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[118] Menopausal Not Mad with Jane Pangbourne
Menopause shouldn’t feel like a maze with a tabloid at every turn. We bring on menopause and HRT specialist Jane Pangbourne to cut through the noise, unpack the science, and give you a simple path to relief you can take to your GP with confidence. Jane shares how the 2002 WHI study distorted public understanding, why transdermal oestrogen doesn’t increase clot risk, and where the real nuance lies with synthetic progestins versus micronised progesterone. We talk timing too: how pregnancies, breastfeeding, stress, and surgical menopause can shift the onset of symptoms long before your 50s, and how tracking changes for three to six months helps you spot patterns without panic.
If sleep is your weak link, you’re not alone. We dig into magnesium, gut health, and practical tweaks that improve rest while you consider HRT. Curious about delivery options? We compare patches, gels, sprays, and tablets, and explain why GLP‑1 meds like tirzepatide may call for non‑oral progesterone to keep your uterus protected. Then we widen the lens to testosterone: what it does for libido, muscle strength, mood, and cognition, why access can be tricky in the UK, and how many women find it’s the missing piece once oestrogen and progesterone are in place.
This conversation also addresses the people too often left out: partners trying to help, and those assigned female at birth who don’t identify as women but still experience menopause. Expect candid stories, clear stats, and scripts you can use to advocate for adjustments instead of giving up when a first prescription falls flat. Subscribe, share this with someone who needs clarity and get in touch with Jane with your questions https://menopausalnotmad.co.uk/ or on Facebook: https://www.facebook.com/menopausalnotmad
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This is the most need to wait. I'm an applied tip and I'll be trying to need an advice to help you stop sacrificing your soul in the name of success. An experience more validable, confident, and fulfilment both in and out of work. Hello, and welcome back to another episode of the Modern Leaderway. And I'm bringing to you today one of these wonderful guests that I promised you for the last few episodes. And this week we've got the lovely Jane Pangbourne. I almost thought I'd said it wrong then. Jane Pangbourne.
SPEAKER_01:I thought double check. Welcome, Jane. Thank you, Emma. Thank you, friend. Happy to be here. Even if you can't say my name right, it's all good.
SPEAKER_00:Oh my god. So we only met a couple of weeks ago. It feels like I've known you for so much longer. I know. We definitely hit it off at the Big Festoon. We had a lot of laughs whilst we had our stands. You obviously wowed the stage with your talk and have created all sorts of waves since uh appearing on the Big Festoon stage. So I was very keen to have you on to talk about um something that's very topical for me and where I'm at in my journey. I'm sure it is for many of my listeners, given that we're of a certain age, and that is, of course, perimenopause and menopause. And just to give you a brief introduction to our listeners, um, I have your lovely book here. It's pink, it's my favourite colour. Um, it's I choose menopause, it's been an Amazon number one bestseller. But your business is menopause or not mad, which I love. Thank you. And you are particularly an advocate for HRT. So 100%. So I love this because we have had menopause experts on from a functional nutrition background. So we've had Caroline and Liz Sargent from Well Nourished Club. So you can go back to those episodes. I'll link to those in the show notes as well. Because that gives us just a different opinion, a different gives balance, yeah. Yeah, and I think your approach as well is like something that's prick piqued my interest given where I'm at. So thank you for coming on. Um give the listeners a bit of a um background as to who you are, what you do with your work in the world, and um we'll go from there.
SPEAKER_01:Understood. So um my name is Jane Pangbourne. I probably should have a much longer version of this, but essentially I am a massive menopause and HRT geek, and I talk about HRT vaginas, period, uteruses on a regular basis, and love, love, love what I do. I've been doing this uh formally under the badge of menopause or not mad for about 10 years, but um I've been in the world of menopause and perimenopause for over 20 years because I became perimenopausal at 37, and I'm now 58 and a half, so it's been going on for a long time. I'm clearly post-menopausal now, but I my interest was peaked to use your term. My interest was peaked when I received no help when I was 37, didn't know what the hell was going on, if I'm honest, and I was angry, I was itchy, I was just low mood, I just felt awful. And assuming you don't mind too much information, Emma, because yeah, that's what I thought. You know me. I mean, I I think I was talking about my vagina on stage, so let's be honest, I'm you know, I'm happy to share with anybody. But the the there was one moment when my husband and I had been away for the weekend and we'd stopped off at a John Lewis, we had a a car full of clothes and stuff because we'd been away. Stopped off at John Lewis to pick something up, and I I I don't know why, I was wearing a pair of hideous grey trousers, but like sort of suit trousers, and I was going up, so I would have been about 38, maybe 39, coming down the escalator, and suddenly felt this gush, and I went, yikes, that wasn't expected. So obviously, I my periods were erratic. I didn't expect that, and I obviously quickly grabbed something, grabbed my jumper, put that ram away, ran back up the escalators to the loo, and that was the beginning, really, of me going, okay, I really need to sort this out. There is something not right. I didn't really know about perimenopause. I knew my mum had been through menopause. Um, she'd actually been on HRT tablets, that's a whole nother story because she really struggled when they took them off her. But I asked for help, was told many, many times um, numerous things, you're too young for perimenopause, HRT will give you breast cancer, we can't give you any HRT until your periods have stopped, and a lot more around that. And so I felt really let down and really sidelined and um just belittled, really, um, and not taken into account for years. So it was probably my early 40s. So I realized I needed to get sorted and uh found that I needed to research a lot, but you can't just Google what is perimenopause, will HRT give me breast cancer? Because if you do that, you will go down a rabbit hole you do not want to go down. And um, so I basically spent the last sort of 18 to 20 years researching and I'm continually updating my knowledge. Um, and about 10 years ago started to help other people uh with their menopause and perimenopause, specifically around hormone replacement therapy, because that is my absolute passion. I'm so passionate about dispelling the myths around hormone replacement therapy, and I'm sure we'll talk about those myths in a minute.
SPEAKER_00:Absolutely. First of all, 37, that's weird it sounds really young, but are you seeing more and more people like with the new awareness? Because let's face it, paramenopause is like a conversation now, isn't it? It's no longer something that's like confined to your 50-something friend group. It's like a conversation that's out there. Um, whereas in the media, social media, like celebrities are more open about it. Are you are you seeing more people with that awareness go, am I entering perimenopause early? Like early, if you like.
SPEAKER_01:Yeah. Yeah. So the formal diagnosis, um, if you um are perimenopausal before you're 40, it's classed as premature perimenopause. And then 40 to 45 is early, 45 onwards is normal, whatever normal is. But actually, I I tend to view that yes, okay, it's called premature perimenopause, but as you've just indicated, Emma, um, it's really not that unusual. It really isn't that unusual. Um, but the the reason it feels rarer, more rare, rarer, is that a word? I don't know. Less less common, feels less common, is because we don't talk about it at that age. And so I'll often talk to women who are um struggling with symptoms, whether that's erratic periods, low mood, um um itchy skin, um, anger, any of the about 50, 60 different um symptoms that you to choose from, but they don't associate them with anything. And what tends to happen is it's only when things are at a peak and you've got like 15, 20, 30 symptoms you go, okay, there's something really going on now. Because we as women, and I'm talking specifically about women, although there are other people affected by menopause, so people um that were assigned female at birth but no longer um uh consider themselves to be female and no no longer identify as female, but generally about 80% of my uh client base are female. But we um as women tend to just absorb symptoms and we go, oh, it's fine, it's just me, and oh, I'm having a bad day, or oh, it's just time of the month. Well, yeah, it might just be time of the month, but um, my steer to clients and to my community is always to say, just keep an eye out for changes, you don't need to worry about those changes. But if things are different for you, just start making a little note of that. You know, if something's different, just check it the next month and go, you know, is that or has something else been added to that list? Um, and it you can track that for as long as you want, but I would always say three to six months, give yourself a little um list of what's going on for you, and then you're ready probably to see somebody a bit more formally, whether that's me or whether that's straight to your doctor. One, you know, one of those will help you.
SPEAKER_00:Yeah. It's so interesting because I think like when I think of some of my friends who are in that late 30s kind of bracket, I'm thinking like someone who's just had a second baby who's um kind of struggling a bit with the like hormonal fluctuations postnatal. I think I read it in your book, did I? That it's almost like your body can say, right, we're done now having kids. So we're done. You read my book, and you've read quite a bit of my book if you've read that, aren't you? Good. I have yeah. But I think but yes, that's exactly it. That made me think of her for one. And then I've got another friend who's like chronically stressed. She knows it is, it's work-related, money related, and it's like, how much of these other factors play into how we enter, like or when we enter this kind of stage of our life?
SPEAKER_01:All I I would say most things are going to impact your hormones, just as hormones will impact most things, it's all interlinked. As you said about um having usually having more than one baby, um uh will likely um make those perimenopausal symptoms arrive a little bit sooner than you expected, and particularly if you've had, you know, more than two children. I often find that once you've had that uh, and this is just my own experience of clients rather than um data, because I haven't really looked into the data on this, if I'm honest. But um, if if a client of mine has had more than two children, usually that third or maybe that fourth baby, um, they'll say, Oh, yeah, within about a year of having ex-child, um, I will uh I started to experience perimenopausal symptoms. And um when you're breastfeeding, when you first have your child, you'll experience perimenopausal symptoms because your estrogen levels really dip. Um, but nobody tells you that, of course. So we're not even talking postnatal depression, we're talking just a normal um situation with your hormones. Um, but yeah, I think I said in the book, it's something uh it again, this is just my wording, but it's almost like your body says, Yeah, we've done that, we've done the children, we're all good, don't really need to worry about your hormones anymore, and that's when perimenopause kicks in. Uh, but it can happen at any time for any reason. So it might be genetic, if if um the women in your family, particularly early um uh hitting perimenopause, if you're very stressed, if you have particular medications, if you've had obviously if you go into surgical menopause overnight, you know, if you have an operation where you have your ovaries removed, um, known as an ouporectomy. Um, if you have a um a bilateral euphorectomy, so both of your ovaries removed, you really should be offered um uh estrogen therapy. Um, sorry, if you have hysterectomy, you'd only need estrogen, but you should be offered hormone replacement therapy straight away. But so many women at a young age are having that, um, if they've had that operation, are not given any hormone treatment, which is devastating because there's no lot there's no few years of going into menopause. It's overnight, your hormones are you know gone. And it's it's brutal for women um going through surgical menopause and um and anybody going through surgical menopause. So um those things are so important and um it can affect somebody not just physically but really, really um psychologically as well. And obviously there have been lots of things in the news about that about um women um taking their own lives because they just couldn't handle it. And it don't get me wrong, that is the extreme, it's not the norm, but it does happen, and those women didn't have to be in that situation.
SPEAKER_00:Yeah, Croiki. That's um it's kind of heartbreaking, isn't it? When you think it's heartbreaking. I I think there's a problem with like the access to information that we have out there because it's all so conflicting, depending on who you come across and the opinions and where what camp or what end of the spectrum they kind of sit on. Um it's like kind of overwhelming, and I'm finding this as I'm even as I'm reading your book and I'm just getting into like um HRT or not kind of thing. And it's like Christ, I didn't realise there's gels, there's sprays, there's a lot this, that, and the other. So before we get onto that, I'd love to just go through some of these biggest myths and where they come from. So let's bust some myths from your perspective. Um, where does the negative press around HRT come from?
SPEAKER_01:Okay, I think uh it would be fair to say that it almost all stems from the 2002 um Women's Health Initiative uh study that was released, um, it was leaked really to the press before the proper diagnoses of all the data was done. And of course, the headlines said HRT gives you breast cancer. And from that moment on, all the people who were doing really, really well on their HRT were being prescribed HRT really effectively, they were taken off HRT, almost all. And that had a devastating effect on the female population because um I don't know the figures off the top of my head, but many, many, many thousands of women um suffered for many years, and some died um prematurely because they were taken off their HRT, and that might have been struggled then with um earlier onset osteoporosis, which then had a knock-on effect of affecting their health, because once you start having those falls and breaking bones um on a regular basis, then that has a massive impact on your longevity. Um, but the mental health and obviously all the quality of life element was absolutely destroyed for many women. Um, my mum would be a good example of that, actually. So I would she struggled, but she she coped, but she was doing so well on her HRT. And I remember her saying, I mean, this was way too much information for me at the time because I was in my I don't know, 20s or so, late 20s, early 30s. And um, she'd said, Oh, yes, you must try this HRT, Jane. I didn't I didn't know what all that was about at the time. And she said, Oh yeah, it really gets your libido going, gets your sex life going again. I'm like, Thanks, Mum. All right, mum. You know, yeah, too much information, thanks. But when they took it off her, I am not exaggerating, Emma, when I say that within two years she'd had to have she'd shrunk by about three or four inches and she'd had to have one, and then later on a second hip operation. And she was slim, she was fit previously. Yes, she smoked, and I I will say that she did smoke, but other than that, she was very fit. She'd stopped drinking years before, um, so she didn't drink alcohol anymore. She ate pretty healthily and walked a lot, but honestly, uh, she became a shadow of herself, really. And I know that's just my experience in my family, but if I'd known then what I know now, I would have pushed and pushed and pushed to have her put back on her HRT because it it it really, really helped her to thrive as she became menopausal. Um, so the Women's Health Initiative um kind of messed it up for all of us, and literally, even now, whatever it is 23 years later, nearly 24, we are still clawing our way back from that. And not just my mum's generation, but their daughters and their daughters' daughters are still living under that cloud of HRT gives you breast cancer. And I am happy to sit here today, Emma, and say HRT does not give you breast cancer. I receive eight uh messages for that comment. I don't care because it's so important that women understand and people who need to know about it, uh, know about menopause support, need to know that HRT is not the bringer of death and doom. There are some caveats to what I've just said, and I'm happy to go into more detail on that.
SPEAKER_00:Yeah, I mean, I was just gonna interject there and just say, because like right now we're seeing this playing out in the press with Davina McCall's sad news that she's also just been diagnosed with breast cancer, right? Thankfully, it sounds like she's caught it. It's treatable. Um, and as we know, these things, you know, we can recover from them. Um, I actually met someone yesterday at an event who's 47 and has stage three breast cancer because she's she's never checked her breasts. And um, you know, she's saying, check your breasts, everyone, and let this be a reminder for all the listeners to remember every month to check your breasts and your balls, guys, because you know, it's a lot easier to treat something like breast cancer when you catch it early. Anyway, side note. So, yeah, I know you've sort of spoken out and you're not afraid to speak out when it comes to um calling out the bullshit that you see in the headlines, and you have received quite a lot of nasty kind of take it as part of the position you're in, I guess, as advocating for something that can be seen as controversial. You are gonna get people that are just do not get it and do not want to agree, do not want to listen to you, and will fight for their cause, right?
SPEAKER_01:Yeah, absolutely. I am quite feisty in my opinions because but it isn't just my opinions. My opinions are based on research and facts. Um, and I I would say most days I am looking up new stuff about HRT and seeing what's in the news and what's being researched and what the latest papers are saying, as in research papers, not the Sun newspaper, that sort of thing. Um, but um, but yes, um it it hurts me when I don't mean hurts me personally, it hurts me for the people who who tell me um that they just will never touch HRT and it's it's the bringer of doom and and it will hurt, it will harm people. And yesterday, as you know, Emma is a good example. I had a very simple post on my Facebook page, uh, on the main um menopause or not mad page just about Davina and saying it was really short, it was um criticizing the Daily Mail for their headline, which said, Did HRT give Davina breast cancer? Because of course she's very outspoken about her use and her advocacy of HRT. And um I I was quite sweary on my post and I just said this is not helpful, you know, this is the all that does is push us back into the closet again for those of us that want to take HRT. I'm not here to force anybody to take HRT. What I want them to do is to make an informed decision for themselves and to advocate for themselves. And I have plenty of clients that are not on HRT, um, and we work around how to make sure they're as healthy as possible. Most of them are on HRT, if I'm honest, but um, but that's not me forcing them to do it. Um, but uh yes, people they're usually in one of two camps, no, one of three camps. There's the um I'm desperate to know about HRT, I just don't know enough about it, please help, which is you, uh or they're on HRT and they need my help, um, or they need some more support in how to sort of tweak their regime because it's not working for them, and they've been told if that doesn't work, they need to stop taking HRT, which is usually nonsense. So, you know, we can all there's always a way. Um, and then there's the other end of the spectrum where you get the people who go, absolutely not. In fact, yesterday, amongst the many hate messages I had, hate comments, one person said, HRT definitely gives you breast cancer. Um here, and this is her research. Um, I've put this into chat GPT, and this is what chat GPT says. And I went, Okay, well that's great research. So so I went, Look, you know, this this is not the case. Please let me give you some statistics and some some um professional and personal experience on this. And she said, You shouldn't be allowed to to do this. I'm reporting you. So she's reported me and whatever. So so I've just so that's fine. I'm okay with that because I can't do anything about that person and what they believe. What I really want to do is reach more people like you, Emma, who say, actually, I'm really frightened of it, I don't understand it. Um, there's so much information out there. Please help. Because my whole ethos is it doesn't need to be complex, it's really not difficult. Honestly, I am I am nothing special, I'm just like you. So I've just spent I've just removed all the the need for for you to do all that research because that's what I love and that's what I do. And I had a client today actually, and one of her biggest issues is fear and lack of confidence. She is on HRT, but um, all that we're doing together, all we're doing is making sure that she feels confident in speaking to her doctor when he pushes back and says, Oh no, you need to go off your HRT. And I'm saying, okay, this is the sort of thing you need to be saying to him. Um, something simple like, I hear you, but I would like to continue taking it for at least another three months and then we'll review it again. Because we have every right to have that opinion of what we do with our bodies. And I was saying on another post just finally on that note, um, I said to um about breast cancer survivors, and I said, you know, you might have been told absolutely not, you can't have HRT because you've had breast cancer. We you've been through a lot if you've had breast cancer. You're a grown-up, you can bloody make your own decisions. Don't tell me what to do, talk to me, have a conversation with me, please, doctor, so that we can have a um an informed decision, mutually uh beneficial decision-making process rather than no naughty girl, you can't have it, because that's just demeaning and unnecessary. We don't need to do that, and it's so much easier for the doctors if we arrive more informed anyway, isn't it?
SPEAKER_00:I think that's where I mean I'm all for like it's your body, like you do what you want to do to it, and of course, make an informed decision that's gonna be best for you based on like your research. So, like I'm a I'm a Manjaro user, right? I I take the old get uh weight loss injections, but it wasn't something I did lightly. I did my own research, yeah. It was a really informed decision. I knew about the side potential side effects, about the risks, um, and I was doing it for a like for my own personal reasons, it was informed, and I'm kind of like, I don't think I'm fearing HRT because I don't think I've ever really paid much attention until now. I've got you didn't think you needed it, did you? So yeah, of course. Why not? You kind of think, oh, maybe I'll I won't need it. Like maybe I'll get away with needing it, uh ideally, but um I feel like I definitely need some support right now.
SPEAKER_01:Well, no, and I completely get that. And actually, now you've mentioned Monjaro, um, again, that's another thing that um people don't we're not told this, so I've spent quite a lot of time researching since Manjaro became a thing, researching that. So I know straight away, because you and I will be talking, Emma, obviously, um, that I need to be uh a little more specific with you about how you take your progesterone element of your regime, because Manjaro can have an impact on how you um retain and process your anything you take orally. So it's really important that you have the right dose of uh progesterone so that your uterus is protected, and that's a whole nother conversation. So I would not want you to be underdosed, and as Manjaro does what it does, there's a chance that might happen. So we need to make sure you're taking that in the right way, and and maybe that wouldn't be orally, you know, you can take these things vaginally and you can have them in different ways. So um that's important, and that's the sort of thing that somebody in your situation or similar to you needs to be told because you need to be able to have that informed conversation rather than feel criticized, you know.
SPEAKER_00:Yeah, and just my experience of GPs and no shade on GPs, it's just like we don't have that opportunity for a conversation about it. I don't have an opportunity to ask them questions, and I don't necessarily get the confidence that they are answering with my best intentions in heart at heart because they're they're giving me the answer they want to get me out the door kind of thing.
SPEAKER_01:Well, they do, they don't have the time and and no disrespect. And I I think I said this when I did the the stage thing at the big festoon, but you know, this isn't about GP bashing. I'm I hope, and there are so many GPs that have been absolutely lovely in recommending me, but I hope that GPs see what I do and people like me do as a benefit to them because my clients turn up and go, Well, this is what I want. Thank you very much. And they go, Oh, yeah, okay, great, that saves me 10 minutes. Uh, because I would never recommend something that wasn't safe. And if I was unsure, I would always say, Look, I think this, but you need to ask your GP to look into that. I'm not gonna just say take any old shit, you know. That's not, you know, that's not what I do.
SPEAKER_00:Just for the listeners, like update, probably since I last talked about any of my own symptoms. I feel like my sleep has been the biggest one, and I feel like it's been 18 months now that my sleep has been like affected, and it's it was affecting my energy. I feel like I've through functional medicine, I've kind of like addressed some vitamin deficiencies and things like that. And I've I've definitely I don't need my afternoon naps as much now, but I know I could definitely do some better quality sleep in my life. Um, and interestingly, I had the marina coil, so I had three coils, so nearly 15 from at the age of 20. And actually, it was after COVID that I was like, do you know what? Because I didn't have any periods, I was like, I actually would like to know if my body is still functioning like a sure it should. So like a fertile woman. Yeah, exactly. Even though I've I've never been interested in being fertile.
SPEAKER_01:No, no, but fertility isn't just about having children, is it? Exactly.
SPEAKER_00:Um I had it removed, I think it was 21, maybe 22. Um and fascinatingly for me, I had periods of return within six weeks, and I have a very consistent cycle. I remember you saying, yeah. Yeah, so it's so that cycle wise is fine. And in and then the other interesting thing, so the sleep is the biggest sort of um indicator for me to start going, oh, is there something going on? But the other thing is um I would say I have been emotionally suppressed for many years. Yeah. A lot of us have been, perhaps. And as I've been on my own kind of healing journey, if we call it that, to be more in tune and connected to my body and its ebbs and flows through cycles, but also its emotional highs and lows.
SPEAKER_01:Yeah, of course.
SPEAKER_00:Um, I'm more aware of those fluctuations, yeah. Cyclical. And in the last six months, I would say, it's been heightened around my phase to the point where I I don't get angry as such, but I get very emotional, like very just heightened emotions that I can't seem to control. And it's so out of character for me. So another big red flag, uh, or or like just another sign that I'm I'm possibly needing some support. So again, it's like all these factors, like I've had the coil, so I guess that masks some of it.
SPEAKER_01:Because yeah, it really does. Yeah, it's exactly you've said that exactly right. It does um progesterone also fluctuates uh and and decreases as well as estrogen, and obviously you've had a synthetic progesterone in place. So, to a degree, that will have masked your initial early perimenopausal symptoms. Um, you may have noticed some small things, but but it would have masked it. So as soon as you have the coil removed, you're running bareback, you know. Yeah, there's it's intentional. Of course, which is great because now you know what's what, and it's great that your cycle is um on point. That shows um that things are running, you know, pretty normally, but that doesn't mean things aren't fluctuating. From what you've just said, you've got um these peaks and you know, uh ebbs and peaks, um, where your um where your hormones are playing that little dance called fluctuations, and at the moment it's quite erratic. I know you've said it's cyclical, but you don't I doubt you can put it down to a particular day at the moment. Is it just kind of or can you?
SPEAKER_00:It's weird. Every second month it seems to be like the 14 days. So after um ovulation, I can I can be in this like emotional way. But this but the month in between, it's more like which I'm in at the moment, yeah. More like um I'm getting physical symptoms rather than symptoms. So it's it's weird, it's like one. One month it's physical, the next month it's emotional. So like my gut is in bits at the moment. Yeah. One in two days. So I'm aware of that. And at night as well, um, and hot flush. Like I'm actually quite warm now, but um yesterday we or the last two days we've been at an event. Um we're walk- I'm walking in with my friend, and I'm like, fuck me, it's hot in here, isn't it? And they're like, No, it's not. No, so just you, just you.
SPEAKER_01:Um, I think did you say are you did you say you're 43? Did I just work that out? 46. Oh, 46. Okay. So um in theory, just from what you've said, it sounds Emma like you are you're perimenopausal, that's a given. But I would say you're relatively early on in that. Um you don't really need blood tests at this stage. I know that's not what everybody will say, but in reality, if you're under, sorry, if you're over 45, you don't really need blood tests. They're not massively useful before you're 45, to be honest. But um as you're as you're already experiencing some symptoms, you're not I'm reluctant to say start HRT now, because actually, probably, and it's rare that I say this, you could probably go a little bit longer without starting it, because there's a few things that can be done just to keep you at bay. However, it wouldn't harm at all if you wanted to crack on with it and start HRT now, because what I don't want is for somebody to say to you, Oh, wait till your periods have completely stopped when you're postmenopausal and then start HRT, because then you've suffered for a bit longer, a lot longer in some cases, and also some degeneration may have already taken place, whether that's heart degeneration or bone degeneration or whatever. It might not have done, but why risk it? So um the advice is to start sooner rather than later. But if you're not, the reason I'm hesitating is because if you're not massively suffering, and we'll get on to your specifics in a minute, um, then I don't want you to start HRT and not see the full benefit, that's all. Um, because if you think, oh well, I've you know, I've just got two or three symptoms, and I say, right, let's crack on, let's get on with your HRT, then if you take that for three months and don't feel considerably better because actually you don't have many symptoms, you're gonna go, well, that was a waste of time, and you won't necessarily continue. So that's why I'm a bit hesitant with you. Um, have you changed do you take any supplements and have you changed anything since you saw your functional medicine lady?
SPEAKER_00:Yeah, so um it so I had a lot of inflammation markers in my body, which I wasn't surprised about, but I had high ferritin levels, which um was one of the things that was flagged. Low B6. So I'm on a B6 supplement in addition to my multivitamin, which is quite um strong. I take uh some probiotics, prebiotics, and D3 in the winter because my D3 levels when I got tested was fine.
SPEAKER_01:The only thing that springs to mind immediately that you can do, um, just aside from HRT, it breaks my heart not to be talking about HRT just for this moment, but I I'm more than happy to do it. Um, is adding in magnesium.
SPEAKER_00:Oh, yeah, if you don't already. I'm meant to take it, but I don't always buy the bed.
SPEAKER_01:Do try to be consistent and take those before bed. And also, in addition to that, if you're taking oral magnesium, you can also add in, I don't know whether I said this when we were together, but add in magnesium oils um or balm. Right, the spray one. Yeah, the spray. Is it like um yeah, it's like a lavender spray? Some of them are, they're really nice. And um, you can put that on the base of your feet, that's really helpful, that's really absorbed well, and you can have that as well as the oral stuff. So that's quite relaxing. And again, if you like a bath, then you can put some magnesium crystals in the bath, and it's just just kind of relaxing. Um, it's not going to solve all your problems, but it definitely helps with with sleep, it helps with your quality of sleep. With your gut being uh misbehaving a bit, that's also a clear sign that something's not right because estrogen, um, when you're low in estrogen, it can reduce the um uh slow down gut transition. So you'll often find that you're very uh bloated and constipated, then suddenly you've got you know really upset tummy for a few days as your body's desperately trying to get rid of the toxins.
SPEAKER_00:And a burrow, which also does that, right?
SPEAKER_01:Which also does that, so therefore, you are at risk of being depleted in in vitamins, so which is going to make you tired and you know all the things that you know would would happen. So, in your case, you do need to. I think your gut is probably more important than anything to make sure you're actually holding those vitamins in and the probiotics, prebiotics, great idea. Um, but also just reviewing your nutrition as well, which you've probably already done, but just making sure you're actually holding those vitamins in um so you don't become exhausted from you know pooping it all out essentially. Um, but also just quickly before I forget, um, I'll talk to you about your HRT um in a sec, but I'm not paid to recommend these. But there is a really good sage tablet, uh, just sage, it's called Mennow Force. Uh, you can get it from most health food places. It's really good because that sage is great for reducing hot sweats and uh flushes. So you can't, I mean, it is just sage, you can't overdose on it. So if you get some of those, that they're really good or something similar. Um, but ultimately it won't be very long at all, and you could do it now until you start HRT if that's what you want to do. And there are loads of different ways to do that.
SPEAKER_00:Yeah, so talk a talk to us about the different ways then, because this was this fascinated me. I was like, what?
SPEAKER_01:So many things to do.
SPEAKER_00:I've heard about the patches, all my girlfriends are on the patches.
SPEAKER_01:Yeah, and patches uh ultimately they're all pretty much the same. Um, that the in terms of what it's delivering to you, it's just the format of delivery. When I first started on HRT, I was put on the completely the wrong regime years and years and years ago. I was on some combined, I can't remember the name of it now, a combined tablet, and I had a period for 10 weeks non-stop, no break. And I just went, well, this can't be right. So, so therefore, knew I needed to look into it more. There are a couple of different types of gel, which are oestrogen gel. There's one called Sandrina and one called estrogel. They're actually listed, I think, in the book, or some of them are anyway. Um, the um they're transdermal, a bit like patches that sort of go on the skin. Um, really nice, safe way of delivering because it does it isn't processed by the liver, so there's no blood clot risk. And the number of people who are told, no, you have a history of blood clots, you cannot have that have HRT, which is completely wrong because there is zero blood clot risk because it isn't going through the same uh in the same process. So there are gels, there are patches, there are patches that contain both your hormones um together, so you'd have estrogen and progesterone within the same patch. There are different doses, obviously, it just depends. There is loads of different ways to take it, or there are estrogen-only patches, and then you have to add in a separate progesterone, which may be a marina coil, which you've had before, or it may be the um tragestin tablets, which, although they're tablets and you normally take them orally, do not have a blood clot risk because they're what's called micronized, so they're processed slightly differently if in the liver. However, if you take the HRT tablets, not the ones I've just mentioned that have progester just progesterone, um, so people might know the name, the term uh Cleophem would be one brand name. Um, they are great, still have the same product within them, but they do have a very small increased blood clot risk purely because of the way they're processed in the liver. Now, um, it's no more than the blood clot risk of taking the contraceptive pill, which people take without any issues whatsoever. And there are uh other than that, there are no other serious risks. Um obviously everybody's individual, blah, blah, blah, you know, all that. I'm not saying that it's the same for everybody, but in the majority of cases, it's absolutely fine. And I tend to say to people, if you're if you do want to take tablets for whatever reason, no problem, but I don't tend to advise it if you're over 60, just because we have that increased blood clot risk anyway. Um, um, and if you do have a history of migraines or blood clots or stroke, I would say let's probably not because you're at a higher risk anyway. Um but we can still we can still do HRT, we just do it differently. That's all. And I used to be on tablets, then I was on gel for five years, and I've been on patches for years now. And and I I I my skin gets a bit sore sometimes, but I kind of move them around a bit when I change them, and it's you know, it's fine. To be honest, uh, you will have to prize them for my dead body because there is absolutely no way I'm no, they're not coming off. And when I went for my hysterectomy, um, they'd said to me, I went private because I was dismissed by my my doctors, and um I was actually going for a bowel prolapse repair, and I said, Oh, can you whip out my uterus while you're there, please? And he said, Okay. Um, and I said, Take my ovaries as well because I don't need them. I'm postmenopausal now, and he said, Oh, well, I'm not sure. And I said, Yeah, take it all. He managed to get them all out. Another story, as they found I had ovarian cancer, that's a separate conversation altogether, but all fine now. But when I was going under the anesthetic, I'd said they'd asked me to go off my HRT. I said, Absolutely not, don't even don't even have that conversation with me. Um, and then the anaesthetist was sweet as a button as I was going under the anesthetic, and I said, Don't touch my patches, and he went, not gonna touch your patches. And I'd said to my husband, who's lurking in the background here, I'd said, When I wake up, when I'm asleep, when I come in this room, can you just check my patches are there, please? So I was there's absolutely no way I can function without them. So it's um even and to end on that, just that little bit about operations. We are always told, or we seem to always be told, if you're going for an operation, you need to stop your HRT six weeks before. Absolutely not. Yes, if you're taking tablets, you need to change to one of the transdermal routes, but you do not need to go without your hormones for six weeks just to go and have an operation because there is no blood clot risk when you have the patches or the or the gel. Oh, that's and that that endeth my my my missive and my my sermon.
SPEAKER_00:But but it's so good because how many people would just go, oh okay then, and I know roll with it because you why would you know any different? Yeah, exactly. Yeah, of course. So thanks for all that. I think okay. You mentioned the caveats when we were first talking about why you're so pro-HRT. So yes. Do you want to come back to them just to tie this in a little bow?
SPEAKER_01:Yes, yeah, no problem. So I've mentioned one of them just now, which is the small blood clot risk with the tablet form. The only other one, um, when I made the sweeping statement earlier about HRT does not give you breast cancer, um, the evidence points very, very clearly and has been for a long time. Um, that um we we normally view estrogen as the the doom um the doom monger, but actually estrogen is really protective, really nurturing, and that actually gives you if you take estrogen on its own, which I do because I've had a hysterectomy, um, it actually reduces your breast cancer risk. So estrogen is fine, even though we're told it's not. But if you take combined HRT, um, as I mentioned, if you have the if you need the progesterone to protect your uterus from uterine cancer, um, the micronized progesterone I mentioned a minute ago, which is called utergestin, or in the US is called um I've forgotten the name of it now, isn't that awful? Um Prometrium. Um, if you take those, that's fine. But synthetic progesterone, like that in the contraceptive pill, and like that you'll find in the patches um and some of the tablets, um does have uh they seem to be indicating it does have a small um risk factor increase uh with breast cancer. So the those who have been identified as having um breast cancer caused by HRT, which uh is is difficult to assess, um, it seems to be that the synthetic progesterone is the thing that's increased that risk. So that's so when I say HRT doesn't cause uh breast cancer, the caveat is if you're using synthetic progesterone, you don't need to be frightened about it, it's only a small increase, but there is a small increase um in risk.
SPEAKER_00:Right. Okay, thank you for that. Um of course it's not just we talk a lot about estrogen and progesterone, but testosterone has a a role in all this as well, doesn't it?
SPEAKER_01:Yes, I love testosterone. So I have been using testosterone for nearly three years, and I haven't yet grown a penis, so we're all good. My voice hasn't got deeper and I haven't grown a beard. Those are the things that we are told when we ask for testosterone, and it's still not licensed for women in the UK. Um, so we have to have the male marketed testosterone. There's Testagel and Tostran, and I don't think the other one is available anymore, so I won't mention their name. Um, you can buy a female uh marketed testosterone called Androphem, which comes over from New Zealand or Australia, anyway, the other side of the world. Um, and you have to buy that privately, your GP won't have access to that, so that's expensive. That costs it's gone up a lot. Actually, it's just under£100 for a tube which lasts three months. So it's not cheap. The testa gel, if you buy it privately, is a third of that, and of course, you can get that on the NHS. But many doctors, many, many doctors just won't prescribe for women, um, which is heartbreaking because when we're younger and when we're pre-perimenopausal, um most women have three to four times more testosterone than they do estrogen. So it's not just to throw away, oh, I fancy a bit of testosterone today. It's really important, and it's not just important for your sex drive, it's important for um it's important for your muscle strength, it's important for your mood, uh, for your brain health. And we have all these hormone receptors all throughout our body. Um, but they but honestly, I cannot tell you how many times people are told, women are told, um, oh no, that's a male hormone, you don't need that, which is heartbreaking to me because it's not for everybody, not everybody benefits from it, but I think the stat is between 60 and 70 percent of women will benefit from it um when they're postmenopausal, and most often women will say it's the missing piece of the puzzle for me, just adding that that extra little hormone in. Um, and I find if I don't have it, I get really sore um um knuckles, really sore hands. So clearly it's doing some good. Wow.
SPEAKER_00:And again, it's another thing that we don't necessarily know think about or know naturally. Of course not.
SPEAKER_01:I didn't know about that until you know 10, 15 years ago. Um, I had no idea that we I have no idea women had testosterone 20 years ago. You know, why why would we know that? You know, we're not told that, are we?
SPEAKER_00:Yeah. Um and I'm and I want to wrap this up because I know you've got somewhere else to be, but the the other fascinating thing for me in terms of like the hate you're getting or or the challenge pushback you're getting online is around when you have declared that you are not just supporting women but their husbands, or I know people that are identify as female that were born up or the other way around.
SPEAKER_01:So yeah, so w women so so obviously women who identify as women who are born um uh um as women and and remain um in that in that guise, then they they are the majority of my my world. But um I've always supported husbands and partners. So that's the I mean, years ago I had a partners, husbands and partners page on my website, and and in fact at the Big Festoon, loads of husbands and partners came up to me and said sort of hush hush, oh can I have a copy of your book for my wife? And which was so lovely. We'd love to know that.
SPEAKER_00:I'm not a thinking of that of that.
SPEAKER_01:It was so lovely. And I did say to one husband, I said, because he was so interested in everything. Uh he asked me loads of questions and and really was digesting it as much as he could, and uh, and I said, you know, your your wife should be really proud of you. I said, you have really gone out of your way to ask some really good questions today. And he said, I just are desperate to help her, it just absolutely touched my heart, anyway. Um, but also I have been in this the world of um the LGBTQIA plus community for a while, but I haven't really been making a big thing of it because I needed to be sure that I was doing the best for that community. And in the last sort of six to twelve months, I've really been much more vocal, and certainly since the Big Festoon, been much more vocal about it because those who are um assigned female at birth, um, whether or not they choose to identify as female later on, are still going to go through menopause. They've still got all the same bits and bobs as you and me. And actually, a lot a good number of people at the uh the Big Festoon uh just came up to me just quietly and said, Thank you so much because we are wholly ignored. Um, and I've spoken to people since then who said nobody, nobody even thinks about us in the menopause conversation, but you know, we have a uterus and we are going to go through the same experience. And yes, I've had a lot of people uh unfollow me, send me hate messages, and um, I'm to be honest, I'm really not interested in even arguing with them because I just want to make sure everybody knows what they need to know and does what they need to do with that information. I don't really mind who you are. If you need that information and that help, uh then I'm happy to share. Um, so yeah, hopefully they um everybody feels safe coming to me with that, you know, with those requests.
SPEAKER_00:Oh, I love that. So thank you. Thank you for doing what you do. Oh, bless you. Keep championing this cause and fighting the hate or just ignoring and blocking it. I'll just ignore it. Yeah, where can people find you?
SPEAKER_01:Wherever you look, I'm under Menopause Are Not Mad, so website, mostly Facebook, a bit on Instagram, and I do have some highly neglected LinkedIn account. But if you really want to follow most of what I do, it's my website or on Facebook. And of course, please buy my book. I choose menopause.
SPEAKER_00:Yes, definitely get the book. Um, thank you so much, Jane. You're welcome. It's a pleasure to have you on. And myths, and um, yeah, if anyone has got questions, uh go seek out Jane, she's great to talk to. So thank you. Um, thank you so much. And thanks for listening, and I'll see you next time. Take care.
unknown:Bye.
