Menopause, HRT & Cancer: Separating Fear From Science - with Dr. Shauna Watts - The Daria Hamrah Podcast

Episode Transcript
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SPEAKER_00 (00:02):
Every once in a while, I have a conversation on
this podcast that stays with melong after we stopped recording.
This was one of them.
My guest today is Dr.
Shauna Watts, a physician, amother of four, and someone
whose understanding of women'shealth became deeply personal

(00:23):
when she suddenly found herselfon the other side of medicine.
As a patient.
What begins as a conversationabout menopause quickly becomes
something much bigger.
We talk about fear, cancer,motherhood, identity,

(00:45):
relationships.
The enormous changes that canhappen to a woman physically and
emotionally.
And why so many women stillsuffer without understanding
what is happening to them.
There are moments in thisconversation that become very

(01:06):
emotional.
And there are other moments thatgenuinely made me angry.
Because some of what women havebeen told for decades simply
does not reflect what we knowtoday.
Whether you're a woman, apartner, or a physician who

(01:27):
takes care of women, this is aconversation I really don't want
you to miss.
So without further ado, this isDr.
Shauna Watts.
So Shauna, thank you so much forcoming on to the show and
sharing your personal experienceas well as your professional

(01:50):
experience and professionalmission, which is very
inspiring, not just to yourpatient and colleagues, but
personally to me, as I'm sharinga very similar viewpoint, albeit
as a male, which I'm not gonnapretend I can feel how you must

(02:11):
have gone through or feel, or alot of my female patients feel
going through menopause.
But that is the very reason whyI like to speak to someone like
yourself.
So not only can I understandbetter what is going on during
menopause and women's health inparticular, but also share that

(02:32):
with my audience, whether it ispatients or colleagues of ours
that perhaps don't have as muchexperience as yourself and carry
the responsibility in educatingtheir patients without fears
from the past and with moreknowledge so that they can
empower their patients to makethe best decision for

(02:53):
themselves.
So you've been very open aboutyour own experience with BRACA.
That's why honestly I brainedup.
Some of the audience mightthink, oh wow, he's getting into
very personal issues, but you'vebeen open about it.
And going through earlymenopause as well.
So can you take us through thatjourney and what is it like

(03:14):
experiencing it as a doctor?
Not just as a woman, but also asa doctor.
So you turned from doctor into apatient overnight.
So can you kind of walk usthrough it?

SPEAKER_03 (03:28):
Well, thank you for having me.
So, yes, when I was um in myearly 30s, I walked a journey
with my auntie who I was veryclose to, and she passed away
with breast and ovarian cancer,and I walked that journey with
her.
And within our family, I had twoquite young cousins who also

(03:48):
were diagnosed with breastcancer.
And at this stage, this was onmy dad's side of the family, and
my dad had unfortunately alreadypassed away, and so genetic
testing came to myself and mysister.
And I don't know why, but I wasjust absolutely convinced that I
wouldn't have this gene, and Iwas not worried at all.

(04:10):
I now know stupidly that I, tobe honest, kind of went into it
quite naively, and it came as areally massive shock to me when
I was given the diagnosis that Iwas a carrier of the BRACO 1
gene.

SPEAKER_01 (04:26):
How old were you?

SPEAKER_03 (04:27):
I was 31 when I found out, and I have to say,
the day I found out I drove homefrom work and I don't remember
the journey home.
It was about a 45-minute drive,and I don't remember even
driving.
I was just so shocked.
And please remember that I hadliterally been at a hospice with

(04:49):
my auntie months before, and I'dreally been there every step of
the way of her death.
And at this stage, I waspregnant with my third child and
had two young children who werealready with me.
And so it was I was verydistressed because I'd watched

(05:09):
her die quite a difficult death,and it was really terrifying.
And I obviously was pregnant atthat point as well.
So I was had all of theseemotions of what am I going to
do?
And you know, the other thingabout me is that I actually
started my journey as a doctor,training to be a surgeon, and

(05:31):
I'd worked really closely withthe breast team on a number of
my rotations, and so again, Iwas very um much comfortable and
confident around this sort ofpart of medicine as the doctor,
albeit the junior doctor.
And suddenly I was like, oh mygoodness, I'm I'm gonna be
having these surgeriespotentially that I watch people

(05:54):
having.
And to be honest, I was actuallyvery, very scared that I was
going to die.
And I'm gonna be really honestwith you about that.
And I did cry a lot, and it wasvery upsetting.
After a while, I made thedecision once my third child was
born that I was gonna have uhrisk reducing surgery.

SPEAKER_00 (06:16):
Can you explain what that is for for the audience?
What is risk-reducing surgery?

SPEAKER_03 (06:20):
Just so maybe if I take a step back and what I
explain is so that what BRCA1 orBRCA2 are is that they are DNA
repair genes.
And whenever someone says thatthey are a BRCA 1 carrier or a
BRCA2 carrier, it means theycarry a faulty gene.
And therefore, basically, we'renot as good at mopping up our

(06:42):
DNA mistakes.
And so in tissue, you and Ialways are having little DNA
errors and mutations all thetime, but we've basically got
this really cool system in ourbody that checks on these and
gets rid of them most of thetime.
But people with BRCA1 and BRCA2have sort of a faulty gene, and

(07:03):
therefore a lot of these errorsgo undetected.
So you start accumulating moreand more errors, and it would
seem that people with thesegenes have a very significantly
increased risk of things likebreast cancer, ovarian cancer,
and some other cancers.
So bear in mind this is nownearly 20 years ago.

(07:24):
You know, at that point, therewas definitely a real push to
have risk-reducing surgery, andthat sort of has come and gone
and come and gone a little bitover the years.
But ultimately, having watchedmy auntie pass away, I decided
that once my baby was born, Iwas gonna breastfeed for a short
period of time because I reallywanted to do that, and then I

(07:46):
was gonna have thisrisk-reducing surgery.
Well, of course, the best paidlaid plans don't work out, and
unfortunately, my third childwas born and was extremely ill.
And we were traveling from ourhome in Belfast to London and to
Great Ormond Street Hospital,and my surgery just kept being
pushed back and pushed backbecause I had this really sick

(08:07):
baby and she was my priority,and I also wanted to continue to
feed her.
And so, in the meantime, I'mhaving all these scans in the
background, and then I get aphone call to say, actually,
we're really not that happy withyour breast scan, and we just
want you to have this surgery.
So I went into hospital, had adouble mastectomy or a bilateral

(08:30):
mastectomy.
I didn't have a lot of time tothink about it because it all
happened very quickly.

SPEAKER_00 (08:35):
And the good news is this is this is while you this
is while you were in training asa surgical resident, or at this
point, I I had at this point Ihad decided to swap from doing
surgical training to be a familyphysician.

SPEAKER_03 (08:51):
Um I knew I loved it.

SPEAKER_00 (08:53):
Had you graduated at that time or were you still in
training?

SPEAKER_03 (08:57):
Um I had graduated as a doctor.
I was a fully qualified doctor,but I wasn't a specialist.
And so I decided to change myspecialty.
Um so I had my bilateralmastectomy because my daughter
was ill, I had to just do a veryquick implant reconstruction
because I didn't want to stay inhospital for a long time.

(09:18):
I wanted to be able to go hometo my sick baby.
And um, I recovered well.
Look, it's confronting to have abilateral mastectomy.
You know, I a lot of people willsay, I'm sure you're really glad
that you knew that you hadBRACA-1 and you can have this
risk-reducing surgery.

(09:38):
And yes, I am glad that I knowit, but please don't
underestimate how upsetting itcan be, you know, as a woman to
have to do this surgery.
You know, you have a verydifferent appearance in your
body, your sensation is gone.
And it's, you know, I also knewthat, for example, if I had any
more children, I could neverbreastfeed.

(10:00):
So it definitely wasn't an easydecision.
But I did it, I had to do itquickly, and that was good.
And when in fact, when we gotthe pathology back, um,
everything looked good.
Actually, everything was fine,and I didn't need to do anything
more.
And what I will say, what wasgoing on in my family was at

(10:23):
that point my 27-year-old cousinhad also just gone to have what
was supposed to be profprophylactic or preventative
surgery.
And when they did her pathology,she actually already had breast
cancer.
So bear in mind she lives likefive miles from me.
So this is all very scary.
I then do make the decision.

(10:45):
I know I love children, to haveanother baby.
I want to have another baby, andI have another baby.
Then during that pregnancy, wemake the decision that we're
going to be looking atpotentially removing my ovaries
quite quickly, and then I havemy cesarean and the decisions
made during the cesarean with myfourth child.

(11:05):
No, actually, we're doing thisduring the C-section, and I
won't get into all the detailsof that, but the decision was
made quickly.
And so I went from the highheights of pregnancy hormones to
um obviously being literallymenopausal within 45 minutes.
And so I didn't get to haveperimenopause, and I'm not

(11:27):
saying that perimenopause isfun, it definitely isn't, but it
it it it does give you that kindof gradual reduction with
spikes, but there is a gradualrunway into menopause.
Whereas women who have asurgical menopause, we literally
are one day having probablyreasonably normal hormones,
depending on our age, of course,and then suddenly we're

(11:50):
menopausal.

SPEAKER_00 (11:51):
Not what does that mean?
What does that mean as far ashow you feel because you went
from a peak hormone state beingpregnant, obviously, to zero?
How does one feel during thatdrop or right after?
Physically, mentally, like whatchanges were you surprised by,

(12:13):
or even though you knew itacademically because you're a
physician, it they stillsurprised you or were tough to
deal with?

SPEAKER_03 (12:22):
Well, I'm gonna be really honest with you.
Even though I was a familyphysician who really focused on
women's health, I'll be reallyhonest that I still, and I'm I'm
happy to admit this, I did notknow a lot about menopause or
perimenopause or surgicalmenopause, and I'm embarrassed
to say that, but I know lots ofmy colleagues feel the same way.

(12:43):
We really just weren't taught alot.
And remember, this is now theera when no one's prescribing
hormones, so we're just allpretending that it nothing
happens.
But what was, I suppose, it wascomplicated, and like all women,
I started blaming everythingelse.
I've got four children, I'vejust had a fourth caesarean
section, I had a doublemastectomy a year ago.

(13:06):
So everything I was putting downto, oh, it must be just having
four kids.
I always had this really, reallysharp brain.
Like I never wrote anythingdown.
I could remember everything, Icould remember appointments, I
never had a diary, and suddenlyI couldn't remember anything.
I remember this one time that Imissed a physical therapy

(13:28):
appointment two weeks in a row,and and the physio phoned me
both times, and I was soembarrassed.
And then I literally did it theexact same time the next week.
He was like, Like, what are youdoing?
Like, we're waiting for you.
And I just felt like my brainhad turned to mush.
I'd always had, for example, areally low cholesterol, and

(13:51):
suddenly I had this highcholesterol, and yet I didn't
look any different.
And then it went on from there.
I started getting these um painsin my hands and my thumbs and my
wrists.
But again, I blamed it.
I thought, oh, I must use mymobile phone too much.
That's what it is.
I'd also had very mild rosaceaand suddenly had these really

(14:17):
red cheeks.
I'd always been slim andsuddenly, and I'd always managed
to lose weight after all mypregnancies.
Suddenly I was gaining all thisweight and I had belly fat.
So, but you know what?
I genuinely and very stupidlydid not put any of it down.
Oh, this is menopause.

(14:38):
And on the rare occasion that Itried to maybe join in a
conversation with some olderwomen who were talking about
menopause or hot flushes orsomething like that, they would
kind of dismiss me and say, Oh,for goodness sake, you're you're
too young for that.
And I would get reallyembarrassed and and think, oh,

(15:00):
well, I'm not gonna get into awhole story.
So I kind of felt like there wasthis club of women, but I wasn't
in it.
And all my friends are in theirearly 30s, they're maybe just
starting to have children or getmarried, lots of them are
doctors, and no one is reallyunderstanding what I'm going
through.
And so, to be honest, I reallydidn't say anything for a very,

(15:22):
very long time.
I did also, and I am open enoughto talk about it because I think
it's unspoken about, I diddevelop really very significant
genital urinary symptoms, andagain, that was extraordinarily
challenging.
I was really embarrassed by it.
I was embarrassed with myhusband.

(15:43):
It was, it made sex almostimpossible.
But again, it was such a taboothing.
I just felt really embarrassedto go and talk to anyone about
it.
I didn't really know what elseto do.
So I think that, you know, youngwomen who go through surgical
menopause are often a group whoperhaps are kind of left in a

(16:05):
bit of a limb by themselves.
And I also think there are a lotof young women who have cancer,
and everyone with them, it'skind of like, oh, well, they
should be so grateful that theysurvived their cancer.
Like, why are they complainingabout some hot flushes or
vaginal dryness?
But but people don't understandthat the actual impact that this

(16:26):
can have on your on your life ismassive.
And so I suppose what was reallychallenging is that I just
didn't recognize who I wasanymore.
I didn't recognize what I lookedlike physically.
I felt uncomfortable, I hadstarted putting on weight.
I think I then suddenly hadabnormal liver enzymes and I had

(16:48):
looked like I was developing afatty liver.
And I was like, I just don'teven understand.
Like, I don't, I'm not adrinker, I don't really drink
alcohol.
So why have I got these weirdlyabnormal liver enzymes?
Now please bear in mind, I'vegot four children, one who's
really very unwell still.
So this is all like I'm thinkingabout it, but I'm kind of not

(17:10):
really thinking about it.
Because you know, as a mother,you're always putting everyone
else first.
And of course, I'm I'm trying tomake sure that I can still work
a little bit as a doctor and I'mstill trying to be someone's
wife, and I'm still having thesekids to look after.
So I want to say that it wasn'tthat this was like front and
center, and I was thinking aboutit all the time.
I kind of was just putting upwith it a lot of the time

(17:33):
because I was just like, ohwell, this is what my life's
like now, and that's how it is.
And I do look back now andthink, wow, like I'm so upset
for myself that I didn't ask forhelp or I didn't ask for
different help sooner than Idid.
I I let a lot of stuffaccumulate for a long time.

(17:53):
And I think that's why I'm sopassionate about being open
about my story, but also wantingto work in this pace, because I
think sometimes when people saythings like, you know, vaginal
dryness, it just sounds like areally like, oh, you know, you
put a bit of vasoline on yourlips, your lips are a bit dry,
but it's really verysignificant.

(18:15):
Or if you're somebody who'shaving constant UTIs all the
time, like it's really impactingyour life.
And so for some women, I feellike these symptoms can be
utterly life-changing in areally negative way.
Uh, and I just wanted toultimately work in this space
because I felt like actually,you know what, I really get
what's gone on here.

SPEAKER_00 (18:36):
I want to thank you for sharing.
This is gosh, I I I just I Idon't I mean, I don't understand
how or I I want people to wraptheir head around what you went
through.
You are arguably the mosttime-consuming, challenging

(18:58):
profession, which is goingthrough medical training and
then working as a physician,then having four children, one
newborn, one sick, goingyourself through risk reducing
reduction surgery, going throughmenopause.
How did you keep it together?

SPEAKER_03 (19:20):
I'm really gonna cry.
I think that I have got abeautiful family and really
lovely friends who've been verysupportive to me.
But look, it's been reallydifficult, and at times it's
felt very overwhelming.

(19:42):
And but you know what, life'sbusy, and I I think I am really
quite a positive person.
So I've probably thrown myselfinto helping other people,
focusing on my children, and um,you know, just trying to keep
putting a foot in front of theother all the time.

(20:03):
But look, it's it's not beeneasy, and at times I've lost
myself and too busy sort oflooking after everyone else.
But um, I I turned 50 in May,and I kind of decided when I was
coming to 50 that it was goingto be time and this is gonna be
my time to maybe start puttingsome boundaries in my life and

(20:26):
to put my health and my wellnessas a real priority and maybe not
worry so much about everyoneelse for a little while.
But look, I appreciate that, butI also think there are so many
other people out there who'vebeen through even worse than me.
So I would I was definitelyblessed.

SPEAKER_00 (20:42):
Yeah, I understand, and and you're you're being way
too humble.
Of course, there's alwayssomeone that has it worse.
I mean, absolutely there's nodiscussion, but usually when we
go through hardships, usually wecompare ourselves with people
that are better off, not worseoff.
I mean, that requires a lot ofperspective for you to say that.

(21:05):
My question is you know, duringthat vulnerable stage where you
basically as a human being, Idon't care how strong you are,
it's easier to give up than tofight.
Well was there a single thingthat gave you the strength and

(21:28):
motivation to overcome this?
I mean, you you mentioned youhave supportive friends, family,
but there's always this onething, and I've been through
this situation, not as bad asyours, but there's always this
one thing.
For me, it was my kids, mychildren.
That just the thought of it onesecond gives you these

(21:52):
superpowers and you overcomeprobably the biggest hurdle
against all odds.
And what was that for you?

SPEAKER_03 (22:02):
I it was my children.
They are absolutely everythingto me.
And I think, to be honest, Iwatched my daughter, who's now
17 and amazing, but I watchedher be extraordinarily ill as a
baby and toddler.
She had like 26 surgeries.
She was, we literally flewaround the world trying to work

(22:25):
out what was wrong with thisgirl.
And she's amazing.
She's training to be aprofessional ballerina right
now.
So she is incredible.
And I think that her and myother kids kept me going.
But you know, don't get mewrong.
I whenever you've got a geneticabnormality like Bracna
Braccawan, I carry a lot ofguilt.

(22:47):
I'm worried.
I'm worried about my daughters.
I'm worried I've got twodaughters and two sons.
I'm worried about everyone.
I feel guilty.
I feel like, oh my goodness, Icould have given this to them.
Are they going to have to walkthe same journey as me?
Sorry, I'm getting emotional,but it's it's really hard.
It's a like it's a burden.

(23:07):
You think, oh my goodness, Ihave given these kids something
awful that they will have to gothrough.
My 22-year-old daughter at theminute is beginning to, you
know, look at a journey forgenetic testing and to decide
what she's going to do.
And it's you you feel reallybad.
Like as a parent, you never wantto give your children an extra

(23:30):
burden.
So I think that's challenging.
But my children definitely weremy main motivation.
I had watched my auntie, um, theone who I walked every step with
her right to the end.
And she actually had sevenchildren, and she died at 50,
and it was absolutelyheartbreaking.

(23:50):
She did everything, she putherself through every treatment
to try and stay for as long asshe could.
And so I kind of just havealways had my kids as my North
Star that I'm I want to be here,and I want to be here as long as
possible.
So yeah, they're the people whokeep me going.

SPEAKER_00 (24:10):
Well, thank you so much for sharing.
I think imagine your parentswould have carried the same
guilt, and I don't know if theydid.
I mean, it's it's human to carryguilt, but do you think if they

(24:31):
let's assume they carried guiltjust like you and now looking at
you, how you are empowering awhole generation of women, how
you're helping, now how you havethe ability to help, not just
professionally as a physician,but also as a patient or a

(24:51):
former patient with aperspective of a patient gone
through everything you've gonethrough, having this ability to
help thousands, if not millions,of people who are going through
the same health scare or healthproblem as you.

(25:37):
And what if your purpose was tobear give birth to four children
who then can themselves bechampions because of the
adversity they go through thatthey've seen their mother gone
through, be able to helpmillions of people?
Well, do you still would youwould do you still carry guilt

(25:59):
knowing that?

SPEAKER_03 (26:00):
I I think I do.
I think I'll always carry someguilt.
And you know, my my dadunfortunately had died before we
knew anything about Braca Onebeing in his family.
Um, and I always took comfort inknowing that he didn't know
because I know he would havefelt terrible about it, and I

(26:22):
would never have blamed him.
So I do know that my childrenalso don't blame me.
And I I do although it took me along time to share my story, I
didn't share it straight away,but I definitely want to share
it, and I know that I see a lotof women who have the BRCA 1 or

(26:42):
BRCA2, or women who've hadbreast cancer, and I know they
feel that kind of affinity withme because they know that I have
walked sort of a similar pathwayto them and that I do
understand.
So, yes, you're absolutelyright.
And it it is a while, I I wish Icould change it, and I'm not
gonna stand here and say, Oh,I'm so glad that I've got this
gene.

(27:02):
I'm I'm definitely not.
If I could get rid of ittomorrow, I would.
I wish I didn't have to havethis surgery, but I also am
really glad that I have aplatform and that I'm, you know,
well enough to be able to sharewhat happened to me.
And I think the other thing Iwant to say is that I do also
want people to understand moreabout, you know, the interaction

(27:27):
between breast cancer andhormones and and how those rules
have become very, very confused.
And, you know, even write downto women like me.
So all those years ago when I umhad my surgery, unfortunately,
even though I was very young,there was very mixed messages,

(27:47):
but even between my treatingteam.
So some of my team wanted me tohave HRT, but a lot of them
didn't.
They were really scared for meto have hormones, and it was
very much that phrase of as lowa dose for as short a time as
you can possibly manage.
And I'll be honest, I spent alot of time not on HRT, which

(28:09):
probably has had healthconsequences for me.
And I now understand that wasnot the right thinking, or it's
certainly not the thinking now.
And I don't blame anyone,everyone was doing their best
for me with the knowledge we hadnearly 20 years ago.
But the thing is for BRCA1,BRCA1 doesn't make oestrogen
dangerous, it makes DNA repairunreliable.

(28:33):
And I think those two things gotvery mixed up.
And, you know, whenever peoplewere having risk-reducing
surgery of having their ovariesremoved, then people got a bit
confused and thought, oh, well,that must mean that this group
of women can't have hormones.
But actually, you were removingovaries and fallopian tubes to
remove tissue that was at risk.

(28:56):
And you're also, um, and we nowunderstand that it's absolutely
fine for those people.
So if you're a BRCA1 carrier orBRCA2 carrier and you have
risk-reducing surgery now, youshould be put onto hormones and
in fact should be put onto areally good dose of hormones
because you're only in your 30sor 40s.
And I think that's one of themessages that I'm keen to get

(29:17):
out there is that the thinkinghas changed a lot, and we need
to really start to separatehormones and cancer because
they've somehow got all mixed uptogether, including in doctors'
minds as well.
And there's all this fear, and Ithink people suffer, people like
me suffer the consequences.

SPEAKER_00 (29:37):
Yeah, I think you went through all of this during
a very tricky time.
I assume it was about what 15years ago you went through this,
which would make it around 2010,right?
Yes.
And although, you know,basically the whole scare just
for the audience, just to sothey have a little history and

(29:59):
understand where this fearactually came from and how it
all started and why we thinkdifferently.
Because in I believe it was2002, right?
The W H I T study came out,which by the way was, I think,
to at that time the mostexpensive study to ever be

(30:21):
conducted.
I think it cost about twobillion dollars, and many
renowned investigators were onin included in that study.
And it basically the studyitself was very valuable.
The data of the study was veryvaluable, but it was how the
data was interpreted at that atthat time that brought this

(30:46):
association between hormonereplacement therapy, which by
the way, in that study they usedsynthetic hormones and cancer.
And the reason why uh there wasan association because they
didn't stratify really bytiming, by age.

(31:06):
So I think the average age ofthe study was like uh early 60s,
so they there weren't any peopleincluded or women included, uh
younger women included in theirhormone replacement therapy.
And also the the timing, uh thethe study wasn't stratified by

(31:26):
time and by even route, whatwhat what how the hormone
therapy was administered.
And so the data was be the data,even though it was good, the
interpretation was verymisleading.
And can you talk about thejourney of how we were able,
after we stratified the data, beable to draw a better

(31:49):
conclusion, come to betterunderstanding, which first is
that in fact it's it's morenuanced than the study initially
said, and then later on in thestudies, I think the first the
first follow-up on that study,they used the same data was I
think before 2010, around 2007,and then again 2013-14, and then

(32:12):
2020.
So we're talking about 26 years,24 years after the original
study, and over 10 years afterthey took another look at the
data after stratifying it andlooking at the nuances, only to
realize that in fact, not onlyit doesn't cause breast cancer,

(32:34):
but it also is doesn't causecardiovascular risk.
As a matter of fact, it reducescardiovascular risk.
So during your journey, can yourelate the timeline of those
events to your personal journeyand what what what happened,
what decisions you made aboutyour own treatment together with
your physicians, and how much ofit did you take in your own

(32:57):
hands versus just rely on otherspecialists?

SPEAKER_03 (33:02):
Yeah, so I think what I would say is I remember I
was a very young doctor when theWHI study came out.
I worked in Belfast at thatpoint in the UK, and um, I just
remember the screamingheadlines.
I remember it was on the eveningnews, you know, HRT causes
breast cancer.

(33:23):
As very young doctors, at thatpoint, the UK is a public health
system, and we were basicallytold that you had to stop
everyone's HRT.
So bear in mind that, you know,I've had this message very much
reinforces a very young doctor,you know, stop all the patients
at the gynee clinic, and theyall had no one's allowed to have

(33:45):
a prescription anymore.
It was really very dramatic, andlots of women had their hormones
ripped off them as a juniordoctor.
I watched that unfold, and andyou know, look, I was quite
young and impressionable.
There were lots of much clevererand more senior and experienced
doctors than me who were alltelling me, you know, go into

(34:06):
clinic, you have to stop all thehormones, etc.
etc.
So, look, whenever you're ayoung doctor, sometimes you just
kind of do what you're told.
Um, and I did that, and Iobviously have regrets about
that.
And I look back and think, gosh,did I even read the study at the
time?
I I have to admit I can'tremember whether I even did.

(34:27):
Um, and I think lots of doctorswill say the same.
We kind of all went with theseheadlines.
So I do think that everyone wasvery influenced by that.
And I think one thing I want tosay as well about in medicine or
Western medicine that I thinkthat we're quite bad at is I
think that whenever we don'thave a solution to something as
doctors, if we don't have aprescription we can write or a

(34:50):
procedure that we can send youoff to have, we probably don't
really like talking about thattopic that much.
Because, you know, and I thinkif you look back over the last
20 years, you know, how manywomen went to the doctor and
probably tried to have aconversation about their
symptoms?
And the doctor in front of them,you know, probably steered the

(35:12):
conversation in a differentdirection.
You know, there's no coincidencethat when hormone prescribing
went like this, and sleepingtablets went the up the other
way, and um antidepressants wentthe other way.
So, you know, we we just changedthe trajectory and suddenly
everyone was being diagnosed asbeing depressed and anxious.
And that's not to say theyweren't.

(35:34):
But what we, of course, havecome full circle to understand
is that anxiety and depressionare often very hormonally
related.
So I think, you know, I wasdefinitely very influenced as a
very young doctor, but alsoplease remember that no one was
also really talking to me aboutit.
No one was proactively asking meany of this stuff.
And I also will put my hand upand say, as a doctor, I'm a

(35:57):
really bad patient.
I don't, I'm not really good atgoing to the doctor.
You know, we just tend to, youknow, pitter along ourselves and
think, oh, you know, it'll beokay.
I think there's lots ofstatistics that say that doctors
are terrible patients, and I'mdefinitely not a great patient.
And I was also very much giventhe message that only take

(36:19):
hormones if I really neededthem, if the symptoms were
really bad, and even if I didtake them, take them for the
lowest dose for the shortestpossible time.
Like that was just the phraserepeated over and over again.
So again, as I said, I reallydidn't take hormones for for big
sections of time over thefollowing decade.

(36:43):
And I I would, and then Ieventually at one point was on
some HRT that I did really like,and then COVID hit and I
couldn't get it anymore.
So I think there's been lots ofthings that have impacted my
hormonal journey, not onlyprofessionally, um, but also,
you know, my silly decisions aswell.

(37:03):
Um, and I think just thatgeneral consensus within the
medical community that when wedon't know about something,
we're not that great at talkingto our patients about it, or if
we don't have a solution, wedon't want to talk about it.
Um, so I think that reallyimpacted my decision.
And look, I'll be honest, I wasstill scared.
I I I'd watched my auntie.

(37:24):
I literally sat with her whenshe died in the hospice.
I I didn't want that to happento me.
I didn't want to leave mychildren.
I was terrified that I mightdie.
So I'd done all these surgeries.
So I thought, well, I'm notgoing to do anything to put
myself at increased risk.
So I definitely had lots ofmixed stories in my head.
And I'm so frustrated at thatbecause, of course, when you

(37:46):
look at the data, you know,remember the newspaper screamed,
HRT doubles your risk of havingbreast cancer.
It sounded absolutelyterrifying.
But in fact, when you actuallylooked at the data, the group
who were on estrogen onlyactually had less breast cancer
than the group who were onnothing.

SPEAKER_00 (38:06):
And in fact, and less cardiovascular risk too.

SPEAKER_03 (38:08):
Yeah, absolutely.
And you know, I think what wealso have to remember is we
can't just reduce women to a setof breasts and breast cancer,
because what about all the otherthings that women die from?
You know?
And so I think that you know myYeah, go ahead.
No, no, sorry.
You're you're fine.

SPEAKER_00 (38:26):
So so I mean, and because I I don't want this to
get lost, you said somethingvery important, and and I and
this is very important for theaudience because there's still,
I would say, seven out of tenwomen that I see in my clinic,
when I bring up hormonereplacement therapy, they still
look scared and they say theirphysician does not recommend

(38:50):
hormone replacement therapy forthem because of risk of cancer
today seven out of ten.

SPEAKER_03 (39:00):
So I I agree.

SPEAKER_00 (39:03):
So why is it that still with the internet, social
media, podcasts, why is it, howis it even possible that there's
still a single physician outthere denying hormone
replacement therapy or at leastnot omitting the opportunity for

(39:24):
the dis even to have theconversation with the patient.
How is that even possible?
And that that's something that Idon't understand because I'm not
in a primary healthcare field,I'm not in the women's health
field, and honestly, it bafflesbaffles me.

SPEAKER_03 (39:40):
Oh, look, I find it so frustrating.
Every day I'm seeing women inclinic and I'm being told the
same thing.
I literally had a womanyesterday morning who told me
that her dentist had told herthat I was a very dangerous
person, that I had put her onhormones, and did she not know
that hormones caused breastcancer?

(40:01):
Like, it's so frustrating.
It is like, how are we evergoing to untangle this thing?
And the thing I find sofrustrating is that nowadays we
use hormones that are absolutelyidentical chemically,
molecularly, to human hormones,and yet so many doctors remain

(40:24):
terrified to give someone ahormone, but yet, you know,
they're not scared to give thenewest drug that the you know
comes out on the market, whichis some other compound.
And it doesn't actually make anysense to me.
And I I say to myself everysingle day, there's all these
women suffering, but also notonly are they suffering from

(40:47):
symptoms, but they're havingpeople make them feel bad,
question their decision, makethem doubt themselves, and also
quite frankly, make them doubtthose of us who are trying to
help them, you know, suggestingthat we're somehow leading them
down a dangerous pathway when infact we know that the data does
not say that at all.

(41:09):
And, you know, I I, like you,feel very frustrated.
I've run another a number ofeducational events, not only for
women, but for professionals.
And what's really interesting isthat, you know, you get this
natural selection.
The people who come to theeducation events are actually
already quite educated.
And the people who you reallyneed to get to those educational

(41:30):
events, yeah.
They're not coming.
They don't want to know.
And they've just got this reallyfixed mindset.
And I just don't know how weseparate this hormones and
cancer thing.
I've never seen a marriage thatyou can't break out like this.

SPEAKER_00 (41:47):
I think it's very hard because it's basic human
behavior and it's called, it's aphenomenon called cognitive
dissonance.
And it affects physicians, itaffects all humans, regardless
of their experience, regardlessof their profession.
You know, one assumes physiciansare scientists and they should
only judge and think with ascientist mind, but

(42:11):
unfortunately, cognitivedissonance is so powerful that
despite providing all evidence,one's beliefs are much stronger
than any evidence presented tothem, and they still believe
their old beliefs because it'sso ingrained in them, and and

(42:32):
that is the problem.
It's basic human behavior.
Now, let's for the audience now,so we can give them something
productive and maybe help withthe fear, let's let's separate
the evidence from fear.
Now, we have an entiregeneration of women, as we
talked about, who obviously havebecome frightened of hormone

(42:54):
replacement therapy, not justwomen, actual physicians too,
like we said, after the women'shealth initiative.
What did we actually learn fromthat study today?
You know, because a lot of whatwe learn today is from the data
that was provided during thatfrom that study.
And how is our understanding nowchanged over the past 10 years?

(43:17):
So that for example, if apatient comes to you and says,
Hey, my doctor said, or mysister said, or my dentist said
hormones cause breast cancer,how do you explain the actual
evidence to her so that she kindof at least gives you a chance
to treat her?

SPEAKER_03 (43:36):
So what I say to every individual woman is I said
the person in front of me, youhave your own individual risk.
And what we also have toremember is that we don't know
why people get breast cancer alot of the time, but we know
it's associated with variousthings.
So for example, if you drinkalcohol, if you drink alcohol

(43:58):
every day, then you areIncreased risk of having breast
cancer.
If you're overweight or obese,you are significantly at
increased risk of having breastcancer.
And we don't entirely understandall the mechanisms of this.
Again, I have women who come inand they'll say, Well, my dad's
sister's cousin had breastcancer, so I've got a family

(44:19):
history.
But listen, breast cancer isvery, very common in the
population.
Very common.
And so it's highly likely if youknow more than 20 people or
you've got 20 people in yourextended family, that someone
will have had breast cancer.
But that doesn't necessarilymean that you've got a genetic
predisposition to having breastcancer.

(44:40):
And so what I think we need toreally separate out is that this
study showed, even though we wedon't like this study, but the
reality is it actually showedthat women who've had
hysterectomies or who don't needto have progesterone and took
estrogen only, they had lessbreast cancer.
So in fact, that kind of debunkspart of the myth that estrogen

(45:01):
seemed to be causing breastcancer.
And then even when you look atthe group within the study who
were taking estrogen and asynthetic progesterogen, the
increased risk was still verysmall.
And we, I mean, nowadays I don'teven prescribe that type of
progesterone anymore.
But you know, even if we did, Ithink we need to also be

(45:23):
thinking about okay, well, whatabout the reality for you?
So if I have a woman in front ofme who can't sleep, is about to
quit her job, her marriage is onthe on the rocks, she's you know
fighting with everyone, she'shaving complaints at work
because she's grumpy andirritable, she's forgetting
everything.
And let's not forget, you know,we have women who actually

(45:46):
become suicidal over this, whoare going to lose their life.
Are we actually gonna just saythen?
But hey, listen, because youknow, when we look at a thousand
women, there might be, you know,one additional case per thousand
if you take HRT, like, is thatreally gonna make us not let
that woman have hormones?
And so what I say to every womanin front of me is like, let's

(46:09):
have a look at your own personalrisks, let's have a look and see
how we can make you as healthyand safe as possible on this
journey.
For me, the menopause andperimenopause journey is
absolutely not just abouthormones.
And I'm certainly not here totell everyone they should take
hormones.
I'm here to take you on ajourney where you make your own

(46:31):
decision.
But what I wanted you to do ismake it based on facts rather
than fear or something that yourmum told you or your next door
neighbor said, or your dentistsaid, and sorry, my best
friend's a dentist, so I'm notmeaning to bad wife dentists.
But um I think I um I just thinkthat we have to start looking at
people very individually.

(46:52):
And I also want people tounderstand that you know your
individual risk is yourindividual risk, and we have to
think about all the things thatyou can do in your life to
minimize your risk and stay ashealthy as possible.
But if in that moment you can'tsleep, you know, you've you know
that you've got a strong familyhistory of osteoporosis, um, or

(47:14):
you know, you've already had aDEXA scan and it's already
telling you you've gotosteopenia, or you've got severe
anxiety and you're about to quityour job.
Well, I have to say, I would saythat really, why are we worrying
about something that'scompletely theoretical and
incredibly low risk and notdealing with the person in front
of us who's actually living alife that is way less inoptable

(47:36):
right now.
So that's kind of what I say.
I think we everyone has to becomfortable with their decision.
And another thing I do say toall of my patients is that some
women that I give hormonereplacement therapy to will end
up with breast cancer.
That's just the statistics.
If I see 20 women in a day, overthe next 30 years, some of them

(47:59):
will get breast cancer.
But both they and I have to feelcomfortable that me giving them
hormone replacement therapy hasnot given them breast cancer.
And I've reached the point inthe in my understanding of the
liter literature is that that isabsolutely the case.
And is that what you think?

SPEAKER_00 (48:19):
Yes, I mean a hundred percent, because
regardless of hormonereplacement therapy, and the
proof is the past generation,the past 20 years, women that
didn't get HRT and still gotbreast cancer.
It's not like suddenly thebreast cancer cases dipped.
As a matter of fact, theyhaven't gone right, they've gone

(48:39):
up and they've gone up despiteus omitting them from HRT, and
for reasons that you alreadystated, which is alcohol
consumption, increased body fat,a poor lifestyle in general,
which is uh one of the rootcauses for all kinds of cancers,
not just breast cancer.
In in women, obviously, breastcancer because women have

(49:02):
breasts, and of course, uh theif all cancers in general
increase, for example, I thinkwith men, but also in women,
colon cancer, the the cases havegone up.
And it's not surprising thatthese rates of cancers go up in
more of the Western world, andwhich is more associated with
high stress, high alcoholconsumption, high processed uh

(49:26):
food consumption, basically poorlifestyle, as opposed to parts
of the world where people liveinto their 90s or have a higher
number of centenarians becausethey have a totally different
lifestyle, and which, you know,for obvious reasons, the reasons

(49:46):
of cancer are much decreased inthose populations.
But I want to talk about whatyou already mentioned, which is
something that most people don'ttalk about, or if they talk
about it, they don't take it tooseriously, perhaps because it's
not very sexy, which islifestyle improvements.

(50:07):
The effects of lifestyleimprovements not just on your
general health, but also oncancer risk reduction.
And there's multiple studies outthere that show the relationship
between your lifestyle andcancer, as well as
cardiovascular disease,neurodegenerative disease,

(50:28):
metabolic disorders.
I mean, all of the symptoms ordiseases of aging are related to
lifestyle.
And there is a lot of studiesfrom the UK Biobank that have
shown us how that's related toyour to all-cause mortality and
your lifespan.

(50:48):
And I think the latest one wasactually published this year
that showed up to 64% reductionin all-cause mortality simply by
sleeping extra 90 minutes perday, exercising 15 minutes,
moderate to vigorous exerciseper day, uh, 15 minutes, and

(51:11):
adding one fruit and one uh cupof vegetables, and getting rid
of ultra-processed junk food.
That alone reduces yourall-cause mortality by 64%, as
well as cancer, because part ofthe reason people die is because
of cancer, it's the number onereason of death, unless you get

(51:32):
in a car accident.
So people don't talk enoughabout that, but when it comes to
HRT, now it's this cancermachine that is, by the way, not
true.
So, how do you or why are wehaving such a hard time shifting
the narrative?
And why do people not holdthemselves more responsible when

(51:58):
it comes to a prescription thatsays, hey, you can't drink
alcohol, you have to exercise,you have to sleep better, and
you have to eat better?

SPEAKER_03 (52:07):
Yeah, look, I think all of us we want an easy um we
we want an easy fix, don't we?
We all would love someone togive us a tablet that gave us
more energy, more motivation,made us have a six-pack, had
muscles, you know, well they aredoing that.

SPEAKER_00 (52:26):
With there are people are selling these tablets
and injections on social media.
They call them peptides.
Um but the question is, do theywork?

SPEAKER_03 (52:38):
Yeah, I know.
Well, but apparently they workon a on a slug and a and a and a
rat.
So um I um so what I will say isthat the alcohol, I live in
Australia, the weather is oftenvery, very good.
Even in winter, even thoughwe're complaining, you know,
it's probably still 15 degreesC, so uh, and we're all we're

(53:00):
all really cold.
Um, but you know, there'sdefinitely a real culture here
of women um sort of in their 50sto 70s, where it's wine o'clock,
wine is opened early in theevening, Australia makes a lot
of good wine, there's a lot ofwineries, it's pretty cheap.
Um, and there's very much thisculture around drinking,

(53:22):
drinking while you're cooking,drinking with friends, drinking
at your book club.
Um, you know, this is just very,very much the culture.
And uh what I also find is thata lot of my midlife women are
also drinking because they'reanxious, they're drinking
because their relationship is introuble, they're drinking
because they're really worriedthat they're not doing well at

(53:44):
work anymore, and they're alsodrinking because they can't get
to sleep, and so they somehowthink that maybe drinking
alcohol will help that.
I will tell you, it tends tomake things much worse.
Alcohol will keep waking you up,so please don't use that as a
remedy.
But we know that women reallyare using alcohol a lot, and
again, big study out of the UKjust showed how much women are

(54:06):
medicating.
And so, one of the challenges Iwould say to my colleagues who
are so scared of hormones islike, do we really, are we
really so scared of giving womenHRT, which we know to be
extremely safe for the vastmajority of women, for the
benefits to outweigh the risksin the vast majority of women?

(54:27):
Are we really so scared of thatthat we would prefer women are
drinking a bottle of wine everynight to get past their anxiety,
their social anxiety, all thethings that I've just mentioned?
Because I think that we reallyneed to have a bit of a look at
ourselves as a profession.
And it's one of the reasons thatmy husband and I, who he's also
a doctor, we decided to reallyjump into lifestyle medicine.

(54:50):
Because I think it's somethingthat Western medicine we lost
our way a long, way, way uh along while ago.
Like our grandparents andgreat-grandparents, they kind of
knew this stuff, you know.
They they cooked from scratch,they were physically active all
the time.
That's what their life was like.
And somehow it's like, you know,we we think, you know, how do

(55:11):
they how do they not know thatwashing your hands was important
before surgery?
Um, but you know, somewherealong the lines, we keep
forgetting stuff that we knowand we've forgotten all this
stuff.
And then everyone's franticallytrying to research, you know,
why is bowel cancer rates goingthrough the roof in young
people?
Well, I would hazard a guessthat it's very strongly related

(55:35):
to all the ultra-processed foodsthat that generation have been
fed.
Um, and you know, I'm not sayingI eat perfectly in any sense,
but I think that we have to facethe reality of the world that we
live in.
I mean, I know I've been to theUS many, many times, and you
know, the portion size um in theUS always blows my mind and the

(55:56):
availability of snacks.
And I always remember my kidsused to be excited every time we
went to Florida because we'd goto the cereal aisle and they'd
never seen as many cereals andas much sugar in their whole
life.
And so I think, you know, we dohave to take some personal
responsibility.
And as I have that woman sittingin the room with me, and I will

(56:16):
tell you that my consultationsfor perimenopause and menopause
are a 60-minute consultation,and I struggle to get through
everything in that time.
But you know, what I'm exploringwith these women is I think
you're scared of the wrongthing.
I think you're scared of thistheoretical cancer and when
actually maybe we should be moreconcerned about the bottle of
wine that you're drinking everyevening.

(56:38):
And I think that's a good thing.
Yeah, they don't want to givethat up.
No, and I think you know, theother thing is that we're, you
know, actually heart disease inAustralia is the number one
killer of women.
And yet again, if you ask a roomof a hundred women, put your
hand up if you're more scared ofbreast cancer or heart disease,
they'll all put their hand upand say they're more scared of
breast cancer.

(56:59):
And I understand that breastsare a very uh female, they're
all about identity and all thethings, but you know, maybe
we're really scared of the wrongthings.
And I think absolutely.
But you know, that's thereality, is that more women are
dying of heart disease than aredying of breast cancer in
Australia.
So I think you know, we need toreally change the narrative.

(57:21):
And of course, I know it's hard.
Like who wants to get up earlyand go to the gym?
It it's it's hard.
You have to motivate yourself,yeah.
You know, you have to find itwithin yourself to change it.
But we also have to face thereality that it is our lifestyle
that's creating the the monsterthat we've got.

SPEAKER_00 (57:38):
Yes, I think you touched on this, which are the
not just the symptoms ofmenopause, it's it goes beyond
hot flashes because one can havemenopause but not have hot
flashes.
That doesn't mean you're notgoing through menopause.
Can you help the audienceunderstand the difference?
Why some people get hot flashes,some don't, uh, despite both of

(58:00):
them going through menopause?
And what are some of the unsungsymptoms that we don't often
talk about that are symptoms ofmenopause?
You briefly mentioned that.
But it's very important forpeople to know that some of the
changes that they see or feel inthemselves is actually

(58:21):
menopause, despite them nothaving hot flashes.

SPEAKER_03 (58:25):
Yeah, absolutely.
So if we talk about hot flashes,or as we call them in Australia,
hot flashes, and so they arerelated to you've got a
thermostat in your brain.
So just like you might have athermostat in your house to
regulate the temperature of theroom, you've got one of those in
the hypothalamus of the brain,and it is very estrogen
sensitive.
During perimenopause, thegeneral trend for estrogen is to

(58:49):
be going down.
Now it does have a spiky journeyalong the way, but the general
trend is that you're losingestrogen and you've got less and
less estrogen.
And that thermoregulatory centeris really impacted in some
women.
Now, what we do know is thateven women who don't complain of
actually overt hot flashes ornight sweats, actually, if they

(59:10):
monitor them in studies, theydefinitely don't have the same
temperature regulation.
And if you look even at themwhen they're sleeping, often
their temper temperatureregulation isn't as good as it
was.
So I think that sometimes womenthink that if they don't have
that one set of symptoms, thenthis must not be menopause.
But what we know is that this isa whole systems issue.

(59:34):
And for a long time, andprobably when I was at medical
school, and I think, andprobably when you were at
medical school, we did learnabout menopause as like this
sort of end of reproduction, endof periods, and hot flushes, and
that was kind of all we weretaught.

SPEAKER_00 (59:49):
That was pretty much it.

SPEAKER_03 (59:51):
Absolutely all I was taught.
But I want to take you from thetop of the head to the tips of
the toes, and I want to tell youwhat the symptoms are.
And this is not an exhaustivelist, but let's start with
people's hair.
So women will often say, My hairis falling out in clumps in the
shower, or my hairdresser issaying, My hair's getting really
thin, or my hair's really dry.

(01:00:12):
And then, of course, theopposite complaint is I'm
getting chin hair, I'm gettinghair on my lip, I'm getting hair
on my nipples and my neck, and Ihate it.
Why can't I have this hair on myhead where I want it and not
where I don't want it?
They'll be complaining of thattheir skin is dry and more
sensitive.
And you and I will see this allthe time.
I see all these barrier impairedskins and almost say, oh, you're

(01:00:35):
completely, I can tell thatyou're in perimetopause because
I can just see you've got likeno skin barrier anymore.
Um and people will tell you thattheir skin feels dry, they're
putting all this moisturizer onit, and also the products that
they used to use that was noproblem.
They could walk through thedepartment store and take a
little sample of something andput it on their face.
Now everything is stinging, andtheir face just feels like they

(01:00:58):
just want to put more and moremoisturizer on it.
And if they're like me, ifthey've got rosacea or acne or
psoriasis or eczema, suddenlythat is completely flaring up
and they maybe haven't had aflare-up for years.
And then, of course, you've gotthe people who've got the dry
eyes, and they might wearcontacts or they might not wear
contacts, but they know theireyes feel burny and sore, or in

(01:01:20):
fact, their eyes are justwatering all the time.
And that's because you actuallyneed hormones to give you a
really good quality tear.
They're complaining of a drymouth and a burning tongue,
itchy ears.
The number of women who come inand they've made their ears
bleed because they've beensticking things in their ears to
try and stop the itching, andthen they're also complaining of

(01:01:41):
dizziness and tinnitus andvertigo, and just can't explain
why they've had these awfulattacks of vertigo.
And as we just keep moving downthe body, they've got frozen
shoulders, sore elbows, sorehands.
They're blaming themselves,thinking, Oh, I must be on my
mobile phone too much, and myjoints are really hurting.
They're complaining ofpalpitations.

(01:02:03):
They often will tell you, myheart feels jittery, my heart's
beating really quickly, I'mfeeling anxious all the time.
And they'll complain of thatsuddenly, you know, they're
doing all the things.
They're going to the gym sixdays a week.
They haven't changed whatthey're eating, but the weight
is just creeping up and creepingup.
They used to be a pear-shape,they used to have all their
weight on their hips, all theirfat was under their skin, and

(01:02:26):
now they're getting this bellyfat.
Their trousers won't closeanymore.
They're having to have find adifferent size of clothing, and
they feel really self-consciousabout this tummy that they go to
the gym and work on and work on,but it's not changing.
They've got hip pain that meansthat they can't lie on their
side.
Or they've got plantarfasciitis, which means that

(01:02:46):
they're limping when they'rewalking because the soles of
their feet are so uncomfortable.
They are also complaining ofgetting up during the night to
go to the toilet.
Their vagina might feel dry andsore and burning, and it can be
uncomfortable to have sex.
They're having recurrent UTIsand they're just feeling that
they're not strong anymore.

(01:03:08):
They feel weak.
They feel like their musclesdon't feel like they've got any
energy, and recovering after thegym feels really hard.
And then if we jump inside thebrain, they're telling me that
they're feeling anxious.
They're worrying about thingsthat they didn't worry before
about.
Lots of women suddenly becomescared to drive their car.
They're scared to drive on thefreeway, they're worried they're

(01:03:30):
going to have an accident, orthey're in a presentation at
work and their brain just goescompletely blank.
They're standing there, they'veprobably given the same monthly
meeting year on year, andsuddenly they can't remember a
word and they are literallyfeeling like they are an idiot.
They're doubting themselves,they're questioning their
ability to do their job.

(01:03:51):
And then they're also describingthat very phrase that I'm sure
you hear all the time.
I just don't feel like meanymore.
And it's so hard for people toarticulate.
What do you mean by like that?
And they just keep saying, Idon't know, I just don't feel
like me.
And then they'll tell you 10things like I used to get up at
five in the morning to go to thegym, or I used to be the friend

(01:04:13):
who organized all the girls'nights out, but now I just can't
be bothered.
Or I used to like love doingstuff with my family, but now I
feel like I'm just watchingeveryone else.
Um, I do I used to love life,but now I'm just like, meh, is
this it?
And that is the type of storythat I'm hearing over and over
again.

(01:04:34):
And so this is a literally topof head to tip of toe set of
symptoms.
And of course, the other one isenergy, fatigue.
No energy for life, no libidofor life, no libido for sex.
If they ever had to have sexagain or never had sex again,
they wouldn't really care.

(01:04:55):
They're often having um, youknow, what I call duty sex
because they're really worriedthat their husband or partner is
gonna leave or that that's whatthe expectation is.
But quite frankly, they'd ratherread their book or watch Netflix
and they are so tired.
They're so tired they fallasleep, okay.
But 218, 3.14, 410, everymorning they are chinged, wide

(01:05:20):
awake, and they cannot get backto sleep, even though they they
know they're tired, but theirbrain is wired.
And that is why we have to thinkabout this as a whole body
phenomenon and stop tellingwomen it's about hot flushes and
it's about not having a period.
Oh, and aren't you lucky youdon't have to worry about
getting pregnant anymore becauseit's so much more.

SPEAKER_00 (01:05:42):
Isn't it isn't it crazy?
Like I'm listening to you.
Of course, I know all of thesethings, right?
But sitting here listening toyou summing up all these
symptoms of what happens duringmenopause.
And the reason is because allour tissues, our brain, Our
skin, our blood vessels, our GItract, our GU tract, everything

(01:06:07):
has estrogen receptors that hasa specific function to keep
those tissues vital andfunctioning.
And when you deplete the body ofestrogen, the whole system falls
apart.
And it is crazy.
It is crazy.
I just even though I know this,just listening to you blows my

(01:06:30):
mind because pretty mucheverything we do in medicine
with women that present with allthese symptoms is just disease
management.
If someone has is moody or hassleeping disorders, we gave them

(01:06:52):
antidepressants or sleepingpills.
If someone has hair loss, we tryinjecting PRP or doing hair
transplants.
When someone has maritalproblems because of the, for
example, moodiness or lack of orlack of interest in sex, which

(01:07:14):
has a lot to do with bondingbetween couples.
They go through couples'therapy.
Look how many different medicalspecialties feed off of this one
thing that declines in women.
And I feel listening to you, itis a crime for the medical

(01:07:35):
community not to get their acttogether and act swiftly and as
quickly as possible in educatingthemselves and making it
mandatory so that women's andhusbands' lives can be saved.
And I think if anything, we oweit to our own profession from an

(01:08:02):
ethical standpoint, not tomention to the patients we
treat.
I mean, this is crazy.

SPEAKER_03 (01:08:09):
I I agree, and I I've racked my brains trying to
think of which specialty inmedicine would not need to know
about every specialty needs toknow.

SPEAKER_00 (01:08:19):
Every specialty.

SPEAKER_03 (01:08:20):
I was like thinking, like if you even think of like
ENT, okay?
So what do women start doing inparimenicals and menacles?
They start snoring.
They start having more sinusissues.
We know that is related.
So, you know, even the ENTsurgeon.
I literally thought to myself,is there any specialty that
might not need to know?
It's like, oh, would apsychiatrist who only

(01:08:42):
specializes in men, would theyneed to know?
Yeah, they do, because theythey're probably the men who are
attending them need tounderstand about their female
partner.
So there is no specialty inmedicine.
And that's why it's sodisappointing when we do have
educational events.
As I say, the people that youwant to have there just don't
come because they don't thinkit's relative, uh relevant to

(01:09:04):
them.
But whether you're an orthopedicsurgeon, a physiotherapist, an
occupational therapist, anyspecialty needs to be here and
talking about this issue.
If you're an obesity doctor, ifyou're a gastroenterologist, if
you're an allergy doctor, ifyou're a rheumatologist, like
how many women, this is what Iwant to know, is how many women
get diagnosed as havingseronegative orthopathy are

(01:09:27):
actually just not just, butwomen who have perimenopausal
joint issues.
And I was thinking, how many menhave I seen with frozen shoulder

(01:09:48):
in 27 years?
And I can remember one.
Um and yeah, wow, all thesewomen, and yet I but why did I
never put that together?
Why did I not think, why is itonly ever middle-aged women who
kept frozen shoulder?
Like, why did we not put ittogether?
And so it's so frustrating.
And I think we have to stopthinking about this as just

(01:10:11):
about the end of periods andstop telling women, well, look,
just do your best.
And if you can't manage thesymptoms, then come and talk to
us because it's absolutelycrazy.

SPEAKER_00 (01:10:23):
It is criminal.
I'm I'm sorry to say that.
I know it might come acrossharsh, but it is criminal.
And if you're a physicianlistening to this and right now
thinking, How dare you?
I I really mean it.
Because I mean, at this point,if you don't see the force for
the trees, I'm sorry.
You have to I mean, I don't wantto say it, but it's it's

(01:10:49):
malpractice.
I mean, because the science isout, I mean this is not anything
different than malpractice ifyou don't address it.
Right?
Or am I being too harsh?
Am I being too harsh?
Because the science is there.
I don't think you are, and Ithink I would be so I'm a I'm
I'm a man, right?

(01:11:11):
And I'm pissed right now.
And and I and I uh for a secondI'm thinking if I was a woman, I
wouldn't be pissed, I would besomething else.
I would probably go crazybecause it is just simply not
fair.
And for me now, it's I can'tunknow or unsee something that

(01:11:34):
I've seen personally, and Idon't want to take much of it
away.
I know we're gonna discuss myperspective on your podcast.
So for the audience, if you wantto know my perspective on it,
make sure I think we're doing itnext month.
Uh I'll come onto your podcastand share how it changed my
practice because I can't unseeit anymore.

(01:11:56):
I mean, the cat's out of theback, so I can't, I wouldn't be
able to deal with my ownconscience offering my patients
services or procedures ortreatments that I know treating
the root cause is moreeffective, which is hormone
replacement therapy.
And that's why I work with a lotof physicians.

SPEAKER_03 (01:12:16):
Can I can I tell you one thing is that when women
come to see me, they are oftenfrustrated, disappointed, and to
be honest, they're nearly I knowthey're waiting to be
disappointed again.
They're almost holding theirbreath when they come into the
appointment thinking, is thisgonna be another doctor who is

(01:12:37):
gonna dismiss me, minimize mysymptoms, you know, tell me that
it's not that bad or that it'sprobably not perimenopause.
Like the number of women that Ihave who come in and they
literally are textbook, butagain, one of our colleagues has
done a blood test and got anormal hormone panel and said,

(01:12:59):
Oh, well, your hormones looknormal, so it can't be
perimenopause.
And I'm like the silencescreaming in my head is so
frustrating.
But for these women, it's soannoying for them.
Like, you know, I think itshould be an expectation.
Like, you know, if you lookafter human beings, you need to

(01:13:19):
know about this.
It's like saying you don't know.
Like as a doctor, even if you'renot anything to do with
antenatal care or pregnancy, youof course know about that
because you know you can't do alot of treatments or you have to
be careful or whatever.
Why do we say that certainspecialties don't need to know
anything about this?
And even think down to thingslike, as I mentioned, dentists,

(01:13:43):
and I have some great friendswho are dentists, like the
change in the mouth, the changein the pH of the saliva, the
increase in gum disease, thechange in the palate and the
snoring and the teeth grindingand the clenching, that all
change.
So every single specialty needsto know this.
And I just feel like all of uswould have a much more enjoyable

(01:14:03):
day-to-day career.
Is life's so much moreinteresting as a doctor when you
know more and you can really getwhat your patients are going
through than whenever they'retalking about stuff and it's
just going over your head.
There's nothing worse than yourpatients.
You know, I love being educatedby patients, but I it makes me
feel then interested to go anddo my own research.
And I just feel like as adoctor, we want to be more

(01:14:25):
curious.
And as you said at thebeginning, we should all be
scientists.
And any good scientist has to beable to change their mind.
When the evidence changes, youneed to know that the evidence
has changed and change yourpractice respectively.
You can't just say, Oh, well,that's the way I've always done
it.
So I'm gonna just dig my heelsin and refuse to change because
that's so unfair to ourpatients.

SPEAKER_00 (01:14:47):
Yeah, I mean, we all swore the oath of Hippocrates.
So what what happened now?
How come we don't hold ourselvesto the same to the same
standards we think we'retreating other things?
And I think if I was the healthsecretary today, I would make it
mandatory for every medicalprofession, for every health

(01:15:09):
profession, includes dentists,chiropractors, physical
therapists, I mean you name it.
Anyone that takes care of humanbeings, uh, psych psychologists,
psychiatrists, all of them, theyshould get a mandatory training
in many menopause.
I would make it mandatorybecause it affects every

(01:15:30):
specialty, because it affectsevery organ in the body,
including the brain.
And unless you educate allspecialties, all healthcare
professionals, there will bemillions of women that will slip
through the cracks, that willget symptomatic treatment for a

(01:15:51):
symptom of menopause, of lack ofestrogen, where the treatment
would simply be you know, givethem estrogen.
I would make it mandatory, and Ihope that happens.
And I you know, f when I said itat first it sounded crazy, but
now thinking of it as not crazyat all.
You know, there are here in theUS, we have a lot of primary

(01:16:15):
care physicians, familyphysicians, and OBGYNs, they can
go get menopause certified.
There's a certification formenopause here in the US that
you can go is continuingeducation and you get menopause
certified.
And I would recommend everyphysician listening to this
podcast, and it doesn't takemuch, do that because you could
help your patients at a completedifferent level.

(01:16:38):
You could save lives.
You know, I don't wanna youcould save marriages.
You could, I mean, if you'reinterested in health, health
span, or if you're, you know,it's funny, there's so many
colleagues of mine that areobsessed with getting NAD
infusions.
I wish they carried half thatobsession with thinking about

(01:17:00):
okay, what is causing my lack ofenergy?
And instead of treating thesymptom, which by the way, NAD
infusions don't even work, butthey think it works, and that's
why they make that decision.
So instead of uh treating thesymptoms of getting an NAD
infusion, uh think about maybemy hormones are not properly

(01:17:23):
regulated.
Maybe I should go to aspecialist and get that looked
at.
And that that is even forphysicians who are patients
themselves, too.
You know, if you're anorthopedic surgeon and you're
going through menopause, youknow, how are you gonna treat
your frozen shoulder?
I literally had a friend of mineduring uh it was two years ago,

(01:17:43):
we're at a scientific meeting,very well-renowned
dermatologist, and we're justchatting, kind of small talk,
how are you, blah, blah, blah.
And she's like, Yeah, you know,my shoulder has been bothering
me.
I can barely lift it up.
I think I have a frozenshoulder.
And my doctor sent me tophysical therapy, but it's
getting worse actually.

(01:18:06):
And I'm thinking, What?
Did she not connect the dots?
And we're literally there at agala drinking a glass of wine,
chatting about life and catchingup, and she's telling me these

(01:18:28):
things, and I'm like, should Itell her?
I mean, is it am I out of place?
And I said, Look, sorry, I I I Idon't mean to intrude, but is it
perhaps that you're goingthrough menopause?
And she goes and she goessilent, she's like, actually,

(01:18:48):
yeah, I am.
And I felt she was kind ofembarrassed a little bit, but
then she opened up, she says,Yeah, I know I have this you
know brain fuck and I'm tired,and now my shoulder, now I can't
go to the gym anymore.
I don't know what to do.
And I said, You should seesomeone that specializes in
hormone replacement therapy andmenopause.

(01:19:10):
This is not an orthopedicproblem you have.
Sure enough, she calls me fourmonths later.
We actually talk about, we'resupposed to be on a panel
together and we're discussingour talks and everything.
She's like, by the way, Istarted hormone replacement
therapy and my frozen shoulderwent away.
Thank you so much.

SPEAKER_02 (01:19:31):
So amazing.

SPEAKER_00 (01:19:32):
And I was like, wow.
And this is just one, this is amicrocosm of what's going on.

SPEAKER_03 (01:19:39):
Absolutely.
And I want to pick up on oneother point that you made there
about her embarrassment.
Um, and I wanna to addresssomething which I think is still
very much pervasive, is that alot of women are embarrassed to
be menopausal.
At the minute, being parry isdefinitely seems like it's maybe

(01:20:02):
a little bit more acceptable.
Um, so it's being chatted aboutand somehow, but there's still
this underlying culturalsocietal thing that when a woman
is through the menopause, um,that it's somehow that they're
over the hill, they're washedup, they're no good or whatever.

(01:20:23):
And and women they almost cringewhen they tell you um that's
exactly what happens.
Menopausal.
They it's like they feel thatthey need to shrink away, that
it's admitting something that'sI don't know, kind of
embarrassing.
And I just wonder how we've gotto this point where, you know, I

(01:20:45):
I love whenever you look atdifferent cultures.
Yeah, it absolutely is.
But you look at some cultures inthe world, and older women are
really revered as being thegrandmother who who knows
everything, who's got the wisdomthat people go and talk to them.
But I think US and andAustralian society are quite

(01:21:06):
similar in that older people arekind of ignored, and women
definitely become more and moreinvisible, both on screen and in
real life.
And I think, you know, it's justperpetuating this.
I mean, the flip side of it isthere are definitely lots of
female physicians, many way, waymore well known than me, who are

(01:21:26):
really changing, hopefully, thatnarrative.
And even the fact that likeForbes have now got a 50 over 50
list shows that, you know, youknow, this phase of life does
not have to be aboutdeterioration and things getting
worse.
I think it's actually an episodeof your life when actually it
can be really thriving andprobably really focusing on your

(01:21:47):
own goals and your own health.
And you've probably done yourchild rearing.
Um, and it is probably a realopportunity to put all the years
of knowledge into good practice.
But I think, you know, what yousaid is so interesting that even
this dermatologist felt a littleembarrassed to admit, but she
probably wouldn't have felt soembarrassed to say that I don't
know, she had high bloodpressure or whatever.

(01:22:10):
And yet we just have this stigmaaround admitting as a female
that you don't have hormonesanymore, is somehow makes you
less than.
And I just wonder how we'regonna change that.

SPEAKER_00 (01:22:22):
Yes.
Very well said, and I think ifanything came out of this
conversation, is for thephysicians in the audience or
healthcare providers, educateyourself.
Please, please educate yourself.
And for the patients in theaudience, if you feel you're not
heard, if you feel your doctoris not able to help you, there

(01:22:44):
is more doctors out there.
There is something called theinternet.
You can now search.
I mean, the menopause train hasalready left the station, and
you know, you choose if you wantto be on that train ultimately

(01:23:05):
or not.
And for the people that arestill in fear, is the answer to
fear is education.
Just educate yourself.
You know, don't cave in, don'thide, don't run away.
You know, educate yourself.
You don't just owe it toyourself, you owe it to the
people around you, your family,your children, your spouses,

(01:23:25):
your parents, and yourneighbors, and and so I've
become now so passionate aboutthis topic as a male that
because 80% of my patients aresuffering, and I again I can't
unsee that anymore.
And for us in the aestheticindustry, and I know our we

(01:23:50):
intersect there too because youalso provide aesthetic services,
and you but you're doing it theright way, you're addressing the
root cause first, and thenhelping them, empowering
themselves through aesthetictreatments.
And for me, it's the opposite.
I usually refer them out first,make sure they get their health
in check before I initiate anytype of aesthetic treatment,

(01:24:13):
because I would be basicallyonly treating the smoke instead
of the fire.

SPEAKER_03 (01:24:19):
So and I love I love that you do that because I I
will say that one of the reasonswhy I end up very much
completely merging my women'shealth and and menopause and
aesthetics together was becauseI felt they were just
inextricably linked.
Yeah.
And I think that, you know, abeautiful uh, you know, facelift
surgery is a beautiful surgery,but um if it's not built on a

(01:24:43):
foundation where that tissue isum healthy and optimized, you
know, to me the result is onlyever going to be um not as good
as it could have been if we havereally healthy tissue that we're
working at because yourfoundation isn't there.
And again, as I said, it's notto say that everyone has to take
hormone replacement therapy.
That's not what I'm here to say.

(01:25:04):
But I want it to be an option, Iwant it to be a conversation and
I want it to go alongside.
And it's also not that HRT willdo it all.
You have to do the other thingsas well.
So, for example, like lots ofwomen seem to think that by just
taking HRT and that they'regonna just completely maintain
their bone mass.
We know that is actually nottrue.

(01:25:26):
Whenever you look at some of themost recent studies, they
actually looked at groups whothey got to do resistance
exercise, who did also very,very light exercise on hormones,
and they looked at their bonemass.
And yes, the group who didresistance exercise with HRT
really did maintain their bonemass really well, and they they

(01:25:47):
had really good bone scores.
The group who did gentleexercise on HRT actually did
continue in certain parts oftheir body to have ongoing bone
loss or bone degradation.
So you can't just take hormonesand go, oh, well, that's great.
I'm gonna have fantastic bonesnow.
It doesn't actually work likethat.
And the lifestyle stuff thatyou've talked about before, the

(01:26:09):
resistance training, the gooddiet, they have to go hand in
hand.
And so what I don't want is forpeople to think that the
hormones, you give someonehormones and that's it, they can
just do whatever they want andeverything else will come good.
It's not just quite as simple asthat.
But I just want people to knowthat it should be an option.
And the other thing I wantpeople to know is that you know
what?
You can try hormones and you cantry them for a couple of months.

(01:26:33):
And if they're not for you, youdon't have to stay on it.

SPEAKER_02 (01:26:36):
Yeah.

SPEAKER_03 (01:26:37):
Like people get really worried that they have to
make the decision, and if that'sthe decision, then they're stuck
with their decision.
You can change your mind.
You know, you're not stuck withany kind of decision.
You can try hormones and you cantake them for three months,
three years, ten years, whateveryou want to do, whatever you
feel comfortable with, that'sokay.
But um, never feel that you'restuck if you made one decision

(01:26:59):
or the other that you're stuck.

SPEAKER_00 (01:27:01):
Good point.
Good point.
And I I I see that with mypatients that come for Botox.
You know, for the first timethey they're not sure.
I said, because they feel likeif they start doing Botox, they
have to continue forever,otherwise their face will fall
apart.
I'm like, no, not at all.

SPEAKER_03 (01:27:17):
Yeah, exactly.
I I hear the same all the time.
And I'm like, you can do this asa one-off, and if you love it,
you can still do it as aone-off, or you can keep doing
it.
It's totally up to you.
Nothing bad will happen bygiving it a go.

SPEAKER_00 (01:27:30):
Now, I want to talk about your your clinic.
We talk, we talked off therecord, but uh now on the record
here, you you have a very uniqueclinic.
It's something I actuallyadmire, something I've been
contemplating to set up, andthen you're actually the first
physician that I've ever met,virtually or in person, that has

(01:27:51):
such a unique clinic set up.
Can you talk to the audienceabout how your clinic is set up
and why you even could?
Constructed it that way.

SPEAKER_03 (01:28:01):
Yeah.
So I'm always really open aboutthis.
I set up my clinic.
It's so my clinic is called U,Y-O-U, U by Dr.
Sean Oaks.
And I love it by the way.
I love my clinic.
Yeah.
So it was like I want mypatients to walk through them
the door as themselves and theywalk out as themselves.
I'm not trying to changeanybody, make them look

(01:28:24):
different.
I'm here to make you the best,most confident version of
yourself, whatever that mightbe.
And what I very quickly realizedin my journey was that midlife
women would often ask my advice,like, what do you think about
hormones?
Or what do you think about thisor what do you think about that?
Or what do you think aboutweight loss medication?

(01:28:45):
And I was kind of running thesetwo separate entities.
And I was like, why am I doingthis separately?
Because I was kind of saying tothis group, okay, you need to
book in to see me in my familyphysician practice.
And then these people are going,okay, you need to come and book
in and see me in my skin in astatic clinic.
And I was like, why am I doingthis?
And so I was like, right, that'sit.
I'm going to have one spacewhere I do everything.

(01:29:06):
And but what I realized veryquickly in my career is that the
most enjoyable part of medicinefor me is collaborating.
I always think two brains arebetter than one, three brains
are better than two.
And so what I knew is that Icouldn't know everything about
everything.
And I also wanted to create aspace where, to be honest, we

(01:29:27):
don't have sick people there.
So it's not like a doctorsurgery where there's coughs and
colds.
People are well.
Um, but they are coming andwe're looking after everything
from their midlife health.
So we're looking after theirskin, their weight management,
their nutrition.
So within the practice, we haveexercise physiology.

(01:29:47):
So if you've got likeosteoporosis or a weight issue,
or um I'm concerned about somefactor, I'm sending you to my
exercise physiologist who istrying to create an exercise
program to deal with whateverour concern is.
I've got a pelvic floorphysiotherapist who's going to
help you.
So let's say sex is veryuncomfortable for you.

(01:30:08):
I want to see what your pelvictone is.
Do you have vaginal atrophy?
Or let's say you've got a lot ofurinary symptoms or stress
competence, she's going to helpyou with that.
We actually have a sex therapistand relationship counselor
because we know this is a time.
There's a real peak of divorce.
Um, at this time, relationshipsare breaking down and women are
navigating their way.

(01:30:29):
And sometimes thoserelationships need to break
down.
Sometimes they're not healthy,and women have had enough, and
that's good.
Um, and then sometimes these arerelationships that are just
really struggling with thefallout of perimenopause and
menopause.
So we have her in the clinic.
We also have um we have apsychologist who specializes in

(01:30:49):
the psychology of weight andeating and the people's
relationships with food.
So she helps us with ourpatients all related to that.
We have a dietitian and shehelps us navigate all the issues
that you and I have alreadytalked about, things like uh
high cholesterol, weight gain,helping our patients eat more
protein, helping our patientseat more fiber, which is the

(01:31:12):
soapbox I'm gonna die on, Ithink.
That's my new obsession withfiber.
Um so, and then I have a team ofother female doctors who work
with me.
I have nurses, so I've got amenopause nurse coach, so she
helps coach my patients, her onmy programs with me, so she
checks in all the time.
So the thing that kills me inmedicine is that people see

(01:31:36):
something like perimenopause ormenopause or peptides or
whatever it happens to be, andthey see an opportunity.
But what actually frustrates meis that they're not prepared to
actually put the work in.
So, for example, if my patientsare on a weight loss journey,
I'm seeing them every month, andmy nurse is talking to them

(01:31:58):
every single week.
We're checking in all the time,they're going off to have
dexabody composition scansbecause I don't want them to
lose excessive muscle.
They're seeing my dietitian.
So I think that, you know, ifyou're um a physician listening
and you think that having aclinic like this is a really
good idea, first of all, it's alot of work and it's trying to
keep a lot of people happy,which could be challenging in

(01:32:20):
itself.
But also, I think it is the bestway to practice medicine because
we cannot know all the things.
Like, I don't know about youreducation on nutrition, but mine
in medical school was quitefrankly appalling.
And so I love that I've got adietitian who knows way more
than I do, or I love that I'vegot a pelvic floor physiotherapy
who's a bit of an expert inthat, or the psychologist.

(01:32:43):
So we've definitely got thiswhole multidisciplinary team
approach to our patients.
We've also, we've even got inour clinic, we've got pathology,
so they can literally come andhave their bloods drawn in the
clinic so they don't have to goanywhere else to do that.
And then I've got a fullcomplement of abdermal
therapists, nurses, nurses whospecialize in aesthetics, and

(01:33:05):
doctors who are um specializingin aesthetics as well.
But the nice thing is that weactually all try and do have an
overview of everything.
And of course, you can't be anexpert at everything, but we are
very holistic in our approach.
So everyone is kind of lifestylemedicine trained, um, everyone
has got a real interest inwomen's health, and then a few

(01:33:27):
of the doctors do aesthetics aswell, but they do it as part of
their day.
So I think that that worksreally, really well for us.
And I also knew right at thebeginning, I know that there are
a lot of clinics that reallyfocus on very young patients,
and maybe perhaps, you know,that very dramatic aesthetic

(01:33:48):
look, which is definitely not mystyle.
Um, and so I knew that from theoutset, I wanted my clinic to be
about an ignored group of women.
And of course it's become verytrendy now, but like eight, nine
years ago when I was startingout my clinics, um it wasn't
really a thing.
No one was talking aboutmenopause that much, but that's

(01:34:10):
kind of how we try and approachit.
And look, are we doing itperfectly?
No.
Is there things that we couldimprove?
100%.
But I think that we're we'removing more and more towards
having this really holisticapproach and because I think
that's when women do best.
Um and sorry, we also have aphysiotherapist who um looks
after our frozen shoulders andour brusitises and all those

(01:34:32):
sorts of things as well.
So I think we're trying to be asyou know all-encompassing as we
can possibly be.

SPEAKER_00 (01:34:41):
That's amazing.
It's it's everything you said ismusic to my ears, is something
that I've been dreaming aboutand contemplating for the past
couple of years, and here youare.
And how do how can people findyou if they want to seek your
services?
And obviously, I know you're youyou you're you're Irish, but you

(01:35:03):
you live and practice inAustralia.
So just for the audience, incase you picked up on our on
Shauna's accent, how can peoplefind you?

SPEAKER_03 (01:35:12):
Yeah, so I um my website is UYO by
drshaunawatts.com.
They can find my podcast um onall the usual outlets and
YouTube.
It's called All About You withDr.
Shauna Watts, and we do offer umsome telehealth and video calls

(01:35:34):
as well.
Um obviously I'm not aregistered doctor in any other
country than Australia, so Ican't be a doctor and prescribe
for people outside of Australia,but I can absolutely um coach
and recommend and support peopleand you know wherever they are.
And I think you know, my podcastis a really, really great

(01:35:56):
source.
I have incredible people onthere, some extremely well-known
names in this space, and somelesser well-known, but no less
helpful.
They bring so much wisdom to thetable, and I'm I'm really
excited to be having you on nextmonth because I want to be
picking your brain about a wholelot of things.

SPEAKER_00 (01:36:16):
I can't wait, and I'm really excited that we're
gonna meet soon again.
I regarded you very h veryhighly and just following your
content and learning about whatyou're about and what you're
passionate about, but now havingtalked to you for over hundred

(01:36:40):
minutes now, you're your truechampion.
And um you're a hero, you're asurvivor, you are you're an
inspiration to me now, and I'msure to many people whose lives
you touched.
And I really uh commend you foreverything that you're doing,

(01:37:04):
and I'm also sorry foreverything that you've gone
through.
But I don't think you would havebecome the person you are today
if it wasn't for all theadversity you went through.
And I think for if I look atpeople that really change other
people's lives, what they allhave in common is that they've

(01:37:28):
gone through tough times througha lot of adversity, and that's
why they are who they are.
And for those of you who feelyou pulled the short straw and
you have it worse than everyoneelse, I could tell you also from
personal experience, there is areason for that, and you might
not not understand it today, butif you are patient and if you

(01:37:52):
hang in there and let the chipsfall, it was meant for you to go
through that so that you can dogreater things, things that you
never thought you will be ableto.
And with that, uh I want tothank you, Shauna, for coming on
to my show.
And uh so uh honored and so uhproud to uh have met you and

(01:38:15):
really excited to uh talking toyou again.

SPEAKER_03 (01:38:21):
It's been such a pleasure.

SPEAKER_01 (01:38:23):
Thank you, Shauna.
Alright, everyone episode sofar.
I hope this will be emotional.
Please don't forget to leaveyour video or leave your

(01:38:44):
comments in the question.
Thank you, and we're gonna doit.

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Menopause, HRT & Cancer: Separating Fear From Science - with Dr. Shauna Watts

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Menopause, HRT & Cancer: Separating Fear From Science - with Dr. Shauna Watts