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00:00:14.715Welcome to Freshleaf Forever, a podcast that gives you fascinating insights week after week.
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00:00:16.687Here's your host, vaikumar.
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00:00:25.893Hey folks, welcome to another episode on podcast Freshleaf Forever.
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00:00:28.106Today we have a returning guest, dr.
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00:00:29.550Nitu Bajekal.
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00:00:45.411She is a senior OBGYN, multiple book author, a senior consultant, obstetrician and gynecologist practicing out of London, uk, with nearly 40 years of clinical experience in women's health.
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00:00:58.523Her special interests include lifestyle medicine, menopause, pcos, endometriosis period problems, complex vulval problems and medical education.
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00:01:04.614She's a keyhole surgeon with experience in laproscopic procedures.
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00:01:09.823Holds surgeon with experience in laparoscopic procedures, including robotics.
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00:01:13.772She's a fellow of the Royal College and recipient of the Indian President's Gold Medal.
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00:01:21.489Dr Bajekal is one of the first board-certified lifestyle medicine physicians in the UK.
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00:01:30.287She has written the Women's Health Module for the first UK plant-based nutrition course at Winchester University.
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00:01:37.224It's with great joy that we welcome back Dr Nitu Bajekal here to podcast Freshleaf Forever.
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00:01:40.090Hey, dr Nitu, how are you doing?
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00:01:41.753today I'm very well.
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00:01:43.263Thank you, Vai, for inviting me.
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00:01:47.644It's always lovely to come back and chat with you, so looking forward to our conversation.
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00:01:49.748Oh, thank you, Welcome back.
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00:01:59.313And how about we start by giving listeners, in fact, first of all, congratulations on this fascinating book.
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00:02:05.713Finding Me in Menopause, it's just beautifully written, and that's the purpose of our conversation here.
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00:02:09.349Yeah, thank you, it was the book I would have liked to have had.
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00:02:16.133Oh, yes, oh yes, it seems like a must read for anyone in the perimenopause and menopause phase.
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00:02:23.909So why don't we get started by quickly telling listeners what perimenopause is and what is menopause?
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00:02:24.751Right.
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00:02:29.782Perimenopause, as the word describes, is around menopause.
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00:02:34.920So basically it's a time leading up to the time when you completely stop your periods.
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00:02:39.931So usually that will be about four years around the age of 47.
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00:02:49.586But we know that life is not necessarily always a certain data point, and so between two to eight years is when perimenopause can last.
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00:02:54.890So menopause tends to occur around the age of 51.
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00:02:57.152But again, that's all over the world.
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00:03:02.437But again, it's not a fixed data point and the range is anywhere between 45 to 55.
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00:03:12.531So menopause is the time when you stopped your periods for 12 months completely, and that tends to be between 45 and 55.
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00:03:14.073It's a retrospective diagnosis.
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00:03:25.852You don't have periods for 12 months and there are no other obvious reasons, and you say this person is in menopause and perimenopause is a time before you completely stop your period.
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00:03:32.841So if you are destined to stop your periods at, say, 45 or 46, perimenopause can be between two to eight years.
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00:03:34.626It's a time leading up to menopause.
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00:03:44.344And so you may be in your late 30s when you're actually going through perimenopause and you're at the peak of your career, or you may not even have started thinking of having a baby if that is your plan.
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00:03:54.435So it's really important to understand what perimenopause is the time leading, or menopause in transition and menopause is the time when you stop your periods completely.
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00:04:14.094Now important note for maybe some of your listeners who are from southeast asia indians, pakistanis, bangladeshi origin and from the black community menopause can occur early, so it can be at 45, 46, 47, depending on which part of India, for example, you're from.
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00:04:16.045It's not, of course again not a fix.
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00:04:19.341There'll be a lot of women who will say I'm still having my period and I'm 54.
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00:04:34.637But there are a lot of women in that early age group, so they may be having these symptoms of menopause and perimenopause much earlier, when they are still in the workplace and nobody is even thinking about menopause at that time.
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00:04:48.882Okay, and just to get to your own journey and transition into that menopause stage, I know you had a lot of challenges and you have outlined it in the book beautifully again.
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00:04:58.052So what prompted you to write the book and what do you think were some of the challenges that you kind of had to go through during that phase?
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00:05:04.471I think my first challenge was that I didn't have the confidence to share with my colleagues.
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00:05:13.273So I was about 38 when I started noticing that my previously regular periods always clockwork didn't really bother me.
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00:05:14.963Suddenly I started becoming very heavy.
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00:05:23.488They were initially a little bit crowded, but then they started hopping and skipping and I thought I was because I was being bullied at work.
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00:05:25.153I was also very busy.
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00:05:28.690I was applying for a consultant job in London.
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00:05:34.466I had two young children, a dog, a husband who worked all God given hours like me, and no real family.
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00:05:35.709We were immigrants from India.
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00:05:40.947There was a lot of balls in the air and so I really my health.
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00:05:44.935I was always a healthy person in that I mostly ate plant-based.
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00:05:48.322I was never didn't have any excess weight.
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00:05:54.038I was very physically active, but it didn't even cross my mind.
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00:05:55.422My mother and my sister were still.
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00:05:57.406My mother had a period since she was 52.
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00:06:01.305My sister, who's who's about eight years older than me, was still having her periods.
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00:06:10.846So it didn't even occur to me that my periods that were stopping was anything to do with perimenopause and my low mood and libido issues, all these things.
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00:06:27.963I tried to brush under the carpet and then realized that actually my periods had completely stopped and I fell into that group where I was one of the specialists in those areas with premature ovarian insufficiency, where a woman, or those who are assigned female at birth, basically their period stopped under the age of 40.
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00:06:35.952So one in 20 000 girls, young women, may never reach um, you know, may have the one period and never have a period again.
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00:06:38.180So that's very rare but it still happens.
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00:06:46.642And then one in hundred and in fact in india and all, there may be as high as four to five women in a hundred will stop their periods under the age of 40.
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00:06:56.990That is a medical condition called POI, premature ovarian insufficiency, previously known as premature ovarian failure or premature menopause.
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00:07:00.565We don't like the word failure, we're not very drastic term right.
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00:07:01.807Very drastic term.
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00:07:05.956So basically anybody who has POI.
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00:07:13.442And there are many reasons genetics, unknown, there may be some medical conditions as well, but most of the times we don't find a reason.
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00:07:25.485And if anybody who's listening hasn't had a period for more than three months because women take three to four doctors before they can actually be diagnosed with POI and there may be other background conditions it may not be POI.
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00:07:27.910It may be polycystic ovary syndrome, for example.
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00:07:31.264It may be an eating disorder, it may be exercising too much.
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00:07:35.702Whatever it is, if your periods are missing for more than three months, never to be ignored.
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00:07:40.521It's important to see the right to see your doctor initially have the right tests.
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00:07:44.492So POI is what I diagnosed, knew I had it.
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00:07:48.942I needed HRT, hormone replacement therapy or hormone therapy.
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00:08:18.153But we are talking I'm almost 63 now, so we're talking 24-25 years ago, when the WHI study and the million women study from the US and UK had come out and basically the media got the information wrong and ran with it and said that HRT is dangerous, it causes cancer, when actually none of that is, you know, remotely true and unfortunately my family doctor refused to prescribe me HRT despite me going several times.
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00:08:23.773So I had I been more confident because I had just become a consultant.
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00:08:26.345I was a keyhole surgeon.
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00:08:29.392I was, you know, an immigrant, a woman, a woman of color.
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00:08:32.126I wanted to be at the top of my game.
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00:08:33.591I did not want to appear weak.
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00:08:49.283But actually, in retrospect, had I shared with my male colleagues because I was the only woman, I would have, I think you know, been able to get heard, think you know, been able to get heard.
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00:08:51.110Instead, I managed on my own for quite a long time and luckily for me.
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00:08:52.575In a way, my younger daughter was nine.
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00:08:55.847Around that time she became vegan and many of my symptoms improved.
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00:08:58.460But I didn't, of course, put it down to diet and lifestyle.
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00:08:59.761I thought it was just life.
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00:09:02.706But now I know what it did.
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00:09:17.530But any woman who's listening under the age of 40, I, who stops their periods, who's diagnosed with premature ovarian insufficiency there's a wonderful book by Dr Hannah Short called the early guy the guide to early menopause and POI.
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00:09:19.921But also to seek medical advice.
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00:09:23.312Please do not let a doctor tell you it's okay not to have periods.
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00:09:25.760So that's my message and I wrote the book.
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00:09:31.692I'd always wanted to read a book like what I had written and it felt right.
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00:09:44.893We wrote the first book because Rohini, my older daughter, has polycystic ovary syndrome and she wanted me not to write a general book, and so she said you've got all these 35, 40 years of experience.
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00:09:50.378You need to write about things that you know a lot about endometriosis or PCOS or menopause.
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00:10:09.225So we started off with PCOS and then, of course, this book was bubbling inside me, and I hope there are many more books to come, but maybe I'm taking a few months off now.
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00:10:36.269I'm sure I'm sure, this just has been a beautiful transition, I should say, and it's flourishing in perimenopause and menopause, and perimenopause because of all these symptoms that we are supposed to get, but most women may have some symptoms, some women will have no symptoms and it's not a time for doom and gloom for everyone so yeah, I just want people to realize you can flourish.
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00:10:42.238And yes, it's really hard when you get a diagnosis when you haven't even started building your family, for example.
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00:10:44.023Those are different medical situations.
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00:10:59.025But for the average person, I don't want you to look at this time and really that's why I wrote flourishing in perimenopause and menopause, because I do believe you can actually embrace it in different ways and seek the right help.
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00:11:02.653But also, you know the attitude is so important, isn't it?
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00:11:19.100Exactly, and we all think it's inevitable and that you know we have to endure those symptoms and it's so much of still, even you know, like we are approaching 2025, and there's still so much of societal taboo in terms of discussing all these things Right.
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00:11:38.207And you mentioned about POI, that's premature ovarian insufficiency, and and coping with it I guess not just to you know remain silent but seek medical help in the form of, say, hrt, which is hormone replacement therapy.
00:11:38.207 -->
00:11:46.772And you have highlighted beautifully how we all tend to, the number of ovaries we all tend to.
00:11:46.772 -->
00:11:51.974You know it just reduces over time and that's like a common process, right yeah?
00:11:52.053 -->
00:11:55.456Let me explain why POI occurs or menopause occurs.
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00:12:02.599So when we are conceived, around 20 weeks, there would be, say, like a couple of million eggs in each ovary.
00:12:02.599 -->
00:12:07.894Ovaries are the egg baskets and they basically are the powerhouse of the hormones estrogen producing.
00:12:07.894 -->
00:12:08.174Of course.
00:12:08.174 -->
00:12:26.590Estrogen, progesterone, testosterone are producing the other parts of your body, but these are the main sites and they're regulated by the brain, by the hypothalamus and the pituitary, which release hormones which are chemical messengers which will work and stimulate the ovary, and there'll be a master switch in the hypothalamus that starts everything off and puberty starts.
00:12:26.590 -->
00:12:31.182So what happens is you have these couple of million eggs by the time you're born.
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00:12:34.971A million have got lost by what is known as natural attrition.
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00:12:52.134It just gets, you know, degraded and so you may be born with a million eggs and then over time, by the time you reach puberty and then the time you reach your early 20s and 30s, the number of eggs keep dropping till you reach menopause, when a critical level of below 1000 is reached.
00:12:52.134 -->
00:13:05.591So if your genetics are dictating, or your environment or whatever it is, if your ovarian egg supply has dropped to less than 1000 and you're only 25, then that's POI.
00:13:06.072 -->
00:13:11.169If you're 40, between 40 and 45, that's early menopause, unless you had it removed.
00:13:11.169 -->
00:13:14.504The ovaries can be removed at surgery and chemotherapy and all as well.
00:13:14.504 -->
00:13:34.062And then after 45 and between 45 and 55, when those number of eggs tend to drop below 1000, then the estrogen levels drop, which is responsible for many of the symptoms, and then the ovaries start telling the brain come on, produce more of the releasing hormones so we can release more estrogen.
00:13:34.062 -->
00:13:44.667So it may work for a bit in perimenopause, your period stop and start and all that, but the hypothalamus ultimately will tell the pituitary we, we can't produce anymore.
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00:13:55.625So the FSH, lh levels, fsh levels, the follicle stimulating hormones, tend to rise to a level that is menopausal and, as a result, there's just no more.
00:13:55.625 -->
00:13:59.052There are not enough eggs to release these ovaries.
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00:14:05.817And the important thing to remember is that life expectancy now in most of the western world is in the 80s.
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00:14:13.876So you are going to have anywhere between 45 to sorry 30 to 35 years in the menopause.
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00:14:15.760So that's a long period of time.
00:14:15.760 -->
00:14:25.732And so people often say, oh, I've just stopped my periods, I've had a few hot flushes, or I've had hot flushes terrible for two, three years and I'm done with menopause.
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00:14:39.312No, menopause is from the day you completely stop your periods until the day we die, and there are long term impacts and there are some short term impacts, but we are always in menopause and that's why it's so important to embrace it, because it's not going anywhere.
00:14:39.312 -->
00:14:41.823And we are not going anywhere, oh yeah exactly, oh yeah, exactly.
00:14:42.245 -->
00:15:03.466and you say in your book you call out like this, almost like 34 symptoms that can, yes, one, can you know, possibly all the overall women population can experience right and you started, you led us there, right there, into heart flushes and night sweats yeah all those they are supposed to be, some of the more common symptoms.
00:15:03.765 -->
00:15:04.828The vasomotor.
00:15:04.828 -->
00:15:06.091Sorry, you were saying something else.
00:15:06.091 -->
00:15:16.706Yeah, the hot flushes the night sweats, all the vasomotor symptoms, right Correct, with so much skepticism and say reluctance to take hormones?
00:15:16.706 -->
00:15:34.072And with all these symptoms at play, why don't you just tell listeners how important it is to not ignore and what are the kind of the ramifications when it comes to, you know, tackling these symptoms?
00:15:34.580 -->
00:15:38.589Yeah, If they go unaddressed, there are, you know.
00:15:38.589 -->
00:15:41.423We say there are 34 symptoms, there are probably 60 symptoms.
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00:15:46.413Okay, and you know, because menopause is a whole body situation at the end of the day.
00:15:46.413 -->
00:15:55.105So you can imagine that estrogen receptors in every tissue, every cell of the body and so you can imagine whether it's from the brain.
00:15:55.105 -->
00:16:00.174You can imagine brain fog, memory issues can be an issue for some people.
00:16:00.174 -->
00:16:05.345But, as I said, remember all these symptoms may never occur for you and some of the symptoms may occur Rarely will I see.
00:16:05.345 -->
00:16:09.395Remember all these symptoms may never occur for you and some of the symptoms may occur Rarely will I see patients with having all the symptoms.
00:16:09.395 -->
00:16:14.268But if you go from head to toe, you can imagine there can be thinning of hair, loss of hair.
00:16:14.268 -->
00:16:22.501You know, depending upon your genetics, your family history, as the estrogen levels drop then the hair follicles tend to not be as healthy.
00:16:22.501 -->
00:16:24.388If you're anemic, that makes it even worse.
00:16:24.388 -->
00:16:26.724So you need to make sure that you have good iron stores.
00:16:27.346 -->
00:16:39.123Again, as I said, going into the brain memory loss, brain fog, feeling, you know, having issues with processing and organizing those things can be issues for some people.
00:16:39.123 -->
00:16:41.067Others may notice joint pains.
00:16:41.067 -->
00:16:50.501Others may notice that they may have palpitations, night sweats, hot flashes, and that's because the temper temperature regulatory zone is set and it's become very sensitive.
00:16:50.501 -->
00:17:06.359So as soon as it falls slightly outside, women will notice that they either have hot flashes or cold sweats or night sweats, because they're basically finding that they have this sensation of heat which can last anywhere from like a few seconds to up to a minute.
00:17:06.359 -->
00:17:14.664Usually can be just once a day, can be 100 times a day and you know that's why layering of clothes can really help in these situations.
00:17:14.664 -->
00:17:19.782So hot flashes and night sweats are the most commonly known, but not everybody will have them.
00:17:19.782 -->
00:17:35.344Low mood, lowered libido, those from brain if you go down to those are real issues can cause relationship issues as well for women, because you may be having different desires at that time and hard to explain.
00:17:35.344 -->
00:17:44.903You also may be at a situation where you have you may have children who are trying to go to university or college, others may have elderly parents or you might be just trying to negotiate.
00:17:44.903 -->
00:17:46.561Do I want a family or not?
00:17:46.561 -->
00:17:48.165So many things can be there.
00:17:48.527 -->
00:17:51.461So perimenopause will have very similar symptoms to menopause.
00:17:51.461 -->
00:17:53.866There can be other things ringing in your ears.
00:17:53.866 -->
00:17:58.806You can have sensations under your skin called formication, like as your hands are crawling.
00:17:58.806 -->
00:18:01.721You can have joint pains, tiredness, fatigue.
00:18:01.721 -->
00:18:16.066You can have erratic bleeding in perimenopause because symptoms such as heavy periods, frequent periods, may become even more prevalent if you have a background of fibroids or endometriosis or adenomyosis.
00:18:16.066 -->
00:18:25.442So those things have to be kept in mind and that women may have pushed them to the back of the because they've been so busy and now they're finding that these symptoms are getting worse.
00:18:25.442 -->
00:18:38.728But all the symptoms that you see in menopause can occur in perimenopause, but in perimenopause, as women are still having periods, however infrequently, they may have period issues as well, and then of course there are genitourinary symptoms.
00:18:39.189 -->
00:18:42.002So, for example, women may notice increased cystitis.
00:18:42.002 -->
00:18:46.880So every time they go to their doctor, the the doctor will say, oh, you have an infection and they give them antibiotics.
00:18:46.880 -->
00:18:48.547But actually you don't have an infection.
00:18:48.547 -->
00:18:59.567Your estrogen levels have dropped, and so, while it's important to check your urine, usually it's because of estrogen receptors and estrogen levels have dropped and so that makes the bladder very sensitive.
00:18:59.567 -->
00:19:07.848The vagina becomes very sensitive, dry, you can have a sensation of paper cuts, especially after penetrative intercourse or and so on.
00:19:08.691 -->
00:19:12.902It is important usually tends to occur in the second half.
00:19:12.902 -->
00:19:33.164So menopausal symptoms tend to be the early first five, six years where you'll have the basomotor symptoms that you were describing hot flashes, night sweats, some joint pains, libido issues and sleep issues While after five, six years women tend to find more of the more arthritis.
00:19:33.164 -->
00:19:47.038They may have heart health issues, cholesterol issues, which can all start in perimenopause as well, but they may notice cystitis and vaginal dryness, as the estrogen levels now have really dropped to a low and local vaginal estrogen is safe.
00:19:47.038 -->
00:19:48.173It is not even HRT.
00:19:48.173 -->
00:20:06.019You can women almost everybody, including women with cancer with the okay of the specialist, can use vaginal local topical estrogen after checking in with your doctor and you can use it for the rest of your life, usually twice a week and it really makes a difference to quality of life.
00:20:06.550 -->
00:20:09.095So there are so many symptoms that can.
00:20:09.095 -->
00:20:17.137If you take any bowel symptoms, you know, know gut upsets, constipation, you know change in gut microbiome that can be a problem.
00:20:17.137 -->
00:20:21.412Bladder increased frequency, you know leaking of urine urgency.
00:20:21.412 -->
00:20:28.191So literally there's a range of symptoms from every organ and that's why easily they add up to 34.
00:20:28.211 -->
00:20:38.826But as I said again please don't panic, because there's help for almost everything and also most women won't have all the symptoms, and this is where diet and lifestyle.
00:20:38.826 -->
00:20:45.741So not every woman can take HRT, not every woman wants to take HRT, not every woman can take HRT.
00:20:45.741 -->
00:20:56.561But even if you're on hormone replacement therapy, which is safe, you need to bring in lifestyle changes because all these symptoms can also be helped when you're doing lifestyle.
00:20:56.561 -->
00:20:58.114It's not one or the other.
00:20:58.516 -->
00:20:59.819It's very important.
00:20:59.819 -->
00:21:03.480I think it couldn't have been underscored better.
00:21:03.480 -->
00:21:09.883I think it's very important that people seek the help of their OBGYN and go for regular visits.
00:21:09.883 -->
00:21:13.057The annual visits are much more important.
00:21:13.479 -->
00:21:38.458Getting a mammogram, getting everything taken care of and discussing you also give a nice cheat sheet for people to go prepare for appointments, right, because this lack of sleep again say, for example, if we were to focus on that one symptom, someone has lack of sleep that can have a rippling effect in terms of mood and anxiety and stress and so on.
00:21:38.577 -->
00:21:47.375Right, because anxiety, depression and, yes, some women do need antidepressants, but a lot of women in perimenopause and menopause may actually all they need is hormone replacement.
00:21:47.375 -->
00:22:00.482So it's so important to have a ob-gyn who understands, who's willing to acknowledge the symptoms and accept and their own limitations and if they don't have the expertise they should be able to refer on.
00:22:00.482 -->
00:22:08.013And also, if you as a patient are sitting there thinking I don't think I've been heard, then do ask for a second opinion.
00:22:08.013 -->
00:22:17.076It's really important and the reason I've written my book really important and the reason I've written my book and because of my website, which is completely free neethubhajekalcom.
00:22:17.076 -->
00:22:26.064What I try and explain is have your questions ready, know your medical history, know your surgical history, know the medications you're on.
00:22:26.445 -->
00:22:35.291Be careful of taking supplements that are not scientifically validated, because you'll spend a lot of money and they can actually harm you in the longer run.
00:22:35.291 -->
00:22:40.652You know collagen supplements and you know all kinds of these menopause relief supplements.
00:22:40.652 -->
00:23:03.194They are all not natural because they're in the form of a tablet, so you're better of standardizing it, regulating it and looking for the right stamps so that they are absolutely, you know, fda approved or any big society approved, because I see every week I see women with 10, 15 supplements sitting in front of them, spending $100, $200.
00:23:03.194 -->
00:23:12.336And I'm thinking you were so much better spending that money on buying soybeans and fruits and vegetables and dals.
00:23:12.336 -->
00:23:26.409I do want to highlight that as well, because women are very vulnerable when they're having symptoms, so it is whether it's with the health professionals or whether it's with the industry so, and then there's social media, to promote everything.
00:23:26.449 -->
00:23:28.172You know promising all these cures.
00:23:28.172 -->
00:23:32.518So it's so, so important to actually take those things with a pinch of salt.
00:23:32.518 -->
00:23:38.746Some supplements, of course, are vital vitamin D and B12 and possibly algae derived omega-3.
00:23:38.746 -->
00:23:44.190And you know, for sleep, like you were talking, there are some of my patients who find benefits with magnesium.
00:23:44.190 -->
00:23:45.595Not everybody does.
00:23:45.595 -->
00:23:46.939The studies are not great.
00:23:47.410 -->
00:24:15.035But having a sleep pattern, a regular sleep pattern, sleep routine, making sure that if you are stressed, learning to do some de-stress techniques of breath work, or going for a walk, or talking to a friend, making sure that you don't eat too late, making sure that you go for a little walk or do some little exercise for five minutes to help your insulin levels settle down after a meal, you know eating early in the day these are all simple things.
00:24:15.035 -->
00:24:18.935Having an eye mask, thick curtains, layering your clothes, you know.
00:24:18.935 -->
00:24:24.590Just having thin sheets so that you can move them away as you feel hot at night, you know.
00:24:24.590 -->
00:24:35.069Having a fan turning the heating down I have all these suggestions and different things will work for different people and I know they sound very oh.
00:24:35.069 -->
00:24:36.132Everybody knows that, but you'd be surprised.
00:24:36.211 -->
00:24:39.499For me, that is my weakest pillar.
00:24:39.499 -->
00:24:48.431Sleep has always been as a when I was an obstetrician I just practiced gynecology now but you know I used to be woken up several times at night.
00:24:48.431 -->
00:24:51.376Every second or third night I have had a very poor sleep.
00:24:51.376 -->
00:24:54.222Then add on top of that the early menopause.
00:24:54.222 -->
00:25:06.098That was a real issue, and so it is so important to prioritize that because, as you said, when you have sleep issues, you will tend to wake up stressed.
00:25:06.098 -->
00:25:15.980When you are stressed and anxious, you tend to eat the donut rather than the apple, and then when you're eating those foods, you don't feel like exercising, you don't feel like remaining your friends, you don't want to go out of the house.
00:25:15.980 -->
00:25:19.096So it's a domino effect for all the six lifestyle pillars.
00:25:19.096 -->
00:25:37.597So it's so important to try and find one pillar that you want to make a little difference, whether it's the food pillar, whether it's the exercise pillar, whatever it is and then slowly build it up and that's the same for any hormonal health condition to optimize one's health, or whether it is perimenopause or menopause.
00:25:37.898 -->
00:25:41.119Okay, and you said erratic bleeding.
00:25:41.119 -->
00:25:43.829Even that's not to be ignored, right?
00:25:43.829 -->
00:25:51.049Because sometimes a physician may order a pelvic ultrasound, and that can reveal so much more information.
00:25:51.049 -->
00:25:51.813Is that?
00:25:51.853 -->
00:25:52.295correct?
00:25:52.295 -->
00:25:55.311Yes, so any woman who has bleeding after sex.
00:25:55.311 -->
00:26:01.895Even if you had a clear pap smear, if you're bleeding after sex, is there an area on the cervix that is causing problems?
00:26:01.895 -->
00:26:03.079Is there a polyp?
00:26:03.079 -->
00:26:03.823Whatever it is.
00:26:04.104 -->
00:26:07.173So bleeding after intercourse should never be ignored.
00:26:07.173 -->
00:26:10.398Bleeding in between your cycles should never be ignored.
00:26:10.398 -->
00:26:15.009Bleeding more than seven days not be ignored.
00:26:15.009 -->
00:26:33.532If you're passing clots which is bigger than the size of your thumbnail, if you're having to use double protection, if you're having to have painkillers all the time, if it's affecting the quality of your life, you should not be ignoring any of these, because there may be background conditions that have not been picked up.
00:26:33.532 -->
00:26:43.990So conditions like chronic inflammatory conditions, like adenomyosis, endometriosis, fibroids, which are benign growths, but if they are in the cavity, they can cause a lot of bleeding as well.
00:26:43.990 -->
00:26:56.883You also may have conditions like polycystic ovary syndrome, so that it's so, so important that you don't ignore these symptoms and have a health provider who listens and arranges the right test.
00:26:56.990 -->
00:27:19.344That is why I have those chapters in my book to say this is what you should be asking if you have this and there are a lot of case studies as well so you empower yourself with the knowledge from the website, from good resources, the NHS website, the Royal College website, good resources, the nhs website, the royal college website, the american college of lifestyle medicine and, you know, the mayo clinic sites.
00:27:19.364 -->
00:27:20.888They give you good advice.
00:27:20.888 -->
00:27:26.131You can always go to chat rooms because, of course, patients and people can give you a lot of good advice which doctors can't.
00:27:26.131 -->
00:27:31.721But you do need to make sure that you is individualized.
00:27:31.721 -->
00:27:51.218It's right for you and you're getting that information because the number of women I see why who come with having gone to these bio-identical hormones, which are, you know, custom compounded, because they think it's better for them but actually they're not regulated at all and no expert will recommend them.
00:27:51.218 -->
00:28:08.278So you always want to choose standardized, regulated HRT that is FDA approved and NHS approved in the UK, in Australia as well, because you want to make sure you're getting the right dose of estrogen, the right dose of progesterone, rather than hit and miss amounts.
00:28:08.278 -->
00:28:19.382And they are also bioidentical, or we call them body identical, which basically means that they mimic the same hormones that our bodies produce, whether it is progesterone and estrogen.
00:28:19.382 -->
00:28:30.297So, again, a lot of women listening here will be seeing people who are giving them bioidentical hormones from unregulated sources and I want to call that out yeah, clear.
00:28:30.557 -->
00:28:37.013And the most important thing with that as well is when you are under the care of an OBGYN, who is giving it.
00:28:37.013 -->
00:28:46.582They have your whole history to kind of go off of and not just something that you do from unregulated sources.
00:28:46.582 -->
00:28:46.982Correct.
00:28:50.471 -->
00:29:22.323Back in a moment with our guest on Freshly, forever and weight gain in menopause yes, I know you have a whole chapter on that you have a whole chapter and you again, you beautifully bring out why body neutrality is so significant there yes, because you know it's very well to keep saying, um, body negativity women struggle with anyway.
00:29:22.363 -->
00:29:29.855They're always being told by society you're not too thin, you're not too, you're too big or whatever you know it is, you're too thin, you're too fat, whatever it is.
00:29:29.855 -->
00:29:39.721Body positivity can also be quite toxic because, you know, sometimes you do feel like I don't want to be positive about my body.
00:29:39.721 -->
00:29:41.230It's letting me down right now.
00:29:41.230 -->
00:29:47.595But body neutrality is actually accepting that this is the body that we've been given.
00:29:47.595 -->
00:29:56.173It's so lucky, it works and you know, even if you have a slight hangnail, you know that whole day you'll be thinking about it.
00:29:56.173 -->
00:30:01.234Or if you have an ulcer in your mouth, but we don't even think about those parts of our body when they're functioning okay.
00:30:01.234 -->
00:30:03.280So I do want people to be aware.
00:30:03.381 -->
00:30:04.692And weight gain is an issue.
00:30:04.692 -->
00:30:16.657It's an issue for all genders, as after the age of 30 you steadily put on weight and but it's particularly more prominent for women in perimenopause and menopause with the way the hormones shift and things.
00:30:16.657 -->
00:30:19.551So we know that that can be an issue.
00:30:19.551 -->
00:30:23.623And also there are several other social factors also that increase our weight.
00:30:23.623 -->
00:30:27.758For example, you may be stressed, you may have issues with.
00:30:27.758 -->
00:30:29.883You know, food regulation.
00:30:29.883 -->
00:30:32.117You may be, as I said, having these, you know, carer issues, looking after parents and children.
00:30:32.117 -->
00:30:32.981You don't have time to look after yourself.
00:30:32.981 -->
00:30:35.093You may be, as I said, having these carer issues looking after parents and children.
00:30:35.093 -->
00:30:36.501You don't have time to look after yourself.
00:30:36.501 -->
00:30:37.829You don't have time to care for yourself.
00:30:37.829 -->
00:30:39.513You don't have time to do exercises.
00:30:39.513 -->
00:30:41.199So these things are important.
00:30:41.199 -->
00:30:46.720Plus, we may have more finances and more money to spend, so we may be eating out more often.
00:30:46.720 -->
00:30:49.452And, of course, if you eat out, what is there?
00:30:49.452 -->
00:30:56.048Oil, fat, sugar, salt, and so we know that that can slowly creep up.
00:30:56.189 -->
00:30:57.594Alcohol again.
00:30:57.594 -->
00:31:05.699Not only is the increased risk of alcohol with every glass of wine you drink in the menopause and perimenopause significant increases after the first couple of units.
00:31:05.699 -->
00:31:13.891So there's no safe limit for alcohol, no safe limit for smoking, tobacco, vaping all these things are, you know, things that you really need to focus.
00:31:13.891 -->
00:31:26.292Have a celebratory drink, if you want, but regular alcohol is also is quite high in calories and, of course, causes seven different types of cancers, affects sleep and menopause worsens hot flashes.
00:31:26.292 -->
00:31:41.852So there are so many aspects that can affect sleep, can affect weight, you know, and so I have lots of suggestions there and of course one of the ways of trying to mitigate that weight gain is by trying to focus on a plant forward diet.
00:31:41.852 -->
00:31:49.020So the more large you eat they tend to be light in calories, very nutrient dense, so you tend not to put on the weight.
00:31:49.020 -->
00:31:57.220For your same friend who would be having a baked potato with uh, which is very popular in the uk, so maybe for y'all oh, it's the same here.
00:31:57.240 -->
00:32:02.618Baked potato is quite potatoes are great source of fiber, potassium.
00:32:02.618 -->
00:32:06.631You know it's very satiating, it's a delicious dish and it's actually low in calories.
00:32:06.631 -->
00:32:29.009But your friend may be putting a dollop of butter or cheese or tuna mayonnaise, while if you have it with hummus and a big salad and baked beans and you know, or make a curry on your own and put it on that, you will find that that is actually a very satisfying meal which is not high in calories.
00:32:29.009 -->
00:32:38.357And for every tablespoon of oil that you consume, which is about 120 calories, you can eat a large salad with some hummus and things like that.
00:32:38.357 -->
00:32:48.371So it's making these smart swaps, uh, so that you know how to increase the nutrient quality of your food but at the same time reducing the calorie content.
00:32:48.431 -->
00:32:50.615So you know I try and talk about this.
00:32:50.615 -->
00:32:55.104I have chapters on various things like work, menopause in the workplace.
00:32:55.104 -->
00:32:59.798You know we talk about the various minority communities that are affected by menopause.
00:32:59.798 -->
00:33:02.324You know very harshly actually.
00:33:02.324 -->
00:33:08.583So I hope that all these different chapters people can read, pick and choose whichever chapters they want.
00:33:08.583 -->
00:33:16.473But for those who don't like reading, then of course, you know, maybe printing out just the small sheets from my website can help.
00:33:16.914 -->
00:33:17.275Oh yes.
00:33:17.275 -->
00:33:20.862And what about the role of exercise?
00:33:20.862 -->
00:33:25.676I do want to go into the plant forward diet a little bit more.
00:33:25.676 -->
00:33:27.380The role of exercise.
00:33:27.380 -->
00:33:40.145And Dr Rajiv Bajaykal, your husband, an orthopedic surgeon, has written a beautiful chapter in your book on bone health and how resistance training and all of that can help.
00:33:40.829 -->
00:33:58.366So, with low estrogen and estrogen deficiency, as we start from perimenopause going into menopause and you already said, we all live the lifespan into our 80s and about 35 years we are all in menopause.
00:33:58.366 -->
00:34:04.114So how important, how much can we just talk about, yeah, exercise.
00:34:04.134 -->
00:34:06.201I have dedicated a whole section to exercise.
00:34:06.201 -->
00:34:10.521First important thing is do not use exercise to lose weight.
00:34:10.521 -->
00:34:12.032Do not use exercise to lose weight.
00:34:12.032 -->
00:34:20.079You will not lose a gram of weight unless you're exercising like Usain Bolt or Paula Radcliffe or you know one of the top athletes.
00:34:20.079 -->
00:34:22.922That's not the purpose of exercise.
00:34:22.922 -->
00:34:29.713The purpose of exercise is to increase your endorphins, make you feel better for yourself, so you make better food choices.
00:34:29.773 -->
00:34:37.623It helps to reduce cancer risks from coming Breast cancer, which is one in seven or one in eight women in the US will get a diagnosis of breast cancer.
00:34:37.623 -->
00:34:40.115So exercising regularly can help with that.
00:34:40.115 -->
00:34:43.182And we know that menopausal women are at a greater risk.
00:34:43.182 -->
00:34:54.490And especially South Asian women and black women tend to have a much higher risk of getting breast cancer earlier on in age, in their 40s, and often a more aggressive form.
00:34:54.490 -->
00:35:03.681So it's really important to bring in exercise to reduce the risk of many cancers, reduce the risk of cancer coming back once if you have got the diagnosis of cancer.
00:35:03.681 -->
00:35:07.559But it also helps to maintain weight loss.
00:35:07.559 -->
00:35:08.161That's good.
00:35:08.161 -->
00:35:09.465It helps you to tone.
00:35:09.887 -->
00:35:17.784But strength training is particularly important because one in three women often will have a hip fracture because of osteoporosis.
00:35:17.784 -->
00:35:22.422So it's important to bring in from the age of 30, our bone loss starts.
00:35:22.422 -->
00:35:26.317So you want to start doing strength training from early childhood.
00:35:26.317 -->
00:35:35.010But it's never too late at all to start making changes at all.
00:35:35.010 -->
00:35:40.474To start making changes so you know doing weights, either with the help of a personal trainer if you can afford it or if you have any health issues, making sure that you get okay from your doctor or otherwise.
00:35:40.474 -->
00:35:50.911Looking at youtube and doing initial five minute exercises and slowly building up with small weights or even like bottles of water and things like that, and using your own body weight.
00:35:50.911 -->
00:35:54.601So strength training is really important, helps with managing things like that and using your own body weight.
00:35:54.601 -->
00:36:04.170So strength training is really important, helps with managing things like type 2 diabetes, insulin resistance, but also helps to strengthen your bones and then adding that with certain foods will allow the bones to be even healthier.
00:36:04.170 -->
00:36:12.597So when you drink soy milk, when you eat soybeans, when you have prunes, these are things that will help your bones and make it much more healthy.
00:36:12.597 -->
00:36:19.103But at the same time, strength training at least twice a week, 30 minutes minimum, is what you should be trying to do.
00:36:19.103 -->
00:36:22.556But even if you do five minutes, 10 minutes a day, it doesn't matter.
00:36:22.556 -->
00:36:26.954Every little bit helps so, and you're never too old to do them as well.
00:36:26.954 -->
00:36:34.657So it's so, so important, because one in three women will have a hip fracture and half of those women will be dead by the first year after a hip fracture.
00:36:34.657 -->
00:36:37.682So we really don't understand the power.
00:36:37.682 -->
00:36:40.016Like heart disease is another situation.
00:36:40.016 -->
00:36:48.039So exercise can really help improve heart health and cholesterol health, because more women die of heart disease than men with a heart attack.
00:36:48.039 -->
00:36:52.255So, um, it's, it's just that we die a bit later, so nobody talks about it.
00:36:52.617 -->
00:37:01.572So with exercise, I really want people to think whether it is a walk, and find an exercise that you enjoy and then bring in some strength training.
00:37:01.572 -->
00:37:02.353So it may be.
00:37:02.353 -->
00:37:07.972You know reformer pilates or you know doing your own body weight and planks and things like that.
00:37:07.972 -->
00:37:11.181But find things slowly, but don't try and rush.
00:37:11.181 -->
00:37:18.438I always say, if you're somebody who's never exercised, start by maybe getting help and then slowly doing five minutes.
00:37:18.438 -->
00:37:21.840Even doing 15 minutes reduces death rates, we know that.
00:37:21.840 -->
00:37:25.239So slowly do that rather than trying to run a marathon on day one.
00:37:25.239 -->
00:37:31.541So always try to slowly build it up over a period of months, because it's really shout.
00:37:31.583 -->
00:37:37.900South Asian women are the world over, tend to be the most sedentary and our jobs tend to be quite sedentary.
00:37:37.900 -->
00:37:49.856So if you are I have a desk job I would suggest standing up every hour so that you go do a walk, do some burpees, maybe do some calf raises while you're waiting for your tea to be made, or whatever.
00:37:49.856 -->
00:37:58.418Try and bring in on in a daily way some ways of acting, uh, action, so that you're not sitting for long periods of time.
00:37:58.418 -->
00:38:05.561We sit at desk, then we come home and we sit in front of the television or in front of our phones, you know, and all of us are guilty of doing that.
00:38:05.561 -->
00:38:14.791So exercise is so, so important, which is why rajiv, who's my husband he's a back surgeon sees a lot of back aches, and that again is from sedentary sitting.
00:38:14.791 -->
00:38:16.896So posture is so important.
00:38:16.896 -->
00:38:28.333So I we discuss all that, all the science behind, why it is so useful for menopause, perimenopause and actually all age groups oh yes, and movement is anti-inflammatory, correct?
00:38:28.472 -->
00:38:38.568absolutely okay okay, and let's delve into workplace dynamics and accommodation for menopause.
00:38:39.030 -->
00:38:39.150Yeah.
00:38:39.289 -->
00:38:41.829What are some factors you think are important?
00:38:41.829 -->
00:39:08.802And in fact, right along this, as a coincidence to this conversation yesterday here on Morning Show, there was talk that it's going to be all over linkedin in 2025, that accommodation for menopause is important and I believe even insurance companies are like offering support forums and support groups and things like that, which will be fantastic.
00:39:08.862 -->
00:39:14.123So I'm really looking forward to 2020 we have a long go, though we have a very long way to go.
00:39:14.123 -->
00:39:19.289Studies have shown, even amongst doctors, that most female doctors don't get hurt.
00:39:19.289 -->
00:39:27.918They don't get any allowances, and one in four will have severe symptoms with menopause, and those women often end up leaving their job.
00:39:27.918 -->
00:39:31.891And so one in 10 women leave their job and they're not meant to leave their job.
00:39:31.891 -->
00:39:33.833And so one in 10 women leave their job and they're not meant to leave their job.
00:39:33.833 -->
00:39:46.599So you know, it is a real issue, and with 60 to 70 to 75 percent of women in their 50s 60s still in the workplace, and we're talking about, you know, 12 women out of 100 having early menopause between 40 and 45.
00:39:46.599 -->
00:39:49.601We have four in 100 under the age of 40.
00:39:49.601 -->
00:39:53.284And then you have the rest between 45 and 55, all still at work.
00:39:53.284 -->
00:39:58.025And work is not only the paid work, don't forget.
00:39:58.025 -->
00:40:01.628There's also work at home, okay, work at caring.
00:40:01.628 -->
00:40:23.088So we do have to realize women have been bottom of the pile for a very long time, and so making these changes that are coming in through government, in the UK especially, is very good, but all employers should be aware, and it is important to have a person who's a menopause um, you know?
00:40:23.088 -->
00:40:29.068Spokesperson, if possible in bigger organizations, so that you can see whether you need leave.
00:40:29.068 -->
00:40:30.552Are you somebody who's has disabilities?
00:40:30.552 -->
00:40:31.759Are you somebody who's from a minority community?
00:40:31.759 -->
00:40:32.824Are you somebody who has disabilities?
00:40:32.824 -->
00:40:34.250Are you somebody who's from a minority community?
00:40:34.250 -->
00:40:36.996Are you somebody who has got who's?
00:40:36.996 -->
00:40:46.942For example, you know trans and so is not able to tell people that they actually have menopause issues because that's not how they're known in the workplace?
00:40:47.289 -->
00:40:52.771These things are all very important, but for everybody we need to be able to talk about it openly.
00:40:52.771 -->
00:40:55.733We need to make sure that you have a toilet.
00:40:55.733 -->
00:41:01.815Because you have increased frequency, you know you shouldn't have to trek to different floors to go to the bathroom.
00:41:01.815 -->
00:41:09.161If you need to have a fan, if you need to sit near a window simple things they can be brought in.
00:41:09.161 -->
00:41:21.925And If you are somebody who's struggling with symptoms and you need to go see your health provider, it is important for the employer to give you time off rather than you having to take annual leave or leave without people knowing.
00:41:22.085 -->
00:41:37.224So I think there are a lot of things people can do, including educating your seniors and having you know people come in, like I often do talks for corporate organizations or, you know, for nhs organizations.
00:41:37.224 -->
00:41:50.329It's important that you do these things because a lot of men and women who have gone through all that have women will say you know people women of my age will say, oh, that happened a long time ago, let's move on.
00:41:50.329 -->
00:41:52.494I didn't have all that support, but that's not.
00:41:52.494 -->
00:41:57.233If we have to move forward, we have to make sure that we're bringing all the right changes in.
00:41:57.233 -->
00:42:08.893So changing the legislation, changing the paperwork, but also bringing these small workplace changes having bowls of fruit rather than biscuits lying around these are all little things that people can do.
00:42:08.893 -->
00:42:17.253Ensure that there's healthy lifestyle promoted, people are allowed to take their lunch break and go for a walk without being made to feel guilty.
00:42:17.253 -->
00:42:21.896Little things like that can make a huge difference to experience of perimenopause and menopause.
00:42:22.266 -->
00:42:32.898Yeah, and including, you know, the simplest thing right, Providing access to some clean water drinking water right alongside you know your desk area.
00:42:33.724 -->
00:42:37.253Yeah, so lifestyle and menopause.
00:42:37.253 -->
00:42:40.402You call it age-proofing your menopause.
00:42:40.402 -->
00:43:03.536In this beautiful book, we talked a little bit about the influence of plant-based diet, so specifically talking more about it and the role of proteins in terms of, know, bone health, and not just protein, carbs, fats everything good fats and a lot of vitamins and minerals that are inherent in food.
00:43:03.536 -->
00:43:06.126Why don't you talk more about that?
00:43:06.126 -->
00:43:07.291Because there's so much.
00:43:07.291 -->
00:43:23.074I think, yeah, we touched upon it when you were referencing weight gain and how we can sort of combat it yeah, I mean, I personally follow a plant exclusive diet, a fully plant-based diet, and have done for 22, 23 years.
00:43:24.056 -->
00:43:28.389But it would be great if people can do that, but not everybody can.
00:43:28.389 -->
00:43:32.268So I want to encourage people to have a plant predominant or plant forward diet.
00:43:32.268 -->
00:43:42.998So if you're somebody who's eating no fruits because you're scared of sugar in the fruits, let me reassure you that the fiber is there in the fruits you want to be eating to reduce the risk of type 2 diabetes.
00:43:42.998 -->
00:44:03.215If you have type 2 diabetes, that will get improved if you want to make sure that you get all the right nutrients and vitamins and calcium in your oranges, so I would suggest starting, if you're not eating any fruits, maybe having one fruit and then a fruit that you like, maybe some satsumas or clementines, and then bringing in some grapes and mango and papaya and watermelon.
00:44:03.215 -->
00:44:08.150Watermelon is supposed to help with vaginal lubrication, so you know, eat more of these fruits.
00:44:08.150 -->
00:44:13.331So fruits is a very important part of one's diet, especially in perimenopause and menopause.
00:44:13.331 -->
00:44:17.548The second group that you want to bring in are lots of vegetables.
00:44:17.548 -->
00:44:19.153Find vegetables that you like.
00:44:19.153 -->
00:44:26.907Again, if you're somebody who doesn't eat vegetables, maybe start with a small handful of a vegetable that you like and slowly build it up.
00:44:26.907 -->
00:44:33.487Some cooked, some raw Green leafy vegetables really help with, you know, heart health and opening up blood vessels.
00:44:33.487 -->
00:44:37.213So it's really important that you try and bring in the vegetables Now.
00:44:37.213 -->
00:44:42.431The particular foods that are very helpful for menopause and perimenopause are herbs and spices.
00:44:42.431 -->
00:44:49.556They can help in a number of ways, whether it is turmeric for joint pains, whether it is cinnamon for blood sugar regulation.
00:44:49.556 -->
00:44:54.514So you want to bring in huge amounts of fresh herbs, dried herbs and spices in your diet.
00:44:54.514 -->
00:45:07.855You also want to make sure that you're focusing on whole grains, tubers, so whole grains like brown rice and quinoa, millet, amaranth doesn't matter Finding foods like that because they keep you full.
00:45:07.855 -->
00:45:11.653They have lots of fiber and fiber helps you lose weight.
00:45:11.653 -->
00:45:13.860Fiber helps you your gut health.
00:45:13.860 -->
00:45:15.914Fiber helps to prevent constipation.
00:45:15.914 -->
00:45:19.351Fiber helps to reduce the risk of cancers and things like that.
00:45:19.351 -->
00:45:21.476So you want to bring in whole grains as well.
00:45:21.967 -->
00:45:26.762You want to bring in legumes, which are the star of menopause and perimenopause.
00:45:26.762 -->
00:45:27.784What are legumes?
00:45:27.784 -->
00:45:32.706They are basically lentils and pulses which you want to start with if you're not used to eating beans.
00:45:32.706 -->
00:45:34.849Start with the soft dals and lentils.
00:45:34.849 -->
00:45:36.532Cook them really soft.
00:45:36.532 -->
00:45:38.215Rohini has written a full chapter.
00:45:38.215 -->
00:45:42.170My daughter, who's a nutritionist, she's written a chapter on bloating and things.
00:45:42.170 -->
00:45:45.065It's important that you bring in these lentils and pulses.
00:45:45.065 -->
00:45:46.088Don't be scared.
00:45:46.088 -->
00:45:48.695Start with a small amount and slowly increase it.
00:45:48.695 -->
00:45:50.260Then move on to the beans.
00:45:50.260 -->
00:45:54.094Beans are again very rich in fiber and the king all beans.
00:45:54.094 -->
00:46:03.731You want to eat chickpeas and burlotti beans and kidney beans and all kinds of beans and try to eat two or three times a day over time as you slowly get used to it.
00:46:03.731 -->
00:46:09.012We know that those communities that eat a lot of beans tend to live the longest and the healthiest.
00:46:09.625 -->
00:46:12.655But soybean is particularly important for menopause.
00:46:12.655 -->
00:46:15.153It has a very good protein profile.
00:46:15.153 -->
00:46:16.925So it is.
00:46:16.925 -->
00:46:19.351You know, all the people who go to the gym are always talking about egg white.
00:46:19.351 -->
00:46:25.510Egg white has got so many um, non good health issues with it.
00:46:25.510 -->
00:46:34.293So you want to be focusing on the soybean because it has got the same plant, same protein profile, same amino acid profile, without any of the nasties.
00:46:34.293 -->
00:46:45.005It helps reduce cancer risk of your liver cancer, bowel cancer, ovarian cancer, you know what else Breast cancer, prostate cancer.
00:46:45.005 -->
00:46:49.536So really you want to be focusing on the protein profile of the soybean.
00:46:49.905 -->
00:46:51.007How do you eat soy?
00:46:51.007 -->
00:46:59.492You want to have it in the form of edamame beans, mature soybeans, you want to have it in the form of tofu and tempeh and soy milk and soy yogurt.
00:46:59.492 -->
00:47:04.594You don't have to go specifically for the organic or the gmo, non-gmo version.
00:47:04.594 -->
00:47:07.505But if people are anxious and they can access that, that's fine.
00:47:07.505 -->
00:47:12.253I'm not fussed about it because that is not a real risk as such.
00:47:12.253 -->
00:47:17.682But soy itself has been around for 5000 years In China.
00:47:17.682 -->
00:47:28.719Huge populations have already always eaten it with huge benefits for overall health heart health, cholesterol health, brain health, weight loss as well as menopausal symptoms.
00:47:28.719 -->
00:47:40.396Neil Bernard did a wonderful study where people ate about 50 milligrams of isoflavones, which are the plant estrogens that you know kidney beans have, blueberries have, pistachios have.
00:47:40.396 -->
00:47:50.347But soy has it particularly healthy and so men and women who eat it and the earlier you start eating, lower is the risk of prostate cancer and breast cancer.
00:47:50.347 -->
00:47:51.768So we know that will help.
00:47:51.768 -->
00:48:11.157But having half a cup of mature soybeans or having a handful of edamame beans, a cup of soy milk, maybe a handful of tofu, will give you the 55 milligrams of isoflavones, which are the plant estrogens, and that will help to reduce the risk of your hot flashes by 84 percent.
00:48:11.157 -->
00:48:16.987So that's a huge benefit, you know, other than for women who can't take HRT, who don't want to take HRT.
00:48:17.568 -->
00:48:30.536I personally tend to take between three to four portions of soy every single day, because I do a lot of strength training, so I will have some plant protein in the form of soy protein, a tablespoon of it, some days.
00:48:30.536 -->
00:48:32.965Some days I'll have pea protein, brown rice protein.
00:48:32.965 -->
00:48:42.568I mix all my different proteins to get the, because, you know, as you get older, you want 1.4 to 1.6 grams of protein, sometimes a little bit higher, but this is a good amount.
00:48:42.568 -->
00:48:49.047So you want to get it from uh, you know the soybean, which has got a very good source of protein.
00:48:49.047 -->
00:48:57.949Also all your lentils and legumes, and very rarely are people allergic to soy, so it's really a very good way of getting tofu.
00:48:57.949 -->
00:49:03.286Tempeh, seitan is another one, which is wheat protein and, of course, protein powder.
00:49:03.306 -->
00:49:10.494So we have a whole chapter focusing on protein, because, as you get older, as you become menopausal, focusing on protein.
00:49:10.494 -->
00:49:15.833But plant protein is more important than animal protein and so you want to focus on that.
00:49:15.833 -->
00:49:22.755So we've talked about fruits, vegetables, whole grains, we've talked about green leafy vegetables, herbs and spices.
00:49:22.755 -->
00:49:29.733We've talked about legumes, including soy, and I really want people to take away nothing else you remember from this chat.
00:49:29.733 -->
00:49:31.711Remember that soy is safe for you.
00:49:31.711 -->
00:49:33.753I have a whole fact sheet on my website.
00:49:33.753 -->
00:49:39.057I have a whole chapter on my book, but I don't get paid by anybody, it's just.
00:49:39.358 -->
00:49:47.606I see the benefits of soy, so it's really important, and, of course, things like potatoes, sweet potatoes, yam these are all very important foods.
00:49:47.606 -->
00:49:55.974They keep you full, they have low calorie, they're very rich in fiber, but you don't want to chip your potatoes and you don't want to fry your potatoes.
00:49:55.974 -->
00:50:02.679You want to have them, you know, baked, or have them, you know, boiled and mashed and things like that.
00:50:02.679 -->
00:50:07.536And when you eat this kind of way, your inflammation levels reduce.
00:50:07.536 -->
00:50:21.202So we know the chronic inflammatory conditions like adenomyosis and endometriosis and type 2 diabetes and heart health and all can improve because you're reducing the advanced glycation end products, which are called AGEs.
00:50:22.628 -->
00:50:29.711Ages are found in meats and in highly fried foods and things that tend to damage your arteries, your ovaries, your heart.
00:50:29.711 -->
00:50:33.391So it's so important to try and eat as much as possible.
00:50:33.391 -->
00:50:43.878Start your day with a big porridge with lots of berries, flaxseed powder to increase your omega-3s, and your soy has that as well, so have it in soy milk.
00:50:43.878 -->
00:50:49.704Lunch can be a big salad or a soup, you know, with lots of tofu on the side, or as croutons.
00:50:49.704 -->
00:50:57.139Evening can be you know, big stir fry with, you know, soy noodles, or you know big stir fry with you know, soy noodles, or you know peanut sauces and different things.
00:50:57.139 -->
00:51:01.677So it's really important to have lots of recipes in my book and on my website as well.
00:51:01.677 -->
00:51:11.793So it's a very joyful way of eating and people often think, oh, I can't have this and I can't have that, so slowly start eating this way, and when you look down on your plate, there should be color.
00:51:12.806 -->
00:51:14.032Yeah, very well said.
00:51:14.032 -->
00:51:20.606And oil, sugar, salt everything.
00:51:20.626 -->
00:51:21.670You know, like it's they should be.
00:51:21.670 -->
00:51:23.132Yeah, they should be condiments.
00:51:23.132 -->
00:51:25.297They should not be central focus.
00:51:25.336 -->
00:51:41.356As I said, one tablespoon of oil extra virgin olive oil can be really good for you, but if you're somebody who's trying to lose weight which is 70 of the population think about do you want to have that, or would you rather have your salad with some olives and hummus and things like that?
00:51:41.746 -->
00:52:35.956So you know, it's just finding things, but for people who need to put on weight, who don't have a weight issue, children, all these people extra virgin olive oil has got a lot of benefits as well as well, but by and large, the use sugar and salt, as you know, little additions rather than having huge quantities of these free sugars, rather than focus on fruits and, you know, have a couple of dates with some nuts that will usually satisfy most people's sweet tooth over time yeah, and if there is one thing you would love to see change, I know with all your advocacy efforts with your book and everything, and you're also very conscious of how we are progressing on the climate front and you also advocate that eating plant forward is so good and I I eat a plant-based diet and I know for a fact I did a whole season on sustainability on this show.
00:52:36.336 -->
00:52:46.697So if there's one thing you would love to see change, what would that be in terms of everything that you have written and in terms of what you see out there from your practice?
00:52:47.079 -->
00:53:00.259I think I would like women to acknowledge themselves and realize that they're very valued members of the world and community and we are the force for change, and that change happens within ourselves first.
00:53:00.259 -->
00:53:04.030So don't worry about your partner, don't worry about your community.
00:53:04.030 -->
00:53:09.108You, yes, you do need to change them, but first, when you make those changes, you will feel so much better for yourself.
00:53:09.108 -->
00:53:11.833Don't be harsh on yourself if you slip up.
00:53:11.833 -->
00:53:22.454I think that's important and really, if I had to make one change, I would say start eating more soy, eat less animal foods.
00:53:22.454 -->
00:53:31.646If you can achieve those two things, you will help climate change, you will help the rainforest, because most of the soy that's produced is for animals.
00:53:31.646 -->
00:53:40.516You will help your health, you will help, uh, animal suffering and you will also help you know your um the climate.
00:53:40.516 -->
00:53:44.630So that's what I would say eating plant forward every time you eat.
00:53:44.630 -->
00:53:52.092Think about what you're putting in your mouth, think about the future generations that you're going to leave this beautiful earth to which we are rapidly destroying.
00:53:52.414 -->
00:54:00.956Well, fascinating conversation, and my takeaway is knowledge is power and all unpleasant symptoms are not to be endured.
00:54:00.956 -->
00:54:02.771So those are the biggest takeaways.
00:54:02.771 -->
00:54:07.516And neethubhajekalcom, that's a website, right.
00:54:07.516 -->
00:54:09.704I'll be sure to include it in the show notes.
00:54:09.864 -->
00:54:17.672I have about 15 different fact sheets all free and lots of recipes and podcast links and things, so I hope people will access that.
00:54:17.932 -->
00:54:22.215Wonderful, so I'll be sure to include the link to the book.
00:54:22.215 -->
00:54:25.007And is it available on Amazon and where else?
00:54:25.007 -->
00:54:26.672Would you like to add anything else?
00:54:27.284 -->
00:54:28.391Yeah, no, not at all.
00:54:28.391 -->
00:54:40.653And do follow me on social media because I'm quite active generally, although I'm taking a little break over Christmas, but TikTok and Instagram, I tend to be sharing quite a lot of information.
00:54:41.094 -->
00:54:41.597Excellent.
00:54:41.597 -->
00:55:02.516I'll be sure to include everything in the show notes and thank you, Dr Neetu, for a fascinating conversation on how best we can help women equip themselves and empower themselves into their transition from perimenopause to menopause Listeners as always follow the podcast.
00:55:02.516 -->
00:55:03.538Rate the podcast.
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00:55:05.927 -->
00:55:10.536Follow me on Instagram and YouTube at YP Kumar.
00:55:10.536 -->
00:55:15.894That's V-A-I-P-K-U-M-A-R for all things digital media and lifestyle.
00:55:15.894 -->
00:55:21.056Until next time with yet another interesting guest and yet another interesting topic.
00:55:21.056 -->
00:55:26.137It's me, mai, along with Dr Neetu, saying so long Bye-bye.
