menopause care

On this week’s podcast, Dr Louise is joined by Dr Peter Greenhouse, a menopause specialist with 40 years’ experience in women’s sexual healthcare who is actively involved in postgraduate lecturing.

He has recently spoken out about NICE’s draft menopause guideline update, and tells Dr Louise it contains inappropriate and inaccurate statements, particularly concerning HRT and breast cancer safety, and ignores the cardioprotective effect of HRT when it’s started within 10 years of the menopausal transition.

Dr Peter challenges NICE’s stance on HRT for primary prevention and proposes a pre-emptive approach that could help reduce the amount of other medications GPs are prescribing menopausal women.

Finally, he shares his belief that women should be able to take as much HRT for as long as they need to.

You can read about Newson Health’s response to the NICE draft guideline consultation here.

Follow Dr Peter Greenhouse on X @GreenhousePeter

You can read Roger Lobo's paper, Back to the Future, which is referred to in the podcast, here.

Click here for more on Newson Health

Did you know a huge number of women face more barriers than others when it comes to receiving vital menopause care? GPs Dr Nighat Arif and Dr Kuki Avery join Liz on this episode to explore inequalities in menopause healthcare, and what can be done to make it truly accessible to all.

Dr Nighat reveals the barriers to menopause care faced by ethnic minority women, such as being left out of clinical research and the conversations surrounding menopause, institutionalised racism, and generational trauma.

Dr Kuki discusses the menopause care hurdles that women with learning disabilities often come across, such as late and misdiagnosis, communication difficulties, and also being left out of research.

Links mentioned in the episode:

• Purchase The Knowledge by Dr Nighat Arif 
• Follow Dr Nighat Arif on Instagram
• Learn more about Chelvey Menopause Clinic

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Are you experiencing symptoms like burning and itching around your vulva and vagina, or painful sex? Or perhaps you have the urge to wee more often or are plagued by recurrent urinary tract infections?

Joining Dr Louise this week is trailblazing US urologist and sexual health doctor Dr Rachel Rubin, to address these common menopause symptoms and the relief vaginal hormones – often used alongside systemic HRT – can bring.

Dr Rachel explains why we need to stop using terms like vaginal dryness and vaginal atrophy, which hugely downplay the impact of declining hormones on your whole genitourinary system.

‘When we say women have vaginal dryness, we minimise their symptoms, we minimise that it's no big deal, that you can just use a little lubricant, a little moisturiser,’ says Dr Rachel.

Plus, Dr Rachel and Dr Louise also discuss DHEA – a hormone treatment which converts to estrogen and testosterone in the vagina – and the benefits this can bring to women struggling with genitourinary syndrome of the menopause (GSM), again often alongside systemic HRT.

Dr Rachel’s three tips if you are struggling with GSM:

1. Know that if you have any symptoms that affect your vagina, vulva or urinary system and you’re over the age of 45, you deserve a vaginal hormone product.
2. Talk to your healthcare professional about access to this treatment that can prevent urinary tract infections, decrease your frequency and urgency of needing to urinate, decrease your pain in intercourse and lead to better lubrication, arousal and orgasm.
3. Keep using your localised hormone replacement: it is a safe product, so can be used long term to sustain the benefits.

 Click here to visit Dr Rachel’s website, and follow her on Instagram @drrachelrubin.

Today I’m chatting with Dr Anne Henderson, a highly experienced Consultant Obstetrician and Gynaecologist who has spent 17 years as a senior consultant at a major acute NHS Trust, following undergraduate studies at Cambridge University

Dr Anne is passionate about women’s health issues, particularly menopause and HRT, which is now a key health agenda. She has extensive experience in this area having undertaken postgraduate research into the menopause, HRT, PMS and post-natal depression.

In addition, she is a British Menopause Society Accredited Specialist, a recognition currently held by fewer than 200 practitioners in the UK and Anne also believes in offering her patients the full spectrum of treatments which includes complementary therapies such as herbal medicine.

She has worked closely with a medical herbalist in Kent for the last 20 years: this collaboration has been highly successful and forms an integral part of Anne’s clinical practice and educational seminars. She believes that the role of complementary therapies, particularly herbal medicine, is greatly under-recognised by most healthcare practitioners … which is why we’re talking about it today!

For more information I highly recommend checking out Anne’s brilliant book Natural Menopause, full of illustrations, tips and practical advice from a trusted professional.

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Victoria Jones is a community pharmacist at Bonnybrook Pharmacy in Coolock, Dublin. She received very little education on the menopause when training and became more interested in hormone health after her sister experienced severe symptoms at 40 and began taking HRT. The dramatic return of her sister’s health and wellbeing prompted Victoria to move away from running a chain of pharmacies to set up her own independent pharmacy with a focus on women’s health. When Victoria experienced her own perimenopause and she saw the profound benefits of HRT for herself, her passion escalated and Victoria now takes a very active role in raising awareness in her community with the public and local healthcare professionals, and in educating others through her social media.

Victoria’s advice to women:

1. Ask your pharmacist if they’ve done any training on the menopause and if not, mention the resources available such as on balance website and the Confidence in the Menopause course on fourteenfish.com. Find the right pharmacist for you.
2. Don’t be fobbed off by healthcare professionals, if you aren’t listened to the first time, go in more empowered with information the next time. Ask for a specific clinical reason why they will not prescribe HRT, and ask them to write it down for you.
3. Your pharmacist can explain how and when to take your HRT medication if your doctor wasn’t sure, or you didn’t have time to discuss thing fully.
4. Your pharmacist can also help with information on improving health through lifestyle measures such as nutrition and exercise.

Victoria’s pharmacy website is www.BonnybrookPharmacy.ie

Follow Victoria on Instagram and Facebook @The_menopause_pharmacist

Healthy Eating Doctor, Dr Harriet Holme, joins Dr Louise Newson on the podcast couch this week to discuss the importance of nutrition for reducing long term risk of disease and improving your future health.

Before becoming a registered nutritionist, Harriet worked for ten years as a doctor before her interest grew in the link between what we eat and our health. She is passionate about sharing evidence-based knowledge to help people understand more about their own diets and health, and offers nutritional consultancy as well as lecturing on culinary science and nutrition.

Harriet’s four key ingredients for eating in the peri/menopause:

1. Calcium is key, try and get it from your diet as much as possible.
2. Balance your diet with a wide variety of wholegrains (brown bread and brown pasta, for example) fermented food (such as kimchi or kefir), lots of fruit and vegetables, and avoid sweeteners and fizzy drinks.
3. Top up your omega 3 by eating 2 portions of oily fish a week.
4. And last but not least, vitamin D. Take this one as a supplement especially in autumn and winter in the UK. If you’re vegan, also take a B12 supplement, but otherwise it’s always best to get nutrients from your diet rather than relying on supplements.

Listen to Harriet on her own podcast, ‘Eating for Health’ or visit her website: healthyeatingdr.com

Find Harriet on social media at:

Facebook = @healthyeatingdrcom

Twitter = @healthyeatingdr

Instagram = @healtheatingdr