00:00:00 – 00:01:12
and definitely while I do love HRT for the right person it is definitely not for everyone and I would never make anyone or try and talk anyone into taking it it’s absolutely your decision but I just want you to know that you still can have real control over your health moving forward and I’m here to help you do [Music] that so today’s episode is one for the women out there who can’t or don’t want to take hormone replacement therapy and the reason I wanted to make this episode
00:00:39 – 00:01:51
today was actually after a really upsetting consultation that I had about a week ago with a beautiful lady who I’ve been looking after for about six months and she had come to me because she really wanted to start some hormone replacement therapy and after we worked out whether that was Poss the right thing to do we got her started but unfortunately we tried multiple types and Doses and she was one of those people who just kept getting side effects and to be honest on the hul a lot of women
00:01:15 – 00:02:28
feel much much better on hormone replacement therapy but this beautiful lady was someone who actually didn’t feel better it actually made her feel worse and she’s actually a very intelligent lady she’s a PhD she’s very very intelligent she was very very well read and she was in tears because she had been doing lots of reading and she’d also been watching probably lots of the things that you and I listen to and hear on podcasts and on Instagram and she had been hearing you know the narrative all about the
00:01:52 – 00:03:01
incredible benefits of taking hormones and through lots of Tears she said to me but what am I going to do I’m going to end up with osteoporosis and she has a strong family history of heart disease and she was very very worried about that and she is a lady who has really struggled with her weight and she’s really struggled with that for a long time and I think to add insult to injury for her is that she’s nursing her mom who has dementia and she had just been reading some information
00:02:26 – 00:03:32
around R the protective effects of hormone replacement therapy on the brain and so I know that there are a lot of women out there who maybe are having treatment for breast cancer or for various reasons can’t or just don’t want to take hormone replacement therapy and I also understand that all the chat about HRT and all the benefits of it can actually feel a little bit exclusionary to those people and so today I wanted to address some of the things that I believe that you could be doing and that
00:02:59 – 00:04:09
I think there’s some really good evidence behind doing to help not only relieve maybe symptoms of the per menopause but also help you live a life that you not just surviving the next phase of life but that you’re really really thriving and so I thought today I would go through a few of them that I think you could probably reasonably easily bring into your life and I think that I want to reassure you that if you could do these things they’ll go a really really long way to helping you
00:03:34 – 00:04:33
not develop osteoporosis and so what I want to help you understand is that it’s absolutely not a foregone conclusion so it’s not that if you don’t take HRT you’re definitely going to get osteoporosis or if you do take HRT you definitely won’t get osteoporosis so it’s just not as black and white as that so um if you’re listening and you’re someone who can take hormones or if you know someone who can take coms please share this episode cuz I think it’s going to be really
00:04:03 – 00:05:16
helpful and I just want to share with you some of the things that I think that you could be doing that will help so the first one is building muscle and to be honest this can be a little bit of an alien um idea to many women of uh my generation uh where aerobics whenever we were in our teens and 20s and 30s it was all about aerobics and step aerobics and running and trying to be really Slim and that was what we wanted to do and it was cardio cardio cardio and to be honest if you went to the gym um it was very rare
00:04:40 – 00:05:42
that you saw women over in the weights area that was kind of exclusively the male area and I certainly know that to be honest I would never have gone over there it was kind of too intimidating and too scary and and also many women will say things to me like oh well I’m not sure that I want to do weights because I want to I don’t want to get bulky but to be honest it’s really hard to get bulky like do you know how hard the people who are really really musly work to be like that believe you me it’s
00:05:11 – 00:06:21
actually really really hard so in reality it’s highly unlikely that you’re going to get bulky but why is gaining muscles so important well what we’re now realizing is that in this phase of life we actually lose quite a substantial part of our muscle mass and that’s very very significant for a number of reasons but one for example your muscle think of it a little bit like um sort of the Furnace or the power Heist of your body muscle Burns a lot of energy so in really really simple terms if you have
00:05:45 – 00:06:51
less muscle then your resting metabolic rate or your resting metabolism is going to be less and you’re going to be burning less calories so they we believe in simple terms that may be uh causing you to gain weight the second reason that it’s really important is to do with our joints stability and of course our Mobility so you know I feel like for years we’ve sort of assumed that you know if you grow older it’s just what happens you’re going to go off your feet you’re going to need a walking frame
00:06:18 – 00:07:19
you’re going to fall over all the time you’re going to get really frail it’s going to be hard to get in out of a chair and yet the other day I literally watched um a 102-year-old run the 100 m in 37 seconds or something like that I mean it was insane I think that we really need to change our perspective on aging and stop thinking that it’s a foregone conclusion and of course some people will get bad health and perhaps you know they won’t be able to stay as strong as they would want to be but I
00:06:49 – 00:07:52
definitely want to be one of those ladies who is um fit and healthy and you know hopefully hopping in and out of my car still in my ’90s if I happen to be here so the only way you’re going to be ble to do that is if you maintain your muscle mass and so we have to start doing strength training we have to start lifting weights and again one of the other concerns people often have is maybe they already do have slightly weaker bones maybe they’ve got osteopenia or in fact osteoporosis and
00:07:20 – 00:08:22
many people are really afraid of hurting themselves but in reality in a safe and supervised environment you’re absolutely the people who should be doing strengthen exercises you definitely need to be putting weight and strength through those muscles and Bones to make them build up so that is a really really big one of course there are all the other added benefits of building muscle we know it releases endorphins we know it makes us uh feel happier it’s a natural dopamine releaser um and it’s
00:07:51 – 00:09:02
also sociable it’s going to get you out of the house it’s going to give you a routine etc etc so muscle and muscle strength building is one of my big tips and I know that if you follow Dr vonder rght and even Dr Mary CLA they’re really big Advocates of you doing as much strength training as you can possibly do the next thing that’s really really important is optimizing your sleep and again I totally understand that sleep is often an absolute nightmare in the Perry and postmenopausal period often women
00:08:26 – 00:09:26
will tell me that is their absolute most debilitating symptom sometimes it is because of hot flushes but for a lot of people it is literally just that they cannot stay asleep so they often fall asleep not too bad but they get to maybe 1 or two in the morning and they are wide awake sometimes with their mind racing sometimes feeling really really anxious but other times there’s actually no reason they’re literally just lying there and of course there’s nothing worse than being awake during the night
00:08:56 – 00:09:57
but getting your sleep under control is so important for so many things so for example we know that if you’re not sleeping well your body gets very very stressed you get higher cortisol levels and of course we know even just like a young child doesn’t function if they haven’t had enough sleep we will not function well but when your cortisol levels are high you tend to put on weight you also tend to make worse decisions around food you often want to eat high carb foods or Ultra processed
00:09:27 – 00:10:24
and sugary foods which again of course makes your weight go up the other thing is that you know what we know I understand about sleep is there’s a cleaning process in really simple terms that goes on in the brain when we’re asleep and if you don’t get enough sleep then that process doesn’t happen and we believe that it can be detrimental to the brain so there’s a few things obviously I live here in Australia sometimes the nights are are hot um and you can have fans on and air
00:09:56 – 00:10:54
conditioning but you know it is actually really important that you have your bedroom probably a good bit cooler than you would think so one thing that a lot of people don’t know is that you need to be able to drop your body temperature by about one degree to fall asleep and actually to stay asleep so try not to have your bedroom warm or have too many covers on the bed perhaps invest in some nice cool cotton or bamboo sheets that are going to make you a little bit more comfortable in bed but
00:10:24 – 00:11:27
really prioritizing sleep the other big one which I have to admit I am really guilty of is having a phone by your bed or scrolling on your phone uh when you’re in bed so I know that sometimes I’ll say I’m heading off to bed for an early night and the next thing I realize that I’ve been scrolling on my phone for over an hour so having that phone out of the bedroom and then obviously just sticking to a regular regime so one of the findings in lots of research is that women actually need a lot more sleep
00:10:56 – 00:12:01
than we had previously thought so probably 9 to 10 RS if you can manage eight of course sometimes that’s as much as people can do but it’s trying to stick to a regular routine so if your sleep is completely chaotic it is trying not to go to bed one night at 8:00 and then the next night at 11:00 and then maybe the next night watching Netflix to 1:00 a.m. it’s actually start setting a really rigid pattern nearly like you would do with a small child and trying to get your body into a bit of a routine
00:11:29 – 00:12:28
and we often talk about things that are called Sleep hygiene and that is things like you know going and having maybe a shower or a bath but that’s not too hot um you know having a bit of a routine where you wind on perhaps not talking on the phone to people who are going to wind you up or stress you out maybe doing a little bit of journaling to get any of your thoughts out that have been stressing you out so that you can go to bed with a clear mind and try and optimize your sleep I do often find that
00:11:58 – 00:12:58
magnesium is often very very helpful in this uh phase of life and I also sometimes find melatonin is helpful too but if you’re not sleeping definitely do come and talk to your doctor because there are options out there and we definitely want to get you sleeping because the whole world feels a whole lot worse whenever you haven’t had enough are you struggling to navigate the per menopause or curious to learn more about the menopause from some of the top experts in this space I am so excited to tell you about an upcoming
00:12:28 – 00:13:34
event she thrives an evening in conversation with myself Dr Kelly casperson who joined me in episode 89 for a brilliant chat about sex during midlife and Dr vandite Who was on episode 54 who shared how to conquer midlife and Beyond with strength training and nutrition join us on Monday the 3rd of March at Newcastle City Hall from 700 p.m. a percentage of every ticket purchased will also be donated to the Debbie Gant Foundation which supports women’s mental health during these transition years to book your spot
00:13:01 – 00:14:08
click the link in the show notes I can’t wait to see you there this is one you’re not going to want to miss now the other one is nutrition and I know that that might feel really obvious um many of you have seen on again on social media on podcast everyone talking about eating enough protein and you know there’s definitely lots of funny memes and videos about you know how eating enough protein becomes nearly a full-time job for a menopausal woman but that there is no doubt the research would suggest that
00:13:34 – 00:14:49
we do need more protein to help us maintain those muscle and mass within the body and the other one I’d like to focus a little bit on as well is fiber so we’re now learning more and more that lots of things happen within the body during the menopause glucose metabolism seems to change insulin resistance seems to become more apparent um and lots of metabolic um changes happen uh but one of the other things that happens is that um people can struggle with their gut a lot and some research recently seems to show there’s
00:14:12 – 00:15:19
a real shift in the gut microbiome at this time of life and that the gut microbiome shifts in a way that isn’t hugely helpful so it’s probably the time of life when you probably can’t get away with just you know hopping into the the petrol station and grabbing a a sort of a cheap processed snack for lunch we do really need to be focusing on fiber some I’m interesting research by a group called Zoe in the UK talks a lot about eating the rainbow so instead of like having an apple every day that you try
00:14:46 – 00:15:46
and really vary your fruit and really vary your vegetables so they would rather that you know in a week you you know had 30 different fruits and vegetables rather than sticking to a very rigid routine and having the same thing now I know that’s always not easy for everyone fruit and vegetables fresh ones can be expensive but obviously using even frozen fruit and vegetables are absolutely fine and thinking about other sources of fiber as well so thinking about you know your your um chickpeas
00:15:16 – 00:16:13
and your beans and and all the other things that you know just thinking outside the box a little bit to make sure you’re getting your nutrients I think it is also really important at this time of life to be trying very very hard to steer away from those ultr processed foods so sometimes people ask well what what is an ultra processed food think of it as something that you probably couldn’t make in your own kitchen so I’m not really talking about you know a lasagna that you’ve you know
00:15:44 – 00:16:46
you’ve bought somewhere that’s probably not Ultra processed though it’s perhaps not ideal but it’s more like something you know I don’t know like a box of Pringles or and you know potato chips or you know chocolate bars or and you know things that would be really really challenging for you to find the ingredients in your cupboard and for you to be able to make the same thing is usually a good indication that it’s ultr processed so the reason we don’t love those Foods is they tend to be filled
00:16:14 – 00:17:11
with lots of fillers and emulsifiers and preservatives and things that are probably not terribly good for us so if you could do one thing at this time of life is that it’s trying to eat as cleanly as you possibly can making sure you’re drinking enough water hitting your protein targets and I really love to get my patients to log their food I think it can be just absolutely eye opening when you log your food for a week and you see what you are eating and also what you’re not eating and I know
00:16:43 – 00:17:51
sometimes I can get to the end of the day and go wow okay well there’s not much fruit and vegetables have happened there or there’s no way I’m nowhere near where I’m meant to be with fiber and things so again this is definitely something that you could really work on now another suggestion and I know this might not be classically popular but alcohol um is definitely an issue I have so so so so many women who tell me a few things around alcohol and Perry and postmenopause one I hear a lot of women
00:17:17 – 00:18:08
who are drinking too much because they’re trying to put themselves to sleep or they’re trying to Quil their anxiety so they will acknowledge that they know they’re drinking too much two I get women getting upset by how much they’re drinking because they’re putting on a lot of weight and then to counteract that they don’t eat during the day because they’re worried about the calories that they’re drinking at night in terms of alcohol so then they’re not having any nutrients during
00:17:43 – 00:18:51
the day and we get stuck in a vicious circle but the other thing with alcohol so many women tell me now is that if they drink alcohol they’re often awake most of the night or if they do get to sleep they’re having really Vivid scary dreams that constantly wake them up and so what we’re beginning to understand and some preliminary research is suggesting is that we just don’t seem to metabolize alcohol as well and my suggestion is often for women to try and take a period of time away from alcohol
00:18:17 – 00:19:17
completely I’ve had a small group of women at my clinic who’ve done that for the last sort of three to four months most of them are getting to that three three and a half months at this stage and it has been quite transformative some of them have find it tricky some of them have not we live in Australia and there’s definitely a real culture of glasses of wine and beers and barbecues and and and it’s definitely a little bit more challenging to say that you’re the person who’s not drinking but I think
00:18:47 – 00:19:45
that the health benefits so many of them are telling me they have they feel like they’re making better decisions they feel like they’re bouncing out of bed in the morning and ready to go for a walk instead of waking with a hang over and um so many of them have lost weight so we actually it’s of course hard to know have they lost weight because they’re drinking less or have they lost weight because they’re not just making better decisions I would say it’s probably a bit of both but it’s definitely making a
00:19:16 – 00:20:22
difference so I would love to challenge you to give that one a go I think it it does actually work and one of the things that has really come out recently um the Surgeon General who’s kind of the chief doctor in America has been talking about this a lot in the last two weeks so he would like to see alcohol have the same type of warnings that um cigarettes had put on them years ago so you know those things they stickers that they know I have on cigarettes that say smoking kills and smoking causes cancer well in
00:19:48 – 00:20:59
reality we know that actually alcohol increases the risk of a lot of cancers and one of the ones that does strike fear Into the Heart of many women is breast cancer and many women are um afraid of HRT because of an old association with breast cancer um and many women are you know worried that whenever they come to have a conversation about HRT um that you know they’ll mention breast cancer but in reality um you know the fact is that um you know the jury is still out on that one but the reality is the
00:20:24 – 00:21:30
jury’s not OED on the connection between drinking and breast cancer they’re very highly Associated and we know that women who drink more have an increased risk of breast cancer so again a really good reason maybe to give up and the last thing that I think that you could definitely do is trying to be sociable now this one can feel really hard many women in this period of time often feel like they become a little bit more socially withdrawn they can become a little bit more anxious they maybe have
00:20:57 – 00:21:59
lost confidence in their appearance they’re feeling perhaps a little bit overweight they’re feeling tired and also for many women this collides with um you know perhaps caring for parents working perhaps teenage children or young adult children and they’re just exhausted so actually the thought of being sociable is actually really really challenging but and I’m going to say a big butt all that’s said and done we know from the blue zones in the world which are places in the world where
00:21:28 – 00:22:31
people see to live not only long lives but actually very happily and active long lives one of the key things about these people is they live very very sociable lives they tend to see other people a lot they tend to interact with neighbors friends they tend to be part of family networks that you know are very connected and obviously nowadays lots of us don’t live like that like all of my family um or my extended family all live overseas I’ve only got my nuclear family here in Australia yeah so
00:22:00 – 00:23:01
it is about creating a family through friends and colleagues and and trying to be as sociable as possible so my suggestion would be just to try and push yourself a little bit and maybe it is just to go and you know join a pickle ball thing or go back to the doing a little bit of basketball maybe if you played that whenever you were younger or you know go and join that pottery class or that art class that you’ve always wanted to do and you just might get to meet some new people but we know that
00:22:31 – 00:23:37
that’s going to really help mental health it’s going to help your confidence and it’s going to help you just navigate this period of life and who knows you might just meet your new best friend and so lastly there are other medications that can be prescribed by your doctor for hot flushes if you’re anxious and in fact even we can help you know with medically managed weight loss so it’s not to say that just because you can’t have typical systemic hormone replacement therapy it doesn’t mean you
00:23:04 – 00:24:09
can’t have anything and the other thing I want to mention as well is again just because for whatever reason you can’t or don’t want to have hormone replacement therapy you should maybe also consider that vaginal hormones might be really helpful for vaginal and urinary symptoms and you can have a look at an episode I made about that called genital urinary syndrome of menopause so in conclusion I hope that’s been really helpful today I do want to stress that you know everything I’ve chatted about of course
00:23:36 – 00:24:46
is helpful to people who are taking HRT and I would like them to do and consider doing all of these things but I just wanted to address anyone who is feeling left out who’s feeling that they’re sort of left in the dark or in the sidelines I never want you to feel like that we are certainly open at our Clinic to helping you and supporting you in any way that we can and definitely while I do love HRT for the right person it is definitely not for everyone and I would never make anyone or or try and talk
00:24:12 – 00:25:16
anyone into taking it it’s absolutely your decision but I just want you to know that you still can have real control over your health moving forward and I’m here to help you do that I would love to know your thoughts I hope this has been helpful and if You’ have any questions feel free to reach out either on Instagram at allabout you with Dr Shauna wats or on our um website all about you pod.com this podcast and any information advice opinions or statements within it do not constitute
00:24:44 – 00:25:20
medical health care or other professional advice information is provided for educational and entertainment purposes only if you have any health concerns always consult your doctor [Music]
