Introducing The Definitive Guide to the Perimenopause and the Menopause
In this episode, Dr Louise is joined by Kat Keogh to talk about Dr Louise’s new book, The Definitive Guide to the Perimenopause and Menopause.
Packed with advice and information from leading experts, it is the definitive, accessible and evidence-based guide to help you navigate your perimenopause and menopause.
It covers key facts about hormones, family histories, the complete guide to HRT, libidos, mental and physical health, how menopause affects careers and relationships and so much more.
Kat, who works at Newson Health, shares her top three reasons to buy The Definitive Guide to the Perimenopause and Menopause:
- It gives clear, practical advice on talking about the menopause with your children.
- If you’re starting, at any age, to feel like your hormones are off balance, buy this book to find out everything you need to know about the role of hormones in your health and how to manage that.
- If you’re struggling and alone with the perimenopause or menopause, turn to this book for reassurance, support, knowledge and to be empowered.
Dr Louise Newson [00:00:09] Hello, I’m Dr. Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health menopause and wellbeing centre here in Stratford-upon-Avon. I’m also the founder of the menopause charity and the menopause support app called Balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause.
Today on the podcast, I’ve got with me a guest who’s also been with me before. I’ve got a few guests now that I’ve interviewed more than once. This person is very important to me. She’s very special and I couldn’t actually have done what I was going to talk about without her. So her name’s Kat Keogh, and I’ve known her for a few years now. So welcome Kat back to the studio.
Kat Keogh: [00:01:09] Thank you Louise. It’s very nice to feel special and be back again. Thank you.
Dr Newson: [00:01:12] So we first met about five years ago. Four and a half, five years ago now. I just found the building that I was going to start my clinic in, the clinic that I was only going to have four doctors working in. That was my business plan. And obviously now we have over 120 doctors and nurses and pharmacists and a physicians associate who work with me. Not just in the clinic, it’s not that big a building, but around the country, as you know. And we went to a little cafe across the road from the clinic because the clinic was a building site, there were only carboard boxes to sit on. And we sat down and then I said, oh, I’ve got this idea of writing a book, and I’ve heard that you might be able to help me. And how much do you know about the menopause and perimenopause to which you said…
Kat Keogh: [00:01:58] Nothing. I think at the time I was, so I’m just so you know, I’m a health journalist by background. And at that point, I think I had a very small baby. I was on maternity leave with my youngest. And yeah, you know, full disclosure, I had an inkling about the menopause just from general knowledge. I hadn’t ever actually heard of the perimenopause until I heard you mention it. And I had to sort of style it out but I think I was quite honest about that. I guess there were things I don’t know, but there are things that I can learn. And yes, yes, I definitely have over the last five years.
Dr Newson: [00:02:36] Yeah. So I, as many of you might know, I wrote the first book on the menopause. When I say the first book on the menopause is because I had written a few books before, but they’re more academic books. So this was the first one I wanted, and I went to Haynes, the publisher, a year before we met actually, and they said, no, we don’t want a menopause book. We’re all men. Why would we talk about the menopause? And then it became one of their bestsellers. So we worked together on it really hard and were really pleased. And then we worked together again on the Penguin book, which they approached me, actually. It was just a small book, really. It was a short book. And there were some health books, there was one on migraine, wasn’t there, there was one on heart health, one on gut health and they wanted to do one on the menopause. So they approached me and I said, yes, great. But it was quite small. And I, actually it sounds really awful, when it came out in print, I wasn’t too excited about it because I felt it was all right, but it wasn’t as much as I wanted to do. And it did manage to become a Sunday Times number one bestseller, which I think is more a reflection that people wanted to know about the menopause rather than the book. Don’t get me wrong, it’s a good book, but it it’s sort of underselling myself, I suppose.
Kat Keogh: [00:03:50] You are.
Dr Newson: [00:03:51] But I always wanted to do like a bigger, better book almost. That’s a bit more grown up. That’s not so chatty. That’s more evidence-based. I’m quite scientific, I’ve got a pathology degree as well as a medicine degree, and I’ve spent the last 30 years translating medical and scientific literature for lay people and for doctors and nurses and pharmacists and clinicians. And I sort of have that as a skill. And I wanted to be able to use this even more with the menopause and try and get away from this fact that the menopause is just about periods, where it’s just about fertility, thinking about hormones. There’s biologically active hormones that go into our bloodstream, that go to every single part of our body. And the effects that not having those hormones can have, but do it in a way that it’s not just me talking, it’s about others that we can invite to be experts and to share their words and wisdom. But also not just to think hormones, think about lifestyle, think about nutrition, think about everything else as well. And so we had this great opportunity with publishers Yellow Kite to write this book, and I knew I couldn’t do it on my own because I am very busy. And I think it’s because of your journalism background, but also your huge knowledge about health in general, mean that you sort of stalk me and you know how my mind works, would that be fair to say?
Kat Keogh: [00:05:21] No, it’s absolutely fair. It’s the way I operate. And you’re absolutely right. I think the opportunity with Yellow Kite for this book has been a fantastic one. And from day one, the aim was to have, you know, a book that sits on a shelf as a companion, like a family companion. And it is, you know, the title, he Definitive Guide to Perimenopause and Menopause. It is just that, it is definitive. It’s, I think, almost three times the length of your previous books. Dedicated chapters just on what are hormones and not just looking at the menopause, looking at puberty, pregnancy, postnatal depression, periods. You know, it’s a really thorough look at hormones throughout a woman’s life. And you’re absolutely right. It’s got, you know, there are experts upon experts in here as well as yourself. Everything from, we’ve got Julia Samuel, the psychotherapist, we’ve got fantastic tips on the talking to your children about the menopause and especially younger children, because we know that women are having children later in life. So the chances that you’ll be menopausal and raising a young family if you choose to have children is more common these days. We’ve got Joe Wicks talking about exercise. And we’ve got Emma Ellice Flint with some brilliant recipes. Dr Rajpar talking about hair, skin changes. It really is a compendium and I think you should be really proud of it.
Dr Newson: [00:06:51 Oh, thank you. We’ve also got Dr Rupy talking about nutrition and eating healthily. How important that is. It’s interesting, lots of people who have books have a ghost-writer and that person’s never mentioned, but I don’t think, well, you’re not a ghost. So it’s really difficult. I mean, we sort of say maybe you’re a commissioning editor or I think you’re just a partner in crime actually, because you sort of amplify my voice. You work out the bits, you know, a lot of it, I feel, it’s a joint project, really.
Kat Keogh: [00:07:27] Totally. No, there’s been lots of early weekends and late nights and just, you know, I think I’ve managed to go to weddings and then come back to emails where you’ve gone through. And I remember shortly before Christmas, I think we were looking through it as one of the last drafts of the book, and you looked at it exactly 24 hours before me and we were working through it at the same speed, I could tell by the track. And I was, you know, just proofreading what you’ve written. And it is quite a funny process when you write a book.
Dr Newson: [00:08:03] It is actually. And I know when we met lovely Carolyn from Yellow Kite and she was a bit worried about how do you work together and what’s it going to be? And we said, no, it’s fine, we’ll be fine. We’re good with deadlines, we’re organised. But sometimes it all comes together at the end. And actually this book, we made more edits than before. So the first time I saw it, I was sort of happy. Second time I was happier. Third time I was even happier. But then at the last minute we put in another chapter, which we were both a bit too scared to tell Yellow Kite about because they said no more changes.
Kat Keogh: [00:08:37] Oh yes, we wrote that in a weekend, didn’t we?
Dr Newson: [00:08:40] And I said, you know what? You know, most of my work is trying to think about women who don’t have a voice. You know, they’re people who had never come to my clinic or don’t know where to go for help or don’t realise what’s going on. So we’ve got this other chapter, haven’t we, that we added for people who maybe haven’t been thought about before and we called it unseen and unheard. Why the menopause conversation must be more inclusive. And so we’ve mentioned about women with eating disorders, women with addictions, alcohol, drug addiction, people in prisons, people who’ve had FGM, people in different communities that perhaps never even been written about. I don’t think they’ve been written about in a book before. And I think I was too scared to tell Carolyn. And I asked you to tell her, you did, but actually they’re really pleased with that chapter as well.
Kat Keogh: [00:09:32] Yeah. You could say it’s kind of got a really good balance. Well, it has a good balance of the science, of the facts, but it also has a lot of women’s experiences in there through some case studies. We’ve had a lot of women who’ve been fantastic and shared their first person accounts of various symptoms, or menopause with coexisting conditions. But also one of the big things about this book is that we ran a survey just before Christmas, early December, late November, early December 2020. I always think you get over a thousand in a survey it’s a good sample size for, you know, this isn’t academic research, but an extended straw poll research. And in eight days, almost 6000 women responded, which was incredible.
Dr Newson: [00:10:27] A huge amount, isn’t it?
Kat Keogh: [00:10:28] It really was. And the survey itself was to bring women’s experiences to life in the book. So, you know, for example, in the chapter, all about hormones, we asked women, you know, gave women a list of hormones. Have you heard of any of these? And you’d expect, 99% of women have heard of estrogen. But when you went down the list, that knowledge dissipated. Testosterone, quite a few did, progesterone, not as many. And it was really interesting. But we also looked at not just the kind of physiological side of things like what symptoms women were experiencing, but also the social side of things, including conversations in the home. So, you know, probably one of the most startling findings was that three quarters of women, or 75% of women, had never had the menopause discussed in their home growing up, which is really telling of where we’ve been at over the last in a few generations talking about the menopause. You know, I certainly don’t remember talking to my grandmother about it. I remember talking to my mum about it. But I know that I may have been quite lucky in that respect.
Dr Newson: [00:11:44] Yeah. I mean, you’re younger than me, but my, my mother only talked about it because she takes HRT and I’ve done a podcast with her before. And as you know, she’s mentioned in the book and that’s the only reason. Otherwise I wouldn’t. But I often think about my grandparents. We were very close to my mother’s mother because my dad died so young. So they were around a lot and my grandmother never drove, but a lot of her friends didn’t drive. And they were, it wasn’t a done thing to really work so much then, but a lot of them, I remember going round for cups of tea and being really bored, like listening to them and they were doing some crochet or whatever and needlework. But then a lot of them had anxiety. They’re sort of they were so nervous of their husband coming home and finding them sewing when they should be doing some cleaning. And it was all I do know, very different to our society now, but I wonder how many of them were hiding behind this sort of veil of the menopause, which we see in other communities, that so many countries when I visit, you see less and less middle-aged women out. You see women with children and you see less women. And you just wonder there’s a cumulative effect or there’s different reasons. But I’m sure some of it is because people don’t know what’s going on. They have less self-esteem, they have less self-worth, they have less self-confidence. And it’s easier to be hidden at home sometimes, isn’t it, When we have a bad pyjama day or a mental health day, it’s great sometimes being at home with the door shut. You don’t have to put make-up on and you can wear your leggings. It’s fine. But you know, if I didn’t take HRT, I would have those days every day because I couldn’t be bothered to do anything, you know, and I sort of wonder about that. But then they didn’t know, so they weren’t talking about it because they didn’t know what was going on, I suppose as well now.
Kat Keogh: [00:13:28] And I think I remember when I was last on your podcast telling you about my grandma, my dad’s mum, my dad grew up on a sort of smallholding in rural Ireland, and I always remember my mum telling me that my grandma really suffered from hot flushes and her way of dealing with them was to run down to the bottom of the plot and scream down a well and you know, we don’t all have wells to scream down, so I wouldn’t recommend it, but it’s just indicative of that was her coping mechanism and that was, she’s quite a formidable woman, eight children, you know, lots of grandchildren. And, you know, that was her menopause experience. And some of the in the survey we had the opportunity to give free text responses, which is where you can really get a sense of people’s experiences as well as those statistics, is that qualitative data. And there were some really moving comments in there, especially around the conversations. And I think it’s actually made it into the book.
But there was one woman who talked about how her mum had gone through an early menopause but had never said anything to her and her sisters and how now her family kind of make a point of discussing it to support each other. And there were also people who are mothers of sons who make a point of discussing it with their male children. And I’m the mum of two small boys and they’re only seven and just five. But my seven-year-old now, because he often peers over at my laptop, is that menopause, mummy? And it sounds silly, but I know that he’s going to grow up knowing about this and that’s really important.
Dr Newson: [00:15:14] When it’s about normalising the conversation, isn’t it? I mean, as you know, I’ve got three daughters and some of the conversations that we’ve had usually in the car, actually, often when it’s dark and there’s maybe a couple of them with a friend in the back of a car talking about porn, about sex, about drugs, all sorts of things, which is great. And I think sometimes it’s easier me being a doctor because they know I don’t get phased about anything. And even, you know, my younger daughter, if she has a bit of discharge, first time, she’s too scared to show me her pants and that’s really important, actually. So these things, I think, are actually more embarrassing to talk about than the menopause, which is just something that does happen, but it’s not normalising it so much to not think about how it affects people or how the treatments available, because that’s sometimes what’s happening now isn’t it, especially in the workplace. It’s well, we’ll talk about it. And it’s very important to talk about all sorts of things, but we have to talk about it in the context that there is suffering. There are women that not being listened to and there are treatments available and women deserve to be offered the treatment that’s right for them, which is not happening at the minute, as we know, too far too many people. But it is this conversation, you know, my 20-year-old quite often when she goes to the toilet in places in London, she’ll hear people talking in the toilets about their menopause or about a parent’s, oh, my mother is going through a really hard time at the moment. She can’t stop crying. Jessica, quite a few times it’s happened, she said to people, I’m sorry to eavesdrop, I don’t mean to big up my mum or anything, but she’s got this app called Balance. It’s free. Why don’t you download it or ask your mum to download it? And these girls and women have been so thankful to Jessica. She’s like, Mummy, this is the most empowering thing ever. I feel like I’m really helping people. And, you know she has really bad migraines and when she spoke to others with migraine who’ve been older, she said, well, could it be your hormones are related with your migraine? Oh yeah, often just before my periods, my migraines are terrible. Well, perhaps you could top out with a bit of estrogen. No, estrogen is HRT? No, actually, she said it’s not associated with a risk of breast cancer. It’s really safe through the skin. You can have it. Oh right. You know, and it’s those sorts of conversations that I think are really important. We don’t want, I don’t know about what you think, although your children are still a bit young, I didn’t have that let’s sit down now and talk about sex and I’ll show you a cheesy book to my children. It was very much led by what they want to hear, and it was all at different times. And sometimes they’d have a bit of information and then three weeks later they would ask you something else. And then the full question they would ask when you’re not expecting it. But that’s how conversations go, aren’t they? I think it’s making it so that it’s easy to ask and understand. You know, like your son, he’s not sitting down and analysing and thinking about vaginal dryness, and reduced libido. He’s just saying it as a word. And the conversation will start with time and it’s a need-to-know basis as well, isn’t it? But it’s an inclusive language that’s being used rather than. Well, no, you don’t need to know about the menopause, darling. That’s not till you’re an older woman.
Kat Keogh: [00:18:19] Yeah. So there’s a difference between having the talk to, like you say, just embedding it in your everyday relationships. And that’s another thing that the book’s got, it’s got talking to children about menopause. It’s also talking to colleagues about it as well. And we’ve got some really good expert views from people like Liz Earle. Baroness Warsi talks about, you know, having a hot flush when she’s about to get up in the chamber in the House of Lords and losing her train of thought. And it’s really refreshing to hear someone who’s got such a public persona and such an important job. And, you know, she’s a lawyer by background and that feeling of forgetting something and not knowing what the next thing is going to come out of her mouth. And she gives some really good advice about talking to your colleagues about it and saying to colleagues, You need to help me because this might happen to me at the moment. This is why. But also here’s what you can do to help. And I think, you know, lots of time as women, we don’t want to ask for help and we should do in cases like this. I mean, menopause isn’t an illness. It’s not an affliction. It’s something natural. But that doesn’t mean it’s something that has to be endured if you’re struggling.
Dr Newson: [00:19:37] Absolutely. And I think there’s this whole conversation, isn’t there, about it’s a natural process. We’re medicalising it. Well, actually, being in pain in childbirth is natural, but most people have some sort of pain control. And that’s where this misunderstanding of what the hormones are, what the menopause means. And I think that’s why the book and I and my children, we used Dr Spock.
Kat Keogh: [00:20:00] Yeah.
Dr Newson: 00:20:01] We’ve grown up in the seventies, the Dr Spock book, and whenever there was a problem, my mum would always go to Dr Spock to have a little look about what was going on. And then she bought me a copy when I had my first daughter, Jessica. And there are sometimes there are things you just want like a motherly advice, but you don’t want to be nagged, so you just want it from a book. And that’s what I sort of thought about with this book. I want it to be the Dr Spock of the menopause. So it can be, wouldn’t it be nice in every household, so you can dip in and out. You don’t have to read the whole book. You can just pick up. And I think for teenagers reading, we’ve got some information about PMS, you know, premenstrual syndrome, that’s going to be really useful for a lot of people, or the workplace. Anybody that employs a woman should be reading this book because they will get more understanding about what it is or what they can do as an employer. So it’s written, I think, in a way that people can hopefully think about the menopause in a different way. I mean, it started the introduction is quite raw, isn’t it? I don’t know whether we have to have a warning, but we start talking about the mental health aspect of the menopause really early on, don’t we?
Kat Keogh: [00:21:10] Yeah. And it’s important, I think, to cover all bases. Like you say, it’s got advice about the workplace. It’s got advice about the home. It’s got a really, really thorough rundown about treatments, which is, you know, kind of the core of the book as well. It’s got, you know, really detailed chapters. Also looking at these, you know, holistic sort of things, because it’s not it goes beyond HRT. It looks at lifestyle, it looks at exercise, the importance of exercise, the importance of a good, healthy, balanced diet. And I think you say in the chapter about diet, you’re not going to prescribe a ‘die’t in inverted commas. These are just principles that you can embed into your, you know, your daily life. It looks, you know, at what needs to change in the future as well. You quite openly address different groups, teachers, CEOs, politicians, doctors. You know, it covers an awful lot in one book and it’s quite a weighty book. it There’s no getting around it.
Dr Newson: [00:22:13] It is, it’s a hardback, it feels very grown up, with lovely colours. And actually, when it first, I looked at it, and it’s black and white inside and I thought, oh, that’s a shame, I wanted it with more pictures, but actually it works really well. The colour is very visual and the cover bright colours, but there is something quite calming about it as well.
Kat Keogh: [00:22:33] Yeah. It’s not a slab of text and it’s broken up quite nicely. You’ve got, as you say, case studies, we have box outs about the survey findings. For example we’ve got a chapter looking at skin and hair and lots of detail, you know, suggested skin care routines, if you’re struggling with dry skin or you might have had a resurgence of acne that you haven’t seen since your teenage years. So we talk about how from the survey, what are the things women are experiencing with their skin as well. And then every chapter also has time outs. So kind of moments to pause either at the beginning of a chapter or towards the end and almost, you know, think about this, take a second, take a step back. And then at the end, you know, you can consolidate your learning from the chapter as well. But it’s not, it’s a long book, but it’s written in a way that’s really accessible. It’s in quite clear language, quite straight to the point in a good way. Professional hand-hold is probably the best way to describe it. I would say.
Dr Newson: [00:23:39] I think that for me is the only thing that I’m a bit uncomfortable. It’s a bit personal about some of my stories and why I do what I do and my various insecurities, and I think that’s the bit that I feel uncomfortable with. But I think it’s actually quite good to be transparent and a lot of people I know misconceive who I am, what I’m doing. So actually to have it all out there, to hear a bit about my background is not a bad thing. Nothing that I do has been handed on a plate to me. I was at a conference recently and someone was talking about some of the bullying that I was getting. He’s a professor in America. And he said to me, Louise, it’s not actually what you do, it’s just because it’s you that people are getting annoyed. And I said, that’s interesting. And he said, yeah, there’s lots of people talking and saying that they think that you’ve got a lot of money that you’ve had from your parents and you’ve got a rich father. And I said, well, isn’t that interesting? Maybe I should just tell them all I don’t have a father, he died when I was young without any life insurance. So everything I have, I’ve worked for without any handouts from anyone. But what’s the point of telling people, you know, it’s like being bullied at school, isn’t it? They’re always going to find something negative. So I am a menopausal women who wants to help other perimenopausal and menopausal women. And this is trying hopefully to move the needle on to, someone said to me ages ago, you can glance back and look forward. Let’s glance back, but not forget the misogyny, the absolute gender inequality that’s gone on with hormones in the past, But hopefully the book, the work I’m doing, the work we’re all doing, will help these future generations will help from here, now, to maybe make people have grown up thinking about the menopause and the perimenopause, about hormones, but more importantly, about women’s health as well. So in a public way, Kat, I want to thank you very much, because I could not have done this without you and your phenomenal brain and encouragement and support. It’s just been incredible. And I’m really looking forward to, a bit apprehensive, but I’m looking forward to some of the feedback. I’ve already got some ideas for another book, but I’m not going to divulge yet, so don’t go anywhere. And I think that some of you might know, Kat works with us anyway within the Newson Health group. So all the content that’s on the balance menopause website and content on balance and all sorts of other articles, Kat is very heavily involved in. And she runs our editorial team, works very closely with our clinicians so all our work can be peer reviewed and referenced. She’s got a huge amount of work that’s going on behind the scenes to enable anybody from across the world to be able to access evidence-based information, which is so crucial. So before we end, though, I’ve got to give you three take home tips, but I’m going to ask you actually three reasons why everybody should buy a copy of the book.
Kat Keogh: [00:26:39] And I think reason number one, if you have children and you don’t know how to talk to them about your menopause buy the book. It’s got really clear, practical and effective tips on how to start those conversations with younger people and help bring about understanding in the home and help bring about some clarity for children as well. So I think that’s really important.
Second reason, if you’ve ever experienced any hormonal changes in your life to this point where you might not be perimenopausal yet or menopausal, you might be, you know, still having periods and you want to find out a little bit more about how hormones affect your body and the processes behind it and the knock on impact when hormones can be slightly out of kilter. That’s another really good reason.
And the final reason would be if you’re someone who is struggling and is feeling confused or alone buy the book, it will give you the information, it will give you the reassurance, it will give you the power to look at your own health, do something about it if you are struggling with symptoms. And it’s something you can pass on to friends as well.
Dr Newson: [00:28:09] Excellent. Well-said. Very good. So I look forward to when people do order it. If you’ve got any reviews, obviously put them on Amazon. And we really look forward to reading them and hearing and look forward to getting you back on to the podcast when we’ve written a fourth book together, Kat.
Kat Keogh: [00:28:28] Thank you for having me.
Dr Newson: [00:28:30] Thanks. For more information about the perimenopause and menopause, please visit my website balance-menopause.com. Or you can download the free balance app, which is available to download from the App Store or from Google Play.