Middling Along Emma Thomas

This time on the podcast my guest is Tina Backhouse, General Manager at Theramex. Tina joined Theramex in 2020 to lead the UK Women’s Health business, helping to establish them as the largest supplier of HRT & Menopause Products in the UK. She is passionate about ensuring equality of care for all women regarding their health in the UK, and that women have choice in their healthcare options.
 
She joins us to discuss the recent research the company funded to investigate disparities in access to menopause support: for example, just 5% of black women are on HRT vs 20% of white women, and individuals in areas of social deprivation are significantly less likely to be prescribed the newer, safer forms of HRT. 
 
We also cover some of Tina’s ongoing frustrations at the lack of prioritization and funding available for women’s healthcare - such as the fact that NHS England developed a public health campaign for menopause that was never launched due to lack of funding.
 
Would it surprise you to know that the UK currently has the largest gender health gap in the G20? We also have a staggering 35% gender pension gap.
The report, published in April 202 interviewed a range of clinicians and allied healthcare professionals, and is available to download at:  https://www.theramex.com/wp-content/uploads/2024/04/Theramex_Tackling-Unequal-Access-to-Menopause-Care.pdf - we discuss the five recommendations that the report concludes with, including better training for GPs and other allied healthcare professionals, and the creation of a national formulary to end the current postcode lottery whereby some newer HRT is available in some areas but not others.
 
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(ish) goodness into your Inbox: https://dashboard.mailerlite.com/forms/323784/90772270045202190/share 
We’re delighted to be listed as one of the Top 25 podcasts for midlife and menopause here: https://www.lattelounge.co.uk/podcasts-about-the-menopause/

In this episode I welcome Dr Angela Wright from Spiced Pear Health. Angela is a GP, Menopause Specialist and Clinical Sexologist. She is particularly interested in improving sexual function and menopausal symptoms in women who have undergone cancer treatment. Angela is passionate about women’s health and sexology and is frequently asked to teach or talk about this subject. She is a registered trainer for the BMS & FSRH, involved in training future menopause specialists and is an active committee member of the British Society of Sexual Medicine, and the education committee of the Primary Care Women's Health Forum.
 
We covered so much in such a short space of time!  We started by talking about the impact of localised (vaginal) oestrogen vs what systemic HRT does - both for GSM (genito-urinary syndrome of menopause) and for sexual dysfunction.  For anyone wanting to know more about GSM, or pass information on to their GP, Angela recommends the British Society of Sexual Medicine consensus statement on GSM that’s available on their website (linked below). 
She goes on to explain that there is no increase in recurrence risk for oestrogen receptor positive breast cancers when using localized oestrogen to treat symptoms (and that it can be used alongside letrozole and tamoxifen). We discuss the need for patients to be able to make an informed choice about risks vs benefits, which can be challenging when healthcare professionals are not taught to understand the impact that GSM and sexual dysfunction can have on quality of life - certainly male sexual dysfunction gets a lot more attention and usually pretty rapid treatment! 
 
We move on to discuss ‘sex tech’ and the burgeoning menopause ‘market’ in this area, including laser therapy (TLDR: more research needed, long term effects not known, it’s expensive, and vaginal oestrogen would be more effective in the majority of cases).
 
Angela gives an overview of what self-care practices can be helpful for someone struggling with GSM - listen in to find out some very little known information about the clitoris (and how to keep it healthy) that was totally news to me! She also explains that a range of prescription medicines (in particular antidepressants, but also antihistamines, and blood pressure medication) can mess with our sexual responsiveness, so could be something to discuss with our healthcare provider. 
 
For anyone struggling that wants to find out more, or support them in advocating for better care, Angela recommended a wide range of resources listed here: 
 
Mind The Gap, by Karen Gurney
Better Sex Through Mindfulness, by Lori Brotto
Becoming Clitorate, by Laurie Mintz ​​
 
Institute for Psychosexual Medicine website directory of practitioners https://www.ipm.org.uk/patients/specialists/ 
COSRT https://www.cosrt.org.uk/ - list of therapists 
British Society for  Sexual Medicine (email admin@bssm.org.uk and ask for a local practitioner) 
Menopause-ull webinars ​​ https://www.mnetwork.org.uk/resources/recorded-webinars/ 
You might also be interested in our testosterone episode with Dr Katie Barber: https://middlingalong.com/episodes/middling-along-dr-katie-barber-helps-us-get-to-grips-with-testosterone-dos-and-donts/ 
You can find Angela online at  ​https://spicedpearhealth.co.uk/ and https://www.instagram.com/spicedpearhealth/
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(i

This time I welcome Simona Stokes, Counselling Psychologist and the Founder of Menopause CBT Clinic, an independent psychology practice which aims to support the psychological wellbeing of women going through the perimenopause and menopause. Based on her extensive clinical experience in this area, Simona has developed EMBERS® Menopause CBT Model which is centered around the psychological principles supported by the best evidence-based research and interventions in the field of mental and emotional wellbeing. She holds professional registration and accreditation with several bodies including the BPS, BABCP, and BACP and has been working in the mental health field for over 20 years. 
We begin with an explanation of what CBT is and how it works for anyone who is not familiar with Cognitive Behavioural Therapy.  Simona explains little more on the different types of CBT, and her experience is that ‘third wave’ CBT approaches seem to work best with those experiencing perimenopause symptoms.
The draft NICE guidelines issues at the end of 2023 caused quite a media stir with the increased focus on CBT as a treatment for menopause. We discuss why the headlines were misleading and how CBT can help with hot flushes and sleep disturbances, as well as psychological and emotional symptoms. As Simona outlines, even individuals who are taking HRT sometimes struggle with their mental health and access to CBT can be helpful. Medication alone cannot address struggles with confidence, self esteem, self-worth, and identity.
We delve deeper into menopause as a psychological developmental stage - just as pregnancy and puberty (see Lisa Mosconi’s book The Menopause Brain for more on this). In all these life stages our brains are remodelling themselves - we are updating who we are and our perspective on the world…a process some of us will navigate on our own or with support of our own networks of support, and some of us may need a little extra help and support from professional - space where we can safely explore these topics.
Simona explains that the way we think about physical symptoms can amplify the symptoms themselves…CBT helps us look at the kinds of stories we tell ourselves and write new ones. It can support us to make meaningful change in areas that help us regulate our bodies and thereby mitigate symptom severity. 
Unfortunately as Simona highlights, the types of CBT available on the NHS are not always tailored to the needs of women going through the menopause and that can lead to sub-optimal experiences when people do choose to pursue CBT as an option. We end by agreeing that there is certainly scope for more practitioners to be trained in menopause-informed CBT practices. 
You can find Simona at https://www.menopausecbtclinic.co.uk/ and https://www.instagram.com/menopausecbtclinic 
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(ish) goodness into your Inbox: https://dashboard.mailerlite.com/forms/323784/90772270045202190/share 
We’re delighted to be listed as one of the Top 25 podcasts for midlife and menopause here: https://www.lattelounge.co.uk/podcasts-about-the-menopause/

In this episode of the podcast I welcome back author and health coach Susan Saunders - Susan’s first appearance on the podcast back in November 2022 focused on preventing Alzheimer’s disease and has been one of our most popular episodes.
 
Susan’s latest book The Power Decade published soon after that and will be out in paperback on 8th June (link below). The book takes us through how to thrive after menopause, and focuses on the ‘window of opportunity’ we have in, and soon after, menopause to take action to prevent the chronic diseases of aging – such as osteoporosis, cardiovascular disease and dementia. 
 
In countries where the average age of menopause is 51, and the average life expectancy is 83, we’re potentially living half our adult lives in a post-menopausal state. The Power Decade explains the impacts of the menopause transition on our metabolic health, heart health, bone health, and brain health. 
 
Susan talks about the ‘protective cloak’ that our reproductive hormones wrap us in pre-menopause, and how the drop in those hormones impacts all areas of our health, helping us understand the changes that happen in the body and what we need to do to remain healthy. She quotes The Lancet as calling menopause “a cardiometabolic turning point for women” - so I ask her to explain more about cardiometabolic health and why it becomes so important to keep top of mind post-menopause.
 
Her book is peppered with interviews with postmenopausal women who are thriving, explaining what they have done to get there, providing a sense of hope and renewal, and showing us that post-menopause can be a positive time where we experience a ‘rebound’ and renewed energy. 
 
You can find Susan at www.susansaundershealth.com  and on Instagram  https://www.instagram.com/susansaundershealth/ 
 
The Power Decade: 
https://uk.bookshop.org/p/books/the-power-decade-how-to-thrive-after-menopause-susan-saunders/7644592?ean=9781472291615 
 
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(ish) goodness into your Inbox: https://dashboard.mailerlite.com/forms/323784/90772270045202190/share 
We’re delighted to be listed as one of the Top 25 podcasts for midlife and menopause here: https://www.lattelounge.co.uk/podcasts-about-the-menopause/

This time on Middling Along I chat to novelist Tracy Bloom about her latest book The Time of Her Life, which follows midlife heroine Kim through the disintegration of her marriage and her subsequent reinvention. 
We discuss the increase in midlife female protagonists - that TV is doing so well with the likes of Sarah Lancashire in Happy Valley. Fiction has been somewhat catching up over the last five years, showcasing the issues facing women in midlife for Gen X who have grown up on Bridget Jones novels. Midlife as a time of re-evaluation and reinvention, opportunities and change, is fertile pasture for novelists…
Tracy talks through her process of learning to become an author, and gives us some tips for anyone listening who is thinking about writing a book. We also discuss Tracy's recent favourite reads and what she is looking forward to delving into next.
The Time of Her Life is out now in paperback (https://www.waterstones.com/book/the-time-of-her-life/tracy-bloom/9780008619114) if you’re looking for your next holiday read, and Tracy’s next book, The Secret Santa Project will be out later in 2024 (available to preorder at https://www.amazon.co.uk/Secret-Santa-Project-heartwarming-friendship/dp/000861914X)
 
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(ish) goodness into your Inbox: https://dashboard.mailerlite.com/forms/323784/90772270045202190/share 
We’re delighted to be listed as one of the Top 25 podcasts for midlife and menopause here: https://www.lattelounge.co.uk/podcasts-about-the-menopause/

My guest today is Leila Ainge - an accredited psychologist with 20 years of cross industry business consulting experience. Leila’s research focuses on how entrepreneurs experience imposter phenomenon - but is relevant for all of us! She’s also the host of the Psychologically Speaking podcast which is currently exploring various experiences of imposter phenomenon.
We start by delving into why Leila prefers to talk about imposter phenomenon or imposter feelings, rather than imposter syndrome and review the origins of the term ‘imposter’ in this context.  We move on to how Leila approaches and interrogates her own imposter feelings, when they arise - beginning with her first imposter experience with a small baby in the NICU and then fairly soon after, the arrival of anxiety in perimenopause.
Leila’s advice on managing imposter feelings includes: interrogate your current surroundings and context - who are you around at that moment? What’s different? What is this environment giving or not giving you? What else is going on for you? 
It’s easy to feel like you’ll always feel like this, but actually imposter is a transient feeling…it comes and goes. 
We talk about social comparison and context collapse, particularly in the technology and online sphere, and the problems that stem from the speed at which we adopt technology - we don’t have the ground rules!  We also touch on navigating online spaces with the myriad individuals and relationships to factor in - and how a lack of objectivity can cause us to struggle.
Often in online spaces there is a bit of ‘shiny new thing’ syndrome! 
We discuss the importance of establishing boundaries around how we use online spaces and compare the experiences of using LinkedIn and Instagram - should we be putting more responsibility back on to platform providers?
We move on to the positive side of comparison for women in business - finding ‘pockets of belonging’ where we can be authentic and gain objectivity. 
We wrap up by looking at the topic of Leila’s PhD: ‘what do we get out of being online?’ - and I ask Leila what it’s like to start a PhD in later life! 
I do hope you enjoy this episode as much as I enjoyed chatting to Leila - who is a friend as well as an interviewee! You can find Leila and her brilliant podcast at https://www.leilaainge.co.uk/
If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 
If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 
You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  
Join our newsletter, The Messy Middle, for fortnightly(ish) goodness into your Inbox: https://dashboard.mailerlite.com/forms/323784/90772270045202190/share 
We’re delighted to be listed as one of the Top 25 podcasts for midlife and menopause here: https://www.lattelounge.co.uk/podcasts-about-the-menopause/