Latest / The Dr Louise Newson Podcast / 05 - Talking to my daughter: understanding hormones, contraception, PMS & the gaps in sex ed

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05 - Talking to my daughter: understanding hormones, contraception, PMS & the gaps in sex ed · The Dr Louise Newson Podcast

• 0:03
  So what privilege today on my podcast to have my middle
• 0:06
  daughter Sophie, who's a student at King's College London,
• 0:10
  sitting with me to talk about contraception.
• 0:13
  Who'd have thought, Sophie? So thank you so much for coming.
• 0:18
  Contraception is something that means different things to
• 0:22
  different people actually, because so much is just not
• 0:26
  getting pregnant. But as a Doctor Who specialises
• 0:29
  in hormones, I think a lot about the type of hormones that are
• 0:33
  used for contraception. So I'm really keen to talk to
• 0:36
  you a bit about not just your contraception but in general
• 0:41
  what people think. Your age, you're 20, you've got
• 0:44
  lots of friends, lots of people presumably either thinking about
• 0:47
  contraception or using contraception.
• 0:50
  So just talk to me a bit about. Yeah, OK, well a lot of my
• 0:54
  friends, including myself have been on some form of birth
• 0:57
  control for a really long time and for the most part it is not
• 1:01
  for the reason to stop getting pregnant.
• 1:04
  Most of my friends I know have been on it because they were
• 1:06
  having really heavy periods or really bad cramps, or it was to
• 1:11
  improve acne or their low mood. So when I do think of birth
• 1:15
  control, 90% of the time it is not the case of it actually
• 1:19
  being used for birth control, it's for the case of being to
• 1:21
  control like external things. So that was really interesting
• 1:25
  actually, because as a doctor I did a lot of family planning,
• 1:29
  all about planning your family. It seems so old fashioned,
• 1:32
  doesn't it, even using those words.
• 1:34
  But actually it's all about stopping that person getting
• 1:37
  pregnant. Whereas you've already said it's
• 1:39
  not even about that. It's about how to regulate your
• 1:41
  hormones. And that is a massive issue.
• 1:44
  And I remember going to, I was doing a presentation years ago
• 1:48
  at the Royal College of Psychiatrists and some people
• 1:50
  were quite hostile in the audience and they were telling
• 1:53
  me that I was trying to medicalise the perimenopause.
• 1:57
  And they said, but you don't medicalise adolescence and
• 2:01
  puberty. And actually that stuck with me.
• 2:04
  And I thought, why don't we try and make adolescence and those
• 2:08
  hormonal changes better for women?
• 2:10
  Because so many people have really heavy periods.
• 2:14
  They have painful periods. And they just said, oh, it's
• 2:17
  just normal because your hormones are changing.
• 2:20
  You're still young, you're adolescent or you're, you know,
• 2:23
  going through puberty. But actually it really effects a
• 2:25
  lot of people. So you're saying people are
• 2:27
  turning to those treatments to turn?
• 2:30
  Yeah. People I think are turning to
• 2:32
  treatments and just taking whatever it is recommended by
• 2:35
  doctors. And I think I didn't really hear
• 2:38
  about the word hormone up until you started speaking about it a
• 2:43
  lot more. Yeah, I didn't really like
• 2:45
  probably understand what it was. And especially all of my
• 2:47
  friends, like they didn't really understand.
• 2:49
  And when being told at like 1617 whether to choose between the
• 2:53
  hormonal or the non hormonal coil for example, or whether to
• 2:57
  take the combined or mini pill, progesterone only pill, they had
• 3:02
  no idea what the apps, what the actual like repercussions of
• 3:07
  these were. And they didn't really
• 3:09
  understand hormones. It either sort of like a really
• 3:11
  positive thing that they needed to balance their mood and not
• 3:14
  properly understanding or they thought it was a really bad
• 3:17
  thing to mess with and therefore have avoided using anything
• 3:19
  hormonal, which therefore has not helped the periods in
• 3:22
  perhaps ways it could have helped if they were properly
• 3:25
  educated. But I don't think you are
• 3:27
  educated in the same way about hormones because you are just a
• 3:30
  teenage girl for the most part when you start to go on these
• 3:33
  types of birth controls. But do you think?
• 3:35
  Quite a failing in education because I know when I had sex
• 3:39
  education at school it was all about not being getting
• 3:41
  pregnant. But actually understanding what
• 3:44
  your own hormones do surely is really, really important when
• 3:48
  thinking about which hormones to use and how to regulate your
• 3:51
  hormones. Do you see what I mean?
• 3:53
  Because I think a lot of people think hormones are something
• 3:56
  that we give people, which, yes, they can be, but actually the
• 4:00
  first thing we need to do is understand what the hormones are
• 4:03
  happening in our body. And I think until we don't know
• 4:06
  that, we don't know what we're doing.
• 4:07
  And that's what's happening with your friends.
• 4:09
  Yeah, I think it's especially hard as a teenager because as a
• 4:13
  teenage girl you are stereotyped as super emotional because of
• 4:16
  your teenage hormones. And therefore the implications
• 4:20
  that these hormones can have as part of birth control, they're
• 4:22
  not considered properly. You know, I've had cases of
• 4:25
  friends who really struggled with their hormones as a
• 4:27
  teenager just because they were super emotional and then they
• 4:31
  are put on these pills with these hormones that don't align
• 4:34
  correctly with their body. And you know, I've had a friend
• 4:36
  tell me that she remembers being 1516, like doing homework for
• 4:41
  her GCSE's and just sobbing for hours being so upset and not
• 4:45
  knowing what was wrong with her. And what's been brought up time
• 4:47
  and time again when I spoke to my friends about it was this
• 4:50
  feeling of not being balanced and not being in control, which,
• 4:55
  you know, can be argued to be normal.
• 4:57
  But when coupled with something that you're supposed to use to
• 5:00
  help control your hormones or being given hormones, that is
• 5:03
  actually like, quite scary and quite worrying.
• 5:07
  That's really worrying, isn't it?
• 5:08
  And I see that a lot because I see a lot of women and younger
• 5:13
  people who have PMS, premenstrual syndrome, PMDD,
• 5:16
  premenstrual dysphoric disorder, and they just expect to feel
• 5:20
  rubbish before their periods because their mood really
• 5:23
  flattens the lows. And then when they go and speak
• 5:26
  to someone, they often get given birth control, a type of
• 5:29
  contraception. And it's taken me years and I
• 5:31
  feel really embarrassed to say it, that I didn't realise there
• 5:34
  was such a difference between our natural hormones and the
• 5:37
  hormones that we prescribe. And it's only doing the work
• 5:40
  that I do on hormones in HRT and realising the difference, it
• 5:46
  then takes me back to thinking, goodness, I used to be like
• 5:49
  those doctors your friends have seen to say, well, we'll just
• 5:51
  give you some hormones to make it all sort of smooth it all out
• 5:55
  and make you feel better and help your skin and whatever.
• 5:58
  But actually they are not natural hormones.
• 6:01
  And they are not just not natural hormones, they're
• 6:04
  suppressing your own hormones. And actually hormones are really
• 6:07
  important. You know, I wouldn't give you
• 6:10
  something to stop your thyroid hormone or stop your insulin
• 6:14
  because you were getting sugar cravings and say, well, let's
• 6:16
  just stop. What you said about PMS, I think
• 6:18
  that's really important to mention because again, as a
• 6:21
  young girl, PMS is really normalized.
• 6:25
  And I don't think it's something that should be normalized.
• 6:27
  You know, a lot of my friends suffer on it, even though they
• 6:30
  are on forms of birth control. And it's just like this is
• 6:33
  expected. You know, the week before my
• 6:34
  period, I will cry over stupid things.
• 6:37
  And this is normal and this is OK.
• 6:39
  And obviously it's not, it's something that like we should
• 6:43
  counteract and it's something that like we should do and
• 6:46
  change things about it. And, and in terms of hormones
• 6:48
  and young girls being prescribed incorrect hormones, I've got one
• 6:52
  of my housemates. Actually, she had been on
• 6:55
  various types of the pill when she was 1516 to help with her
• 6:58
  hormones, to help with her low mood.
• 7:01
  And these pills that she was on cause a massive imbalance in her
• 7:05
  hormones. And she was really upset a lot
• 7:07
  of the time. And then because of that, she
• 7:10
  strayed from using any hormones. And when she was offered the
• 7:13
  hormonal, the non hormonal coil, she opted for the non hormonal.
• 7:17
  And because of that, she has not had much improvement in her PMS,
• 7:21
  in her cramps, in her heavy periods, and she still has quite
• 7:24
  a hard time with her. And I think this lack of
• 7:26
  education and this crossover between general team teenage
• 7:29
  hormones where you do get super upset and being attributed, oh,
• 7:33
  it's PMS, like everyone has it, you'll get over it.
• 7:35
  I think that creates something really complicated.
• 7:38
  I think so and I think it's really unfair for people to
• 7:41
  normalise something that is affecting them and had you to
• 7:44
  find normal. That's another conversation, but
• 7:47
  it's really basic Physiology. When you you might have done
• 7:51
  those graphs in, in biology where our hormones fluctuate.
• 7:55
  So we have this spike of estrogen and progesterone in the
• 7:58
  middle when we release an egg. And then the second-half of our
• 8:01
  cycle we get a peak of estrogen and progesterone.
• 8:03
  Then it goes very, very low. So that crash of hormones causes
• 8:08
  often this PMS type symptoms. So we know what it's related to.
• 8:12
  And in medicine I'm always taught treat the underlying
• 8:15
  cause. So I see a lot of people in the
• 8:18
  clinic who have PMS like your friend have been given different
• 8:22
  contraception. It hasn't helped or even made
• 8:24
  them worse. Yeah, I think what you say about
• 8:26
  natural and synthetic hormones, I think that's something that is
• 8:31
  starting to become a big conversation in the menopause,
• 8:33
  but it's not at all for people my age.
• 8:36
  And in terms of birth control, and my dermatologist told me
• 8:39
  yesterday that actually the use of synthetic progesterone in a
• 8:44
  lot of these birth controls is a cause for acne.
• 8:47
  And people go on the pill for acne.
• 8:49
  And there's so many different types of pills out there.
• 8:52
  And I've been on nature through myself and I've never once heard
• 8:57
  from any GP or doctor the importance of natural or
• 9:01
  synthetic hormones, or the difference or the breakdown of
• 9:03
  them in these different types of brands of pills.
• 9:05
  It's really important and I learned a lot actually when I
• 9:08
  was preparing for the theatre tour, you know, that I did
• 9:11
  because I wanted to understand the history of the hormones and
• 9:14
  what what sort of has gone wrong almost.
• 9:17
  And, and I'm very interested in sort of chemistry and science
• 9:21
  and so how these hormones work different in their body.
• 9:24
  And it's a bit like those jigsaws, you know, we used to do
• 9:26
  with you when you were a little where you fit in like a shape of
• 9:29
  a duck into a hole and a shape of an elephant into a different
• 9:32
  hole. And it's sort of, so when you've
• 9:34
  got those hormones, you want the same structure going into the
• 9:38
  hole, which is the receptor. And then it works properly in
• 9:40
  the body. Whereas these hormones have been
• 9:42
  chemically altered. So you might have an extra ear
• 9:46
  on your elephant. It's not going to fit in the
• 9:48
  puzzle in the same way. I know that sounds a bit weird,
• 9:51
  but it won't fit on the receptor.
• 9:54
  But if it does fit on the receptor, it won't have the same
• 9:57
  effects in the in the cells. And it also blocks the your
• 10:01
  natural hormones floating around to have an effect as well.
• 10:04
  So it has like a double negative almost, which people don't often
• 10:08
  realise. And they made those hormones
• 10:10
  that way because they wanted to make money out of them, they
• 10:12
  want to put them to market. But I think what's really ironic
• 10:16
  with all of this is that they were never tested as
• 10:19
  contraception. So we've got contraceptives
• 10:22
  where they never did the studies looking at contraception.
• 10:24
  What they did is they looked at the lining of the womb, made
• 10:28
  sure that people weren't having heavy periods.
• 10:31
  And so a lot of people didn't have periods or had light
• 10:34
  periods. So they said this is great, we
• 10:36
  can probably use this as contraception, but they were
• 10:39
  never really tested. And then because they work all
• 10:43
  throughout the body, they don't just work on the womb, they
• 10:45
  haven't really tested the effects on the heart, on the on
• 10:49
  the brain, on the rest of the system.
• 10:52
  And it's with time, people have done more and more studies now
• 10:56
  showing there is an effect on mood in a negative way.
• 10:59
  For many people, there are risks of clot, there are small risks
• 11:03
  of even cancers, but everyone's ignored that because generally
• 11:08
  you give the contraceptive to well, people.
• 11:10
  So the risk is small, their background risk is small, so
• 11:13
  let's not worry. But actually there are risks
• 11:17
  that are not really being discussed.
• 11:18
  And I think they've been spoken about more by by your generation
• 11:22
  because you share things a lot more freely and openly than even
• 11:27
  my generation. Because we weren't didn't really
• 11:29
  talk about it. And then we didn't have social
• 11:31
  media. So you couldn't just like put it
• 11:34
  on snaps or WhatsApp or chat about it?
• 11:38
  So yeah, I know you're right, but I obviously think another
• 11:41
  thing relating to all these things that cause low moves that
• 11:44
  perhaps you can shed some light on because I don't really know
• 11:47
  much about it. But another thing I had a lot of
• 11:50
  my friends saying, because I also run a lot in preparation
• 11:52
  for this podcast, is that they go on a pill and it's not quite
• 11:58
  right for them. They feel imbalanced.
• 12:01
  They give it three months, which is a recommended time, and then
• 12:03
  they come off this said pill because they feel worse for it.
• 12:06
  They don't feel good. And then because they've come
• 12:08
  off that pill, they feel even worse again.
• 12:11
  So they've gone from feeling a little imbalanced to super
• 12:15
  imbalanced on the pill, totally depressed and causing a lot of
• 12:19
  worry. And I'm just wondering like what
• 12:22
  causes this and how can this be counteracted?
• 12:24
  Because this has been a really common problem for my friends
• 12:26
  when trying to navigate the pill, and it's actually
• 12:28
  something that has put them off it totally.
• 12:31
  It's interesting, one of the things is that when they when
• 12:34
  people have the pill, they will still have a still have effects,
• 12:37
  they will still help the receptors a little bit.
• 12:39
  Depending on the, the type of contraception it's used.
• 12:43
  They're all synthetic, but some are more synthetic than others.
• 12:46
  You know, they've got extra bits, meaning that they really
• 12:49
  won't affect the the receptor. So some people will definitely
• 12:52
  have benefit and feel better because they might have come
• 12:56
  from a place of not having enough hormones.
• 12:58
  And we know that a lot of people who are younger don't have
• 13:02
  enough progesterone. So they have enough hormones to
• 13:05
  to have regular periods, but they don't have enough hormones
• 13:08
  to really get into the brain and get, you know, people's mood and
• 13:11
  energy and everything else, right.
• 13:14
  So they have the contraception, which will help a little bit,
• 13:17
  and then they come off it and they're back to where they were
• 13:19
  before. And sometimes that isn't enough,
• 13:23
  if you see what I mean. And that's the problem.
• 13:25
  And it's really hard because then you please say, well, is it
• 13:28
  a hormonal problem or is it because she's stressed?
• 13:31
  Is it because there's other things going on?
• 13:33
  And so much is just blamed on society and mental health as you
• 13:37
  know, it's just blown up. Especially people your age,
• 13:40
  increasingly in the clinic, but also people I speak to, they,
• 13:44
  they go on the contraceptive for whatever reasons and then their
• 13:48
  mood lowers and then they're given antidepressants and then
• 13:52
  they might put on weight and then it's just like layers and
• 13:56
  layers of problems, but no one even thinks about the
• 13:59
  contraception being related to it.
• 14:02
  Yeah, I think only kind of now and at university and stuff,
• 14:07
  people have actually been taking birth control as a form of
• 14:10
  contraception because as a 1516 year old it is rarely used in
• 14:14
  that way. But you said something really
• 14:15
  interesting that I also would like you to shed light on
• 14:18
  because myself included and every single person that I have
• 14:22
  spoken to about birth control has said that it has made them
• 14:26
  put on weight, especially in instances of the pill.
• 14:31
  And I'm wondering why this happens and why like different
• 14:36
  pills cause us more than others, and how this perhaps be avoided
• 14:39
  because as a teenage girl, when you're feeling extremely
• 14:42
  hormonal, putting on weight can honestly feel like the end of
• 14:47
  the world sometimes, you know? Differently there's different
• 14:49
  reasons so and a lot of it hasn't been done because very
• 14:52
  few studies, really good studies have been done looking at this,
• 14:55
  but I think it is really important.
• 14:57
  So one of the things that the estrogen so in in the most birth
• 15:02
  controls, they've got estrogen and progesterone.
• 15:04
  It's combined pill. So the estrogen bit is always
• 15:07
  synthetic. And so that will block the
• 15:10
  natural estrogen working in the body.
• 15:12
  And the estradiol that I talk about, the anti-inflammatory,
• 15:15
  the good estradiol is nowhere to be seen in your body because
• 15:18
  you're having this synthetic type.
• 15:20
  And there's no birth control at the moment with natural
• 15:23
  estrogen. No.
• 15:27
  So then then what the body does is then it wants some natural
• 15:32
  estrogen, but it can't produce it if it's all been blocked.
• 15:36
  But the fat cells can produce a very weak type of estrogen
• 15:39
  called estrone. And it's usually fat cells that
• 15:42
  are in the midline. So a lot of people find they put
• 15:44
  on weight in the middle and that's their body producing this
• 15:47
  type of estrogen saying, oh, look, this is better than
• 15:50
  nothing. I'll give you this type of
• 15:51
  estrogen, but then the other thing is the progesterone, the
• 15:56
  synthetic progesterone can cause a bit of fluid retention as well
• 16:00
  because it also interferes with the way the kidneys work, for
• 16:03
  example. So you get a bit of fluid
• 16:05
  retention, bit of bloating as well.
• 16:07
  Lots of people get bloating, don't they as well.
• 16:10
  So it's not just fat that they put on their sort of they've, a
• 16:14
  lot of people say, gosh, I've, you know, certain times of the
• 16:17
  month my tummy is a lot bigger. They might have some swelling of
• 16:21
  their ankles and that's often and related to the progesterone
• 16:24
  as well. And then these hormones can
• 16:27
  affect the metabolism as well and the body.
• 16:29
  So like how quickly you burn food, it can also, they can
• 16:33
  affect your stress hormones, which then can affect your sugar
• 16:36
  metabolism, can also affect even your thyroid.
• 16:39
  There's all our hormones like work very closely together.
• 16:42
  So like when you're stressed, you're more, you're more angry
• 16:47
  that you experienced earlier. It's because your sugar levels
• 16:50
  are changing and that affects your emotions.
• 16:52
  And that's the same with our sort of estrogen, progesterone.
• 16:55
  And then the other thing that happens when people take
• 16:58
  contraception, it increases something called your sex
• 17:02
  hormone binding globulin, which binds testosterone.
• 17:05
  So then people on contraception often don't have testosterone in
• 17:09
  their body. Now, testosterone is a female
• 17:12
  hormone, as you know, as well as a male hormone.
• 17:15
  But testosterone is really good often for mood, energy,
• 17:18
  concentration, stamina, as well as libido.
• 17:22
  When I was learning about contraception, I was taught that
• 17:24
  testosterone would be blocked. But people said, oh, don't worry
• 17:28
  about low libido because young people often have a higher
• 17:30
  libido anyway, so it doesn't matter.
• 17:33
  Actually, I think it does matter.
• 17:35
  But that aside, if you're blocking your testosterone and
• 17:38
  then you have low mood, reduced energy, poor motivation, well,
• 17:43
  you'll probably put on weight because you're not going to the
• 17:45
  gym, you're not eating as healthily.
• 17:46
  So it's a combination of things. Why do you think so many of
• 17:51
  these things are normalised? For example low mood, PMS,
• 17:57
  putting on weight, having problems with the pill and then
• 18:00
  another issue of if you have the arm, the implant, then
• 18:04
  consistent bleeding for months on end and then being doubled up
• 18:07
  with the pill. Why do you think all these sort
• 18:09
  of hormonal things are normalised for young girls?
• 18:13
  I think one of the things is because it's about it's for
• 18:16
  women. Can you imagine men been putting
• 18:19
  up with all this? Absolutely not.
• 18:21
  It wouldn't happen. Do you know?
• 18:22
  It's just so I think it's about women and I think it's about
• 18:26
  lack of research, lack of proper really thinking about the
• 18:30
  problem. And the other thing is it's
• 18:33
  about contraception. It's not allowing women to get
• 18:35
  pregnant. It's back to the old times,
• 18:38
  thinking about women. Our purpose in life is to
• 18:41
  reproduce, to have a healthy womb.
• 18:43
  End of conversation, which is totally wrong.
• 18:47
  And the history of the way that these hormones were produced,
• 18:51
  they did really awful experiments on very high doses
• 18:54
  of contraception to women in Puerto Rico who had awful times,
• 18:59
  and they ignored that data. And so that's the problem.
• 19:02
  We haven't got good studies. And it's just been, I mean, it
• 19:06
  was amazing when the contraceptive came out in the
• 19:08
  60s because it was all about sexual liberation and freedom.
• 19:12
  And women thought, this is incredible.
• 19:13
  And I get that, but I don't know if you remember when we went to
• 19:17
  the Women's Revolt exhibition, it was last year and there were
• 19:20
  things there was the people wrote in the 1970s about ban the
• 19:24
  depot, that injection, the depot Provera, the injection of
• 19:29
  progestogen, which is a bit like the implants.
• 19:32
  And women were saying in that there were posters in there
• 19:35
  saying ban the injection because it's synthetic.
• 19:39
  And they were so much forward thinking.
• 19:41
  The women were saying stop having these man made medicine,
• 19:45
  literally man made medicines. And they could see that it was
• 19:49
  affecting their mood. They were putting on weight.
• 19:51
  They were feeling awful. That was 1979.
• 19:55
  Like it's now 2025 and people are still saying hang on.
• 20:00
  I don't feel well, I don't feel right.
• 20:03
  I'm putting on weight. My mood is awful.
• 20:05
  But then. Some people will be saying give
• 20:08
  it that person's not going to get pregnant and that's really
• 20:11
  important. And that worries me because
• 20:14
  recently less people have been using contraception, partly
• 20:17
  because they've been thinking and knowing more about the risks
• 20:20
  inside of. Having horror stories themselves
• 20:22
  with them, he traumatises them and puts them off.
• 20:25
  It absolutely. And then people have been
• 20:27
  saying, well, people shouldn't be talking on TikTok or social
• 20:30
  media about their own experiences or the risks of
• 20:32
  clocked, for example, because more women will get pregnant.
• 20:36
  But in my mind, it's about, hang on, let's give women a choice.
• 20:40
  Let's understand that they don't all have to have hormones as
• 20:43
  contraception. Like you're saying, your friend
• 20:46
  who's not on a, a hormonal treatment for contraception,
• 20:49
  she's on the non hormonal coil, but she's having some problems
• 20:53
  with bleeding. But that can be addressed in a
• 20:56
  different way because the hormones that we often
• 20:59
  prescribe, the natural hormones are not contraception because
• 21:03
  they're really, really low dose. But actually often giving a low
• 21:06
  dose of progesterone can be transformation of people with
• 21:09
  heavy bleeding or with PMS. But we're giving that that she's
• 21:13
  got the the non hormonal coil in for contraception.
• 21:18
  So that is something I think people will use more and more
• 21:20
  because a lot of people, even some of your friends have said,
• 21:24
  oh, I just feel so much better when I'm not on the pill.
• 21:27
  But it is nice to have a reliable contraception.
• 21:30
  Yeah, yeah, exactly. And I think what you said about
• 21:34
  TikTok is quite interesting. And you said earlier about my
• 21:37
  generation being more freeing. I am in a mostly girl family.
• 21:41
  I live in an all girl house right now.
• 21:43
  Talking about periods and birth control is something that has
• 21:46
  always been super open for me. And I think that is really
• 21:50
  important. And people are sharing their
• 21:52
  stories on TikTok, which is helping people kind of educate
• 21:56
  themselves and be like, hey, like I had a similar experience.
• 21:59
  Let's talk about it. But then on the flip side of
• 22:02
  that, I think that is there's also a risk of people with no
• 22:05
  kind of credential giving their advice, which can come across is
• 22:09
  fear mongering. You see a lot of videos of
• 22:12
  people talking about their awful experiences, which cannot be
• 22:16
  diminished. But then you have these videos
• 22:18
  of people saying things like birth control can cause cancer,
• 22:21
  it can cause infertility. And I'm just wondering if you
• 22:25
  can talk a bit about that because I've even had some
• 22:27
  friends say that they're worried about the fact they are on birth
• 22:30
  control in case it leads to infertility in the future.
• 22:34
  And that's what's really difficult because firstly, when
• 22:38
  people put negative things out because they've had bad
• 22:40
  experiences, it's always going to be amplified more because
• 22:43
  generally if you've got a good experience, you just get on with
• 22:45
  your life. You don't bother telling people.
• 22:47
  Yeah, So it's always very skewed.
• 22:49
  And that is really difficult. And it's really easy just to
• 22:53
  believe everything that you see. We all do it in the news, on
• 22:56
  TikTok, on social media and. Anyone can put on, you know, a
• 22:59
  doctor's jacket and glasses. You'd be like.
• 23:01
  This is what I think. Yeah, and you are so
• 23:03
  susceptible, especially teenage girls on TikTok to believing
• 23:06
  these things. Totally.
• 23:07
  So that is really, really important.
• 23:09
  And then but the problem is also it's really hard to find out
• 23:13
  proper information. And also I think as a doctor,
• 23:18
  it's really difficult to define what a risk is.
• 23:20
  So you're, when you say about risk of cancer, yes, there have
• 23:23
  been studies showing that with the synthetic hormones, there is
• 23:27
  a small risk of cancer. We've known that for many years
• 23:31
  with all types of hormones, but it's only been HRT that
• 23:34
  everyone's got really scared about.
• 23:36
  But actually the risk is there, but it's small.
• 23:40
  But you're looking at benefits as well.
• 23:41
  So for some people, going on the pill is transformational.
• 23:45
  Their mood is better, their skin is better, everything else.
• 23:47
  So they'll accept that small risk.
• 23:49
  Whereas other people, if they feel worse and they feel
• 23:53
  dreadful and maybe they smoke, they are overweight, they have
• 23:57
  an unhealthy lifestyle, their risk of a cancer is going to be
• 24:00
  higher anyway. Then again, it's looking at that
• 24:02
  risk. But the problem is you can't put
• 24:05
  the same people in the same box and say every risk and benefit
• 24:08
  is the same. Yeah, but it's really hard
• 24:10
  because how do you get that information properly that is
• 24:15
  balanced, that's individual for you.
• 24:17
  And I spoke to someone the other day who tried 16 different types
• 24:21
  of contraception and you're like, Oh my goodness me, When
• 24:24
  did someone say to you it's probably you're not going to
• 24:27
  find that right type, There must be something else that's causing
• 24:31
  your symptoms and it let's just start all over again, really.
• 24:36
  And I think it's really difficult because it's really
• 24:37
  hard. You know, it's really hard to
• 24:39
  access a Doctor Who understands as well, isn't it?
• 24:43
  Yeah, yeah, I mean most of my positive experiences with birth
• 24:50
  control have been from your advice, someone super educated
• 24:54
  in hormones and my friends that have just turned to their GPS
• 24:59
  with lack of like super specialised care, which is
• 25:02
  important, you know, to have access to these GPS.
• 25:05
  But that is where these kind of horror stories are coming from
• 25:10
  and kind of brushing off of slightly more serious or
• 25:15
  inconvenient symptoms. For example, as I mentioned
• 25:20
  earlier, having the implant and bleeding for three months
• 25:23
  straight, this is brushed off as normal.
• 25:26
  Read it out. This is just what happens when
• 25:28
  actually that really affects the individual.
• 25:31
  And also why can that happen? Because this is such a common
• 25:34
  thing that I've spoken to with so many of my friends that have
• 25:37
  had the implant, they have had these cases where they just will
• 25:40
  not stop bleeding for months and months and months.
• 25:42
  They've been told to wait it out and the only way for it to stop
• 25:45
  is if they double up with the pill as well, which feels
• 25:47
  counterintuitive to eventually the point where a lot of them
• 25:50
  get it taken out and give up. So why does that happen?
• 25:53
  Well, again, it's because of the the way the synthetic hormones
• 25:58
  acting on the womb affecting that your own hormones as well.
• 26:02
  And some people have this breakthrough bleeding, it's
• 26:05
  called. But what happens often in
• 26:07
  medicine is that a lot of doctors don't like to admit that
• 26:10
  maybe it wasn't right. So it's easy just to sort of
• 26:13
  give another treatment and another treatment.
• 26:15
  And you see this all the time. They're layers of treatment.
• 26:17
  So you treat a side effect with a treatment and then you might
• 26:20
  get another side effect and have another treatment, which
• 26:23
  actually isn't helpful in often you want to unpick.
• 26:27
  One of the things that you said earlier was about is there a
• 26:31
  natural type of contraception? And actually there is one and
• 26:34
  and you're you're on it called Zoli.
• 26:37
  But actually this is the most body identical that we have.
• 26:41
  And what's really frustrating is it's more expensive than
• 26:45
  microgynon or some of the other contraceptions that have been
• 26:48
  around for ages. But it's a relative thing
• 26:51
  because when you look at cost, it's not just the cost of the
• 26:54
  medication. We have to take into account the
• 26:57
  cost of all the consultations, going back and forth to the GPS,
• 27:01
  with the bleeding, with the bloating, with the side effects,
• 27:03
  everything else as well. And you'll probably hate me
• 27:06
  saying this, but when you went from the contraception you were
• 27:09
  using before to this one, your mood was better, your energy was
• 27:13
  better. You just were easier to live
• 27:16
  with. But it's very easy to say, oh,
• 27:18
  well, that's because I was 18 then and I was more, you know, I
• 27:21
  was just growing up and everything else.
• 27:24
  But there was definitely a change.
• 27:25
  And I don't think it was a coincidence because I see it a
• 27:28
  lot in the clinic because you're having something that is
• 27:32
  biochemically and biologically more like your own hormones.
• 27:36
  So you're sort of replacing like for like.
• 27:40
  And that's where I find it really frustrating when I speak
• 27:43
  to people and say, look, speak to your doctor about having this
• 27:46
  type of contraception and they're told no, it's too
• 27:48
  expensive. But it's not really expensive if
• 27:51
  it's really improving quality of life, making people more able to
• 27:55
  function, to work, to contribute to society and everything else
• 27:59
  as well. Yeah, God, I mean, you'll
• 28:00
  remember this. I remember when I got my first
• 28:02
  period when I was what, like 12? I remember saying to you like
• 28:06
  Jesus Christ like do people actually go to work?
• 28:09
  Like do people carry on with a normal life?
• 28:12
  Like surely you take like 2 days off and just lie in bed.
• 28:15
  I just couldn't comprehend the fact that like this was normal
• 28:19
  and that woman meant to just live like this.
• 28:22
  I do remember that very clearly because you came downstairs to
• 28:25
  the kitchen and you were in floods of tears and you just
• 28:27
  said no, this is not normal, this pain is not normal, this
• 28:31
  bleeding is not normal. There is no way.
• 28:32
  That I just couldn't comprehend. The woman still went to work
• 28:38
  like nothing can happen. I think I had a new found
• 28:40
  respect for women that day for sure.
• 28:43
  But you know what? Isn't it interesting?
• 28:45
  Because I do think, Can you imagine daddy or some of your
• 28:50
  male friends going through what women do every month?
• 28:52
  Because I don't think it would happen.
• 28:54
  No. And, and I, I not long ago I
• 28:57
  spoke to someone and she was saying she's not a doctor.
• 28:59
  And she was saying it's absolutely ridiculous that
• 29:02
  people are not coming into work because of heavy periods and
• 29:05
  actually hang on. Have you spoken to women who
• 29:07
  can't stand up because they flood so much?
• 29:09
  They can't sit in a meeting because they need to go and
• 29:11
  change their sanitary? You know, they can't do fun
• 29:13
  activities if there's not a bathroom, for example, like a
• 29:16
  little boat trip if they're on holiday time at the beach, if
• 29:19
  they don't have immediate access to the bathroom within an hour
• 29:22
  due to such like heavy periods. Because I think it can be so
• 29:25
  debilitating. And that's what is so
• 29:27
  frustrating, but also can be so wonderful about birth control
• 29:30
  because if you find the right one for you, like I feel I have,
• 29:33
  then it is a blessing. It makes your life so much
• 29:36
  easier. But there is just so much trial
• 29:40
  and error and I feel like each experience, it's so unique to
• 29:44
  you. What is right for one person
• 29:46
  will not be right for another. I'm having a good time on Zoli,
• 29:49
  but another friend may need more hormones or I don't know, need
• 29:54
  something that has a stronger effect.
• 29:56
  And I think that is just so hard to navigate because it leaves
• 30:00
  people slightly traumatized and slightly put off birth control.
• 30:04
  Like, only, you know, when I'm messaging my friends, I'm
• 30:07
  saying, hey, I'm going on this focus with my mother.
• 30:09
  Please tell me your stories about control.
• 30:12
  Maybe 5 out of 10 times, it would be like, yeah, so that is
• 30:15
  why I'm now not on anything. I'm trying out nothing.
• 30:17
  I'm trying because that experience was too awful.
• 30:20
  It was too like, I was so out of control.
• 30:23
  Whatever. I just couldn't navigate the
• 30:25
  random, the heavy bleeding, the constant bleeding, the cramping,
• 30:28
  the feeling like I had no balance in my life and all of
• 30:31
  that. It's really hard, isn't it?
• 30:34
  I think it's really difficult for people, not just your age,
• 30:38
  because you know you need contraception up until you're
• 30:40
  menopausal. So it's decades.
• 30:42
  And if you don't get it right, it just can really, really
• 30:46
  adversely affect people's lives. And I really worry about how we
• 30:50
  can change this conversation so that people can be given a
• 30:53
  choice, a choice of contraception, a choice of type
• 30:56
  of hormones and also more knowledge knowing there are
• 30:59
  difference between the different hormones and what's synthetic
• 31:02
  natural really means. So I'm very grateful that you
• 31:06
  have been so open, including about your first period, which I
• 31:09
  forgot about. You told me just now that I
• 31:12
  always finished Sophie with three take home tips.
• 31:16
  So what's three things? Would you want people you're
• 31:20
  hate to say age or generation? Three things that you think they
• 31:24
  should know early on about hormones. 1, I would say it's
• 31:31
  really important to know that you can advocate for yourself.
• 31:34
  If you are on a birth control, if you're on a pill that is
• 31:38
  making you really depressed, if you're got the implant and it's
• 31:42
  making you bleed a lot, you're having a bad experience with a
• 31:44
  coil. You can be like, this isn't
• 31:47
  right for you and because you're young, you're a young girl, you
• 31:50
  may not be taken as seriously. It is super important that you
• 31:54
  do have that right. You can't be like, no, this
• 31:56
  isn't working for me. Another point would be just
• 32:01
  making sure that you're really educated in your hormones and
• 32:04
  not seeing it as much as a buzzword as it can be.
• 32:08
  Because you know, when these girls have had these bad
• 32:11
  experiences and it's like, oh, it's due to being pumped with
• 32:13
  hormones. It's like, no, it was a wrong
• 32:16
  type of hormones and the wrong type of hormones for you.
• 32:19
  Not shying away from it totally, which is really a really hard
• 32:23
  thing to say, but it's really important in order to get the
• 32:25
  right treatment in the end. And then a final take away point
• 32:29
  is how important it is to be open with each other because I
• 32:32
  am so blessed to live in a generation where we can talk
• 32:36
  about periods. It's not a massive thing.
• 32:38
  It's not embarrassing for me to buy tampons from Sainsbury's.
• 32:41
  And it's, I'm not shocked if I see content about periods and
• 32:45
  birth control on TikTok. And I think it's important to
• 32:47
  make use of that and be able to be honest with people that you
• 32:51
  can trust and confine in people about things that worry you.
• 32:54
  And just knowing that it's not something that should be
• 32:56
  stigmatized or embarrassed or a taboo subject.
• 32:59
  It's it's part of life. Thank you.
• 33:03
  Thank you for being so open and honest and I'm sure loads of
• 33:06
  people will really, it will resonate with what you said.
• 33:09
  So thanks for coming, Sophie. Welcome, thanks for having me.
• 33:14
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• 33:18
  on new episodes.