PROF. SARAH BERRY: MENOPAUSE CAUSES 10% OF WOMEN TO LEAVE THEIR JOBS

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2:16Hello, everyone. My name is Jamie Lang, and this is Great Company.

2:26Well, good morning, everyone. And good afternoon or evening, wherever you are in the world. To all you wonderful listeners of Great Company. Straight in there, my name is Jamie Lang. I'm the host of Great Company. And you are? Jemima, the producer. You're the wonderful producer who makes this whole thing tick. Yeah. Hey, do you want to know something that I don't know why I've never done until now? We're this far in. But I logged into the Great Company Instagram and saw our DMs. Yeah. Lovely. Lovely, yeah. Why haven't I done that before? You should do that more. As a producer, you should probably look into that more.

2:57Yeah, guys, love your messages. I read every one of them. Did you really? Yeah. And one thing came to my attention. Owls. A lot of owls in there. No. Owls. There is a podcast by Jenny Eclair, which it's called Older and Wider. And they call their listeners older and wider listeners. We've got to change it up. They call them owls. And someone said, you young upstarts can't be called owls. There's already. So I thought, I looked up what baby owl is called. Do you know what they're called? No. Owlet. We're not calling our listeners owlets. Owlets. No, absolutely. That's lovely. It's totally not and we're not doing that.

3:34Our wonderful listeners luts. Listener luts. Okay, I'll tell you what. If you have any ideas for what you would like to be called as a listener. No, we are going to be called a version of an owl. But maybe they could be called... Tawny. Tawny owls. Barney. Snowy owls. I don't know if it's a version of it now. Hedwig's. Why don't you let us know some suggestions? You can send us into our DMs at Great Company Podcast. I'll read every one. Oh, you can send us an email. Greatcompany at jampotproductions.co.uk. Everything is in the show description. Okay, today's episode we have... A special expert episode.

4:08Professor Sarah Berry, who is from Zoe. Our lovely friends at Zoe. We love Zoe. And this is a bit of a different episode for you. I think it'd be a bit difficult one because... Well, this is what you and you wanted and I'm really excited for. Yeah, it will be great. So this episode, Sarah Berry is a nutritionist and an all-round wonderful woman. And Zoe have new research that they've released about menopause. So we thought, why don't we know anything about menopause? Do you know anything about menopause? Well, the title being Menopause, I thought I would, but I don't know anything. No, that's quite good.

4:44You like that? Yeah, that's really good. Thank you very much. Yeah, so this is a very special episode. And Jamie, well, also myself, I don't really know. I just know it's something that's going to happen to me in my life at some point or another. So very good to know what's coming. And also, I generally think that if you're seeing the title of this episode and you're listening to it now, I imagine you're probably swaying towards more females listening to it. But I encourage your partner or your husband or a brother or some male in your life, you should get them to listen to this. because I imagine this is going to be incredibly thought-provoking and understanding.

5:18For me, I cannot wait to learn more about this. I grew up with sisters. I have a wonderful mother. I have a wonderful wife. I have a wonderful producer. Yep. And whether you're going through it or not, you're going to be around people going through it. Yeah, exactly. So you, in like secondhand, will kind of, it's good to know what's going on. So should we do it? Let's get into it. Okay, ladies and gentlemen, please enjoy the episode of Great Company with Professor Sarah Berry. Hi, I'm Professor Sarah Berry and I'm great company Professor, is that how I should start? Do you know, I actually got promoted to professor only a couple of months ago Wow So this is, I think my first, second podcast with that title This is after 27 years as a scientist and an academic scientist It's taken a long time, so yeah, use it Professor Sarah Berry I'm going to be really naive throughout this episode and I apologise if I am and if I ask any silly questions feel free to tell me that was a silly question or you cannot offend me in any way I want you to know that I love silly questions I have a 12 year old boy so that's all I get I'm going to be younger than him and say so many things because I think the conversation hopefully that we're going to have today is so important for lots of different reasons I think it's important to educate myself I think people who are listening it's really important to educate them on what we're going to talk about.

6:42And I think it's really important for the women who are listening to maybe understand what perhaps they're going through and for men to understand and appreciate as well the sort of changes in our own bodies. So before we kick off, can you explain to everyone who you are and what you do? Okay, so I am Professor now, Sarah Berry. Does that feel good to say? It feels a bit weird. I am a mum to two kids I have a teenage daughter who loves me sometimes hates me a lot of the time I have a 12 year old son who is still in that I adore my mum phase but I don't know how much longer that will last and I'm a wife and in addition to that I'm a scientist and I've been an academic scientist meaning I'm working at a university teaching students but also conducting research and I've been an academic scientist at King's College London for over 25 years.

7:39And I work in the area of nutritional science. So I have a PhD in nutritional science. I have spent many years researching all different areas related to diet, cardiovascular disease, how food structure impacts how we respond to food and more recently menopause as well and how menopause impacts us, how diet might help alleviate some menopause symptoms. But also I spend a lot of time, as well as my research, myth-busting and doing things like this to hopefully communicate evidence-based science, what's real, what's not. Because there's a lot of bullshit out there. You can, yeah, there's a lot of shit out there.

8:19Or as I call it, there's a lot of nutribollocks out there. Nutrition bollocks. You know, we all eat. What's the one thing that we all do apart from wee poo, sleep? we all eat and so everyone has an opinion everyone thinks they know something about it and there's a lot of money to be made by certain uh myths uh perpetuating really yeah okay so so why don't we start there so give me some myths that are out there that i just you just find completely bonkers that maybe people are following or believing so there's some that are more related to my research area so um there's one myth out there that cedar oils are toxic i don't know if you've seen that on social media yeah it's neutral bollocks absolutely codswallop i love that word so so um when we talk about things like rapeseed oil and things like that oh it's fine that's absolute nonsense what what i'm glad you've had that reaction because so you're i need a phone my wife sophie she stopped me from eating to the point sarah to the okay sorry to transition really quick.

9:27Should we not bother talking about menopause? Let's just talk about seed oil. Screw all that. Let's just talk about that. I have a confectionery company called Candy Kittens and we are looking in very excitingly to create a chocolate and the chocolate that we are looking at has some seed oil in it and I gave it to my wife and she said, I won't eat that because it's got this in it. And I went, well, so we've been looking at changing the recipe just because of that. Wow! The problem is you go into social media, if you put seed oils in, You get these like crazy things saying seed oils are toxic, they're going to kill you.

9:58Absolute nonsense. But where does that come from? Why do people think seed oils are bad? Oh, it comes from often people's misunderstanding of the evidence. So if I could give you an example, we know that the intake of seed oils has increased over the last 20, 30 years. It's in a lot of heavily processed unhealthy foods. at the same rate that at the same time that the seed oil intake has increased, obesity has increased, heart disease, you know, has increased, et cetera, et cetera. And so you can look at a nice, simple kind of figure and say, oh, okay, well, as seed oils has increased, so is all of this other stuff.

10:36So is cancers. It must be due to seed oils. But actually, if you take a step back, it's not due to seed oils itself. I think what else has happened in the last 50 years, We have sedentary jobs. We're eating loads of crap food. And so it's easy to pin it down to that. So it's, again, cherry picking evidence. Yeah. If someone's listening right now and they have been saying on their Instagram, their social posts, they have heard it on podcasts that something like C-dolls are bad, they're probably going to sit here and go, well, hang on a second. I've been told all of this information. Well, how can people get fake information on something like C-dolls saying it's bad?

11:14Where does that come from? So I think this is a huge problem with nutrition communication that everyone has an opinion on it. And a lot of the people talking about it are people that aren't evidence-based scientists, that don't understand how to interpret the evidence. And you can often pick up, you know, a scientific paper and there's different ways of interpreting the evidence. And it's not so much the knowledge, it's how you interpret the data, the studies. and I've seen this in newspapers there's been some studies that you see in one newspaper an article that might say you know this fat's bad for you and another article from exactly the same study that's just been published saying well this fat's good for you and often it's about well what are we comparing that fat to what are we replacing when we add that fat in and the same kind of applies to cedars that you can interpret it different ways and the problem is a lot of the people making the big noise on social media about CEDAWS and I'm going to get CEDAWL hate mail now I can see this I'll be with you to collect it don't worry um I'm not all but you know often aren't interpreting the evidence correctly yeah so for example there's one particular study that people use as evidence for CEDAWS I don't know whether you want me to go into the details of I want you to honestly take as this is your forum.

12:38Take as long as you want to explain or talk about anything. I'm going off on a tangent, but this is a great example. Just to let you know, if this was I'm so excited I get to be in the room with you because I would listen to this podcast if I saw it come out. So I'm just excited to be here. So you just go. Thank you. So for example, there's this one study where this was some years ago where they wanted to look at the effects of adding in a particular type of fat and see how it impacts your health. And so they were going to add in seed oils in order to increase this particular type of fat. It's a particular type of polyunsaturated fat.

13:16So you might have heard of like omega-3 fats, which are found in fish oil. And then there's the omega-6, which is another type of polyunsaturated fatty acid. Got it. I take omega-3. Okay, yeah. Perfect. Great. That's good. I keep it in the fridge. I don't think you need to do that. Someone told me that and then it really smells of fish. Okay, I haven't heard that. But if you've got space in your fridge, I don't see why not. Okay, okay. But the other polyunsaturated fat is these omega-6 fats. And these are the ones that are in seed oils. And it's believed that these fats are pro-inflammatory, they increase inflammation.

13:56But actually, when you, as humans, as we eat them, they are not pro-inflammatory in the way that we previously believed. But anyway, in this particular study, they fed people over a period of time these polyunsaturated omega-6 fats, but in the form of seed oils. but a lot of the fat that they fed them was in the form of seed oils that had been modified to be used in spreads in like margarines and back in those days they used a process called partial hydrogenation that produced something called trans fats so the food industry used to convert a liquid seed oil into a hard fat using this process called partial hydrogenation and so at the time it was considered this is great because it means we can produce hard fat in replacement of butter really cheaply got it it's also might be better for our health because we know that saturated fat which is in butter isn't great for our health and we now know that trans fats are really bad for us so they're no longer produced by the food industry they're no longer in our foods but this study that was conducted some years ago was taking seed oils and converting it into these bad fats and they were giving people seed oils in the form of seed oil, I said rapeseed oil itself, but also in the form of these, what we now know as bad fats.

15:17So they were clumping them together? Yeah, because they originated from the same seed oil. And so obviously we now know we were feeding these people trans fats, which we know are really bad for you. They increase your cholesterol, they increase your inflammation they do loads of bad things in the body and so to say that eating putting rapeseed in your chocolate or your candy is bad for you because of that study is nonsense because we don't even use rapeseed or seed oils in that way anymore and it's just not a appropriate or correct comparison so this is how you can misinterpret the evidence if you hadn't really dived into the paper and looked at the publication and looked at, well, how were these seed oils being fed to people?

16:06What was being done to them? Then obviously you can make the interpretation that, holy shit, these are bad. These studies, is it right that historically have been mostly done on men? So I can explain why lots of research is done on men from a very pragmatic personal experience as well. So having been in the research field now for 25 years, I've conducted about 30 clinical trials. So 30 trials where I feed people different types of food for however long and then measure how it changes different parameters of health. Apart from the Zoe Predict research and one other study, all of those 28 other studies were done on men.

16:41My studies always conducted on men. Why? Because they're easiest to study. And I'm sorry to say that things are changing and I'm not saying it is the right way. We live in a very competitive funding environment. So for me as a scientist to get money to do studies, so I might have this amazing idea. If I can't get money to run that study, I can't run that study. I have to apply to grant bodies to get the funding. I have to be competitive. I have to think of everywhere I can reduce my cost. Now, if I want to look at how, let's say seed oil, how seed oil impacts a particular a health measure, inflammation.

17:20If I was to do it in men, I could recruit a third of the number of men than if I was to do it in women. The reason is, is because for women, I'd have to think about recruiting people who are premenopausal, perimenopausal, postmenopausal. I would also have to think about the phase of their menstrual cycle. What phase are they in for when they come in for me to take the blood? And so it might take a longer period of time. So it's so much more expensive because women are more complicated and I know that's a real cliche thing to say and I don't mean it in that cliche way but biologically we are complicated because of these hormonal changes so women traditionally have not been studied partly because it's cheaper to study men it's easier it's more convenient it's changing and this is the good news grant bodies recognize that we have to be able to study women as well and so it is changing now but historically that was the case.

18:15So I can tell you how sweet oils affect you, Jamie, but not how they affect me. They're not bad for you. That's what I'll say. Your inflammation is absolutely fine. So go put them in your chocolate. I can't wait. I'm going to go and eat them all. Can't wait.

18:33I don't even know where to begin on this subject because I don't even know what menopause is. I know it's something that happens to women I know it happens to women at a certain time in their life I don't know what it affects, what happens I hear this word and I feel slightly ashamed I don't really know what it is So can you explain to me what menopause is? I can, but I think Jamie, the first thing to say is you're not alone Even as a woman, until I started the perimenopause transition which I'll explain what that is I didn't really know what it was or until I started researching it because we don't talk about it we're starting to talk about it we certainly didn't talk about it like I vaguely recall my mum being a bit hot and sweaty in the night but god forbid you know you didn't say the word just why I don't know it's like growing up you know I was a child growing up in the 80s you didn't talk about sex you don't talk about menopause you don't talk about menstruation that's it it's changing and that's a good thing and so for those that don't know what menopause is menopause simply put is the point at which is a year after you've had your last period so you've last menstruated so it's menopause the pausing or cessation of menstruation the thing is you don't go to bed one night um you know pre-menopausal having periods and then wake up the next day and hey i'm post-menopausal it's not like that there's a menopause transition and we call that the perimenopause.

20:06And this is the point at which your oestrogen starts to decline because what stops you having periods and why you go into menopause is because your oestrogen's declined and your oestrogen is at a point at which therefore you're not menstruating. But you don't have like suddenly loads of oestrogen next day, that's it. You don't even have this nice, slow, gradual decline in oestrogen. You go on a roller coaster. So you literally, you know, you might be plodding along in your 40s okay and then suddenly it's like it goes down it goes up it goes down and so and this is what's so confusing for women because I think again until I started researching I didn't know that I just thought oh I might reduce a bit and I might get a little bit of a hot flush or might get a bit of brain fog but it sets your body into this kind of roller coaster of craziness and the reason is is because you have estrogen receptors all over your body in your brain you you know, in your bones everywhere.

21:00And this is why menopausal symptoms are so widespread, because the reduction in estrogen, the fluctuations in estrogen, impacts nearly every cell in your body. So explain to me what happens when you, as a woman, when you're going through menopause, what happens to your mind, your body, what goes on? So when you're going through menopause, when you're in that menopause transition, that's the period that most people have symptoms of menopause. So by this, these are the kind of symptoms that we are talking about more like brain fog, anxiety, palpitations in the morning, aching bones, loss of libido, poor sleep, change in body fat distribution.

21:45There's about 50 different symptoms. There's 20 that are very common. You have your symptoms, which we can pick up on in more detail if you want to that are particularly bad during that perimenopausal phase during that transition phase they still continue after the menopause they still continue after you know that menopause transition phase but what also happens at the same time and I don't think we're talking about this enough really we're starting to talk about symptoms but your change in risk of disease also changes what do you mean by that estrogen impacts a lot of the way that our blood vessels work, our body metabolizes food, because like I said, it affects every cell in our body.

22:25And so the way that our body has functioned from a kind of disease perspective also changes. So I can outline some results from some of our research to illustrate this. So if we look in our zoepretic cohort, so this is in a couple of thousand people, and we look at key risk factors for disease. So these are chronic diseases such as cardiovascular it's these type 2 diabetes so blood pressure, cholesterol, inflammation, body fat around the belly for example. So if we look at those in our individuals and we look across different ages what you see is that these risk factors increase as you age. So your blood pressure as a natural part of aging goes up.

23:09Now we can go on to talk about how we can minimize that through diet and lifestyle but generally it will go up as you age. Your cholesterol goes up, particularly your bad cholesterol, which we call the LDL cholesterol. Levels of inflammation go up and you tend to start putting a little bit of weight around the belly. That starts to go up. Now, what happens is that up until the menopause, men are on a different trajectory than women. Women are doing quite well. So men have, at any given age, on average, slightly higher blood pressure, slightly higher cholesterol, slightly higher inflammation, etc.

23:41etc and women for once are kind of smiling we're a bit smug at this point because we're doing a bit better what happens is you hit the late 40s so the average age of menopause is 51 the average age of perimenopause is about 47 you hit your late 40s suddenly women who've been having this nice like slower trajectory suddenly when it goes up suddenly their blood pressure their cholesterol their inflammation, their fat tissue around their tummy suddenly goes up to the level of men. And this is because they're losing estrogen and the estrogen is involved in many of the processes that help maintain a healthy blood pressure, help maintain a healthy cholesterol, help maintain appropriate inflammatory responses.

24:26And so suddenly, therefore, your disease risk increases the same level as men, in some cases might go above it. And so I think it's important we talk about symptoms. I think it's also important for women to recognise that this is also a point in time to really take stock of how diet and lifestyle can help reduce your risk of some of these chronic diseases like cardiovascular disease, like type 2 diabetes, like obesity as well, because you're fighting a bit of a tidal wave as well. It must be so scary that if you're suddenly just experiencing these things and you don't really know what's going on.

25:04Why do I feel anxious? Why are my hormones all over the place? What is going on? And if we don't talk about it, dare I say it, I feel like relationships must break down during this period because why would people understand if something is going on within someone's body? Yeah, and I think it's so hidden. So the disease risk factors that we talked about are hidden unless you're going to the doctor and having blood samples or having a blood pressure measured the symptoms also something you're suffering and many women who are now in that perimenopausal phase like I am are of a generation where we didn't talk about it yeah our parents my mum never talked about it you know you suck it up and you get on with it I'm really lucky that it's changing that I feel I can talk about it and for my daughter I think it will be even better because I think she's being brought up being in an environment where yes you do talk about it but it does it impacts all aspects of your life you know I can be bloody grumpy and irritable like ask my husband and he'll honestly like the amount of times he's like Sarah I told you this and it almost feels like a cop-out for me to say oh yeah but it's because I'm perimenopausal I've got brain fog that's why that's actually what's going on with me but I even I even though I research it feel like oh I can't really say that we know from our own research that 99.8 % of people women of that age in our cohort have at least one menopausal symptom.

26:2966 % of people, women in the peri and postmenopausal stage have 12 or more symptoms. 80 % of women who are perimenopausal, so around my age, have sleep disturbances. 85 % have anxiety, palpitations when they wake up, brain fog, mood swings, all of these things going on that we're contending with. Now the good news there were some things you can do about it but the bad news is until now we weren't talking about it and we weren't helping solve it 10 % of women leave their jobs because of menopause there was this you gov survey that was done and that asked people and they they specified that the reason they left it was because they could not cope in a working environment with the symptoms they felt embarrassed because they were forgetting things they weren't sleeping so they couldn't cope the next day their anxiety of going out into a normal workforce.

27:23And 30 % of women say their symptoms are so debilitating it's having a significant impact on their quality of life. And to think that for generations, we've not recognised this and talked about this. And my mother's no longer alive. And I feel sad that I wasn't appreciative of actually, probably she was having a difficult time. That's really sad. And thank you for explaining that. But if you were going to go into the symptoms, you mentioned there were 50 different types of symptoms. But you said some people experience 12. What would those 12 symptoms be if someone was experiencing that? So the most common symptoms we find in our research is sleep disturbances, change in energy, like how energetic they feel, change in how they feel their metabolism is working, change in lots of cognitive aspects, so the brain fog.

28:17the memory loss I mean honestly why does memory loss happen because you've got estrogen receptors in your brain you've got estrogen receptors everywhere um so you become forgetful you just literally have memory loss so things like you introduced me to your wonderful team earlier and I'm not going to remember anyone's name if you'd have asked me five years ago I'd have remembered everyone's name it's that kind of thing i mean when i go into i'm one of the things i'm filled with fear about i love socializing i'm very chatty as you can tell but when i go to parties and i might have to introduce my husband to work people who i might have worked with for ages and you know have an incredibly close relationship with i get this like you know it's awful i can't remember their name i didn't that didn't happen five years ago But I can still be high functioning as a scientist, but then you have that kind of momentary memory loss.

29:14So these are the kind of common symptoms. Irritability, mood swings, changing your body composition. So estrogen changes where you distribute your body fat. So men typically have what we call an apple shape, i.e. you have fat around the abdomen, around your tummy. and women tend to up to the menopause have what we call pear shape so you know nice little bottom and hips so the fat is distributed there that's because in very simple terms your estrogen is kind of directing the fat to be distributed there once you lose estrogen it's no longer directed to your hips and your thighs and so it's then directed more to your tummy so this is a really common symptom that women have that suddenly their fat where their tummy is suddenly increases apart from the aesthetics is also the fact that we know that fat around the belly is really bad for us it's metabolically really active compared to fat anywhere else in our body so it increases it produces more inflammatory chemicals it uh is more involved in mechanisms that we know are unfavorable for cardiovascular disease for example and so suddenly as well as shit you know i don't look quite so good in my bikini you're also increasing your risk of chronic disease as well and it's I'm assuming harder to lose weight once you've hit menopause so this is a really good example of where you're just in this catch-22 or you're kind it's like a perfect storm I think is a good way to describe it now I don't want to be really defeatist but I think that it's important to acknowledge there's this perfect storm because I think it can allow women to understand why despite all of these things they're doing why am I just not shifting the weight so you've got these symptoms You've got lack of sleep a lot of the time.

31:03You might be having these mood swings or depression or anxiety. Do you want to exercise and eat healthy if you're feeling really bloody fed up? I certainly don't. We know if you have a bad night's sleep that the next day the reward centers in your brain are heightened. So if you have a bad night's sleep, Jamie, the next day your reward centers are going to say, Hey, Jamie, go and eat. I don't know. What's your kind of treat food that you know is bad for you? Candy, kitchen, sweets. Okay. go and eat loads of these candy kitten sweets so you're craving but as well as craving those because the reward centers in your brain are going whoa I need a quick fix the way you metabolize those are different and so we've got some great research that we've published as well showing that if you have a carbohydrate load exactly the same one day versus another day but all that's changed is your sleep you have a difference in the way you metabolize that so if you have a good night's sleep firstly your reward centers are like oh i'll just eat a normal healthy breakfast you'll have a nice calm glucose increase so blood sugar after that that breakfast if you've had a bad night's sleep your reward centers are like go eat those candy cake that's all what they're called candy kittens candy kittens sorry go eat those candy kittens and also your body is going to have a worse blood sugar response to those candy kittens so you're going to have this big peak and then you might have a slump and the slump and the dip in the glucose causes you to go on and eat more food, etc.

32:29And so the sleep is having that effect as well on what choices you're making and how you respond to it. And this is a great example of what we've also talked about, about how you eat, that sleep can impact how you respond to food as well as the rate at which you eat. So you've got periopostmenopausal women who, not all, but many aren't sleeping very well, so we're making the you know wrong choices you're caught in the cycle feeling a bit shit you know not wanting to exercise and then the loss of oestrogens causing all of the fat to go around their tummy causing more of it to be laid down and so you're kind of in this vicious circle and it's really hard really hard to break and so it requires more willpower it requires more work and this is what you hear people anecdotally you know often saying i'm eating exactly the same but i'm more hungry yeah estrogen affects your hunger receptors so unfortunately what used to keep you full before doesn't necessarily keep you full now how you're responding to it's differently you're not sleeping you know etc so it's really difficult but it's not all gloom and doom no i think it's important to acknowledge that you know it is tough now what we do know is that hrt can help so hormone replacement therapy if you can take it not everyone can take it not everyone responds well to it some people respond really well some people less well on average um that can do a lot to help people but what we also know from some research that we've only just recently published is diet can also help now i was really skeptical when i started out on this research about diet because i was very much like no you just need to take hrt get the estrogen back in there because what is hrt quickly so hrt is hormone replacement therapy um very simply it's giving you estrogen back into your body.

34:19You can take it different ways. Typically you have it what we call transdermally. So it's like a gel or a patch that you put typically like on your thigh or on your arm and so that you're absorbing the estrogen back in that you're losing. In the old days they gave hormone replacement therapy in the form of a tablet but we know that the way you metabolize that isn't very good for your health. And so younger people listening to this, it might not be so relevant, but older people listening to this might still remember 20 years ago when these big headlines came out in the newspapers saying HRT is really bad for us, it increases your risk of heart attack and cardiovascular disease.

35:04That was based on a study that was actually a poorly conducted study to answer that specific question, but using tablet form of HRT. so you've got many women who are probably my age or a little bit older that remember that and are not taking hrt because they're scared of the risk because of this study but actually if you're taking hrt in the way that it's given now which is through the skin then uh there doesn't there isn't a risk for the majority of the people now i do need to caveat this so i'm not a medical doctor i am a scientist and i'm just presenting the evidence uh that we now know

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37:27Can I ask again, this might be a really dumb question, because evolution has led us to these situations where menopause seems to happen. So, but then we're fighting it for obvious reasons, which you've explained. but then why has evolution done that? So there's a couple of theories here. One theory is well actually the majority of us 100, 200 years ago were dead by then. So it didn't really matter. True. There's another theory and I can't remember what the name of it is but it's like this grandma theory. I'm not using the correct fancy terminology but this is how I understand it to be. that in the days where we were hunter-gatherers, where, you know, when you were in your prime of your 20s, for example, you were still needing to go out there to be very physically active, someone had to look after your children.

38:22So remember, like three, four hundred years ago, most people were having kids in their late teens, early 20s. So therefore, when women were reaching their mid-40s or early 50s, that was nature's way of saying, OK, you can't have any more children so that you can look after your grandchildren to allow that generation i your child your daughter to go and do the work she needs to do and i don't mean the work in the office so there's that that grandma that grandma theory about it as well because you know back then people weren't using birth control you know people every year or so were producing babies and so this is a way that's life okay my mom sent me a message because I asked her what happened when she went through menopause and she's and I said and I said what was that oh I remember that and I haven't listened to her voice note but I thought I'd play it to you because it might be interesting to see what she says about it so I'm going to play it now hi Jampart message for you in answer to your question to me but I'm not sure you're going to want to listen to it because I'm your mother and you'll probably have your fingers in your ears when you hear what I'm going to say.

39:38Menopause, I actually got the menopause relatively early, I think. I started when I was between 46 and 48 and didn't really struggle hugely with things that my girlfriend struggled with. I managed hot flushes and I still slept fine and everything else. For me, the biggest, biggest change and the most difficulty has been the change in sexual whatever, I mean, sexual life, in that your libido drops significantly. And of course, men's libidos don't seem to change. So there becomes a disparity, which is, I find very difficult to deal with. And I wish, wish, wish I could have the sexual enthusiasm of my youth.

40:24So that's probably my main thing. Secondly, I didn't do HRT because I had two girlfriends who swear they got breast cancer due to it. And when I tried it, all it did to me was seem to make me bleed all the time. So I abandoned any form of HRT and maybe that would have made a huge difference to me. On a vanity side, I really miss my lovely bouncy, glossy hair. I would love my hair back too. But apart from that, I didn't find the menopause too difficult. I don't know if that's any help at all. Could you ask your lovely expert how to get my sexual function back to my youth? That'd be very nice. Thank you very much.

41:15Love it. So that was my mum, Penny, who is the greatest. I mean, lots to unpack there. So, I mean, firstly, let's talk about libido, because that's probably a really important thing, right? And from what my mum is saying, and even though it was from my mum, I think it's important, that must be a difficult thing for both sides of a relationship, especially between, you know, men and women. Yeah, again, because it's not talked about. And so a lot of men won't understand, well that's why my partner my wife whatever you know isn't interested but we know again from our own research and this is some research in 70 ,000 people that that was one of the most common symptoms which really surprised me and what was interesting and I loved hearing this from your mum is that we find that actually that libido loss of sexual interest and some of the other symptoms I've mentioned like the sleep irritability are so much more common than the hot flushes the hot flushes are one of the least common symptoms.

42:14Someone might have one or two. Some people, yes, it might impact them massively. But traditionally, we have thought of, or women have thought of menopausal symptoms as the hot flushes. We haven't talked about any of this other stuff, including loss of libido. But our research shows it's one of the least of the common symptoms. And yet, I still think there's this fixation on these hot flushes. We call them in science vasomotor symptoms. And so most of the research that's been done to do with menopause is looking at how diet or lifestyle or this supplement or that supplement can impact what we call vasomotor symptoms, which is basically the whole flushes.

42:53People haven't started looking at how we can then help minimize the loss of libido. And it's really interesting that when I came into this, I hadn't thought about this as being one of the big problems. And we're seeing this in our data. there are lots of advocates out there though for how we can help to improve who aren't scientists but are have a good understanding of some of the data out there so even people like davina mccall for example and she talks a lot not just about all the other symptoms but about the impact that it has on your sexual function on your libido on your sexual desire etc and how for her testosterone has worked it's different for different women but there are other options you can take in addition to the traditional HRT, which is the oestrogen, that might help as well.

43:39My mum also mentioned she said that her friends swear by the fact that they took or they did HRT and that was the link between their breast cancer. Any truth in that? So there is some evidence to show that if you are at increased risk of breast cancer or if you've had breast cancer in the past, that it may increase your risk of future breast cancer. the data has been quite inconsistent around HRT use and breast cancer for those who aren't at risk and this is partly because like that trial I referred to earlier some of the way that studies have been run I think the totality of the evidence shows that the increase in risk of breast cancer if you are not already at risk and it's really important to caveat that but for the majority of people is very, very, very minimal.

44:32And so if you are being bothered by your symptoms, which most people are, that it is impacting your life, that again, it's an individual choice. But I chose, when I hit about the age of 45, I chose to take HRT because I had a couple of hot flushes, but I was grumpy. I was irritable. I wasn't sleeping well. I knew that my body was changing. changing i chose to take that knowing that yes you know maybe i'm an increased risk of breast cancer and i'm not even aware of it and maybe this will compound it but actually the benefit that it's going to have for the rest of my life makes total sense and the benefit that it has in terms of other disease so when i mentioned that when you go through the menopause your blood pressure increases your cholesterol increases your inflammation increases if you take hrt our research and other research shows that it it attenuates so it reduces that increase in blood pressure, that increase in cholesterol, that increase in inflammation.

45:27So I've also taken it. Again, this is my choice because I believe that it will help reduce the natural increase that I would have got in some of these disease risk factors as well as the symptoms.

45:43So is this sort of scientific suggestion or a personal suggestion to start thinking about menopause before it's even happened so perhaps changing diet or perhaps taking hrt before that's even happened i think that i would caution about anyone taking hrt before they need to take hrt um i would uh suggest is the discussion you should have with a medical practitioner i'm not a medical practitioner i think that we should be having a healthy diet healthy lifestyle all our life the reality is we don't now a lot of the time people have a wake-up call whether it was covid or whether it's that you're going through the menopause a lot of the time this is a wake-up call for many women that you know i'm not feeling the same got to do something about it you know the stronger and healthier healthier we are going into the menopause the better so for example we have some interesting data showing that people who are overweight or living with obesity they have a lot higher rates of symptoms if you're entering the menopause physically inactive you're also more likely to have symptoms so if you can enter the menopause transition so in your early 40s our bodies are changing anyway because we're aging but if you can enter that that that your kind of 40s and start your 40s thinking about making sure you're getting yourself in good shape for it great because we know it will help reduce some of your symptoms so you're not getting in that vicious kind of circle.

47:12You mentioned your research into diet. How can that help? So our research shows that following a healthy balanced diet can reduce your risk of symptoms by about 35%. Now that's huge. I must say, being very skeptical, I went into that research thinking, oh, diet's not going to make any impact. Just go on HRT. That's it. I was really surprised by the results. Wow. Really surprised. Now, this research was from people following the Zoe program, and this is a personalized nutrition program. So there's a few different things that are changing as well. So we do encourage people to be physically active as well as changing their diet.

47:50So I can't say that 35 % is purely due to diet, but what we know is people following an overall healthier diet we do know that that reduces your symptoms there are a lot of supplements out there that claim to do all wonders for menopause you know these silver bullets this is where i'm really skeptical there's a term we use in menopause research called menno washing i don't know if you've heard of that term it sounds like green washing oh yeah stick menno in front of it you can charge 10 times as much you know there's there's menopause hair wow your mum said she had problems with her hair yeah this is really common skin and hair problems with menopause just because again it's impacting all of our health but changing your shampoo or rather spending 10 times as much on your normal shampoo because it's got meno in front of it it's not going to make your mum's hair any glossier unfortunately and so companies are selling these products because they know it's a it's it's 50 of the population which who are going through it yeah So I think, Jamie, one really good thing about the last 10 years or five years is that we're starting to talk about menopause.

48:58But the downside of that is miscommunication. And the downside is people trying to make money out of it. And so like, oh, these menopause supplements or menopause face cream. I mean, I don't even know what that's about. Like, why would you change your cream? Because you're in menopause. Maybe it's a bit drier. So just get a thicker cream. I have no idea what the difference is. You mentioned that 10 % of women have claimed that they have left their businesses due to menopause. And, you know, thank God that I've sat here with you and understood it more. So as a partner, maybe I can be more sympathetic and understanding towards it.

49:33But how can we change that sort of narrative within business? What can we do to help women, I suppose? So there are some companies already starting to think about how can we change, not just the narrative, but what we're doing. How can we support women going through the menopause transition? and there's lots of businesses now that have workplace advisors in place they have like menopause lifestyle consultants coming in to talk through this I think it's allowing people to feel that they can talk about it so allowing those women that can't remember x y and z to say to be able to if they feel comfortable experience or rather the people around them understand it's you to menopause.

50:14Like when I was in my twenties, it didn't even figure in my head. And so I would have just thought whoever that, you know, 50 year old woman that was being a bit, dare I say it, ditzy, you know, I now realize, gosh, wasn't that awful that that's how I thought. But it's because you just don't think so. I think it's about letting educated people from a young age so that they're more empathetic as well. So the ownership isn't just on the boss of the company to put whatever support in place but for everyone to be more mindful that we don't know what's going on do we with people and i suppose someone listening to this right now who um maybe um it's a woman and they're going through it and they're understanding the sales better but also if it's a somewhat some man listening to it and perhaps thinking maybe this is happening to my partner yeah at this time i mean being more sympathetic yeah and understanding yeah in that process is probably going to help a lot isn't it i think i do think that's a real generational thing so my husband was brought up where you didn't it wasn't talked about um and I do think our children's generation I'm really hopeful that it is something people are more mindful of people are more aware of people are more understanding of it's so funny because I don't see I have no I would have no problem talking about it but obviously there is this I don't know unspoken issue about it but for me I would just be like oh my god I would be so open with it but you went on reality tv and talked about all sorts i know i forgot i totally forgot how open i am but i think it's i think you're unusual i think that is quite unusual yeah i think you are you are that slightly younger generation as well maybe so i'm talking about my generation like late 40s early 50s who i think you know it has been a taboo and i think it's not till you get to the menopause you start talking about it but then what's really interesting and your mum said this as well is the variety of symptoms that there's this perception that it's just about flush as well it's not but also how everyone's symptoms are so different and every day is so different because you know in that transition your hormones are going up and down and all over the place and it's really difficult for women to kind of quantify their symptoms it's really difficult for people to understand well what's my the burden of my symptoms so we've generated something at Zoe building on the last kind of five years of research we've been doing on the menopause called the Menno Scale Calculator and this is a free online resource that anyone can go on and it asks you about what symptoms you have so we ask people about the 20 most common symptoms the kind of symptoms we've been talking about today so first ask you do you have these and then for each symptom it asks you on a scale of zero to five how impactful they are in your life how what burdens they have in your life and then we create a score out of 100 and that score out of 100 is an overall score to tell you how much of an impact menopause is having for you on your life and what's really good about this tool is that when you're going in that through that menopause transition you might go to your doctor and you might say this is what happened for me I think I should go on HRT they say track track your symptoms well apart from a scrappy piece of paper that I don't know about you but I lose every scrappy piece of paper that I have um how are you going to track them?

53:29How do you know how they're changing? Because every day they're changing, every week they're changing. And so this is a really great way that you can track your symptoms so that you can see, for example, if you decide to go on HRT, is HRT improving it? So like for your mum, it didn't seem to have an impact. She could have tracked it. She might have actually seen that actually there's so many symptoms she hadn't thought were menopause and actually is improving it, but also how changing my diet can improve it. And so it might be people decide, okay you know i'm going to try physical activity i'm going to try changing my diet oh but i don't know if it's having an impact because it's so difficult to remember how crap you might have felt previously when you're feeling good isn't it and so what's great about this calculator is this free online resource takes about two minutes to fill out and it's a way of you can get a score an overall score so you can see if you decide to make a change to a diet or lifestyle you know you could measure every day if you want every week every month however you want to do it and you can see how you know or what works for you i think it's so sarah firstly thank you for educating me and i'm sure educating a lot of people and um i think as a partner a son or brother i think being more appreciative and understanding of this is really important

54:44we like to end with eight questions are you ready for this yep what's a saying or phrase that you want people to come away from this interview with? So I would say if a food is too healthy to be enjoyed, it's just not healthy at all. Love that. Best compliment anyone's ever given you for your work? Oh, I was going to say the compliment you gave me earlier, that my skin is really nice. It's fantastic. That's not my work. It's fantastic. So I spent quite a bit of time working on this Zoe Predict study, which was quite a groundbreaking study looking at the variability between and within people and how they respond to food.

55:21And this is having worked for about 20 years as an academic scientist. And it ended up making the cover of the New York Times. And I remember waking up and seeing that. And it was just like, wow, little old Sarah, who's been plugging away with these research studies for however long, her research is on the front cover of New York Times. I mean that blew my mind and you know that goes back to this way that as scientists we are very much we we stay in our lane we don't step out of it and that was like a big moment thank you that's a great moment what's the scariest thing about the menopause or people's knowledge or lack thereof?

56:05The billions and billions of pounds that are spent on absolute neutropolics, that is not going to help people. And the millions of pounds that are spent on testing. Because your oestrogen fluctuates from one day to the next, doing hormonal testing, unless you can afford to have every day, it's a total waste of money. When was the last time you cried and why? oh this is getting a bit personal i know and as a scientist you won't like that um the last time i cried was in july at my son's last day of primary school when they do this graduation ceremony and i cried because it was a sign that my son is growing up that he's entering the next phase of his life i cried for what i was losing which was all of these amazing friendships that i have at his school and my daughter went there and it's been part of my daily routine despite juggling two jobs I dropped my I would drop my children's school every single day I'd collect the most days and then carry on working that's been part of my life and I also cried for what I worried that I hadn't done which I know is a terrible thing like had I been there enough for the kids have I put work before the kids have I given enough time have I read him enough bedtime stories it's all of those things that now that I know that he's entering into teenage-ism that he's not going to want me to do anymore did I do it enough did I appreciate those baths that he used to jump into when I'd just be like just leave me alone I want to have a bath alone why didn't I appreciate those at the time that was very honest I love it I'm always honest that was amazing what's something you can't let go of so I think if I'm to say what I can't let go of in terms of what I do so not so much at a personal level it's the truth and I know that sounds a bit cliched again but there are so much mistruths around science so many different ways of spinning evidence and it's only as I've become more aware of this influencer world and podcasts and stuff, I've realised how many mistruths are out there.

58:25So something I will never let go of, however boring my message is, however much I write might ruin the party, I will always stick to evidence-based research. That's a good answer. What's something that people are most embarrassed to admit with menopause? I do think the generation is slightly above me, So people who are kind of in their 60s would be embarrassed, I think, from discussions I've had to talk about how much it's impacting them and therefore feel a failure. So embarrassed to feel that it's impacted them to an extent that they have failed at something because it's something that, you know, our previous generations, you just suck it up.

59:09You just get on with it. So it's feeling like it's impacting you. Great answer. what's your biggest turn on? McDonald's after the pub Rick and Sarni with white bread and lashings of butter the morning after the pub I'm going to get killed if you put this on by everyone that knows me but it's fine it's the truth it's the truth I like it what's your biggest turn off? in sincerity and what do you like most about yourself? can I have two actually? mm-hmm I think I'm very tolerant mm-hmm as I've got older I've become tolerant to people and how we all have things going on that people don't know about we all have a boulder yeah um but i think loyalty that's something i pride myself on i'm a slow burner took me 10 years to say yes to my husband to marry him but once yeah once you've got me i love that bonus one your favorite swear word you know i never say the f word my husband says it far too much my 12 year world has started saying it but I say bollocks an awful lot and there's a big conversation we have at home where I tell my son not to swear and he's like but you say bollocks all the time well that's not really a swear word kind of as well don't tell her nap Sarah thank you so much I think this has been fantastic and I hope so many people are going to take so much away from this and everything's going to be in the show description so go and check it out there Professor Sarah Thank you so much for coming on Great Company.

1:00:41Oh, thank you. Bad. Let's hear it back.

1:00:49Okay, mind blown. Good. Wow. It's exploded everywhere, his mind. It's honestly everywhere. I did not know. Do you know what's so upsetting is the amount of women who's had to quit their jobs because of men and boys in the workplace. It's unbelievable. Yeah, no idea. And feeling so helpless and alone. And like every woman will go through that at some point in life. I'm also really glad that my mom spoke about her libido. I just knew that was coming when she started this, when she went, I'm not sure if you want to know. You know, and you're like, it's definitely libido. It's definitely about libido.

1:01:20She even sent me a message after saying, what did she say about my libido? And I said, not. I said, I honestly said, get some testosterone. And she replied saying my, she honestly, I don't know if this is funny, but she replied saying my friend did that and her fanny grew. What a penny response. That's what she said. Love that. So, you know, I don't know. Look, I think hopefully, I know I learned a lot of things. So did I. Yeah, I hope you as a listener have learned a lot of things. What we're going to do is in the show description, leave some just links to Zoe and places where you can check some more information out.

1:01:55If you're worried or concerned or perhaps are going through menopause, maybe it'll be a good thing to read up about. Absolutely. And also the seed oils. Blew my mind. Yeah. Blew my own mind. Blew your mind. And that episode of Zoe is out now. You can go and listen to it. It is out. Yeah, it's very good. Fabulous. That's it. Okay, listen. If you would like to send us any messages, anything at all, you can do to our email, greatcompanypodcast, at jampopproductions.co.uk, or slide into our DMs at greatcompanypodcast. Everything is in the show description. Yes. And also we're on TikTok. Just go there.

1:02:27TikTok and Instagram. And YouTube. Lovely. All right. I cannot wait for next week. I just want to say this for a weekend. I love this podcast. It's fantastic. Thank you so much for always joining in. And if you can click that subscribe button, it means the whole world. Yeah. That's the end of the show. And if you send us a DM, I will be reading it. She will. We'll see you next week. Bye. Bye.

1:03:04Hi, this is Knox from the Popcast with Knox and Jamie. And maybe like us at the Popcast, you also know people who have been smokers or vapors. And Zen is the one product it seems like everyone is talking about. because there are many good reasons to make a change to Zen nicotine pouches. Reasons like Zen nicotine pouches are still America's number one choice for smoke-free, hands-free nicotine satisfaction. And you can choose between 10 varieties, each variety available in either 3 or 6 milligrams. Check out zen.com slash find to find Zen at a store near you. Warning, this product contains nicotine.

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