Wendy Molefi | Ep #44| Is there a right time to speak about Menopause?



integrative and preventive healthcare the content discussed in this episode is for informative purposes only and should not be replaced by individualized professional consultations or

professional medical advice hey guys i’m tasha hey listeners this is gooni and we’re here to discuss lifestyle medicine so hi everyone today we are going to be speaking about the ins and out of menopause for this we have wendy molefi yes she is a gp and a menopause specialist with the british menopause society advanced menopause specialist certificate she is the founder and owner of vital wellness clinic a specialist menopause clinic based in hetfordshire welcome to thought of the podcast wendy we’re excited to have you here today thank you so much for having me really looking forward to having this conversation so menopause for women who are in their 30s something that we know is gonna come but we just know that our mothers and our aunts and uh sisters are just you know acting crazy and funny and it will happen i’m a menopause woman so be careful what you say this looks like a black box so i see the effects of of us talking about it earlier on are there things we can do to improve that experience because in a survey uh done by the british menopause society in 201717 over 50 percent said it had a negative impact on their lives women were saying that uh they felt that and 45 percent felt that the menopause symptoms had negative impact on their work that said so for a community or an audience that is in their 30s these are daunting statistics you’re absolutely right i mean you know there’s transitions in life and you can actually always kind of be thinking a little a step ahead so in terms of why really we need to be having this conversation the earlier the better we’ve already established that by definition um the menopause will affect all women at some stage in their lives it’s coming so it’ll affect us i don’t know i know it doesn’t have to be scary so yes we’re talking half the human race here um and and if it affects many of us women who are still very much at the peak of our careers and we we know that women are living longer these days life expectancy is is longer so women will stand will spend quite a significant amount of time of their lives being post-menopausal and to actually give it give this a bit of context the world health organization estimates that about 50 million women would have reached the menopause by the late 2020s that’s not far and this actually rises to 1.2 billion by 2030. so that is a lot of menopausal women here perhaps we should put a bit of context and sort of uh have a sense of what is the menopause and why do we actually need to be having these conversations perhaps earlier on in our lives as women the menopause is a natural physiological stage in a woman’s life when they stop having periods when their ovaries stop working which means they can no longer have children without assistance anyway so that’s that has huge implications that means a lot to a lot of women so our ovaries for a little bit of science there produce three important hormones which are vital for many physiological processes in the body and these hormones are estrogen progesterone and testosterone so when our ovaries stop working or this ovarian function declines women are deprived of these hormones and they then begin to experience many different menopause symptoms as a result we’ll talk a little bit more about that and then in terms of ages most women will go into the natural menopause between the ages of 45 to 55 and this is actually in developing countries like america the us and other developed countries the average age women go into natural menopause is 51 and this actually goes down by two three years in poor non-industrialized countries it looks like in cities or developed countries it’s coming in earlier is there are there any factors and any reasons for this to happen absolutely the menopause i guess transition is very complex other factors that contribute to the age at which a woman would enter the natural menopause include that genetics so you find that mothers and sisters and they may go into the medicals around the same sort of time and then environmental factors and then there’s the socio-economic status whether women are working or not which also includes lifestyle and also factors like reproductive factors whether women have had children or not have children because women who haven’t had children a research shows that they tend to go into the menopause earlier and women who’ve had more children than menopause is much later and then more importantly modifiable factors like lifestyle factors such as smoking nutrition or physical activity so those are the factors that actually contribute to the complexity of the whens of when a woman might go into that natural menopause about 1 in 100 women will have going into the menopause before the age of 40. and one in a thousand women will go into the menopause before the age of 30 for all those various reasons as well i’d like to understand also what are the physical impact uh in your body if you go into menopause earlier that’s a really important question kuni i mean we know from studies such as the swan study which is the study of women’s health across the nation in the u.s they followed thousands of women between the ages between the years of 1996 i think to 2007 and be pre-menopausally and just see what happens and when they go into the menopause and actually some of the conclusions were that an earlier onset of the menopause so women will go much earlier than expected into the menopause it is associated with an increased risk of conditions such as osteoporosis which is the thinning of the bones because they’re lacking the production of of the estrogen remember that when you go into the menopause your ovaries stop producing all these protective hormones so there’s an increased risk of osteoporosis there’s an increased risk of heart disease there’s an increased risk of stroke because again all these hormones are important in various metabolic processes in the body and there’s also an increased risk of sudden cancers and actually they’ve also shown that there’s um an increased uh risk of early death in women because women are not having the benefit of all these hormones protecting them their bodies and protecting the various processes in their bodies what you’re pointing out is like if you get it earlier there are increased risk factors so would it be right to assume that if you get it later actually you’re reducing your chances of developing different types of illnesses it is not that straightforward as you probably will expect it it’s about kind of maybe the menopause coming in at the sort of that naturally expected time if it’s later than the 55 years that was sort of mentioned then there are other risks associated with that it means you’re the your body is exposed because the body knows how to look after itself and the body this body is something to model about really so so if this is delayed later than a lot of people then the body is exposed to levels of estrogen of all these hormones again much longer than it actually needs to and then that can increase other risks to other diseases other cancers certainly like breast cancer like endometrial cancers those are higher in women who are experiencing their menopause much later than the average age a very relevant point that we are making here is like that there seems to be somewhat of a window of time is it too early to talk about it is there a right time to talk about it so basically my question is when should we start talking about menopause as far as i’m concerned with regards to the menopause it is about finding the right opportunity to bring up this conversation in schools so where they talk about the human life cycle puberty sex education pregnancy and i think that’s where an opportunity lies there to mention the menopause if anything is part of this life cycle that before women die there is this element or aspect of their life which is part of the aging process really and then layers of education can be added along the way and be made age-appropriate i’m not saying bombard children with things about the menopause another opportunity is at home it is very important that the menopause is not treated like the taboo subject at home i’ve never had a conversation about the menopause with my mom yet as you mentioned gurney we all have an auntie who is forever with that fan at every sort of social event and yet we don’t have these conversations i wish i could be talking to this auntie that is finding herself so that to be honest because i’m sure that she must also be feeling alone in that process yes and so we kind of know that she’s going through something but it’s taboo so nobody’s really talking about it but he’s talking about it i was just thinking of my one of my aunts that always comes to like any event with a towel uh and she’s like she just kind of like keeps it on her neck all the time and i now i’m just relating it to think that oh my god it’s actually her menopause i just it just clicked in my head i should probably speak to her about it and just kind of build a sensitive way yeah yeah yeah and so she doesn’t feel so isolated as mothers as sisters grandparents we just need to be openly talking about this sharing our experiences and passing on the wisdom because really the menopause is not all about doom and gloom in certain cultures especially eastern cultures uh women who are post-menopausal are actually revered they’re respected in the they’re regarded as the sage in the community so the home environment is where this conversation can happen and also at work we need to be talking about it because women are working it needs to be part and parcel of the health and safety policy and as women we’re nurturers we gather people we form all these communities here then everywhere in churches so there’s opportunity there again to to bring up the conversation to talk about it so i guess the point that i’m saying is that there’s opportunities here then everywhere it’s about having the courage to bring it up and see it as something that is that is vital and that the sooner we have this conversation the better the more education and information women have earlier in their lives as we’ve already pointed out regarding the affect other factors lifestyle factors then there’s an opportunity for young women in their 30s to be modifying their lifestyles you know to ensure that their bodies are just primed for a better transition and actual long-term health in the women who are going through menopause what is going through your head and your and yeah your emotions you know the emotional aspect of it and the physical aspect of it they can be very much intertwined something can be happening physically that can lead to somebody having all these other emotional complex symptoms but if we start with the psychological symptoms of what they experience it’s essentially i women notice for for no particular reason sometimes mood swings one minute they’re happy next minute to that low just you know to the extent where some women will experience depression they they report anxiety symptoms and these symptoms can often be exacerbated by you know the perception the stigma as well they’re not talking about things oh it’s it’s just happening to me and then this compound and it’s just me suffering and what most people think of me sitting here sweating away here and then it just compounds the whole cycle women then isolate themselves become more withdrawn and they don’t want to talk about this this what is going on for them in addition to that as well because of the lack of the support of these physical hormones physiological hormones it affects the brain in such a way that a lot of women will report that this forgetfulness of pro-concentration and the brain fog brain fog is another buzzword you might have heard that a lot of women talk about and simply and certainly in in my clinic sometimes women will come and just sit and tell and and describe or struggle to describe how it is and just say they’re just not feeling themselves and that in itself is such a powerful statement because i guess indicates the impact of what is going on in the woman’s body and the impact it has in in their lives and also because what happens the menopause is that it happens at midlife and for a lot of women at midlife there’s all these other stresses um that are happening in life in terms of work changes career changes marital issues supporting that children the adolescent children the you know young adult children and also looking after their parents so they’re like this sandwich generation who are stuck in the middle that body is doing one thing here and then there’s life happening on the other side do women feel that they are losing a part of their femininity or their womanhood is there something related to that yeah absolutely that is a huge factor of that because let’s remind ourselves in the fact that as i mentioned these important hormones that play a part in our reproductive lives our ability to to have children our ability to to nurture so suddenly this is taken away from you it it it almost takes away part of your identity somehow and yes yeah physically and psychologically your femininity you feel different you no longer because you know some of the other physical symptoms that come along with the menopause the changes in metabolism people women gain weight and they just don’t feel as sexy or as themselves as they are and all these other things that really have a huge impact on perception and how women perceive the menopause the other thing i was going to mention is culture as well we are all brought up from different cultures different expectations of the role in society as women and that hugely influences women’s perception of of of the menopause and in 10 this can then become like a societal thing that compounds how the menopause is deemed i mean since you touched on culture in your experience as a a a woman who is part of the bam community you know the like black asian uh and minority minority ethnic community do you see that um women in this community i guess experience more severe symptoms or maybe a more have a tougher experience with menopause and integrating that that that change in their lives or like basically maybe maybe i should step back and ask like what do you see with women that experience this that is the really question what do i see not as much as i’d like to see because from a professional point of view women from our culture from the black and asian ethnic minority culture we don’t come forward we don’t talk as much as women from western cultures are caucasian women because of the communities we come from so i don’t see as many as i’d like to see but generally actually from studies the swan study that i mentioned in the u.s where they followed it was actually quite a diverse population in the us and different u.s states and women from different ethnic backgrounds in the u.s and women complained of different things they found that caucasian women would tend to complain more of their hot flashes and night sweats and things like that and women of the ethnic minority women would tend to have more we call musculoskeletal symptoms like the aches and pains and this and the other um symptoms so all i guess underpinned by how we’re brought up and perhaps how we tolerate dif different experiences or discomforts of unpleasantness so it’s a very it’s a very curious observation in the how different cultures experience or talk about the mentals the reason for musculoskeletal issues earlier on in life indicates that it’s all intertwined with the perception sometimes it might just be maybe it’s something that’s easier to talk about or to report to health professionals the fact that i’ve got a pain or an ache that sort of thing it’s more acceptable to present like that but that the question i guess in the way as you were asking i was thinking for us healthcare professionals perhaps that might be our cue to notice when women from ethnic minorities come to see us and they have all these non-specific symptoms and you know that of a certain age or maybe a beginning to think about that and to to to just have a thought process of how you can help them in that sort of way to bring up that conversation because in certain cultures some of these things i was just reflecting on this that actually in my my culture we don’t have a word for menopause as a word like that but certainly the experience is there of course yeah we have experiences there so it’s about finding a way and being attuned to how different cultures and population might just exhibit certain aspects of ill health i know that the menopause is not ill health or the body changing what you’re saying is it’s essentially like you know with any illness and issue like societal issue right it’s it’s so complex um culture is a huge aspect to it and you know socialization so it’s it’s very layered yeah and i as you said in your culture in the language itself it’s not acknowledging that it’s a thing it’s just reflective of how first of all our world is run by men and that sure yeah yeah a masculine issue or a thing that men would experience there would be a word for that and so that just shows that it has not been valued and it just goes to show again we don’t talk about it hence it’s stigmatized hence females are experiencing a negative aspect to it so i think it leads to my next questions like what can we do to increase um the awareness and the mindfulness and the positive aspect of actually transitioning into menopause yeah what can we do again if i split flat as women what can we do how can we help ourselves so as i said because we know that suddenly going to the early menopause you know there’s an increased risk of some of these conditions and we know that there are there are things that we cannot change certainly our genetics and you know where we grow up certain things like that but there are a lot of modifiable lifestyle um um factors that are within our control and and for me that is fundamental in terms of perhaps preventing tipping into an early menopause or certainly minimizing symptoms or the unpleasant symptoms of the menopause i mean we’re not talking rocket science here we’re talking the basics here yeah seeing food as medicine what we eat what we put in our bodies valuing that and giving some thought process to what we’re eating you know all the stuff around be more plant-based less of things that are toxic to our bodies minimizing alcohol smoking smoking has huge implications as well regular exercise because what that does because what we need to be thinking about is that the loss of these hormones in the body it may cause these menopause symptoms like your heart flashes your night sweats and you know hair loss and gut problems all these other unpleasant symptoms but there’s also the long term impact over time that there’s you know there’s bone loss cardiovascular issues as well so we can actually live our lives in such a way that we are delaying those things we know regular exercise is good for cardiovascular function it’s good for maintaining muscle strength it’s good for bone protection cultivating sleep quality hydration and also keeping stress levels low as you mentioned techniques like yoga mindfulness relaxation cognitive behavioral therapies all these things can help sort of decompress all the stresses that we cannot change in our bodies and all really this is all in the spirit of yes minimizing the symptoms and priming the body and so that it just copes better some of these symptoms are not as unpleasant as they could potentially be so there’s all these things that are within our control that we can do and certainly if we are struggling we shouldn’t struggle alone we should seek help there are health professionals out there who can help and talk about all the different options that are available and i know you have a background in wellness coaching and also mindfulness teaching so maybe with that like can you maybe shed some light on how using mindfulness will help women in perimenopause or in menopause um to navigate their experience as you said as a mindfulness teacher that actually formed the basis or the argument of my dissertation for my master’s degree so as you will know mindfulness is the cultivation of present moment awareness minimizing our own often self-inflicted suffering or distress in all mineral ways and among a list of many many benefits through cultivation of mindfulness practices we kind of learn to accept what we cannot change i mean we’ve already established the fact that the menopause is part of the natural aging body so we learn to accept that this is happening so we don’t contract around it we learn to sort of appreciate different experiences whether they’re pleasant or unpleasant and we learn to appreciate the fact that they are impermanent they will pass this too shall pass these hot flushes will pass so we learn to kind of sit with that discomfort when it’s there because what happens is what the human body does or what we do is when we’re feeling any kind of discomfort we contract around we don’t want it there immediately but sometimes when you learn to be with discomfort when you learn to sit with what is uncomfortable whether emotionally or physically you are giving space to it and more often than not actually it can transform the experience itself and if it doesn’t transform the experience as it unfolds it can actually transform your relationship with that particular experience so it’s about cultivating a different relationship with the mood swings with the heart flashes to know what your body needs how can i be kind to my body today as it’s feeling this way that too shall pass and there’s actually signs behind that there are some randomized control studies that have shown the benefits of some of these mindfulness practices in the menopause right can i ask maybe it’s a bit of a personal question when you went through your own experience of menopause was this something that helped or was a game changer for you or how did you navigate that experience right now i the funny thing is i when i i think was experiencing some of the menopause centers i didn’t even know i mean here i am a doctor mental specialist and it was kind of completely off my radar we were living in this old old house which everything was breaking down around it and then it was the heating’s tend to break down the radiators will go on and off on and off and it was a nightmare cut a long story short we’d had engineers come in to look what our boiler wasn’t doing we didn’t they couldn’t figure it out anyway one one time i was working in my study and um it started again the ready would go on and off on and off and so i’ll whip off my jumper off because it’s hot in the room i’ll put it back on because it’s cold anyway called the engineer again eventually they came somewhere in that week when i went to look at whatever it is that they were looking with them only to realize actually that at that moment in time the boil over the heating wasn’t even on so it wasn’t i was waiting for the movement it wasn’t eating all the radiator going on it was my home radiator going on so that was really funny i called a friend of mike to answer your question called a friend of mine we had a good laugh about it i’ve always had a sense of looking after myself i run i eat well i practice mindfulness and i think these qualities have served me well they’ve made it because it’s it’s a it’s an ongoing transition depending on where you’re at so they’ve made it almost like yeah that’s acceptance of that’s what is and just some self-love self-acceptance thank you for sharing your story it’s really it’s it’s relative i’m sure it’s relatable to all of the women and if we experience this internal uh radiator issue you know what’s happening yeah i think i’ll have to reference this conversation to guni in a couple in like more than a couple of years and definitely in a couple of decades maybe yeah well dr wendy thank you so much for all the insight just enlightening us and like sharing your wonderful experience with us and as we normally conclude our conversations we have a rapid fire round of questions which is what is the first sign that you are out of balance well for me when i’m really cranky when when all it takes is for my husband to look at me and i’m like what so that’s like when i realized oh okay i need to kind of just retrace my steps and just going to wake up properly and be mindful of what this body needs so when i drank it the thing is that it takes a bit of time to recognize when you’re cranky right because like you’re so much in it sometimes so the second and so i guess the second question is what is the method of coping when you do identify your being cranky so that you can get back into balance just take a step back if it needs for me to just pause and just do a short breathing mindfulness practice to just ground myself that’s one way or i just put on my trainers and go out for a run and when i come back everything’s fine with the world so it’s about having a few tools up your sleeves that you can deploy easily because sometimes i just don’t feel like running so i’ll stop or maybe i’ll just do a gentle yoga practice so having a few things they all don’t all have to be high octane it’s about having a sense of where there’s a need like that having a few tools um and the last question is is there a book one book that has impacted the way you approach wellness and health the book that was a kind of a game changer starting point to this journey if you like was a book by susan jeffers called feel the fear and do it anyway so because sometimes we can hold ourselves back for all manner of reasons and be held back by fear where’s fear if we learn again to sit with the discomfort of fear it’s not gonna kill me it’s just going to make me feel a little bit sick and uptight or whatever if i can just ride that wave and do that one thing that i’m stopping myself from doing it has just changed so many things and just allowed me to just not overthink things to to not to just not take myself too seriously all the time to not be afraid to fall and to fail know that i can forgive myself and just pick myself up and go great i love that yeah very powerful yeah i think i will have to look the book up um well thank you so much for being on our show today now thank you so much for having me it’s it’s been a pleasure if you enjoyed this episode go ahead and select that follow or subscribe button for now stay safe and we’ll see you next week you

Wendy Molefi | Ep #44| Is there a right time to speak about Menopause?

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