Latest / The Dr Louise Newson Podcast / 69 - How hormone treatments can prevent disease

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69 - How hormone treatments can prevent disease · The Dr Louise Newson Podcast

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Today on my podcast, I've got Doctor Hartpreet Sood who is auk
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and US trained Dr. and he currently works in both London
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and Dubai. We talk about the global health
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problem of not being well for long enough, about how we can
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personalize medicine and how of course we can have hormones in
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our everyday consultations and helping people make the right
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choices for their future health. So heartbreak, you're in the
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studio. I've dragged you in at short
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notice because you're over from Dubai for a short period of
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time, but you're UK trained. I've known you on and off for a
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few years, but I feel like I'm getting to know you a bit more
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and you're getting to know the work that I do a bit more, which
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is great. But we're both GPS, we're both
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really keen in keeping our patients as healthy as possible.
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But just tell me a bit about your background.
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Absolutely. That's OK.
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So we've actually known each other since 2015.
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We got introduced by by a woman called Gwen Reese.
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You don't. Remember, I do remember her.
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She's great. She.
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Was like Louise's amazing, fantastic doctor she wants to do
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more in Women's Health and set up a clinic.
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Please get in touch. That was the e-mail.
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So we did speak but no, it's it's been great following your
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journey and and really seeing where you've got to so and thank
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you for the invitation being here delighted to be here.
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You know, it's, it's always great to have this moment to
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talk with friends, but also colleagues.
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So my background, as you know, GP in the UK trained both here
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and the US background in public health, health systems, but
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increasingly been doing a lot more in preventative health,
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proactive health. And thinking about how we flip
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the model from being essentially A reactor service that we're all
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used to here in the UK to do a more preventative proactive
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service. And, and in particular,
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combining that with the role of technology and wearables, as
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we've seen advancements, as you know, great advancements in
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diagnostics, therapeutics, but also wearable technology.
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I mean, I wear aura, I wear. You.
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Know all sorts, but yeah, are they 100% accurate?
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I don't know, probably not. But at least it gives you enough
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of data to do something meaningful with it.
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And I think that's the main thing.
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So that's really where I'm spending a lot more time now.
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And you mentioned Dubai. So with my partners, we've just
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set up a clinic out in Dubai, which is essentially doing that.
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So we're creating a new model of primary care, a lot more focused
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on concierge primary care, but really thinking about
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prevention, proactive diagnostics, but also how we
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bring elements of longevity, stroke health span into the
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conversation. And so that personalized
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approach that I think all of us strive to do, but we find it
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very hard to do in the NHS. It's really hard, isn't it?
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Because we've been trained in probably a similar way we've
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been trained to diagnose a disease.
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Think about the treatment pathway, but it's almost waiting
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for the accident to happen, isn't it?
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And you know, I've, we've, I'm sure you have as well.
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I've worked in some really busy jobs in really deprived area
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where you just feel like you're firefighting the whole time.
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You're just personally trying to get through that shift,
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especially working in a hospital, but also for the
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patient, you're literally just going from one disaster to the
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other. And if you work in a hospital
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long enough, you'll see the people coming back and back and
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back. And it is that cycle of, you
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know, someone's this maybe got an asthma attack, then they have
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a chest infection, then they maybe have a clot or then they
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have osteoporosis. You know, you just see or you
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see it in families, don't you? And it's, and as a General
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practitioner, I mean, I was at the same practice for 20 years.
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So that was really gave me a feel for what it's like to get
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to know the families. But you can see it's
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generational as well. And you know, since I left the
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NHS, things have got even harder.
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It's so reactive. Whereas we know if we can invest
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not money wise but invest with education, with the right tools
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for our patients, it can just transform their future content.
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100% and you know, my ambition always has been, you know,
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currently seeing 40 patients a day, but actually really need to
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see 10/12/14 patients a day. But actually really have that
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dedicated time with them where we're spending half now 40
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minutes with them and their families on education them but
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also coaching them, guiding them on various elements of it.
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But unfortunately the system is against us on from that
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perspective, but also from the perspective of using the latest
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biomarkers and diagnostics. When I went into private
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medicine, I made this unwritten rule to myself and I still do
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it, that I wouldn't do anything different clinically that I done
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in NHS. But the one thing that I do do
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differently is I have time, like you say, and actually, you know,
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that time is such a luxury. But actually to have that time
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means that I, we don't have this cycle of people coming back so
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much. So actually, you know, if I, I
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spend 3 or 4 times the time that I would spend as a 10 minute
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appointment in general practice. But actually that's probably
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worth 2 hours of them coming back and forth, you know,
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multiple times for those 10 minutes.
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Yeah. The. 100% and, and look, the
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nation, the NHS, the public are used to going to their GP just
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to see their doctor. But actually I believe that the
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world is changing that you don't always need to see a doctor and
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doctor may not be the right person to see right.
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And actually, I think we've seen progress in particular in the
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NHS where we now have physios, pharmacists, healthcare
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assistants, you know, social prescribers, health and
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well-being coaches. And there's a good
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multidisciplinary team that could initially see a patient
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before they see you, right? And it shouldn't be that the
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first appointment that you see or the first contact you had was
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a doctor. The doctor potentially could be
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the last resort for those complex patients or those that
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need it. So it's a mind shift shift, I
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think firstly, cultural shift, secondly, but also raising
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awareness amongst the public to say just because you're not
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seeing AGP doesn't mean we're fobbing you off.
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It's actually because we believe there's others that can.
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Help. And I think it's a really
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important model because I feel very strongly as a doctor that
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I'm the patient's advocate and you're not arrogant at all,
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whereas I don't want to talk out of term.
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But there are quite a few doctors that are arrogant and
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they once be in control of their patients.
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And you know, when I was at medical school in the 80s and
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90s, it was very unidirectional because there was no Internet.
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There was very little information available for
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patients. So they would be handed their
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prescription and really ask no questions.
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I'm the doctor, I'm in control. And it's been wonderful to see
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how for many of us, that consultation model has really
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changed and put the patient in the centre.
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But the patient now has a unique advantage for having almost as
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much information available to them that we have.
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You know, you can go on to pub Med, you can read all the
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evidence, you can look at the guidelines.
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Which GBT? I mean everything.
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Yeah, whereas years ago you couldn't have that.
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And I think that's the same with wearables as well.
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As you know, there are quite a few articles often in the
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medical press saying this is terrible, that people are
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monitoring their their pulse or their blood pressure or, or
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their stress or their sleep. But I actually think, you know,
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more data is really important. It's what you do with it is and
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how you interpret it. I love it actually, a lot of
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people, like you said against it.
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I love it because AI learn a lot.
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BI believe that those people who have actively made a effort to
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do that are generally interested in the health.
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So I know that if we do engage with them in a different way, we
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learn together. We think about shared decision
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making and like you rightly said, you know, continue to
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remain the advocate for your patient, then the outcomes will
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generally be better, right? And also that is amazing to push
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this innovation, which has always been backbone of what I
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do, is that how do we bring the latest to our patients and if
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the system doesn't allow you to do it, get the patients to it.
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If you can't work the system, get the patients to be their own
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advocates and we support them through that.
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Yeah, I think it's really important.
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And again, it's about ownership and choice.
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And I think it's really important because so often we're
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medicalising people to make us feel better as doctors.
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And I reflect back to some of the patients that I treated in
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the past. And I know I feel bad saying it,
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but I know that I gave people antidepressants who probably
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didn't really benefit or need them.
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I probably gave antibiotics. I gave other things because I
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was, I just needed to give them something often when they'd come
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back and back and I often wasn't thinking so much.
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The bigger picture, and you probably know what I'm going to
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say, obviously didn't think about hormones either.
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But for men and for women here, and I feel like we've got to be
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looking across the board. And also like 20 years ago, if I
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start to talk to someone about exercise or nutrition, they
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probably would have thought, well, you're a doctor, why are
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you talking to me like this? Where's my prescription?
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So you sort of feel that's, that's almost your job is the
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prescribing. Whereas I've really changed in
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my practice in that actually 99.9% of what I prescribe as
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hormones. And I don't see that so much as
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medicine because it's just a natural replacement of body
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identical hormones. But the rest of my time is
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really digging quite deep into nutrition, exercise, lifestyle,
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supplements if needed, which is quite different to how I was as
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a quick fast turn around GP. I'm right behind you, so a few
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years behind you, but we're we're doing exactly that, right,
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Which is, you know, look, globally, I think we still have
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a challenge that there are very many different cultures and
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perspectives on what it means to go and see a doctor and what you
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expect, right? I think the vast majority of the
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world still today expects a pill.
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They still expect a prescription of some sort.
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But I believe that is changing and it requires, it will require
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a lot more for it to change globally where we will see a
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pivot. But nonetheless, let's take
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where we are in the bar at the moment.
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You know, it's probably got hundreds of nationalities, lots
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of different people with the members that we see today.
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We have a spectrum of people who are doing that, right?
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Some of them are coming and say, I know exactly what I want and I
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want to get it versus some who are willing to go down the
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journey of, of what you're talking.
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But what we're building at Sky, similar to what you're talking
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about, is to say, look, fundamentally it's about the
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holistic assessment for a lot of this stuff, right?
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Hormones is an absolute key player in that because both men
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and women, you know, science is getting better, evidence is
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getting better, awareness is also getting better, right?
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But it doesn't mean it's for everyone because, you know, for
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vast majority of people, yes, but there might be some people
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that we can optimize their sleep, their nutrition, their
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strength, you know, we do VO2 Max metabolic, you know, the
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list goes on, right? But if you do it in that
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context, undoubtedly you'll have a better outcome for that
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individual. And if you top it up with the
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hormones, and I think that's the important thing is to say
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hormones, yes, Medication, yes. But let's put it in the context
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of. And that's everything.
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And that's really important because I think over the past,
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most people have misunderstood my work thinking all I do is
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give hormones. And like, yes, I take hormones
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myself, but actually if I didn't exercise, if I didn't eat well,
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like the hormones are good, right?
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But they're not that good, you know, And that sometimes is, is
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forgotten because for me it's basic bread and butter, right?
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Well, the same bread and butter. I don't eat bread, but you know,
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but, but for a lot of people, the basics has gone, but not
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just patients, I think for doctors as well.
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And you know, you're healthy. You look after yourself.
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There's lots of our colleagues that don't or they don't see
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it's a priority. And even my husband this morning
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was telling me how many chocolates there were lots of
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chocolates on the wards. And he just looks at the back,
11:28
looks at the labels and said to the nurses, do you really want
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all of this in your body? And he's noticed the nurses very
11:32
well, so it's fine. And they know what he's like.
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But he said, kid you not, Louise.
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It's taken me about 7 years for them to understand there were
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different types of chocolate and there were different types of
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food. And you know what it's like in
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the hospital, it's impossible to get really nutritious food if
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you're doing long shifts. Yeah, yeah, yeah.
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But but they're understanding because they've had Paul in
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their ear for ages. But it can take a while.
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And, and I do feel we have a duty as healthcare professionals
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to educate, but give people choice, you know, and I think
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that's the other thing that's often misinterpreted is choice.
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You know, I actually, if you and my patients, I actually wouldn't
12:08
care if you smoked or not. I wouldn't treat you any
12:10
differently. I wouldn't judge you any
12:12
differently. But I do feel my duty would be
12:14
to tell you it's not good if you smoke.
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Don't get wrong, you don't smoke.
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Just say as an example. And it's the same with hormones.
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You know, I think it's really important that people know that
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there are health benefits of hormones.
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But I feel like our education in the past about hormones,
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especially focusing on menopause has been very much fleshes and
12:36
sweats and you could have HRT but actually try to avoid it
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almost. So opening up the conversation
12:43
and thinking about our hormones being biologically active,
12:46
having big anti-inflammatory properties in our bodies, then
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it's almost symptoms are secondary.
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It it with, you know, often people take them for their
12:56
future health. But just because we haven't been
12:59
taught like that, it's quite different to sort of change your
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mind and perception about hormones, isn't it?
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To be honest with you, I can't remember what I got taught
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medical school because so much of it is out of date or or not
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relevant to our practice today. But actually even a lot of our
13:12
training as AGP, family medicine consultant, I think there are
13:15
massive gaps in the education, especially with things we're
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talking about, right? So we talk about medicine 3.0
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and we talk about prevention, we talk about hormones.
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We hardly spend time on things like sleep, nutrition, exercise,
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you know, VO2 Max, all the things that we're talking about,
13:30
for example. But it plays such a fundamental
13:33
role in who we are today. OK, granted, like I said,
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evidence hasn't proved considerably over the last 5-10
13:39
years, but nonetheless, I think you need to start becoming a lot
13:41
more mainstream. And but going still back to your
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point earlier, you know, hormones for me, it's become a
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much lower threshold now, right? And that's partly to know what
13:50
honestly speaking, that's partly due to raise, you know,
13:53
awareness people that you have done, you know, we've spent a
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lot of time together and education through you and your
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work. I think it's been fantastic
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because often people get very scared when it comes to things
14:02
like HRT or testosterone because a, we're not used to it.
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But I think for me personally, it's been that kind of gender
14:10
issue, which is a male thing, which I've had to come over
14:13
myself. And I'm a lot more confident in
14:15
that space now. But also that because there's
14:18
been a lack of training, right? So, and I think people always
14:22
share these horror stories of you might get cancer or you
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know, you might get XYZ, stay away from it.
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I mean, I saw a patient from India recently and India's so
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far behind, right? Because everyone there is saying
14:34
absolutely no to HRT because it's going to lead to everyone
14:38
getting breast cancer. And I think these
14:39
misconceptions, misinformation, I think is dangerous because
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ultimately a lot of women are missing out on these important
14:46
hormones. And I think that needs to change
14:49
very quickly. It needs to be quick because
14:51
women really are missing out. And I'm sure, you know, there
14:53
was the FDA announcement in America and you know, to hear
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Doctor Mccurry, the FDA commissioner for health, talking
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about the millions of women, like 10s of millions of women
15:04
that have missed out on hormones.
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And often I'll talk to healthcare professionals about
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the risks of not having hormones to their patients because like
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you say, we've always thought about the risks or perceived
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risk, usually because the risks aren't there for the body,
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identical hormones, but the risks, you know, thinking about
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your patient from India, her cardio metabolic risk, so her
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risk of heart disease, diabetes, hypertension.
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I mean, you know, the risk goes. On Absolutely.
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It's so important, whereas if you've not been taught about it
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and the patients don't understand, then it's almost
15:38
like the elephant in the room that no one talks about.
15:43
If you've ever felt confused, dismissed or just left to figure
15:46
out your hormone health on your own, that's exactly why I
15:49
created my free Balance app. It's designed to educate women
15:54
about their hormones at every stage of life.
15:57
You can track your symptoms and periods if you have them, read
16:01
evidence based articles and connect with a community of
16:04
women who are asking similar questions that you might be
16:07
asking. I see everyday how powerful
16:11
knowledge is. When you understand what's
16:13
happening in your body, you can make informed choices about your
16:16
health and your treatment, and you can advocate for yourself
16:20
when you speak to healthcare professionals.
16:22
If you want clear, trustworthy information without the noise or
16:26
the misinformation, then download My Balance app today.
16:30
It's there to educate, support, and help you take back control
16:34
of your hormone health. And it's the same for men.
16:39
I remember years ago, one of the things that we had to do was
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measure testosterone levels in men who had diabetes.
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But then we found that they were always low.
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So then they changed it to say don't measure it.
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But I remember once there was one of my patients who was a
16:56
male patient and he had awful night sweats and was really
17:00
tired and I was doing all these tests.
17:02
I couldn't work out what was going on.
17:04
And then I, his wife, I knew really well I was coming in and
17:06
saying they had no sexual relationship either.
17:08
And he just wasn't himself. His mood was low and I was like,
17:12
what else? I mean, I've done everything.
17:14
I didn't know what else to do. So in the end I did his
17:15
testosterone level and it was so low.
17:19
And I remember then saying to my husband, oh, should I give him
17:23
testosterone? I don't really know.
17:24
And it, I probably about have a lot of doctors do now about HRT
17:28
for women because it's, it's all about having confidence.
17:31
And as a doctor, you can have confidence with knowledge, but
17:34
it's very different. You've got a patient and you're
17:35
giving that prescription. So I wasn't sure what to do.
17:38
So I thought, well, I know it's going to take him quite a few
17:41
weeks for the appointment to come through with an
17:44
endocrinologist. So in the meantime, I can't
17:46
watch him suffer because it's quality of life is so awful.
17:48
And I'd found a diagnosis and the guidelines are very clear.
17:52
It was low enough. So anyway, I gave him some
17:55
testosterone and then I got a lot of complaint back from the
17:59
endocrine pneologist that went to the senior partner and I got
18:01
hold in front of them and said how dare you?
18:04
He's got a risk of stroke because he'd had a mini stroke
18:06
at Tia many years before. And I said, well, my
18:09
understanding is this is natural testosterone.
18:11
I gave it to the gel through the skin.
18:13
It's the same structure as the own testosterone.
18:15
There's no risk of clot, very different.
18:17
If I'd given him a synthetic testosterone, of course, and
18:20
they wouldn't have it. And it was so awful.
18:23
And I was about to leave the that surgery to for my clinic.
18:28
And the last time I saw him and his wife, they said, well, we've
18:32
still got some left. We're using it.
18:33
But we've been to the endocrinologist and they've said
18:37
you can have a very low dose. But the problem is he's so
18:41
tired, he's not able to drive. But they said, well, maybe you
18:45
could just not drive on a motorway and drive on the A
18:47
roads. I was like, it's just the, it
18:51
was just like so ridiculous. But I didn't have the confidence
18:55
to go back to that endocrinologist with the
18:57
evidence because, you know, male testosterone is still isn't my
19:00
specialty. My gut feeling was that it was
19:03
absolutely safe and I was following the British Society of
19:06
Sexual Medicine guidance, but I didn't have enough clinical
19:08
experience. I didn't have enough scientific
19:10
knowledge. I was only, you know, AGP in a,
19:14
in a practice where I wasn't getting supported.
19:17
And the consultant endocrinologist was telling me
19:19
that I was really wrong. And I remember feeling, gosh,
19:22
this is really awful. But that must happen a lot for
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GPS and other clinicians who aren't experienced with women's
19:29
hormones as well. Yeah, I, I absolutely and I,
19:32
I've probably experienced something similar more more so
19:36
for for women rather than prescribing testosterone.
19:39
But look, I think it's how you approach it, right?
19:43
And what I've done and you, you, you could probably vouch this
19:46
because I've built a network around myself of people who I
19:49
trust, but also who I know working in the space, who I can
19:51
just pick up the phone so and say, look, what do you think?
19:54
It's amazing to do that. And I think with WhatsApp today,
19:57
it's so easy, it's so much easier, right?
19:59
Emails, text. And I think, you know, look,
20:01
ultimately there'll always be naysayers, there'll always be
20:02
people who are protecting their corner.
20:04
But frankly. As we said at the start, I'm
20:06
there to be an advocate for my patients, my members who are
20:09
part of our clinic where we want to do best for them, right?
20:12
And I'll go to Lents to figure out whether it's, you know, so
20:17
UK, we've got people in the US, we've got people in the local
20:20
region. And I think if we come together
20:21
more together as a network and raise the awareness, raise the
20:25
voices around, I think more and more people start listening and.
20:28
Actually, as doctors, there are a lot of doctors that put each
20:32
other down, we know that, but there are a lot that really
20:33
supports each other. And I'm on this menopause group,
20:36
which is a group of menopause specialists, hormone specialists
20:39
across the world, a lot in US and some from other countries,
20:43
including Australia. And it.
20:46
I'm often an observer from it, but I will, you know, join in as
20:49
well. But often people say, I've seen
20:51
this patient. What do you think?
20:52
And no one's judging them at all.
20:54
And often, we'll add in references or papers and give
20:57
support. And it's, you know, people are
20:59
so grateful for that. And that's something that we
21:01
couldn't have done 20 years ago. And I think like it's fine for
21:05
patients if you say to them, look, I, I don't really know,
21:09
but I'm going to find out for you or I haven't had much
21:12
experience, but I would like to help you and like, I'll talk to
21:15
you. Patients love that.
21:16
And like what I hear a lot from women is that they see their
21:20
doctors as no, absolutely you can't have hormones or you're
21:22
too old, you're too young or whatever.
21:24
And they're giving them inaccurate advice.
21:26
And it's obviously because they, they're not educated in that
21:29
area. But the patients would like it a
21:31
lot more if they just said, I'm sorry, I, I don't know the
21:34
answer today. And that's fine as a doctor.
21:36
I mean, we're not, we're not robots.
21:38
No, absolutely. And actually through my
21:39
experience you get more people that trust you on the back of
21:42
that because you've actually gone out and not tried to fib
21:46
your way through or you know, try and question.
21:48
You've actually said, look, I don't know, but I'm going to go
21:50
and find out. And and I've seen that more and
21:52
more patients are actually very happy with that kind of approach
21:56
and it builds a much stronger trust is my.
21:58
Yeah, absolutely. We have a clinical teens chat
22:00
going all the time and you know, we've got dozens of doctors and
22:03
we've just recruited some new ones and you know, they feel
22:06
really well supported. And I think that's really nice
22:08
for the patients to know. And you know, I don't know
22:11
everything. Sometimes I'll be thinking and
22:13
I, I think I've done what's right, but I'd always maybe say
22:16
to someone else, look, I've seen this patient, I've done XYZ.
22:19
What do you think? And it's really nice and
22:21
validating. And I think to have that
22:23
professional curiosity is really important as a doctor.
22:27
Like, we've all seen arrogant consultants who who don't want
22:31
to learn from others. Yeah, yeah.
22:32
And I think we can always learn from others and to look forward
22:34
to. Learn from others, but also do
22:35
it yourself, right? So like I said, I've done CGM,
22:37
I've done my VO2 Max, I've done my DEXA, yeah, I've done my
22:40
sleep, you know, scores, etcetera.
22:42
Good. Yeah, I mean look, the VO2 Max
22:44
can certainly get better DEXA body compositions good.
22:48
I've already dropped four percentage points since the last
22:51
two months. I believe I can get down even
22:52
further. Very good.
22:53
But I think it's when you walk yourself through that journey,
22:56
it makes a more realistic because you've felt the pain or
23:00
you've gone through the motion of it, then you can talk more
23:02
confidently, right? I'm not at that stage where I
23:05
need hormones, but when I do then I will certainly take them
23:07
well. Totally.
23:08
And I think that's probably why I'm even more gobby because if I
23:12
wasn't taking hormones, I wouldn't be working.
23:14
There's no, there's no shout of doubt.
23:15
My brain had just not not worked.
23:18
And in fact, one of my husband's colleagues just been off for two
23:20
weeks with flu, like really, you know, bad flu.
23:22
And he's he's not been ill, he's not had time off at all.
23:25
And, and Paul said to me, oh, he's, he's come back and he's
23:28
just said it's a, the first day his brains felt clear.
23:31
And I said there, that's just like being menopausal.
23:34
That brain fog is so horrid and it's so hard when you need your
23:38
brain, you know, it's and you don't know until it happens, of
23:42
course, but it's also, you know, it again, it's that choice.
23:46
And that's where I think, you know, a work of empowering our
23:49
patients and following them on a journey and involving others,
23:55
you know, who are allied healthcare professionals is is
23:57
crucially. Important, but also, you know,
24:00
on that like again, in Dubai, but we also see this in London,
24:03
but most places now that a lot of women are in many more senior
24:07
positions in executive roles. And I think it's good to see
24:10
more corporates taking this seriously given the
24:12
opportunities to for women to have the treatment, but also the
24:16
space they need. But it's incredible because you
24:19
know, maybe 10 years ago, as you know, short as that, looking
24:23
back, this wasn't there, right? So you can imagine all these
24:26
women who were in high-powered jobs were really struggling to
24:30
get the attention and the space they need.
24:32
And I think people like yourself and the others who have been
24:34
really pushing faces, I think it made a big difference.
24:36
But I still think we've got a lot.
24:37
More to go. Yeah.
24:39
I mean, I remember about 10 years ago when Dame Sally Davis
24:41
was the the, the CMO, the chief medical officer and going to a
24:44
meeting at the Department of Health and saying then, you
24:48
know, 40% of NHS employees are menopausal women.
24:52
We know around 10% give up their jobs.
24:55
We did a survey and found that 37% of women were going to their
25:00
jobs but not enjoying it. They would reduce their hours if
25:03
they could afford to because of their menopausal symptoms.
25:07
And we know the main symptoms are that affect people at work
25:10
are anxiety, fatigue and memory problems.
25:13
So, you know, even looking at our NHS that employs so many
25:17
people. Massive numbers.
25:19
There should be clinics everywhere for people.
25:21
There should be easier access to hormones.
25:23
Yeah. And I think you raised a really
25:24
important point, right? Because, you know, today we've
25:27
got really well defined pathways when it comes to frailty care or
25:31
Pediatrics or, you know, diabetes or, you know, the list
25:36
goes on. But when it comes to menopause,
25:37
it's terrible. It's fragmented, it's
25:39
inconsistent, it's often looks at menopause equals hormones.
25:44
But I think like we've discussed, you know, it's about
25:46
the holistic approach of how we think you might sleep, mood,
25:50
nutrition, metabolic strength, all of that, right.
25:53
And I think these clinics will help, but I think there needs to
25:56
be a much more structured pathway program.
25:58
So we. Have these and it's multi organ
26:00
exactly you know humans get everywhere So what we're
26:03
basically saying is we should probably take it off
26:05
gynecologists and as GPS we're. Is that it's the college thing?
26:09
I don't know, right? It's more a journalist.
26:10
Thing if I had type 1 diabetes which my pancreas not working
26:15
well, I wouldn't go and see a pancreatic surgeon and it's the
26:18
same if my ovaries weren't working well why would I go and
26:21
see a gynecologist? It doesn't.
26:23
So our GP, we have a Women's Health GP now she's doing women
26:26
menopause clinic, Women's Health clinic in general practice,
26:29
general practice setting and it's amazing actually.
26:32
Clinic's always full and it's that relationship, right?
26:34
And obviously when you need specialist input, we know where
26:37
to get it. But on a day-to-day basis, it
26:39
doesn't require specialist input unless it's a complex patient.
26:42
It's going to be routine more, far more routine.
26:45
It's sort of opt it rather than opting in for hormones.
26:49
It should be opting out because the majority of women should be
26:52
considering them for their future health.
26:54
Where? Are you seeing the most progress
26:55
being made in this? Like globally?
26:58
Which country? Yeah, or region or.
27:00
Well, those people say UK is the best, but I think it's, I mean
27:03
it is, it is best in that it's about 14% of menopausal women
27:07
are prescribed to 1414. Is that good or bad?
27:10
It was still rubbish, but globally it's only about 5% of
27:13
menopausal women. Wow 5.
27:15
Percent, whereas before the WHI study, you know the the terrible
27:20
study that it was about 30% in the UK and 40% in the US.
27:27
Oh wow, so it's dropped? So it's dropped due to it went
27:30
down and it's come up, but it's plateaued the last year at 14%
27:33
areas of deprivation, it's a lot lower.
27:36
So you know, but the guidelines are clear.
27:38
The majority of women first line treatment is hormones, majority
27:42
is not 14%. So this inequality of this poor
27:46
access to safe, effective medicine has got to change.
27:49
I mean, the other thing I think is a lot of people look at it
27:53
from a lens of what age are you? And I think that needs to change
27:56
because actually. Absolutely.
27:57
Women or men are, you know, everyone's different.
28:00
Yeah, and and also it's not just menopause, obviously with
28:03
perimenopause, but also PMS and PMDD.
28:06
So, you know, my 23 year old has PMDD.
28:09
She uses natural hormones and they've transformed her life.
28:12
And I see a lot of younger people in their in their 20s who
28:16
maybe just have hormones for a few days when they're, they're,
28:19
you know, their pedestrians dropping before their periods
28:21
and it's transforming them. So I think the biggest
28:24
difference is women are are empowered with knowledge and
28:27
then they can choose. I think that's, that's, you
28:29
know, when women get together, like some quite powerful things
28:32
happen, as I'm sure you know. So yeah, so it's great.
28:35
So it's there's lots to do. And I know we're going to do a
28:39
lot more with education, a lot more global work.
28:42
We're going to just drive forces and just do a lot more.
28:45
So it's exciting. There is exciting stuff
28:46
happening, I'm sure. So, So what three things do you
28:50
think we can do, like at speed that's going to make the biggest
28:53
difference to health generally? So look, I think firstly we need
28:59
to grapple the whole concept of personalisation and the use of
29:02
wearable tech, but also understanding the individual in
29:04
front of you, right? Guidelines are guidelines, but
29:06
you need to understand the individual and, and provide a
29:09
holistic assessment. So I would like to see more
29:11
people focusing on that and, and thinking about that in a
29:14
different way. I think secondly, the space
29:17
we've just talked about hormones, I think need to start
29:19
becoming more mainstream. I'm shocked to hear such low
29:21
numbers of people around the world, women around the world
29:24
who are prescribed hormones. And I think we all have a duty
29:27
to raise the awareness and, and do more.
29:30
And I'd like to see that number go from 5 to 25%.
29:32
And I think that would be amazing.
29:34
Again, not just purely hormones, but how we bring that holistic
29:37
approach to, to the individual and do the new all the other
29:40
things. And I think the third thing is
29:41
that we all need to educate ourselves and educate the public
29:44
because again, cultural shifts, shifts in thinking amongst
29:48
professional around the world will only change when we bring
29:53
use cases, case studies, we educate one another, but also
29:56
bring the latest sites. I think we can actually move
29:58
quite quickly on that because there is already tons of stuff
30:01
out there that we can leverage on.
30:02
But it's about taking that advocate advocacy approach to
30:07
the individuals which I think we can do more of everyone.
30:09
So those we might two or three things if that's.
30:11
Helpful. That is pretty good.
30:12
Yeah. So let's see what the next few
30:15
months and years bring. But yeah, I think it's an
30:17
exciting time because, you know, partnering with each other,
30:21
partnering with our patients, with communities, we've just got
30:25
to have a group effect to really work at speed to improve future
30:29
health, which is what we want really.
30:30
And I think globally there's multiple cultures and we need to
30:34
shift those cultures in particular, like I said, Middle
30:37
East, India, Asia generally, I think they're they're a lot more
30:42
risk averse to this. And I think that could change
30:44
considerably if we put forces together.
30:46
Excellent. Thank you so much for coming.
30:48
Thank you so much for having me here.
30:50
Thank you. Thank you.
30:53
Thanks so much for listening. It would be amazing if you could
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30:59
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31:03
Thanks so much.