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    223 - OCD, depression and the menopause

    enSeptember 26, 2023

    Podcast Summary

    • Impact of Hormonal Changes on Mental HealthHormonal imbalances during perimenopause and menopause can lead to mental health issues like depression and OCD. Proper diagnosis and specialized therapy can help manage these conditions.

      Hormonal changes during perimenopause and menopause can significantly impact mental health. Anna shared her personal experience of experiencing depressive episodes and OCD symptoms during and after pregnancy, which she later realized were linked to hormonal imbalances. She emphasized the importance of proper diagnosis and specialized therapy to manage these conditions. Anna's story underscores the need for increased awareness and individualized care for women dealing with mental health issues related to hormonal changes. Through her experiences, she learned to manage her symptoms with the support of her healthcare provider and therapy, allowing her to have positive experiences during subsequent pregnancies.

    • Mental health challenges can resurface despite physical recoveryMental health setbacks can occur even after successful management, requiring specialized help and new approaches

      Mental health challenges can resurface even after a long period of improvement, often triggered by external factors like a major illness or stressful events. The speaker, who had successfully managed her OCD with medication and therapy for years, was caught off guard when she experienced a severe relapse despite being physically recovered from COVID-19. She tried increasing her medication and reaching out to her old therapist, but nothing seemed to help. It's important to remember that mental health is complex and that setbacks can happen, even to those who have previously found effective coping strategies. If you're struggling, don't hesitate to seek specialized help and consider new approaches.

    • Unexpected Impact of Menopause on Mental HealthMenopause can bring unexpected mental health challenges like depression, anxiety, and OCD, which are often overlooked or misunderstood. Education and awareness are crucial to recognizing and addressing these issues.

      The onset of menopause and its impact on mental health can be subtle and unexpected, even for healthcare professionals. The speaker, despite her background, was unaware of the connection between her hormonal changes and her mental health decline. She was misinformed about the age at which menopause typically begins and assumed it would only bring physical symptoms like hot flashes. However, her experience involved severe depression, anxiety, and OCD, which she didn't recognize as related to menopause until much later. This underscores the importance of education and awareness about the various ways menopause can affect women, including their mental health.

    • The Importance of Honesty in TherapyBeing truthful in therapy, even when it's hard, is essential for mental health recovery. Progress may not be linear, and setbacks are common, but honesty and support can help lead to improvement.

      Engaging in therapy is crucial for mental health recovery, even when it feels like there's nothing to say. The speaker experienced deep depression, feeling like there was no point in therapy because her life was good. However, her honesty about her lack of motivation and emotions was met with skepticism by hospital staff. She felt suicidal but was motivated to stay alive for her children. Her brain felt unplugged, unable to process anything, and she was discharged due to financial reasons, only to be put on more medication at home. Despite becoming functional, she felt emotionally flat and cried endlessly, unable to identify the cause. She lost her confidence and felt like a different person. This experience highlights the importance of being truthful in therapy and the complex nature of mental health recovery. It's not always a straightforward process, and setbacks are common. But with support and persistence, progress can be made.

    • Menopause and Mental Health: A Connection Often OverlookedRecognizing the potential link between menopause and mental health is crucial. Seek expert help if experiencing symptoms to determine if hormonal changes could be contributing.

      The connection between menopause and mental health is often overlooked, but it can have a significant impact. One woman, who had been experiencing symptoms for over a year, was initially skeptical about the possibility of menopause being the cause of her mental health struggles. However, after watching a documentary and discovering a podcast episode about the topic, she began to suspect that her hormonal changes could be contributing. Despite her reservations, she sought help from a private nurse who specializes in menopause and was diagnosed with perimenopause. The nurse prescribed her HRT and, within a week, the woman noticed an improvement in her energy levels and overall sense of well-being. This experience highlights the importance of recognizing the potential link between menopause and mental health and seeking expert help when needed. It's important to remember that everyone's experience with menopause is unique, and what works for one person may not work for another. If you're struggling with symptoms, don't hesitate to reach out to a healthcare professional for guidance.

    • Hormonal Changes During Menopause Impact Mental HealthHormone Replacement Therapy (HRT) can significantly improve mental health symptoms in some women during menopause, highlighting the importance of understanding the connection between hormones and mental health.

      Hormonal changes during menopause can significantly impact mental health, leading to psychiatric illness in some women. This was exemplified in a patient's story, who experienced tearfulness, panic, and debilitating psychiatric symptoms during progesterone weeks. After three months on Hormone Replacement Therapy (HRT), she felt a noticeable improvement, reducing her need for psychiatric drugs. Another patient, older and housebound due to her condition, also experienced a remarkable transformation after three months on HRT. The power of hormones in the brain, particularly estrogen, testosterone, and progesterone, is often overlooked in medicine, leading to a divide between psychiatrists and gynecologists in addressing this issue. Understanding the connection between hormones and mental health can lead to earlier intervention and improved quality of life for women during menopause.

    • Managing hormonal symptoms during menopauseEffective HRT dosing can significantly improve mental health symptoms during menopause. Close collaboration with healthcare providers is crucial to find the right dose and monitor symptoms.

      During perimenopause and menopause, women may experience worsening symptoms, including psychological ones, due to hormonal changes. Women with a history of postnatal depression or premenstrual dysphoric disorder (PMDD) may be more susceptible to these hormonal symptoms. Hormone Replacement Therapy (HRT) can be effective in managing these symptoms, but the right dose is crucial for individual women. Some women may require higher doses to effectively treat brain symptoms. It's essential to work closely with healthcare providers to find the right dose and monitor symptoms. The benefits of proper HRT dosing can significantly outweigh the risks for mental health. Personal experiences and input from healthcare providers can be valuable in advocating for appropriate treatment. Ultimately, every woman's experience is unique, and open communication with healthcare providers is essential for effective management of perimenopause and menopause symptoms.

    • Impact of Hormonal Changes on Women's Mental HealthDuring menopause, hormonal imbalances can lead to mental health issues. Encourage open conversations, track symptoms, and ensure reliable resources for education.

      Hormonal changes during menopause can significantly impact women's mental health, and it's essential to increase awareness and education about this issue. Anna shared her personal experience of struggling with mental health issues due to hormonal imbalances during menopause, and she emphasized the importance of open conversations about hormones and menopause starting from a young age. She also suggested that symptoms can occur much earlier than commonly believed and encouraged tracking menstrual cycles and symptoms to spot patterns early. Lastly, Anna advised ensuring that resources for information are evidence-based and reliable to avoid misinformation. The organization Anna works for is taking steps to increase awareness among psychiatrists about mental health and hormones. By sharing stories and increasing education, we can help normalize conversations about menopause and its impact on mental health.

    • Advocate for Yourself During MenopauseDon't give up if you feel misunderstood by healthcare providers regarding menopause symptoms. Advocate for yourself, ask for a referral to a menopause specialist, and keep trying until you get the help you need.

      If you're experiencing menopause symptoms and feel like you're not getting the help or advice you need from your healthcare provider, don't give up. Anna, a guest on the podcast, shared her personal experience of facing misdiagnosis and lack of understanding from some healthcare professionals regarding menopause symptoms. She emphasized that this isn't the fault of the professionals, but rather a result of their limited training on the subject. Anna encouraged listeners to advocate for themselves, ask their healthcare provider who is the best person to speak to about menopause issues, and try again if they don't feel they're being heard. This message is about empowering individuals to take charge of their own health and raising awareness that menopause involves more than just hot flashes for some women. Anna's bravery in sharing her story is appreciated, and for more information on menopause and resources, visit Newson Health Group's website or download their free Balance app.

    Recent Episodes from The Dr Louise Newson Podcast

    264 - What happens to fibroids during the menopause?

    264 - What happens to fibroids during the menopause?

    This week on the podcast, Dr Louise is joined by Osama Naji, a Consultant Gynaecologist who is an expert in advanced gynaecological scanning at Guy’s and St Thomas’ NHS Foundation Trust.

    In this episode Osama shares his vast knowledge on fibroids – common, benign growths that usually develop during a woman’s reproductive years when oestrogen levels are at their highest. He explains the impact menopause can have on fibroids, treatment options and the possibility of HRT.

    Finally, Osama advises on things to consider if you’ve recently been diagnosed with fibroids:

    1. Find out all the facts about your fibroid - number, location and size – as knowledge is power. You can usually get this from an ultrasound scan. Use that knowledge to get professional guidance about managing your fibroids.
    2. HRT is safe. The benefits of it usually outweigh the risks. The only thing to consider is if the fibroid is causing problems before starting HRT but even in this scenario, HRT may worth trying.
    3. If you experience rapid growth in the fibroids or accelerated symptoms seek help to determine the right treatment.

    Find out more about Osama here and read his feature on balance on fibroids and the menopause here.

    Click here to find out more about Newson Health.

    Dr Corinne Menn: I’m a doctor who’s had breast cancer – here’s what I want you to know

    Dr Corinne Menn: I’m a doctor who’s had breast cancer – here’s what I want you to know

    This week on the podcast, Dr Louise is joined by Dr Corinne Menn, a New York-based, board-certified OB-GYN and North American Menopause Society Certified Menopause Practitioner, with more than 20 years of experience caring for women.

    When she was 28, Corinne was diagnosed with breast cancer. Following her BRCA2+ diagnosis, she underwent multiple surgeries and chemotherapy then navigated pregnancy and menopause plus longer term survivorship issues.

    Corinne received support from the Young Survival Coalition, an organisation that advocates for women under 40 with breast cancer, and worked with her oncologists to manage her pregnancy, menopause and treatment options.

    She feels passionately that women who have or have had breast cancer receive individualised care and treatment for their cancer and menopause symptoms, and shares three tips to help with quality of life:   

    1. Do not minimise your menopausal symptoms, your hot flushes, your night sweats, sleep etc. So whether you use hormonal therapy or non-hormonal medications, make sure you get help and can sleep so you function better and breaking the vicious cycle of spiralling menopausal symptoms.
    2. Please do not neglect vaginal sexual health. Again, if you can preserve a little bit of that, it can stop a negative cycle of suffering, of urinary tract infections and relationship and intimacy issues.
    3. Scheduling time to have a separate appointment with your oncologist and your GYN. Come prepared. Listen to Louise's podcast. Listen to Menopause in Cancer podcast and Instagram page. Be empowered because you and your quality of life are worth it.

    You can follow Corinne on Instagram at @drmennobgyn

    Click here to find out more about Newson Health.

     

    262 - Acne: from teen years to menopause and beyond

    262 - Acne: from teen years to menopause and beyond

    This week on the podcast with Dr Louise, Consultant Dermatologist Dr Sajjad Rajpar returns to talk about acne and its effect on women during the perimenopause and menopause, including on their self-confidence and mental health.

    Dr Saj explains the causes of acne and the different treatments available, including an encouraging new treatment that could make a big difference to acne sufferers in the long term.

    Finally, Dr Saj shares his three tips for anyone who might have acne:

    1. Keep skincare simple and targeted. Pick one of three active ingredients – retinoids, benzoyl peroxide or azelaic acid – and give it three to six months to work. Only supplement it with a very simple supporting skincare regime.
    2. Assess the impact of the acne – if it is leaving persistent blemishes, pigmentation or scars, then escalate the treatment. If the first line treatment hasn’t worked, give it three months and see a medical professional to try to get it under control because prevention of scars is so much easier than trying to reverse and cure them.
    3. Be mindful about all the different risk factors and triggers, and do not underestimate the impact of diet and stress. Where we can treat acne holistically, we should.

    You can follow Dr Saj on Instagram @dr.rajpar_dermatologist

    There is a chapter dedicated to skin and hair in menopause in Dr Louise’s bestselling book, The Definitive Guide to the Perimenopause and Menopause, which includes expert contributions by Dr Saj. Order your copy by clicking here.

    Click here to find out more about Newson Health

    261 - Chronic pain and menopause: what’s the link?

    261 - Chronic pain and menopause: what’s the link?

    About 28 million people in the UK are thought to be living with chronic pain – that’s 43% of the population, according to the 2011 Census.

    But what is chronic pain, and how can it overlap with the perimenopause and menopause?

    In this week’s episode Dr Louise is joined by Dr Deepak Ravindran, a consultant in pain medicine and author of The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain.

    Dr Deepak unpicks the science behind chronic, or persist, pain and the two discuss the relationship between hormones, inflammation and pain.

    Dr Louise and Dr Deepak have co-authored a new article which offers 10 top tips for primary care practitioners on improving care for women with fatigue and/or pain. You can access the article here.

    Follow Dr Deepak on YouTube, Instagram, LinkedIn and X.

    Click here to find out more about Newson Health

    260 - Get comfortable with the uncomfortable: mental health and the menopause

    260 - Get comfortable with the uncomfortable: mental health and the menopause

    Content advisory: this podcast contains themes of suicide and mental health.

    This week on the podcast, Dr Louise is joined by Andrea Newton, a postmenopausal woman whose own experience of mental health during the menopause lead her to train as a tutor with the National Centre for Suicide Prevention Training. Over the last six years, Andrea has trained thousands of people in suicide intervention skills and she is now training to become a menopause coach.

    Andrea explains how her work in the corporate world has allowed her to share the importance of educating line managers, HR managers, and everyone about the menopause. She is also the author of the book, Could it be Your Hormones Love? (And Other Questions Not to Ask a Menopausal Woman).

    Andrea shares her tips on widening the conversation about menopause:

    1. Women need to educate themselves more about how the menopause affects all aspects of their health and be better at advocating for themselves.
    2. Let’s take the conversation to the wider audience and stop the awful, narrow, stereotypical view of menopause. Instead, educate people so we can avoid tribunals, retain talent and have more menopause-friendly businesses.
    3. Get comfortable with the uncomfortable and have conversations about things like menopause, mental health, suicide risk. We need to stop waiting for people to reach out, and we need to get better at reaching in and being proactive.

    You can follow Andrea on LinkedIn, Instagram @in.her.right.mind and Facebook @InHerRightMind  

    Click here to find out more about Newson Health

    Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email jo@samaritans.org.

     

    Related articles

    Westlund Tam L, Parry BL. (2003), ‘Does oestrogen enhance the antidepressant effects of fluoxetine?’, J Affect Disord. 77(1):87-92. Doi: 10.1016/s0165-0327(02)00357-9

    Ibrahim WW, Safar MM, Khattab MM, Agha AM. (2016), ‘17β-Estradiol augments antidepressant efficacy of escitalopram in ovariectomized rats: Neuroprotective and serotonin reuptake transporter modulatory effects,’ Psychoneuroendocrinology. 74: 240-250. 10.1016/j.psyneuen.2016.09.013

     

     

    259 - All about Dr Louise’s theatre tour Hormones and Menopause: The Great Debate

    259 - All about Dr Louise’s theatre tour Hormones and Menopause: The Great Debate

    This week on the podcast Dr Louise meets comedian Anne Gildea, who will be joining Louise on her 34-date theatre tour this autumn, Hormones and Menopause: The Great Debate.

    Anne, a founding member of Irish musical-comedy trio The Nualas talks to Louise about her diagnosis of breast cancer, aged 45, and her ensuing menopausal symptoms, which she was unprepared for. She explains how her research inspired her to create her own show, How to Get the Menopause and Enjoy It.

    Louise and Anne discuss why they’ve come together to create a new show that will take you on a journey through the history of women’s health and lead you to see menopause and hormones in a whole different light.

    Finally, the pair share some of the reasons they think people should come to the show:

    1. It'll be a wonderful night out - a real sharing experience where you can also have a laugh.
    2. There’ll be lots to learn with new content and a sharing of knowledge.
    3. You’ll be able to ask questions and gets answers. Some shows will also have doctors available in the interval but Louise will answer questions on the stage as well.

    You can follow Anne on Instagram @annegildea  

    To buy tickets to the show click here

    Click here to find out more about Newson Health

     

    258 - I’m 27 and perimenopausal: how testosterone helped my symptoms

    258 - I’m 27 and perimenopausal: how testosterone helped my symptoms

    This week on the podcast, Dr Louise is joined by Elin Sullivan, a young woman who suffered a myriad of symptoms for years before getting the right treatment.

    Elin first experienced recurring urinary tract infections at 19 years old, and twice required hospitalisation. She also suffered from sweats, sleep disruption and fatigue, shaking and lichen sclerosus. After a chance encounter with Louise, she tried local HRT, which was transformative, and now takes testosterone to balance her low levels.

    Elin talks about how hard it can be to experience perimenopausal symptoms at a young age and shares her tips for other younger women experiencing issues that they think might be down to their hormones:  

    1. Although it can feel really hard, don't stop advocating for yourself. You may have self-doubt or worry that you’re wrong but keep pushing. My doctor was sick of seeing me, I was there probably every week, but don’t give up.
    2. Rather than just giving your doctor a list of your symptoms, show them when they were happening as well. Have a log of symptoms and anything that might have affected them on that day. This will help your doctor rule out things but also show if your diet, etc, has an influence.
    3. Don't be scared to try medications or suggestions. It might help but if it doesn’t it can potentially help your doctor decide the next step. I never believed local HRT could make such a big difference but am so glad I tried it.

    Click here to find out more about Newson Health.

    257 - Oestrogen, your heart and the menopause

    257 - Oestrogen, your heart and the menopause

    This week on the podcast Dr Louise is joined by Dr Felice Gersh, who is double board-certified in OB-GYN and Integrative Medicine, and specialises in female health, with a focus on managing female hormonal dysfunctions.

    She is the author of the book PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness, and recently published a paper on oestrogen and cardiovascular disease, and a 2021 paper on HRT.

    Here she talks about the family of oestrogens and the important role of hormones on the heart. Finally, she shares three tips on improving heart and whole body health:

    1. Eat a lot of phytoestrogen-containing foods - so every kind of plant in all the different colours, including beans, nuts, seeds, fruits, vegetables. They are nature's gift to us.
    2. Sunlight is like happy medicine. Try to get sunlight in the morning, midday and watch the sunset every chance you get. This will help you to sleep better, make more serotonin, and help to set your master clock in your brain, which tends to drift when we lose our oestrogen production.
    3. Move. Your fitness status is more predictive of healthy longevity than your blood pressure. Think of your fitness, strength, flexibility and balance as a critical part of your life so get active in every way you can.

    You can follow Dr Felice on Instagram @felicegershmd.

    Click here for more about Newson Health.

    256 - Spreading the word about menopause care in the US, and beyond

    256 - Spreading the word about menopause care in the US, and beyond

    This week Dr Louise is joined by Aoife O’Sullivan, a family medicine doctor who trained in Dublin before completing a second family medicine residency at the University of Maryland.

     

    After taking some time out to complete extra training in perimenopausal and menopausal care, including Newson Health’s Confidence in the Menopause course, Dr Aoife is passionate about providing more comprehensive and holistic care to women during midlife.

     

    Dr Aoife share the ways clinicians, and all people, can educate themselves in order to improve the health of women in the US, and across the world:

    1. Take every opportunity to learn and educate. So join any local healthcare Facebook groups and pass on links to the Confidence in the Menopause website, the balance app, etc. Even if you reach one or two people like that, it will make a difference and they might reach another one or two people.
    2. Share small bites of information because it can be a little overwhelming. So when you're trying to reach somebody, give them small amounts of information at a time.
    3. Harness the power of friends. If everyone informs their friends and they all go to their doctors, obstetricians, gynaecologists and urologists, and ask questions, it will fuel discussion and increase knowledge.

    You can follow Dr Aoife on Instagram @portlandmenopausedoc

    Find out more about the Confidence in the Menopause course and click here for more about Newson Health.

     

     

    255 - Mental health issues and hormones: introducing Newson Health’s psychiatrist Dr Louisa James

    255 - Mental health issues and hormones: introducing Newson Health’s psychiatrist Dr Louisa James

    This week on the podcast Dr Louise is joined by a new colleague, Dr Louisa James, a psychiatrist who has recently joined the team at Newson Health.

    Dr Louisa’s personal experience of the menopause prompted her to learn more about the impact of hormones, and incorporate her knowledge in her role as an NHS consultant psychiatrist in a home treatment service. Here she discusses the importance, and power, of asking patients about their hormones during a psychiatric appointment.

    Finally, Dr Louisa shares her tips for thinking about your hormones alongside your mental health:

    1.Consider whether this feels different to any previous episodes of depression you may have experienced or if your symptoms are fluctuating. Some women have suicidal thoughts or are depressed at certain times of the month. Track your symptoms and look at the fluctuations.

    1. Your history can affect your menopause. If you’ve had an episode of postnatal depression or PMDD, then you're more likely to experience mental health difficulties in the perimenopause.
    2. How do you feel about your life? Lack of joy rather than a sadness, the emotional lability, is often greater with a hormonal mental health problem whereas irritability, rage and impulsiveness can be greater with mental health problems.

    Dr Louisa James is now offering consultations to existing Newson Health patients. Click here for details.