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Joeli Brearley from Pregnant then Screwed

Two important issues for women come together in this episode of the Dr Louise Newson Podcast featuring guest Joeli Brearley. Joeli founded the charity Pregnant Then Screwed after she was fired from her job the day after telling her employers she was pregnant. Joeli wanted to create a space for others to share their stories of discrimination at work, which quickly grew into Pregnant Then Screwed, a charity dedicated to ending the motherhood penalty and campaigning for change.

Joeli shares a personal story of her own changing hormones in her late 30s; she recounts her struggle to be listened to by healthcare professionals and to find the right treatment for her symptoms that were exacerbated by progesterone intolerance.

Joeli’s three tips for women who think they might be perimenopausal:

  1. Talk to other women, it’s a great way to find out really useful information
  2. Keep going and don’t give up. Trust in yourself and how you know you’re feeling. Keep pushing for what you feel you need.
  3. If you don’t feel well and feel like you’re going mad after having the Mirena coil fitted, tell your healthcare professional. You could have a sensitivity to the progestogen in it and there may be a better alternative method for you.

For more about Joeli’s work and her books, visit

Follow Pregnant Then Screwed on Instagram or Twitter.

Episode Transcript:

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.

Dr Louise Newson [00:00:45] So today on the podcast, I’m going to introduce to you someone who I very, very recently met actually called Joeli, who I’ve been reading some of her amazing work over the last few months and then last week someone alerted me to a post where I was mentioned and read some really harrowing comments, actually and I really I reached out to her and said, “Let’s do a podcast!” And here we are on a Sunday morning recording the podcast, so thank you ever so much Joeli for coming today.

Joeli [00:01:12] Thank you very much for having me on this glorious, frosty Sunday morning.

Dr Louise Newson [00:01:17] Yes. So you are the founder of something called Pregnant Then Screwed, which obviously you can’t listen to that or read that without thinking what’s going on here. But as soon as you read it, I think most women will know exactly where you’re coming from. Which is a real shame, isn’t it? But talk to me. Why did you set this up then?

Joeli [00:01:37] So I set it up seven years ago because when I was four months pregnant with my first child, I told my employer that I was expecting and the next day they sacked me by voicemail and my employer was a children’s charity. So it was quite the shock. And I found myself unemployed without an income and unable to pay my rent or put food on the table. And then I tried to do something about it and discovered that accessing justice was almost impossible. It was completely taken out of my hands. There was nothing I could do. That’s a really long story as to why I won’t go into it. But essentially, women often find, you know, we know that 54,000 women a year pushed out of their jobs for getting pregnant. That’s one in nine pregnant women lose their job. It’s a woman ? minuets gets pushed out of a job because she’s deared to get pregnant. And 77% of working mums encounter some form of discrimination in the workplace. And many of them think, you know, “Oh, well, this is illegal, I’ll do something about it”. And then they realise that it’s almost impossible. It’s just so difficult. The justice system does not work for women at all. I was so furious that firstly that it happened. Obviously when I was at my most vulnerable, my boss would pushed me out. But secondly, that then the justice system completely failed me and it sort of ached away at me for two years. I had my baby and I was going to parent groups and talking to the mums and so many of the mums had these awful stories and it just sort of built this rage filled inside of me until it was International Women’s Day 2015 and that’s come up with the name Pregnant Then Screwed. It was going to be far worse than that to begin with, ?, but I decided to slightly tame it down and then I sort of launched it as a website on International Women’s Day and immediately got loads of attention on it. People saying, you know, commenting on it, people looking at the website and then took a while to get a number of stories which are finally did and it’s just sort of mushroomed from there. So it was just a blog originally for people to tell their stories of pregnancy, maternity discrimination anonymously. But then of course, people wanted help and support. And so slowly I just sort of added these services and different as I sort of found solutions to different problems. And now it’s a fully blown charity with seven staff, 120 volunteers, it’s international, and we helped 80,000 women get the support that they needed last year. So it’s gone from just a blog to this. And it was just I never meant for this to happen. I mean, I’m happy that it did, but it just shows the need that’s out there and the fact that this sort of discrimination happens all the time and there’s very little that women feel they can do to have power in that situation.

Dr Louise Newson [00:04:29] It’s so sad, isn’t it? And I think the more work I do, it’s about women not having a voice or when they have a voice, it’s not listened to. And even I know when I moved down from Manchester a long time ago in 1999 and I went for a job and it was a full time GP job and I said to them in the interview, I probably shouldn’t say this, but I have been married now a couple of years and we are planning a family. So how would you look at if I went part time if in the future I became pregnant and they said, “Oh, we’re so child friendly here”, brilliant brilliant, you know, “it wouldn’t be a problem Louise at all”. And I was offered the job, which was great. And then a year or so later, I became pregnant. And I said to them, “oh, could I reduced my hours and I come back?” and they said, “Oh, yes, yes, you could just reduce the number of days, but you have to work eight till 630”. And I said, “But I can’t find a nursery. I would live half an hour away. That’s open half seven to could I just not you know it’s my hours in the day maybe work, you know, spread them over three or four days” and there was just no way. Absolutely no. That’s never been done in the history of the practise. Can’t do it. So I just resigned when I was, you know, 18 weeks pregnant. I just thought, I can’t work for these people regardless of what happens with my pregnancy. I just thought, this is really. You know, and you’d like to think things have changed. But I, I don’t think. But it is part of this bigger picture, isn’t it, Joeli, that we’re just women. Who cares? We’re replaceable. Does it matter? And I feel really sad about that because we’re individuals and you wouldn’t treat men like that. And why should anyone be treated like that, actually? But it happens when we’re pregnant often, as you know. But then it also happens when we’re perimenopausal or menopausal and we know around 10% of women leave their jobs because of memory problems, anxiety, fatigue. But also we know from studies we’ve done, a lot of women are not going for promotion or they’re changing their jobs or they’re going part time. And that’s just haemorrhaging workforce, isn’t it?

Joeli [00:06:28] Yeah, it’s really bad for the economy. You know, if you look at it through the lens of a government and cold hard cash and you want to rebuild your economy. We’ve got over 600,000 people who have become economically inactive over the last couple of years. And the chancellor keeps talking about these economically inactive people and how we can get them back to work. And he never mentions childcare and doesn’t think about this through the lens of mothers and the barriers that they encounter. Nor does he mention menopause and the challenges that women face when they get older. It’s a complete blindspot with the government’s planning, and all of these problems are systemic. So women in the labour market, because the labour market was built around there being one income earner in a household and so the be a woman ? kids and there’d be a man that goes out to work. And we haven’t adapted the labour market to the fact that in almost every family there are now two earners in a household and you have to have two earners to keep a roof over your head. You can’t afford to not. And it’s similar I’m sure with menopause and the fact that there aren’t the trials, there isn’t the impetus to really understand what is happening with women in their bodies, because it’s just not seen as important as men’s bodies. And it’s complicated.

Dr Louise Newson [00:07:45] And it’s well, that’s it’s you know, it’s a bit scary talking to a hormaonal woman, isn’t it? Because they might shout at you. But I think there’s all this misunderstanding as well. We know Amanda Pritchard for the NHS put a document together a couple of weeks ago talking about flexible working in the NHS and how we can support women through their menopause. And one of my friends who’s a consultant anaesthetist actually wrote to the Telegraph to say, how can I, as an anaesthetist do more work at home? You know, I’m intubating people who are going for surgery. They just can’t do it. And and actually, it’s not about reducing hours because that means reduced pay, reduced identity. And even those women who are working part time, if your brain isn’t working, it doesn’t matter whether you’re doing 1 hours or 40 hours a week, you’re not going to do the same job. So it’s about how to provide the right support and treatment as well, especially when it comes to the perimenopause and menopause and which is just not there and no ones joining up the dots at all. You know, women working part time, often it’s because we’re looking after children, but often it’s because we’re not getting the right help and not being listened to and not having individualised solutions. Because there are ways that we could be far more productive if we could change our hours slightly or change the days that we work. Because, you know, there’s no doubt in the term time a lot of us can work a lot better, more productively than in the holidays. And, you know, some jobs, obviously, you can’t change, but others you can I’m sure people could do a lot more, couldn’t they?

Joeli [00:09:21] Well yeah, exactly. I mean, an employers often say to me, what should I do? How am I a better employer for mothers? And I say, just listen to them. It’s not rocket science, just like give them a forum to be able to have a conversation about what the problems are that they’re experiencing in your workplace so that you can enable those that have less power to contribute to that conversation. So you getting all levels of staff and then give them your ear and allow them to tell you really honestly and brutally what is going wrong and then fix it. But, you know, it’s not that complicated. And they sort of, employers sort of forget that they look at they are to outsource these problems often without actually just talking to the people that are affected by it. And it you know, again, it tends to be men who are employers. It’s men that are in more senior positions within organisations and there’s so much that still needs to be done in the workplace by the government in health care settings, that it means that women are just sort of a forgotten cohort often and yet we’re 50% of the population.

Dr Louise Newson [00:10:35] Yeah. So just when things get really depressing enough talking about that, but just talk me through this post that you put on. And had this overwhelming response. I mean, I know a lot of your post gets responses, but the one that brought me to reach out to you.

Joeli [00:10:52] So I, I’ve been on my journey of perimenopause, which started I mean, I said in the post, it started three years ago. I think it probably started even before that. And I was getting really bad symptoms of brain fog and headaches and they would start after my period. So as soon as my period started, it would start and it would last for up to two weeks. And at points, it got so debilitating that I could barely move. I couldn’t think, I couldn’t speak. I spent a lot of time talking to people. I’d do interviews, talks in front of big groups, people about the motherhood penalty, you know, radio and TV. And so it was really affecting my work. And, you know, I remember sitting on my sofa a few years ago and just feeling unable to move and able to really function at all. And then it would pass and then I would feel okay again. And then the anxiety started quite crippling anxiety where I would feel really awkward when I saw people that I knew and didn’t really want to go out anymore and I remember friends coming over here one night and I felt so uncomfortable and so awkward and anxious I had to put the tele on for a bit to sort of ease myself into the situation and calm myself down before I could even sort of have conversations with them, which was very unusual, wasn’t like me at all. Really heavy periods that were bleed through my trousers really quickly and jaw ache like I would get terrible jaw ache for like two weeks of the month, which was a sort of really odd symptom.

Dr Louise Newson [00:12:28] Gosh, yeah.

Joeli [00:12:28] And then night sweats that were just disgusting. And I would wake up absolutley dripping, you know, all down my cleavage. And so I initially I just thought, there’s something wrong with me. What’s wrong with me? I must be allergic to something, is what I kept thinking. So I went to a nutritionist and they tried all sorts. They did like made me do a big poo sample and then they, you know, made me change my diet and did all sorts of stuff. None of it worked and it cost me a fortune. So I went to the doctor and I said, I’ve got all these symptoms and I don’t know what’s wrong with me. And they said, okay, well, it’s obviously related to your menstrual cycle, lets do a blood test and see what we can find so they did blood tests. Two or three weeks later called back and said, “Oh, no, nothing wrong with you”. So I said, “Great. Okay, thanks very much”. I mean, what do you say when someone says nothing wrong with you? Your making it up, it’s what you feel like they’re saying. And she suggested that go in the mini pills, to calm my periods down, which I did, and I went completely crackers and I had a non-stop period. My period just didn’t stop when I was on it really heavy and I was crying all the time and felt just really bonkers. And it took me a while to realise that it was the mini pill that was causing it. And when I realised I threw that in the bin, stopped it, registered again at the doctor’s for another call. 30 days it takes each time you register the doctors to get a call back. So they call me back and then I said, “Well, that’s not worked. I don’t really know what else to do.” And you know, again, there was just no real conversation about menopause or perimenopause. And it wasn’t until actually I met a woman who’s written a book about the menopause who also worked on the Davina McCall documentary. Kate I totally forgotten the surname, but I met her at an event.

Dr Louise Newson [00:14:18] Kate Muir probably.

Joeli [00:14:19] Yeah, that’s right. Yeah. And I told her, you know, poor woman, I sort of ? her and told her my symptoms and she was like, “Well, you are very clearly perimenopausal”. So I thought, okay, well, I really need to push this with the doctor. Went back to the doctor had another blood test. Absolutely fine. No problem with you. And then I met a GP who told me the blood tests do not identify whether you’re menopausal or not. So this was a revelation to me. So all this time they’ve been giving me these blood tests and not telling me that your hormones jump around like crickets all over the place. And it depends when you have the blood test, as to what they identify. So by this point, you know, we’re sort of over a year in of me trying to get some help. And by this point, I am absolutely convinced it’s perimenopause. And so I registered with the Newson Clinic, which somebody recommended. So I had the appointment. I was told I was ticking pretty much every box, you know, yes, you are perimenopausal. And I remember saying to the doctor, “how do you know it’s perimenopause and not depression?” And she said, “I don’t. But what I do know is you tick every box and I am really confident that I’m going to give you this medication and you are going to feel better”. After it, I said, okay, that’s good enough for me. So she put me on the gel and progesterone and it was going great. But I am the most forgetful human you have ever met in your entire life. Like I can literally, I will have lost these glasses before the end of this podcast recording. Like, I just lose things and I forget things. So I thought I’m not going to remember to take progesterone when I should do. I was ? but I thought, something will go wrong. So I thought, right, well I’ll get the coil fitted because I’ve had the coils quite good, the marina coil so that I don’t have to think about it. So finally got the coil fitted and I felt dreadful, absolutely awful. And I called 111 because I was panicking because I couldn’t at first the thought I was burnt out. So a message my staff and said, “I am really burnt out. I need to stop working now.”  And then I thought, hold on, this is this isn’t burn out. I know what burnout feels like. And I couldn’t get up. I was in bed, I was crying all the time. I just felt horrendous. And I ended up getting a call with the doctor. The doctor told me there’s no reason why the coil would be making me feel unwell, and if I wanted to out, it would be 12 days time before I could get it out. And she said, “But I think there’s something else wrong with you. I don’t think it’s anything to do with the coil so I think by the time we get to those 12 days, you will not want to get out because it’s good, you need to have it in, it seems like it’s the right thing for you”. So I kept it in and then I did start to feel a bit better and I thought, Oh, maybe it is me. Maybe I have, you know, maybe I wasn’t. Well, I did start to feel a bit better and then it crashed again. So I started feeling a bit better. And then I crashed again.

Dr Louise Newson [00:17:34] And then it.

Joeli [00:17:35] And that was about to go to the Labour Party conference, do a talk at the Labour Party conference. And I thought I can’t go feeling like this because I feel crackers. And so I tried ? coil out myself. I thought I’ve got no option. So I googled how to do it and I spent all morning before I went to Liverpool desperately trying to get this coil out of me and my friend Kat was meeting me at the Labour Party conference and she said that with a pair of rubber gloves and she said and she had here coil in a plastic bag to show me what it looked like. And she said, right, let’s get back to the hotel room and I’ll get this coil out of you. And I was like, Kat, I love you, but no, this is too much. You are a friend. I’m not sure I want you fishing around my vaginal canal. That’s just probably crossing a line. So we decided not to do that. And I kept the coil in. And then finally the appointment came and the woman that was taking it out said to me, “There’s no way this is causing you problems. And I think this is a mistake that you are going to have out.” Anyway, I said I don’t care, you get this thing out of me. So she did. And immediately I felt better. And then I did Googling around and discovered that the progesterone that your clinic had put me on is body identical progesterone. And the progesterone in the coil..

Dr Louise Newson [00:18:52] Is synthetic.

Joeli [00:18:54] Yeah.

Dr Louise Newson [00:18:54] Yeah. And it’s really important to know that there’s a difference. And, and there’s so much this story, obviously, that should be thought about and unpicked even. But, you know, you’ve made the diagnosis yourself because you’re telling me even if I wasn’t a menopause specialist or even a doctor, that you have changes that are fitting in with your periods. So it’s got to be some hormonal change. And what’s really difficult sometimes with women is knowing, is it PMS, is it PMDD, is it perimenopause? Actually, all of these are just labels. It is a hormonal changes that are occurring in the body. And often our hormones change for many years before our period stop. So there’s lots of women in their thirties and forties and even younger are having some hormonal changes. And I’m hearing more and more from various groups that I go to to say it’s outrageous that women in their twenties and thirties think that they might be perimenopausal. And I sort of think, well, it’s not actually outrageous because one in a hundred women under the age of 40 have an early menopause. That means there’s one in 100 women in their thirties who are likely to be perimenopausal. But we know that PMS is really common. Most women will have some symptoms that change through their periods, through their menstrual cycle, rather, and they can just get exaggerated as we get older. So some women are very responsive to changes in oestrogen levels. Some people are very responses to a drop in testosterone levels. And some people it’s the progesterone. And there are many women who have PMS or psychological symptoms related to the perimenopause as well, who are progesterone intolerant. But progesterone, as you say, there are different types. So the natural progesterone often people tolerate better. But the synthetic progestogens that are in the contraceptive pills, all the contraceptive pills have synthetic progestogens. There are different types though, and then they many pill, the implants, the injection for contraception and like you say, the marina coil, they all have different types of progestogens. So progestogen just means it’s a synthetic progesterone. So it’s been biochemically changed so it doesn’t lock on to the receptors in the cells quite as easily as the natural progesterone in the body identical progesterone does. Many women find it doesn’t make any difference. They benefit and it doesn’t cause problems. But certainly there are women and some studies say that around one in ten women, so not insignificant, who have some psychological changes. And, you know, what you’re describing is very common for someone who has got progestogen intolerance. With the Mirena coil, the dose is very, very low and lots of people say, well, you don’t get any systemic absorption as and it doesn’t go in the bloodstream. It doesn’t affect the rest of the body. Well, there are women who are very sensitive that it even a little bit in the bloodstream, as in probably happened to you, it’s still going to cause problems. And for a lot of women, they do feel a bit low or a bit flat for the first 3 to 6 months, and then they feel fine. And then Mirena coil, as you know, is licenced for five years. So if women don’t feel too bad, sticking with it can be a good thing because when it settles down, you can imagine the concentration is highest when it’s new and fresh and then it sort of stables and reduces. But there are a lot of women, I spoke to a psychiatrist recently who actually did pull out her own Mirena because she was suicidal. And it was at the weekend and she knew it was here Mirena coil. And she just she was really scared, but she had insight and she pulled it out herself. And she said within literally minutes she started to feel better. And, you know, it can happen. And I think what’s really sad is that when you’re not believed or understood it, it makes it even more difficult. And especially when you’ve got a mental psychological symptoms, then you think, well, maybe I am sensationalising it or maybe I am going mad. Or maybe like you say, maybe I’m having a breakdown. And that’s really, really scary actually. And I always feel with women who I speak to like I have no idea whether their hormones are related, which hormones they are, or whether it is that they’re having a breakdown. How do I know? Because there’s no diagnostic test. I can’t do a blood test. As you know, your hormone levels were fine, but at three in the morning when you were having a night sweat, they probably aren’t fine, but no one’s going to come and do a blood test then. So then we go on symptoms and a lot of uncertainty. But I often say to women, well, let’s just balance your hormones and then see what’s left. And some women even actually still have side effects with the body identical hormones, are very, very sensitive to them. And I personally have progesterone intolerance. And when I was starting to take progesterone as part of my HRT, when I was perimenopausal, I had three or four days a month where I kind of just shut the doors, shut my clinic, walked away from everything, and I just thought it was at the same time as I was I was setting up my clinic, so I thought, I’m just like  you, a bit burnt out. And then my husband said, but Louise, its when you’re coming towards the end of it, it’s two weeks of those pills. Look at you. You’re lying on the bed. You’re not even moving. You’re not interesting to talk to. It’s only 8:00 and you’re telling me you want to go to bed, something else is going on. And then you sort of think, “Oh, right, maybe I’ll try not taking the pills”, or you can insert them vaginally to reduce the absorption. And some women that helps. But even I found that I could have still walked away from life with that. And so it’s very hard sometimes to work out the right dose of the because you have to balance oestrogen and progesterone and testosterone to protect the lining of the womb. On occasion, women actually have a hysterectomy because they need oestrogen and testosterone if they take testosterone as well, but they can’t tolerate any progesterone at all.

Joeli [00:24:40] So I was going to say, what do you do if you have complete intolerance to progesterone?

Dr Louise Newson [00:24:44] Yeah. And you know, I have got some women who do have a hysterectomy because of progesterone intolerance. And that sounds really quite dramatic. But I’ve had a patient recently who was diagnosed with premature ovarian insufficiency when she was 34 and she’d given up her job as a police officer. She tried some bioidentical hormones, which were just horrendous, and she had managed to have a donor egg, actually. So she had had one pregnancy and then she adopted a child and was really high up in the police. And then her life fell apart with her hormones and then she started to feel a lot better. But every time she took progesterone, she felt dreadful again. And then we tried to reduce the amount of progesterone, but then she was getting bleeding. So the gynaecologist said, “Well, we’ll do a an ultrasound, a hysterectomy and a biopsy every six months as long as you’re on HRT”. Well, at this time she was 42 and she said, “Well, I’m going to take it forever. I can’t be subjected to a hysterectomy and biopsy because I’m sure you’ve heard or women listening might realise they can be very uncomfortable and painful and intrusive as well.

Joeli [00:25:50] Yeah.

Dr Louise Newson [00:25:50] And cost money to the NHS. So she said “I don’t want that”. They said, “well you’re going to have to increase your progesterone”. And she said, “But I can’t because every time I do I feel suicidal and without HRT, I’m suicidal, so I can’t be without it. And I’m young and I need it for my bones, heart and brain and future health”. So then she had a hysterectomy and I reviewed her recently and she’s just so happy and it seems like a big thing to have a hysterectomy. And of course, it’s not an operation you would do first line. But if you think when I was doing obstetrics training in 1999 and when I was training as a doctor in the eighties, lots of women would come in with very heavy periods thinking about they’re all perimenopausal because they were often in their late forties and people would do hysterectomies for heavy bleeding. If these women didn’t have a hysterectomy, they would have had to wait probably two, three, four or five years until they were menopausal. Yeah. So you’re doing an operation to get them through the next three or four years because Mirena coils weren’t around then, so it was a lot harder to manage heavy periods. Now moving forwards, we’ve got the Mirena coils. Great. So there’s less hysterectomy, so heavy bleeding. But if someone like this lady has had a hysterectomy for her menopause, you’re not just helping her for three or four years. It’ll probably be helping her for 30 or 40 years. So it’s actually even more cost effective. So but I think the important thing is knowing there’s always choice. And I think, you know, reading your comments from this post is just makes me so sad because women are not being listened to. There’s no one to say. And I think as a doctor, I always say to people, whatever treatment, whether it’s a blood pressure treatment or a HRT treatment, if this doesn’t work, we can go to this. And I think sometimes just knowing that there are options is really, really useful, isn’t it? Because if you know you’re at the end of the road, then what do you do then?

Joeli [00:27:41] Then you just feel completely helpless. The thing that I found really shocking was this arbitrary age 44. So when I finally did get the doctor to talk to me about properly about perimenopause and admit that the blood tests weren’t necessarily the right indicators to whether I was menopausal, she said, “But you’re 43, so I can’t prescribe you with HRT”. And I was, you know, 43 and a half. And I said to her that that’s ridiculous. Like that is absolutely the can you not see that that’s madness? Because, of course, everybody’s body is different. And ? no. And I heard that so often in the comments as well.

Dr Louise Newson [00:28:20] Yes. And I think, you know, I work out of the Nice guidance, which are now seven years old, and we’ve got the International Menopause Society guidance that a six years old. But it doesn’t matter. They’re still the most current guidance for the menopause, and they’re very clear that there isn’t a lower age limit. They talk quite a lot about premature ovarian insufficiency and also they do mention perimenopause as well. So there’s no one’s too young to be considered for hormones. And I think it’s really crucial and this is one of the reasons that I’ve worked so hard on the information that I’ve written, I’ve given out freely to people, is that women can then  become advocates and really like you’re doing with Pregnant Then Screwed, allowing people to have the information, then they can go back, you know, obviously for you it’s the employers, but for me it’s going back to a different maybe or even the same health care professional and say, look, actually that’s not true, or could you show me where you’re getting your evidence from? And I’m happy to be challenged. But what I have read from the Nice guidance is that there is no age or there is no reason why I can’t try. But it’s very hard and it just shouldn’t be this exhausting for women to be listened to.

Joeli [00:29:27] No, it really shouldn’t. And it’s that’s the hardest bit when you really are fighting your corner against a medical professional and you feel ? to them, of course, because they ? and so you should, you know, in many regards because they’re the trained people. But certainly for me and certainly for many of the people that commented the information they’re getting is just not accurate.

Dr Louise Newson [00:29:49] Yeah.

Joeli [00:29:49] And so you have to go off and find your own information and then go back and have these conversations with them. And of course, some people are not receptive to that at all as well. Medical professionals sometimes don’t like you to, you know, challenge them on those those issues.

Dr Louise Newson [00:30:05] Yeah, but I think, you know, I love being challenged and I’m very happy. And I think it’s really important that we learn from our patients all the time and what’s concerning them and what they want. And it’s not for us to say what people can and can’t do. And I think often when we feel threatened, it’s because we’re in an area of uncertainty or an area without the right knowledge. And so I think positioning it in the right way, you know, making sure that you’re respectful to health care professionals. But say I’m finding it very frustrating, actually, and this is contrary to other information that I’ve read and is this someone else in the practise that might be able to help me? Because I don’t want to fall out with you over this, then keep that respect going, because some people have actually helped by writing a letter to say to the consultation, I’m going to leave now because I’m not getting anywhere, and then write a letter to that doctor or nurse or pharmacist or whoever it is you’re having difficulty with, and then saying, is it possible for you to ring me when you’ve considered this information that I’ve read from the Nice guidance or whatever is relevant and and that can help because it’s like, you know, for those of you who’ve got teenage children, there’s no point arguing. If everyone’s worked up, it’s better to diffuse and go back. But it’s essential that women do get listened to because we’re talking about lifelong improvement if you get the right treatment. And that’s really important.

Joeli [00:31:28] How can we change the system? What do you think needs to happen for menopausal symptoms to be firstly be better understood, but also for women to be listened to when they go to the GP and get the right treatment?

Dr Louise Newson [00:31:40] I think a lot of it is about training and education.

Joeli [00:31:43] And big questions, sorry.

Dr Louise Newson [00:31:45] Yeah. No, no, no it’s fine. A lot of it’s about training and education of all health care professionals. And I think, you know, allowing women to understand what’s going on is, number one, because I think medicine has really changed where it’s so much more patient centred. So allowing women to be in the centre of the consultation is huge, whether it’s about their pregnancy, their PMS, their endometriosis, their migraines, whatever, or they’re perimenopause or menopause. And then it’s the education for healthcare professionals, and it is happening with younger health care professionals, and they’re a lot more aware. But it’s also making sure that the right colleges are involved and the government and NHS England and it’s, it’s a huge amount of work because it’s a big culture shift and it’s changing people’s perceptions of what perimenopause and menopause is. And so many people just see it as something that causes a few hot flashes and stops periods. They don’t see the bigger picture. So there’s a huge amount of work that needs to be done. But I think in the meantime, the most important thing is allowing women to know what’s going on and give them tools to try and get help. So for you mentioning or even talking about the topic was overwhelming. But again, it’s showing that women need a platform, they need a voice and they need to be listened to. So I’m very grateful for you spending some time on Sunday morning, Joeli. But before we finish, three take home tips. So three things that you’ve learnt from, you know, your experience of the perimenopause that maybe you could impart for others so they are a bit more in control and hopefully don’t suffer like you have.

Joeli [00:33:20] Probably, first thing I would say is talk to as many people as you can about it because I found out the majority of my information from just having conversations with a variety of different people. I got so obsessed with it that I it was the first thing I was talking about a pretty much any woman I met who I thought could potentially be of perimenopause age. But that’s where I got most of my useful information from. And that’s essentially how I ended up diagnosing myself because of all these different conversations I was having with different women. I think it used to be such a taboo subject and people never used to talk about it. And it’s not now people want to have a conversation, and I found people really relished talking about it and we learn from each other and that can be really powerful. Probably second tip would be, you know, keep going, don’t give up. You will ? face doctors or other health professionals who will tell you things that aren’t necessarily accurate and you know yourself how you’re feeling. And if you’re not getting the help that you need, keep reading and keep pushing for what it is that you actually need. And thirdly, if you have the Mirena coil and you feel absolutely mental, then it’s the Mirena coil, get the thing out!

Dr Louise Newson [00:34:42] Probably not by your friend though, go and see a healthcare professional.

Joeli [00:34:46] Don’t get Kat to come over with rubber gloves, go back to your health professional.

Dr Louise Newson [00:34:50] I think, yeah, absolutely. And I think the most important thing is just if you feel something, whether it’s the coil or the tablets or just the way you’re feeling isn’t right, or if you think it might be related to your hormones, then just be persistent and eventually, hopefully you’ll find someone that will help. So I’m very grateful for your time today and I’m looking forward to seeing how the response to what you’re doing, but also how you just changing the ? for women going forwards because it’s so important to start young and keep the conversation going. So I feel that what you’re doing, all these women who have been pregnant, guaranteed to become perimenopausal, menopausal after so doing this sort of joined up thinking I think is really exciting. So thank you again.

Joeli [00:35:33] Thank you. Thank you. I mean, literally, your clinic saved my sanity, so I am enormously greatful. Thank you.

Dr Louise Newson [00:35:41] Thanks, Joeli. For more information about the perimenopause and menopause, please visit my Website balance hyphen menopause dot com. Or you can download the Free Balance app which is available to download from the App Store or from Google Play.


Joeli Brearley from Pregnant then Screwed

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