Friday Q&A: Dr Shireen on Your Health Concerns

0:00Georgia Dayton: This message is a paid partnership with AppleCard. This is Felix Salmon from Slate Money, and I'm here to tell you about AppleCard. Even as a seasoned traveler, things can still get stressful, which is why I use AppleCard on my international trips. And with 2 % daily cash back on every purchase with Apple Pay, I'm actually earning daily cash as I travel. Instead of coming home feeling like I've drained my bank account, I come back with cash back. I can put toward my next trip. Apply in the wallet app on iPhone. Subject to credit approval, Apple Card issued by Goldman Sachs Bank, USA, Salt Lake City branch, terms and more at apple.co slash applecardbenefits.

0:45Georgia Dayton: Seeking, pushing, optimizing, creating, learning, discovering. At Aramco, we believe in harnessing the power of data to push the limits of what's possible. That's how we deliver reliable energy to millions across the world. Aramco, an integrated energy and chemicals company. Learn more about us at aramco.com.

1:16Georgia Dayton: Hello and welcome to Made by Mamas, the podcast. I'm Zoe Hardman. And I'm Georgia Dayton. And this is your parenting safe space where no conversation is off limits. with five kids between G and I we have seen a lot we really have each week we'll be joined by some famous faces and experts and we'll chat about the brands and products that have saved us along the way in short we're the parenting podcast for you before we get started hit subscribe or follow so you're the first to know when each episode lands and they're on Tuesdays and Fridays and it really helps if you leave a rating and a review you can also find us on Instagram we're on at made by mum is.

1:52Georgia Dayton: But for now, George, should we get into it? Welcome to Friday's episode of the podcast. It's just me again. I mean, not sure where Zoe is. Has she made it back from Ibiza or not? She has. She will be joining us shortly. But I have got another amazing guest on today. And we are going to be talking all things women's health, skin, hair loss, and actually with a guest who messaged us back in 2020. So joining us today is Dr. Shereen. Hello. How are you? I'm good, thank you. Thank you for having me. It's so funny. So like six years later, you've come on the podcast. And when I actually messaged you guys, I just set up my Instagram, but I didn't, I think in my wildest dreams, I'd never thought back then I'd come on as a guest or anything.

2:36It was a genuine just, I love your podcast.

2:38Georgia Dayton: And I feel like we didn't see it, which is even worse. Because I look back and I was like, why have you been on our expert list for ages? So I don't know. Six years later. Yeah, here we go. So that's great. just before we get into all the questions because we actually recorded a podcast a few weeks ago with holly hagan and charlie hedges and we were talking about periods and um you know why they change and all that kind of stuff and since then we've had so many people message like oh my god please do it like do an episode where we can answer all these women's health questions so before we get into all of those because there's been so many do you want to just give the audience a bit of background on you you started your instagram six years ago but you are a gp uh yeah so I am an NHS GP I still work as an NHS GP so three days a week and I actually became a GP this year will be 10 years since I've been a GP and when I started working after a couple of years I just felt to myself within the NHS system it is very stretched at the moment you have 10 minute appointments and I felt like I wasn't giving my patients but particularly women the time that they needed with me to be able to explain their medical conditions whether it's PCOS endometriosis well enough for them to go away feeling satisfied so back in 2019 I decided to set up an Instagram and um I used to just share just it was all infographics it was before even reels existed but it was just like cartoon pictures with the caption to be very educational and it ended up being very kind of like shareable but valuable content that girls would share in the group chat um and my Instagram grew and then during that time I fell pregnant I had my first and then when he was born I was like this is just such a big change in my life and it's something that I could bring into my Instagram so although I never shared my pregnancy I did share like a surprise I've just had a baby post and I entered the motherhood realm of Instagram which is a whole kind of area in itself and yeah I really enjoy sharing um just really relatable content as a mother but then also as a doctor I feel like I've got the privilege of seeing everything from all angles and just yeah being able to reassure people educate people appear on podcasts like this to you know just speak and try and empower people really yeah because I think that's one of the really positive things about social media is particularly like in the women's health space because for so long I think women in particular have suffered with you know painful periods endometriosis perimenopause all of these things and not really known what was going on and maybe not getting the support from their GP because it's the time restrictions or also just not going that's the other thing um but now I think we're learning so much more and so like having Instagram accounts like yours is such an amazing resource um so yeah but let's I think we should get into the questions because otherwise we are going to run out of time um because there are so many um so here's a question and there's been a few like this do I have to wait to be in full-blown perimenopause forward slash close to the menopause to start HRT?

5:42Georgia Dayton: Okay, this is a really good question. And I think even in the medical world over recent years, the doctor's thinking has changed about this as well. So if we look at what perimenopause is, it's the run up to menopause where your periods completely stop. And people, so we know that menopause happens around the age of 50, so kind of between 49 to 51 is normal. But we know that perimenopause, so that run up can actually start 15 years before the menopause so we're talking about mid-30s yeah and it's often not on someone's radar where they start having the symptoms of menopause be that the brain fog anxiety sleeplessness often especially nowadays women are having their babies in their 30s so they put it down to postpartum or i'm just a new mom with a baby and this is why i'm not quite feeling myself um but we know now that you know from from 35 onwards the perimenopausal symptoms can start and they they just gradually ramp up over the years and if we think about our lifespan 15 years is quite a long time it's not a great amount of time to be not feeling yourself exactly and it's it's also the time where we're peaking career-wise we're trying to grow we're trying to bring up our families we were trying to be there with our husbands and partners so it's a time where as women it would be such a shame to lose those prime years not feeling yourself as you say so the answer to that question is no you don't have to wait to menopause is when you've not had a period for a for a whole year so you've had one year with no with no period up until then it cuts kind of up and down you don't have to wait to menopause um and menopause is one day so you've got perimenopause menopause is that day and then you're postmenopausal so you don't have to wait to that point to start hrt you can start it much earlier and so if you think that you are at that perimenopause sort of stage you're seeing you know various different symptoms what should you do to get you know the help okay so I think um the first thing to do and this is what we say kind of with all medical conditions is know your body know what's normal so you can start picking up what's not normal so even if you're in a position now you're not at that but you're preaching the age just really get in tune with your body start tracking symptoms would be the first thing that I would say and I'm coming at this as a GP when someone comes to me what I would like them to have done to get the most out of the appointment so if you start tracking your symptoms and be that sleep brain fog anxiety night sweats hot flushes and start thinking about when they happen how often they happen and really importantly is the impact they're having on your life are these hot flushes stopping you from going to work are they stopping you from having a good relationship with your husband?

8:26Is it affecting intimacy? Are you dry down below and you can't have sex? So as a doctor, I don't just want to know the symptoms. I really want to know the impact on your life because that would help us to determine, okay, this is something that we need to, you know, go hard on, or this is something, let's try kind of other things before maybe something like HRT. So the impact is really important. So my first and most important, I think bit of advice is knowing your body and tracking your symptoms.

8:54Georgia Dayton: Yeah okay no that's great. Is it safe to stay on the pill? I'm 40. So that is a really good question. I mean it's a complicated question so you can be on the pill at 40. Yeah. But we need to take things a bit closer into account if that makes sense. So for example if you are a smoker it's not safe to be on the pill if you're 40 but if you're younger you you shouldn't but you can but it's an absolute contraindication which means rather than a relative contraindication so it means you absolutely cannot smoke and be on the pill if you're over 40 if you've got migraines migraines with an aura any history of blood clots in these situations it's not safe but many women in their 40s find that the pill is really helpful for them either as a method of contraception or period control while we're going again through perimenopause periods can become a little bit all over the place so just to help regulate the cycle so I would say if you're 40 you can be on the pill but I as a GP I review my patients a lot more closely so when they're asking for their next pill set I will make sure that they're having their reviews every six months whereas someone who's like 25 we do annual pill checks.

10:08Georgia Dayton: Right okay and what other like methods of contraception could you look at when you're in your 40s? So the mini pill is a great alternative. So if you are someone who wants to take a pill, the progesterone only pill is much safer. So we don't worry so much about things like blood clots with that. Other things, so if you suffer with heavy periods, the Mirena coil is incredible. It's been proven to lighten your periods and actually it's the first line treatment for heavy periods. Oh wow. Yeah and if you've got something like endometriosis it can really calm that symptomatically. And a lot of women notice either their period is really light and sometimes they even disappear with the Mirena coil and it offers you the contraception.

10:50Georgia Dayton: Amazing. And what are the symptoms that you can get, like other symptoms you can get on the Mirena coil, just for anyone who doesn't know? Do you mean like... Like are there any like negative symptoms or... No, there's generally no negative symptoms. Wow, okay. As far as I'm aware, yeah. Really? Yeah, just get it in. I mean, for many women with endometriosis, they find that it really does help with their symptoms. Wow, there we go. We'll be right back after this short break.

11:20Georgia Dayton: This message is a paid partnership with AppleCard. This is Felix Salmon from Slate Money, and I'm here to tell you about AppleCard. Even as a seasoned traveler, things can still get stressful, which is why I use AppleCard on my international trips. And with 2 % daily cash back on every purchase with Apple Pay, I'm actually earning daily cash as I travel. Instead of coming home feeling like I've drained my bank account, I come back with cash back I can put toward my next trip. Apply in the Wallet app on iPhone. Subject to credit approval, Apple Card issued by Goldman Sachs Bank, USA, Salt Lake City branch, terms and more at apple.co slash applecardbenefits.

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12:38Georgia Dayton: If you're searching for reassurance, inspiration, or just an honest conversation that reminds you you're not alone, join me every week for How Do You Cope? Listen wherever you get your podcasts.

12:51Georgia Dayton: Welcome back to this episode of Made by Mamas. Now, where were we? Okay, so this is a question for her daughter. So daughter 14 gets severe anxiety from around eight days before her period, but is then okay. What can I do to help her? Oh, bless her. Yeah. I mean, when we first start our periods and through puberty, there's so much going on hormonally. If it is kind of always in the run up to the period and kind of in that luteal phase, we do think about things like premenstrual syndrome. So like PMS. So there are, it affects a lot of women. and again we always look at okay you're having these symptoms but what's the impact and if it is really impacting for example her school life and her friends not wanting to go out leave the house then it's something that needs to be taken really seriously so there are lots of different ways that you can help so we know with pms lifestyle makes a huge difference so we're thinking about sleep optimization having a good diet and eating lots of protein can really help exercising again at 14 some a lot of the time we're finding kids just want to stay at home yeah um but getting out getting into nature all of these things can actually we find um really helped with those symptoms but I would say if you do try the lifestyle stuff and it's not helping then definitely speak to the GP and speak to the school as well and let them know so that she's getting support kind of from a 360 approach yeah because eight days every month is a lot it's like a third of a month almost exactly um yeah that's what I find so wild about so much of this you know especially around periods is it's not like once a year it's like every month every few weeks I know and it's it's like so a lot of adults because obviously with school you don't have that flexibility but I I see a lot of patients who will literally make their work commitments they'll they'll do it around their cycle yeah and it shouldn't be like that we should be able to be like right okay even though I'm in kind of my luteal phase I should be able to perform to like at adequate level and not be at home and kind of paralyzed by this yeah yeah yeah it's scary um is there a way to naturally reduce heavy periods rather than being put on the coil or pills um yeah so with heavy periods i would first of all say it's really important to know what's causing the heavy period yeah um because there are lots of different causes so things like fibroids for example really common cause and something that often would need some kind of like surgical management so I would say looking at the cause of the heavy periods would be the most important thing and then looking at lifestyle you can with your lifestyle with supplements with your diet exercise all of these things can help with your periods but I would say don't completely try and avoid I think we are in a time where everyone wants the natural approach but sometimes you know the medical stuff can really help and you have to kind of look at the balance of how much it's impacting you and your life versus potentially having a little bit of support and help yeah but i think with with most things women's health even things like endometriosis lifestyle and diet and exercise and sleep um and supplements i think like magnesium and things they can all really just help support your hormones and then i'd say after that speak to your gp and speak about the options because there are options and what classes is a heavy period okay so in terms of a heavy period I mean, there are kind of factual ways of looking at it and the amount of blood that you're losing.

16:18But from my perspective, if someone comes to see me and they are changing their pads kind of every hour, they're leaking through their clothes or their periods impacting their life. They can't go and stand up in a meeting because they're so scared that they're going to leak through. For me, that's a heavy period and that's something that needs to be addressed.

16:35Georgia Dayton: Yeah, because I think sometimes when people say, oh, you know, it's this many tablespoons of blood, you think, well, how do you measure that? I know. It's like you're standing there with a bowl underneath. You have to sit there for like five days with a bowl. Yeah, be like, right, I can't. Get your syringe out. Yeah, I just wouldn't know. No, I think, yeah, it's really hard. And I think another thing about periods that's so hard is we only ever really know our own period. Yeah, exactly. So it's really hard to compare. So what constitutes as heavy, like what I think is a light period might for someone else be a really heavy period.

17:06Exactly, yeah. And you can talk among your friends.

17:08Georgia Dayton: Like, you know, I've got friends who'd be like, oh my God, I could never, ever wear like anything light because I just wouldn't trust it. And I think, oh my God, like that's, you know, awful. But it could just be that I'm wearing like super heavy period knickers and a tampon or whatever. And I can do that now. Or, you know, it's so difficult to sort of determine like what's normal, like what isn't. um are optimal tsh ranges for those trying to conceive lower than what is considered normal otherwise yes so um so tsh is the thyroid stimulating hormone so it's a hormone that is produced by our brain to stimulate our thyroid gland to produce thyroxine which is a really important hormone when we think about metabolism and things um so when we have women under fertility treatment like going through IVF or ICSI they aim for the TSH to be less than 2.5 so that's even if your thyroid is producing enough thyroxine and within a normal range we we don't want the brain to be having to produce more than 2.5 of TSH um it's not for all women if you are trying to conceive kind of naturally and you're at the beginning of trying to conceive I wouldn't focus over focus on on your TSH it's mainly for women with recurrent miscarriages or struggling to get pregnant or going through fertility treatment we just really want to optimize everything from all angles and a tsh of 2.5 is is yeah okay optimal yeah i'd actually never heard of that before so that's why i definitely wanted to get that answered um i've started getting spots under my skin after coming off the implant and they stay are there any tips um so that sounds like potential hormonal acne um i would say it depends when you've come off the implant and have you given your body enough time to kind of readjust and reset hormonally it can take a few months for these things to start to settle um but hormonal acne is it's really common and especially we're seeing it more and more women in their 30s really yeah so there's kind of it's just the hormonal changes that we start to go through and the kind of the imbalances the androgens start to increase um which can also contribute to its own testosterone and we often see around the jawline under the neck and for some women it can be really troublesome so um i mean there are lots of different ways that we can think about treating it but hormonal balance um is really important and whenever we talk about hormonal balance our bodies actually do a really good job of balancing our hormones but what we can do is support our body to balance them so again we're thinking it comes back down to the same principles of sleep of lifestyle eating exercise and not trying to do anything that's going to trigger that acne and then also and with regards to the spots thinking about your skincare routine is so important making sure there's nothing in it that might be worsening it or irritating the skin or the skin barrier so there are lots of things you can do and but i would say the most important thing is just to know that this is probably related to your hormones being a little bit off coming off the implant and just giving it a little bit of time yeah and for those listening you know you've mentioned sleep a lot yeah who might have young children and they you know sleep is not it's not controlled by them yeah what can they do what can you do to I guess like maximize your rest when you've got young kids it's really I've got two young kids myself five and two so I know you you are often you know for a few years really in the trenches when it comes to sleep and it impacts us we know in so many different ways even our skin our skin's got a memory in terms of if you have one poor night's sleep it's gonna it's gonna remember that and it's going to show up um there is unfortunately no easy fix if there was I'd bottle it up and sell it yeah um but I think what's really important is if you are fortunate enough to have a support system around you to lean into them especially in those early months and years where people often are willing to come and help and they do want to help you um a lot of the time we as moms will be like I can do it I can do it and you kind of want to prove either to yourself or to the people around you that you can do it but it doesn't it doesn't make you a hero someone who's been through it it doesn't saying no to help doesn't you don't get a gold star for it yeah so reach out to your support network and have a break even if you're sleeping in the middle of the day for an hour or two that can make such an impact in terms of your mood and your physical health as well and then when we think about sleep hygiene as gps there's so much we recommend to people in terms of putting the phone away you know an hour or two before sleep reducing caffeine we often as mums we're running on coffee and I'm you know I'm not impartial to the odd like 7pm espresso but it's not oh that's wild I know but you know despite that I can still sleep can you that's how tired I am oh my gosh um but you yeah it's just about you know there's certain sleep hygiene habits that can really help dimming the lights down using your bed literally for sleep and for sex that's it not don't use it as a place to scroll you're training your mind to think that okay when I'm in bed I have to switch off and sleep um having having a book if you're not falling asleep going down doing something else um like a low level activity then come back try again because again as mums sometimes we're so tired but our brains are so wired that even when we get that chance to sleep we can't yeah it's which is like a paradox it's like I'm so tired but I'm almost too tired to sleep yeah but it's because you've fallen out of that routine right okay so You almost just need to get into really good habits.

22:39Georgia Dayton: That's it. Yeah. Okay. Before my period, I have pink spotting. Is this anything I should be concerned about? Look, sometimes you can have a bit of spotting and that's just your period kind of announcing itself is coming. It depends if I would say if it's something new or if that's kind of how your cycle is. But I would definitely speak to the GP just to get it checked. Make sure you're up to date with your smear tests. sometimes um you can have like kind of little benign sort of red growths on the cervix it's kind of like a vascular that can bleed on contact so if you've had sex it can sometimes bleed so we can literally look with a speculum and have a little look there to see if there's any kind of polyps or anything um a scan can sometimes help as well and again often it isn't anything to worry about it could just be something structural or something even hormonal so a blood test a hormone profile would help so I would say don't over worry but but definitely speak to your GP okay is it normal for periods to change after pregnancy three years on and heavy and long periods GP tests are clear yeah that's the bottom line yeah why I know I know it's like you've just gone through all of this you've got a newborn baby and you're just having really heavy periods so yeah it's we often find especially in the first like year or so after a baby even after you've kind of finished breastfeeding and your periods are kind of coming back to normal they are much heavier um in some women that does settle and they kind of go back to kind of pre-pregnancy but in some women that change is a bit more permanent and it can be their long term but again it's not something i would just assume so this person's obviously done the right thing they've seen their gp really important to have a scan yeah because again with all the hormonal changes and things that have happened you want to check are there any new polyps fibroids growth is the the lining thicker these kind of things you just want to make sure there's no abnormalities but if it's all clear then unfortunately it's part and parcel oh gosh not what you want to hear um but actually it's good to know that it is normal um someone here's put info on h pliary symptoms and confusing it with IBS I don't know what that is okay H.

24:56pylori okay there we go is that what it yeah so that's helicobacter pylori right okay big word yeah uh but it's something that we talk about and see all of the time in GP land so what is that so it's a bacteria that lives in the stomach and what that can often do some people are completely asymptomatic meaning they have no symptoms and it's just there so I might have it you might have it we don't even know but what it can sometimes do is cause symptoms of indigestion so heartburn reflux lying down kind of getting acid brush so if someone comes to see me and they're like i have i'm having all these symptoms of indigestion the first thing i'm going to do is check them for h pylori and the way that we do at my practice is we get a sample of their poo so we ask them to provide a sample send it to the lab and if we detect the antigen of that bacteria we'll treat them and it's really easy to treat it's one week two antibiotics one ppi which is an antacid and it kills off the bacteria and often we don't even recheck then to make sure it's gone the patients just don't come back because their symptoms go wow it's very different to ibs so ibs is irritable bowel syndrome and that is often related to kind of the gut brain axes and it's changes in bowel habits so you might alternate between constipation and diarrhea or be more prone to one rather than the other and it's a bit more lower and less likely to be having all the upper GI side effects so the things like the acid brush but what's really important to note is you can have them both at the same time right so you can have h pylori and ibs i would say if you've got either of those symptoms so the lower constipation diarrhea any change in your bowel habit or you are having new onset of indigestion it's really important to speak to your gp i think um quite often especially in younger people we just kind of be like oh it's probably fine i probably just had a heavy meal but it's important to check because for both of them we can offer

26:48Georgia Dayton: treatment yeah i was actually in the hairdressers last week and my hairdresser was talking about acid burps or something and then loads of people started talking about it in the hairdressers and i was thinking i've never it would that be that so with indigestion you can it can make you a bit belchy yeah because they were saying oh i really suffer with this and i was thinking i've literally never heard anyone talk about this before today. Yeah, it's a common symptom. Wow. Yeah. So again, if that is happening, getting this H. pylori test can really help. Give her a call. Yeah. I know what it is.

27:22Georgia Dayton: We'll be right back after this short break.

27:29Georgia Dayton: This message is a paid partnership with Apple Card. This is Felix Salmon from Slate Money, and I'm here to tell you about Apple Card. Even as a seasoned traveler, things can still get stressful, which is why I use Apple Card on my international trips. And with 2 % daily cash back on every purchase with Apple Pay, I'm actually earning daily cash as I travel. Instead of coming home feeling like I've drained my bank account, I come back with cash back I can put toward my next trip. Apply in the wallet app on iPhone. Subject to credit approval, Apple Card issued by Goldman Sachs Bank, USA, Salt Lake City branch, terms and more at apple.co slash applecardbenefits.

28:14Georgia Dayton: This week on Help, I sexted my boss. They like Captain Underpants, but I always read them. Goosebumps, did you ever read? No. Oh, there you go. I thought they were a bit common. How do I make it clear to her that she'll be lucky to even be my friend for much longer, never mind my bridesmaid, without souring the relationship between my partner and her fiancé? Oh, she sounds horrible. She sounds toxic. She sounds awful. Do you know what's very in for the summer now? It's always been on the fringes. And I'd love to see you in them. Speedos. Listen and watch wherever you get your podcasts.

28:47Georgia Dayton: Welcome back to this episode of Made by Mamas. Now, where were we? I'm having endo and adhesions removed this week. Any tips for recovery? Well, that's a really good question. I think endometriosis, obviously, we already, she's probably if she's at the point of surgery has gone through a lot and it's in many women it can be helpful but it is a chronic inflammatory condition unfortunately despite all the surgery and things that can sometimes come back so I think to go into the surgery with kind of the mindset that this is hopefully going to help symptomatically but with also the mindset that you know see how things go because it's all about managing your own expectations and I think in the run-up to the surgery like with all surgeries it's really important to physically get yourself into as stronger position as you can and by that i mean things like diet so really upping like protein it will really help the recovery um mentally as well just making sure that you're in a position where you can recover well from the surgery i think mind mind is really really important when it comes to that making sure that if you are a mom you've got kids you've got family you've got responsibilities you've kind of before the surgery and you're like kind of in the trenches with the recovery you've got a system in place i think preparation is really really important and then after the surgery things like laxatives because again like with a c-section you can sometimes the bowel can where it kind of gets pushed and manipulated it paralyzes right so it takes a few days for that to come back the constipation on top of the post-op pain it's a lot so that's something that you can really help yourself with and I always say this for c-section as well I'm like always have your lactulose because that bowel movement just really really helps um and then mobilizing really as soon as you can so back in the day post-op we would tell people just rest just rest just rest but actually getting up on your feet and moving helps your recovery it's like they call it like the enhanced recovery program so it's it's really good for you to to mobilize but again not too much pressure on yourself but where you can and if you've got that support just try and mobilize gently around the house and just take each day as it comes yeah that's great advice night sweats soaked sheets but blood's coming back normal should i push for hrt yeah look so with when we think about perimenopause and hrt it's not we don't treat the bloods we treat the person during perimenopause your bloods your hormones are so up and down and we're taking literally a snapshot of your blood test so um your hormones might come back as normal but that does not mean that you're not going through perimenopause okay yeah i and this is a really common question people like i've been to see the gp my bloods were normal so i'm not in perimenopause i'm like it's not that it's it's the clinical picture that we look at so your age how your periods are the hormone the symptoms that you're having and i would say if you are having night sweats and you are in an age where you could be perimenopausal and there's no other reason simple explanation which obviously in the bloods at the moment there's nothing um and you're not like sleeping in a room that's like 30 degrees do you know what i mean then i think i i personally as a gp wouldn't see any harm in trying hrt and if it works great and if it doesn't back to the drawing board yeah because soaking the bed sheets doesn't sound like something you should have to live with no absolutely not most of the symptoms of perimenopause yeah we shouldn't yeah totally Absolutely.

32:17Georgia Dayton: Is it safe to have a baby at 40 slash 41? Yeah, it is. Yeah, definitely. I think at the age of 40, 41, there are obviously factors that you just need to take into consideration. So there are increased risks of things like hypertension and gestational diabetes and chromosomal abnormalities. we know it's increased as you get older um but there's no reason why you can't have a baby at 41 and beyond if you are if you're able to fall pregnant yeah and you're under the right obstetric care they've kind of changed the way that we talk about older women now they used to call it like geriatric yeah i think you were 35 yeah i know it's like when we think about x factor and the overs i'm like 28 i'm like babies we were like oh they're so old louis and the overs um so yeah so i i'm really glad that these conversations are being had and things are changing because absolutely and we are in a life like living a life now where women are opting to have children later and a 40 41 year old they might have frozen their eggs at like 25 and you know why why not would you would you tell your daughters or daughters friends or you know whatever to freeze their eggs i would definitely present it to them as an option yeah yeah i think there are i have friends now who are like i wish i knew yeah yeah no same it's something because i've got a daughter i mean she's seven for god's sake well not seven yet but you know it's one of those things you think oh is that a conversation that you do have you know when you're you know girls are in their 20 like early 20s even even at school yeah just to not like to know that it's an option because I'd never heard of it until I probably did this podcast, to be honest.

34:03Georgia Dayton: Yeah. I didn't know that you could even do that. But I think now, especially like friends that I've got who are the same age and they haven't met anybody yet, but they do want a family, they always think back and they just think, oh, why didn't I do it then? And also before like financial responsibility and all of that kind of stuff starts playing into it. Exactly, yeah. I think with regards to schooling, I actually feel quite strongly about this, that we obviously in sex education it's like use condoms don't get pregnant don't get pregnant but we never actually speak about you know you some people struggle to get pregnant yeah and fertility so for me it wasn't even like throughout my 20s it wasn't even really on my mind um but i think it should have been because i potentially could have fallen into issues uh so yeah if i had a daughter i would definitely talk to her about not how to not get pregnant yeah but also how to get pregnant how to make your life easier and i think we are in a generation where women are having children later and later and we should have that option to do it yeah but one caveat is with with egg freezing sorry one caveat with egg freezing is that um it's not a guarantee yes and i think this is another thing that's really important it's not like you've just done it and that's it you can and are there things you can do you know just and make part of your routine that help your fertility just in general you know like I think back and I think I don't know like would I have been on the pill for that long or would I have done this or would I have done that like you know I've you know touched wood I was fine but I do wonder if we have you know we have conversations about not getting pregnant do we have conversations about you know if you are wanting to have a baby in the next three years these are the sorts of things that you would do to help I don't know it's so So as women, we're born with all of our eggs.

35:52And we do know that obviously as you get older, the egg quality does start to reduce. And with men, lifestyle plays such a huge role with their fertility. So we know that, you know, not going for hot saunas, not like bike riding, all of these things can help their sperm. Because every month or two, they're generating new sperm. we have our eggs but we also have an environment in our body where we want an embryo to latch onto and to implant and there are some women with you know what i would consider pretty unhealthy lifestyles who fall pregnant very easily and there are others who are very healthy and they do everything by the book and i think i we always have to think very carefully about when we're giving advice because for someone who's not getting pregnant who's doing all these things that they might almost feel like they're have I done something wrong but there are things that again it always comes back to lifestyle so things that we can help to optimize our body so like diet wise things like an anti-inflammatory diet can really help again just to support your hormones then obviously things like not smoking and reducing alcohol intake you just want your body to be in a non-inflammatory state as much as you can but I think in terms of like egg quality and things it is really hard we're born with with what we've got supplements can sometimes help there's loads on the market um and i think for anyone that's trying the most important thing is folic acid and vitamin d they're really important especially folic acid and to start there great um

37:22Georgia Dayton: we've only got time for a couple more so let's do a hair one because you mentioned that that you know always goes down well 37 and hair starting to thin more falling out what supplements should I'd be looking at? Okay, so hair is having its moment, I think, in 2026. We're all talking about hair, and everyone wants good hair. I think when it comes down to hair, it is often multifactorial. So it's not one thing that's causing hair loss. It's often a few different things at play. So I would say if you are starting to lose your hair, the first and most important thing is to see your doctor. For them to take a full history, there might be something in your history that's causing it so things like stress for example hormonal changes we want to look at your cycles things like that but then also a blood test a blood test is literally a window into your entire body so we will be looking at things like ferritin levels in women of childbearing age ferritin a lot of the time is very low because we're bleeding every month and again like we said we don't know what's a heavy period what's not how much should we lose when we have kids pregnancy takes our iron childbirth blood loss all of that and it takes years to catch up if you're not supplementing it and a really important point that so many people don't know and I literally talk about this all of the time is when we look at iron we look at something called ferritins and that's a marker of iron and on the NHS yeah if it's 13 it's normal yeah but for hair we need 80 yeah and it's really hard to get to 80 but for your hair to be growing if you are losing hair because of iron is that but then we want to look at other things as i said like hormones thyroid function can really impact it um often in women again 37 perimenopause hormonal changes you can lose it typically we lose it around the temples and at the crown area and that's called androgenic alopecia there are certain supplements that can really help so pumpkin seed oil sore palmetto really good at blocking dht which is the hormone responsible um and then there are certain hair tips that people don't realize that we should be washing our hair more like our scalp is an extension of our face it's our skin and we I mean I grew up being told that try to not wash your hair once a week it was like the natural oils the best thing to do is have a blow dry once a week and then not wash your hair it was like yeah status symbol like I only have to wash my hair once a week because it's so great I know and it's not rank it's rank and the product build up blocks the follicles and it stops it growing so you need to be washing your hair at least every other day yeah another myth is that you have to leave your hair to dry no heat on the hair but actually controlled heat like low level setting after you've come out the shower to especially dry your scalp but also the hair ends as well which are prone to breakage when the hair's wet and fragile really really important in your scalp that moisture can cause an overgrowth of yeast which can cause your hair to fall out as well so wow yeah so we always say don't blow dry your hair but yeah i'll leave it to dry naturally but no don't no don't yeah wow okay so i would say yeah For this person, like looking at your hair habits is really important.

40:21And it's a bit senior. Yes.

40:23Georgia Dayton: I went to see a trichologist maybe at Philip Kingsley about, might have been five years ago. Yeah, four or five years ago. And my hair like on the surface seems thick and healthy and all that. I was so low in everything, but not like by the NHS line. It was like I was just, you know, just under or just above. and actually like yeah like my ferritin like b12 like all of these things the only thing i wasn't deficient in was vitamin d which is so random because everybody is apparently so um and the last one um so this is actually personal but i when i spoke about it lots of people were talking about it perioral dermatitis yeah so many people are getting it now what can be done what should we be doing not be doing so i think with perioral dermatitis a lot of the time it is we're kind of overdo I think the reason we're seeing more of it is because of TikTok and Instagram and everyone's adding things into their routine and quite often it's a sign that maybe we've overdone it or we've used something that has irritated the area and the first thing that I would say is stop everything literally stop everything and go back to just really basic skincare so products that have just like one or two ingredients in them nothing really very active acidic or anything that's going to cause any harm and give it time it takes it takes a long long time for that barrier to start to heal and the inflammation to start to go and I think the um urge is often to put more and more on it to try and fix it but actually it's it's the opposite just stop everything and just kind of just just wait and have that patience and yeah settle but yours I can't say no mine I actually had antibiotics in the end oh did you yeah I did I did try like lots of different things and actually it was the only thing that helped that helped yeah and I didn't you know I guess you don't really want to have to go there but for me that's the only thing no no yeah if it's there for a reason yeah exactly thank you I feel like we could have kept going and going but that was really really helpful so anyone listening where can they find you so I'm at dr shereen on instagram and on tiktok but more I've got my community thank you so much um and as always we would love you to rate, review and subscribe to the podcast and tell your friends.

42:42Georgia Dayton: And if you have got any feedback on this episode or other guests you'd like to hear from, drop us a DM on Instagram. We're on at Made by Mamas and we'll be back on Tuesday.

43:01Seeking.

43:02Georgia Dayton: Pushing. Optimizing. Creating. Learning. Discovering. At Aramco, we believe in harnessing the power of data to push the limits of what's possible. That's how we deliver reliable energy to millions across the world. Aramco, an integrated energy and chemicals company. Learn more about us at aramco.com.

43:30Georgia Dayton: This week on Help, I Sexted My Boss. They like caption underpants, but I always read them. Goosebumps, did you ever read them? No. Oh, they were gone. I thought they were a bit common. How do I make it clear to her that she'll be lucky to even be my friend for much longer, never mind my bridesmaid, without souring the relationship between my partner and her fiancé? Oh, she sounds horrible. She sounds toxic. She sounds awful. Do you know what's very in for the summer now? It's always been on the fringes, and I'd love to see you in them. Speedos. Listen and watch wherever you get your podcasts.

44:08Thank you.

44:42Thank you.