother

• 46:57Speaker 01

  had 30 years of being in a psychiatric hospital. She had, her first mood change was after a termination of pregnancy. She had postnatal psychosis three times, she had PMDD. Her mood worsened when she tried contraception. Then she was perimenopause and he just reached out to me on Instagram 18 months ago. And I managed to persuade the psychiatrist to prescribe for her. Now I've prescribed for her, the, the GP won't have anything to do with her, doesn't, won't prescribe hormones, yet they'll prescribe the lithium, the quetiapine, the antidepressants for her. She's had electroconvulsive therapy over the years. Nothing has transformed her life like hormones. It's, it's there in black, you know what I mean? It's, but I've seen it so often and, and like I said, I didn't know it when I did psychiatry

• 47:41Speaker 01

  training, I didn't know it as a GP. But you learn, you know, I've learned from scientific evidence, which is there when you look for it and basic physiology. That's why in the book, it was so important to write about the basics of how hormones work, so others can work it out for themselves. But then I've got a wealth of clinical experience, you know, we see so many women in our clinic and we're constantly, you know, writing up our data, sharing it with other people. And we just have to, we have to join the dots because the suffering is palpable, not just in the UK, but globally.

• 48:12Fearne Cotton?

  Well, of course, if, um. Women out there feel like there's something up and they've done nothing about it. Me.

• 48:20Speaker 01

  Yeah.

• 48:21Fearne Cotton?

  What would your one bit of advice be?

• 48:23Speaker 01

  I would say download balance, get information that's right for you, ignore the noise. It's like having children, everyone will tell you things, you've got to do what's right for you. And you've got to make sure that the decision is right for you. And no decision is irreversible as well. So, but I would also seek out someone who really understands hormones, have a really good conversation about it, but also try and have that mind shift about, is it right for not just me, but my family, my friends, my colleagues? If I keep ignoring it and not having hormones? And often I say to people who, a bit like you going, not really sure. I'll often say, look, I'll rebalance your hormones in a physiological way. You've got to wait three to six months for them to have an effect and then decide.

• 49:07Speaker 01

  If you don't want to carry on, I'm not coming around to your house and putting them on for you every day. Like then you stop, but then you can decide and it's really hard because also when you don't have hormones, your brain doesn't function properly. So you often overthink and catastrophize and think about things that really you shouldn't worry about.

• 49:25Fearne Cotton?

  Yeah, that's me.

• 49:26Speaker 01

  Yeah, there you go.

• 49:27Fearne Cotton?

  That's me. Now, obviously, many people out there will be in a heterosexual partnership and their partner will not have a fucking clue about any of this, will have checked out. This conversation weirdly seems to actually determine completely. Or they just think, oh God, time of the month, hormones, like all the usual stuff that we're fed. But if you're in a loving partnership, of course, you know, it's a two way street. You want to support each other. If one person's struggling, the man or the woman, then you want to be there for each other. So I believe that men should be fully integrated into this conversation.

• 50:01Speaker 01

  Absolutely.

• 50:01Fearne Cotton?

  What one thing do you think all men out there should understand about perimenopause, menopause?

• 50:08Speaker 01

  They should probably listen to my podcast with Jo Warner, because that's a man talking about, you know, from a man's experience. They should know that hormones affect women, but we can do something about it. So I really feel that that men, partners, whether it's heterosexual or same sex relationship, they should be an advocate for that person because, you know, when you're with yourself 24/7, it's really hard. You can always sort of make excuses for how you're feeling. But if you notice that your partner's changing mentally, physically, it doesn't matter. You should, rather than just normalizing it, say, look, I'm going to read this book. I'm going to listen to podcasts. I'm going to work out. Let's try and work together.

• 50:49Speaker 01

  And let's go to and find a doctor who can, you know, give you or talk to you about having treatment. So you'll feel better. And so many partners come to consultations with us and it's really important. That's so lovely. It's so lovely. It's really lovely because, you know, they, they really care. It's not just because they want to have sex again. They really care. Yeah. You know, divorce rates increases. It's, it's quite awful, but we need to. And I, you know, I only suffered symptoms about six months and my lovely husband really didn't join the dots at all. And I didn't because I thought I'm just working too hard. I'm just like, I've got three children. I can't cope with my work. The people at work weren't very nice to me and I, everything was just, and it was really, it was actually my,

• 51:32Speaker 01

  my daughter, who's now 21, she was about 12 and she just said to me one day, Mama, you are so cross and irritable. I just wish you'd have your period and your mood might improve. And then I suddenly went, oh, Sophie, I haven't had a period for about six months. That's why I've got all these symptoms. But it took her and she, obviously my children are very well educated about hormones now, but then she didn't know. She was just using common sense. Yep. Because she knew her friends, their mood improved and they got their periods. So we can't be normalizing it. And that's what I feel really sad. So many people are like, let me hold your hand and talk to you while you're having these symptoms. And people also think it's some transition that we go through. And all these people on Instagram saying, you know, it's a phase of our lives. It's not a phase in our lives. The low hormones last forever.

• 52:16Speaker 01

  And we have to wake up to the fact as women, we're less healthy the last 10 years of our life. So at the age of sixty, most women are on six, seven medications. They're on antidepressants, blood pressure treatments, statins, painkillers. You know, like, why? Whereas if they're on natural body identical hormones, they won't be needing all these medications. So we're sort of investing in our future health as well with hormones.

• 52:40Fearne Cotton?

  And also, all of those other medications you've just mentioned, we hear far less about the side effects of those. I mean, some of those, and I've been on antidepressants, I couldn't tell you what the side effects are. I didn't look into it. I just was desperate and was like, I'll take them. Whereas with this one, you could live under a rock and still have heard the breast cancer, the cancer.

• 52:59Speaker 01

  Well, this is the thing. So, you know, antidepressants have a risk of early death, dementia, osteoporosis.

• 53:05Fearne Cotton?

  Yeah, I didn't know that.

• 53:06Speaker 01

  So who tells people that? No one, because they're just pushed out like smarties. I read the other day that one in seven children in the US are taking antidepressants. Like, it's awful. Yet, you just mentioned the word HRT and everyone goes.

• 53:20Fearne Cotton?

  Everyone knows.

• 53:21Speaker 01

  Cancer, cancer, contraception. Like, you know, it's, that's where I feel like it's a double standard, really. But we, no one really talks about the benefits. And in fact, it was amazing, because I'm sure you know, the FDA in the US did this big announcement last year that they were removing the black box warning of estrogen. So you've got Dr. Martin Makary, who's the FDA Health Commissioner, who says that he estimates fifty million women have been harmed by not having hormones. Like, that's a big thing for the government to state that. So that's probably an underestimation. And that, he was saying they have been harmed, they want to change it. But it's still every day, because you've already said for fifteen

• 54:02Speaker 01

  percent of women. And that's fifteen percent of, on average, in areas of deprivation, it's as low as two percent of women who have hormonal changes are taking hormones. So the harm of not having those hormones is happening every single day.

• 54:17Fearne Cotton?

  I feel like I need to go on holiday to process everything that you've just told me in the best possible way. Because this is a conversation that. I've wanted to have for so long, you know, since probably since I hit forty where I was like, oh yeah, things are, things are changing. I'm noticing things. I've just been like head in the sand, head in the sand. So I am so grateful for your time for reading the book. I mean, we've literally skimmed the surface of a very big conversation. So I would urge everybody just to read the book, listen to your podcast, do the research if they want to get more information on this, to make the right decisions. So we can all feel as empowered as possible to walk down a path that feels right for us, rather than be so bombarded that we bury our heads in the sand, pretend it's not happening,

• 54:58Fearne Cotton?

  or deny ourselves of, of help that, that is available. Um, before we wrap things up, I want to first of all, ask you a bit of a careful question that's not related to menopause at all, but we're making a playlist at Happy Place of songs that make us feel great. And I wonder if there's one song that make, puts pep in your step.

• 55:18Speaker 01

  Yeah, well, I've been doing a bit of a warm up song, like for the theatre tour, just because I don't want my voice to go. I've got so many tours left to do, shows left to do. So I really like My Life by Billy Joel.

• 55:29Fearne Cotton?

  Oh, I love that song.

• 55:30Speaker 01

  Yeah, because it's a bit of a F you to other people, like just leave me alone. It's my life. And I, my children sort of chose it for me last year when I was having some dark times because of the stuff that's going on. And I just, it makes you just feel good, actually, and a bit stronger, which I think is, is great.

• 55:46Fearne Cotton?

  We all need that. I love that. And where Louise is your happy place?

• 55:50Speaker 01

  Oh, on my yoga mat. Yeah, I, I do yoga most mornings and, and I, I have a, I do Ashtanga yoga and my teacher's now seventy, James Critchlow, he's amazing. I've known him for twenty three years. And so my yoga mat, if I'm allowed to, with James, because his voice, he's just so calm. And it's just like, I mean, you do yoga, don't you?

• 56:10Fearne Cotton?

  I do, but I've never done Ashtanga. I've never, I've never tried it even. What's the difference?

• 56:15Speaker 01

  Well, it, it's the whole primary series is, it's just, it's a whole, every breath is a movement. It's a lovely flow. It's really lovely. It takes about an hour, fifteen minutes to do properly. So, but I, I do it with him every week. It's a bit difficult with the tour, but that's really powerful. And I just love doing headstands. It's like.

• 56:33Fearne Cotton?

  I love a headstand.

• 56:34Speaker 01

  I just love it. And it's one of, I think I also do it because I know like a lot of these people that really hate me can't do them. And I'm like, it's just a bit of a power thing as well. But I do, I do like it. I do. And I sort of think if I don't keep doing them most mornings, one day I'm not going to be able to. And I'll feel, I want to be like a 70 year old woman doing headstands.

• 56:53Fearne Cotton?

  Me too. I want to be able to do the splits forever. I also think turning yourself upside down once a day is a really good thing. I do handstands up against the kitchen cupboards every day. And there's something about it that is just like, I needed to do that. I don't even know why.

• 57:05Speaker 01

  No, it's great. I love all that blood going to your brain. It's brilliant.

• 57:07Fearne Cotton?

  It's so good. Well, Dr Louise, what an absolute pleasure to have you on. It's been a chat that I really needed to have. So thank you so much.

• 57:15Speaker 01

  Thanks for inviting me.

• 57:18Fearne Cotton?

  Oh God, thank you Louise. My main emotion coming off the back of that is relief. Because as I said at the start, that is a chat that I've been putting off having for a very long time. I am 45 this year in a few months' time. So this is very much a conversation that I need to be having. And these are subjects that I fundamentally want to understand better. So that I can make informed decisions about what I want to do next. As Louise said, she's not sat here saying everybody should take hormones. But what we should be doing is looking out for symptoms that are causing us great distress, or even just like mild annoyance, and do something about it. Louise's new book, The Power of Hormones, is out on the 21st of May. Now Louise mentioned in the conversation that I'd had a chat with the brilliant Liz

• 58:03Fearne Cotton?

  Earl last month. If you haven't already listened to that one, that is probably a good one to go and listen to next if you want to get deeper into this kind of sort of healthy aging conversation. A massive thanks again to Louise and to you gorgeous lot. You are brilliant.

• 58:41Fearne Cotton?

  Happy Place is researched by me, Fern Cotton. The producer is Anushka Tate at Happy Place Studios, with studio engineering by Basil Oxtavie.

• 58:52Speaker 05

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• 59:22Speaker 06

  Hello, this is Susie Ruffel.

• 59:23Speaker 04

  And Maisie Adam.

• 59:24Speaker 06

  And together we host Big Kick Energy. Hey Mais, what is it?

• 59:27Speaker 04

  Only the best podcast ever.

• 59:29Speaker 06

  Yeah.

• 59:29Speaker 04

  A comedy entertainment podcast with a focus on all things women's football, all things hilarious, all things friendship. It's a laugh is what it is, Ruffel.

• 59:39Speaker 06

  Yeah, and a fair bit of gossiping, too.

• 59:41Speaker 04

  Oh, and a lovely bit of gossip. Chow down on the gossip.

• 59:43Speaker 06

  Nom, nom, nom, nom, nom. You can listen wherever you get your podcasts. You just need to search Big Kick Energy.

• 59:49Speaker 04

  Grab a knife and fork and tuck in, baby.