Middling Along

This time I’m joined by author Cathy Kelly - Cathy is a former journalist whose debut novel, Woman To Woman, became an instant number one bestseller. Since then, she has published 22 novels, which have sold millions of copies globally. She has been a Goodwill Ambassador for UNICEF Ireland since 2005 and has visited many countries to report on UNICEF's work. When not writing with a small dog nestled at her back, she reads voraciously, dances round the kitchen, travels pillion on a motorbike, has a variety of textile art projects on the go and pretends to Marie Kondo the house.

 

Cathy’s latest novel Sisterhood is - of course - about two sisters - Lou and Toni. Lou is someone who habitually puts herself last…until the events that unfold at her 50th birthday party push her to stop pleasing other people and decide to finally put herself first.

 

This prompts us to discuss how commonly those of us coming up to 50 are prompted to examine our lives, sometimes interrogating what we have been putting up with and questioning, asking ourselves… “What am I for?”

Cathy also talks about her own treatment for cancer - another life inflection point that makes you question everything…

 

We move on to talk about the appeal of historical novels and Cathy is kind enough to share a few recommendations for books that she has loved recently: the Cazalet Chronicles by Elizabeth Jane Howard (https://www.panmacmillan.com/blogs/fiction/cazalet-chronicles-books-in-order) and A Discovery of Witches https://deborahharkness.com/all-souls-world-home/the-all-souls-world-books/  (and I mention one of my all time favourite historical novels: https://historicalnovelsociety.org/reviews/the-needle-in-the-blood/) 

 

Cathy calls out the misogyny and snobbishness around fiction written ‘by women, for women, about women’s lives’ and we touch on the evolution of the so-called ‘chick lit’ writers now hitting their 50s and writing about this new age and stage of their lives.

 

We also head off on a few tangents, reminiscing about carefree pre-Internet times and 80s fashion!

 

Find out more about Sisterhood at https://harpercollins.co.uk/products/sisterhood-cathy-kelly?variant=40276782973006 

 

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My guest this time is Cindy Gallop - consultant, coach, keynote speaker, and founder of MakeLoveNotPorn. I’ve been a fan of Cindy’s since I first watched the interview on the Style Like U channel that saw her become an older female role model not just to me, but to thousands of women of all ages (and apparently a few men too!). I was also lucky enough to finally meet her in person at the Upfront conference earlier this year where she gave the brilliant closing keynote - I had my own ‘Upfront’ moment asking her to come on the podcast and she graciously agreed. 

We talk about the genesis of her sex-tech business MakeLoveNotPorn.tv: a place for ‘socialising, normalising and destigmatising real-world sex’ and Cindy reminds us that when we don’t talk about sex ‘porn becomes sex education by default’... I was fascinated to learn more about MLNP - from the rigorous checking and vetting processes that all content and comments pass through to create safe spaces for all concerned, how empowering and healing many of the ‘stars’ find the process of sharing their videos, to hearing about how hard it is for sex-tech businesses to attract funding (prompting their current round of equity crowdfunding: see https://wefunder.com/makelovenotporn/ if you want to find out more). 

For those of us who do have kids, particularly younger children, the ready availability of pornographic content online is a huge concern - Cindy’s next goal is to fund https://www.makelovenotporn.academy/ to create a platform for age-appropriate sex-education for individuals of all ages that will also serve as a way for sex educators to make a living from providing their content (currently most struggle against platforms that censor even educational content). (This: https://www.theguardian.com/society/article/2024/may/27/more-than-300m-children-victims-of-online-sexual-abuse-every-year is the article I refer to in the course of this episode - shocking statistics and a stark reminder that we can’t afford to be complacent in talking to our children about sex, no matter how tricky we may find those conversations. Cindy shares with us her two tips for how to navigate those conversations - advice that I know I’ll definitely find hugely useful. 

Last of all we cover ageism in the advertising industry and Cindy’s determination to change societal attitudes towards ageing - creating a culture where ‘living older’ is aspirational and ads are created by and for older audiences and as a result. Music to my ears!

 

You can find Cindy at https://www.instagram.com/cindygallop and MLNP at https://makelovenotporn.tv/ 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

follow along on Instagram at https://www.instagram.com/middlingalong_podcast/

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This time on the podcast my guest is Tina Backhouse, General Manager at Theramex. Tina joined Theramex in 2020 to lead the UK Women’s Health business, helping to establish them as the largest supplier of HRT & Menopause Products in the UK. She is passionate about ensuring equality of care for all women regarding their health in the UK, and that women have choice in their healthcare options.

 

She joins us to discuss the recent research the company funded to investigate disparities in access to menopause support: for example, just 5% of black women are on HRT vs 20% of white women, and individuals in areas of social deprivation are significantly less likely to be prescribed the newer, safer forms of HRT. 

 

We also cover some of Tina’s ongoing frustrations at the lack of prioritization and funding available for women’s healthcare - such as the fact that NHS England developed a public health campaign for menopause that was never launched due to lack of funding.

 

Would it surprise you to know that the UK currently has the largest gender health gap in the G20? We also have a staggering 35% gender pension gap.

The report, published in April 2024 interviewed a range of clinicians and allied healthcare professionals, and is available to download at:  https://www.theramex.com/wp-content/uploads/2024/04/Theramex_Tackling-Unequal-Access-to-Menopause-Care.pdf - we discuss the five recommendations that the report concludes with, including better training for GPs and other allied healthcare professionals, and the creation of a national formulary to end the current postcode lottery whereby some newer HRT is available in some areas but not others.

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

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In this episode I welcome Dr Angela Wright from Spiced Pear Health. Angela is a GP, Menopause Specialist and Clinical Sexologist. She is particularly interested in improving sexual function and menopausal symptoms in women who have undergone cancer treatment. Angela is passionate about women’s health and sexology and is frequently asked to teach or talk about this subject. She is a registered trainer for the BMS & FSRH, involved in training future menopause specialists and is an active committee member of the British Society of Sexual Medicine, and the education committee of the Primary Care Women's Health Forum.

 

We covered so much in such a short space of time!  We started by talking about the impact of localised (vaginal) oestrogen vs what systemic HRT does - both for GSM (genito-urinary syndrome of menopause) and for sexual dysfunction.  For anyone wanting to know more about GSM, or pass information on to their GP, Angela recommends the British Society of Sexual Medicine consensus statement on GSM that’s available on their website (linked below). 

She goes on to explain that there is no increase in recurrence risk for oestrogen receptor positive breast cancers when using localized oestrogen to treat symptoms (and that it can be used alongside letrozole and tamoxifen). We discuss the need for patients to be able to make an informed choice about risks vs benefits, which can be challenging when healthcare professionals are not taught to understand the impact that GSM and sexual dysfunction can have on quality of life - certainly male sexual dysfunction gets a lot more attention and usually pretty rapid treatment! 

 

We move on to discuss ‘sex tech’ and the burgeoning menopause ‘market’ in this area, including laser therapy (TLDR: more research needed, long term effects not known, it’s expensive, and vaginal oestrogen would be more effective in the majority of cases).

 

Angela gives an overview of what self-care practices can be helpful for someone struggling with GSM - listen in to find out some very little known information about the clitoris (and how to keep it healthy) that was totally news to me! She also explains that a range of prescription medicines (in particular antidepressants, but also antihistamines, and blood pressure medication) can mess with our sexual responsiveness, so could be something to discuss with our healthcare provider. 

 

For anyone struggling that wants to find out more, or support them in advocating for better care, Angela recommended a wide range of resources listed here: 

 

Mind The Gap, by Karen Gurney

Better Sex Through Mindfulness, by Lori Brotto

Becoming Clitorate, by Laurie Mintz ​​

 

Institute for Psychosexual Medicine website directory of practitioners https://www.ipm.org.uk/patients/specialists/ 

COSRT https://www.cosrt.org.uk/ - list of therapists 

British Society for  Sexual Medicine (email admin@bssm.org.uk and ask for a local practitioner) 

Menopause-ull webinars ​​ https://www.mnetwork.org.uk/resources/recorded-webinars/ 

You might also be interested in our testosterone episode with Dr Katie Barber: https://middlingalong.com/episodes/middling-along-dr-katie-barber-helps-us-get-to-grips-with-testosterone-dos-and-donts/ 

You can find Angela online at  ​https://spicedpearhealth.co.uk/ and https://www.instagram.com/spicedpearhealth/

 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

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This time I welcome Simona Stokes, Counselling Psychologist and the Founder of Menopause CBT Clinic, an independent psychology practice which aims to support the psychological wellbeing of women going through the perimenopause and menopause. Based on her extensive clinical experience in this area, Simona has developed EMBERS® Menopause CBT Model which is centered around the psychological principles supported by the best evidence-based research and interventions in the field of mental and emotional wellbeing. She holds professional registration and accreditation with several bodies including the BPS, BABCP, and BACP and has been working in the mental health field for over 20 years. 

We begin with an explanation of what CBT is and how it works for anyone who is not familiar with Cognitive Behavioural Therapy.  Simona explains little more on the different types of CBT, and her experience is that ‘third wave’ CBT approaches seem to work best with those experiencing perimenopause symptoms.

The draft NICE guidelines issues at the end of 2023 caused quite a media stir with the increased focus on CBT as a treatment for menopause. We discuss why the headlines were misleading and how CBT can help with hot flushes and sleep disturbances, as well as psychological and emotional symptoms. As Simona outlines, even individuals who are taking HRT sometimes struggle with their mental health and access to CBT can be helpful. Medication alone cannot address struggles with confidence, self esteem, self-worth, and identity.

We delve deeper into menopause as a psychological developmental stage - just as pregnancy and puberty (see Lisa Mosconi’s book The Menopause Brain for more on this). In all these life stages our brains are remodelling themselves - we are updating who we are and our perspective on the world…a process some of us will navigate on our own or with support of our own networks of support, and some of us may need a little extra help and support from professional - space where we can safely explore these topics.

Simona explains that the way we think about physical symptoms can amplify the symptoms themselves…CBT helps us look at the kinds of stories we tell ourselves and write new ones. It can support us to make meaningful change in areas that help us regulate our bodies and thereby mitigate symptom severity. 

Unfortunately as Simona highlights, the types of CBT available on the NHS are not always tailored to the needs of women going through the menopause and that can lead to sub-optimal experiences when people do choose to pursue CBT as an option. We end by agreeing that there is certainly scope for more practitioners to be trained in menopause-informed CBT practices. 

You can find Simona at https://www.menopausecbtclinic.co.uk/ and https://www.instagram.com/menopausecbtclinic 

If you enjoy the podcast and would like to help me keep it running (on a shoestring!) please consider buying me a ‘virtual coffee’ at Ko-fi.com/middlingalong - or you can support me in a non-monetary way by sharing this episode, or writing a short review online! 

If your workplace wants to become more ‘menopause friendly’ then please let them know about the work I do at http://www.managingthemenopause.com 

You can also find me over on Instagram https://www.instagram.com/middlingalong_podcast/ and https://www.instagram.com/managingthemenopause  

 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

follow along on Instagram at https://www.instagram.com/middlingalong_podcast/

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In this episode of the podcast I welcome back author and health coach Susan Saunders - Susan’s first appearance on the podcast back in November 2022 focused on preventing Alzheimer’s disease and has been one of our most popular episodes.

 

Susan’s latest book The Power Decade  takes us through how to thrive after menopause, and focuses on the ‘window of opportunity’ we have in, and soon after, menopause to take action to prevent the chronic diseases of aging – such as osteoporosis, cardiovascular disease and dementia. 

 

In countries where the average age of menopause is 51, and the average life expectancy is 83, we’re potentially living half our adult lives in a post-menopausal state. The Power Decade explains the impacts of the menopause transition on our metabolic health, heart health, bone health, and brain health. 

 

Susan talks about the ‘protective cloak’ that our reproductive hormones wrap us in pre-menopause, and how the drop in those hormones impacts all areas of our health, helping us understand the changes that happen in the body and what we need to do to remain healthy. She quotes The Lancet as calling menopause “a cardiometabolic turning point for women” - so I ask her to explain more about cardiometabolic health and why it becomes so important to keep top of mind post-menopause.

 

Her book is peppered with interviews with postmenopausal women who are thriving, explaining what they have done to get there, providing a sense of hope and renewal, and showing us that post-menopause can be a positive time where we experience a ‘rebound’ and renewed energy. 

 

You can find Susan at www.susansaundershealth.com  and on Instagram  https://www.instagram.com/susansaundershealth/ 

 

The Power Decade: 

https://uk.bookshop.org/p/books/the-power-decade-how-to-thrive-after-menopause-susan-saunders/7644592?ean=9781472291615 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

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This time on Middling Along I chat to novelist Tracy Bloom about her latest book The Time of Her Life, which follows midlife heroine Kim through the disintegration of her marriage and her subsequent reinvention. 

We discuss the increase in midlife female protagonists - that TV is doing so well with the likes of Sarah Lancashire in Happy Valley. Fiction has been somewhat catching up over the last five years, showcasing the issues facing women in midlife for Gen X who have grown up on Bridget Jones novels. Midlife as a time of re-evaluation and reinvention, opportunities and change, is fertile pasture for novelists…

Tracy talks through her process of learning to become an author, and gives us some tips for anyone listening who is thinking about writing a book. We also discuss Tracy's recent favourite reads and what she is looking forward to delving into next.

The Time of Her Life is out now in paperback (https://www.waterstones.com/book/the-time-of-her-life/tracy-bloom/9780008619114) if you’re looking for your next holiday read, and Tracy’s next book, The Secret Santa Project will be out later in 2024 (available to preorder at https://www.amazon.co.uk/Secret-Santa-Project-heartwarming-friendship/dp/000861914X)

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

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My guest today is Leila Ainge - an accredited psychologist with 20 years of cross industry business consulting experience. Leila’s research focuses on how entrepreneurs experience imposter phenomenon - but is relevant for all of us! She’s also the host of the Psychologically Speaking podcast which is currently exploring various experiences of imposter phenomenon.

We start by delving into why Leila prefers to talk about imposter phenomenon or imposter feelings, rather than imposter syndrome and review the origins of the term ‘imposter’ in this context.  We move on to how Leila approaches and interrogates her own imposter feelings, when they arise - beginning with her first imposter experience with a small baby in the NICU and then fairly soon after, the arrival of anxiety in perimenopause.

Leila’s advice on managing imposter feelings includes: interrogate your current surroundings and context - who are you around at that moment? What’s different? What is this environment giving or not giving you? What else is going on for you? 

It’s easy to feel like you’ll always feel like this, but actually imposter is a transient feeling…it comes and goes. 

We talk about social comparison and context collapse, particularly in the technology and online sphere, and the problems that stem from the speed at which we adopt technology - we don’t have the ground rules!  We also touch on navigating online spaces with the myriad individuals and relationships to factor in - and how a lack of objectivity can cause us to struggle.

Often in online spaces there is a bit of ‘shiny new thing’ syndrome! 

We discuss the importance of establishing boundaries around how we use online spaces and compare the experiences of using LinkedIn and Instagram - should we be putting more responsibility back on to platform providers?

We move on to the positive side of comparison for women in business - finding ‘pockets of belonging’ where we can be authentic and gain objectivity. 

We wrap up by looking at the topic of Leila’s PhD: ‘what do we get out of being online?’ - and I ask Leila what it’s like to start a PhD in later life! 

I do hope you enjoy this episode as much as I enjoyed chatting to Leila - who is a friend as well as an interviewee! You can find Leila and her brilliant podcast at https://www.leilaainge.co.uk/

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

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In this episode we meet Emerald May - an international Embodied Sex, Intimacy & Breathwork Coach. Her passion and mission is to support women and parents to live a more authentic, connected and pleasure-filled life, whilst raising the next generation. I had the pleasure of working with Emerald as a client a few years ago (to be fully transparent), and I can honestly say it was quite an unexpectedly transformative experience. 

If you’ve ever wondered what an ‘intimacy coach’ actually does - well now’s your chance to find out! In this warm and wide-ranging interview we cover topics including:

• patterns of disconnect and waning of desire in longer term relationships;
• how little we are taught when we are growing up around expressing our desires (especially if socialized as female), and how Emerald works to provide the skills, tools, and language for us to manage our emotions and express those desires - and boundaries;
• new relationships in midlife are a chance to avoid repeating same patterns and mistakes and learn about our needs (and see the link below to the work of Dr. Evelin Molina Dacker and the STARS Talk Emerald refers to here);
• sex and intimacy doesn’t happen in a vacuum - all relationships take work, even the one we have with ourselves, and it’s easy to fall into not prioritizing intimacy, especially if we happen to have children around the house!;
• different tools and techniques that Emerald uses, including the Wheel of Consent, the Three Minute Game, the Yes/No/Maybe Game, and Waking the Hands (and listen to this part to learn the term ‘desire smuggling’ and what it means!);
• spontaneous desire - and why scheduling time for intimacy is essential.

I hope you enjoy this episode, if you want to find out more about working with Emerald you can find her at  http://www.rootedpleasure.com

Here are some of the resources mentioned in this episode:

Wheel of Consent: https://bettymartin.org/category/wheel-of-consent/

STARS Talk: https://www.maketimeforthetalk.com/

Emily Nagosaki - Come Together https://www.penguinrandomhouse.com/books/712001/come-together-by-emily-nagoski-phd/

Cyndi Darnell - Sex When you Don’t Feel Like It - https://rowman.com/ISBN/9781538161708/Sex-When-You-Don%27t-Feel-Like-It-The-Truth-about-Mismatched-Libido-and-Rediscovering-Desire

 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

follow along on Instagram at https://www.instagram.com/middlingalong_podcast/

or subscribe to my Substack at https://middlingalong.substack.com/ 

The biology nerd in me is so happy about this one! Joining me this time is Professor Jack Gilbert from the University of California San Diego: in 2023 he gave the Annual Lecture at the British Menopause Society conference, which is how his work came to my attention (via our Managing the Menopause Clinical Lead - also my sister-in-law - Dr Beth Thomas). 

 

In the course of this wide-ranging conversation that focuses on our gut microbiome we cover:

• why understanding the interaction of our sex hormones with the microbiome is a burgeoning area of science and how everything in the body is connected in series of complex feedback cycles; 
• The key role of decreasing oestrogen in inflammation: leading to depression, anxiety, aches and pains, and gastrointestinal issues;
• How our microbiome changes pre- to post-menopause (post-menopause the female microbiome tends to look much more like it would in men);
• The important of butyrate and why a healthy gut barrier is so important;
• Why we should consider ‘priming’ the body to consume fibre with fermented foods;
• The long-term chronic health implications of not getting enough dietary fibre, which are often not felt immediately but accumulate over decades;
• How fecal transplants are being used to repopulate the gut microbiome - early studies have shown promise in menopause symptom treatment but more research is needed;
• That HRT appears to ‘rescue’ gut dysbiosis (reduce inflammatory bacteria, more balanced microbiome);
• The Hypothalamic-Pituitary-Adrenal (HPA) axis (aka how your body senses stress): - cortisol keeps you alert and anxious, but the system can be hijacked by inflammatory bacteria, neuroinflammation triggers the HPA axis causing elevated anxiety, i.e. there is no reason to be anxious but the body is on high alert;
• Why acetominophen (paracetamol) can cause liver cirrhosis with excessive consumption in certain people;
• How antibiotics wipe out other useful bugs that keep resistant strains under check, and how ‘problem’ strains thrive on high sugar and high saturated fat (and why your diet in the run up to an operation could make a huge difference);
• Exposure to microbes in nature and the potential impacts of bacteria in soil that have an antidepressant effect;
• ‘Gut feelings’: how the state of our gut can impact our decision-making abilities, and that changes in microbiome can impact how hungry we are, our propensity to snack, and even our choice choice of snacks…eg sugar cravings;
• How 80% of serotonin is made in gut, but that it is actually a  serotonin precursor that can pass out of the gut into the body to then be made into serotonin by other cells - although the relationships between levels of serotonin in the gut and the brain is not currently understood. 

 

Listen to the end to find out about the research study that Professor Gilbert would  most like to run if he had no constraints! 

 

You can find our more about Professor Jack Gilbert’s work at:

https://gilbertlab.ucsd.edu/ 

 

 

If you enjoy the podcast please help us grow by sharing this episode, or writing a review.

You can also find me at www.thetripleshift.org 

connect with me at https://www.linkedin.com/in/emmacthomas/ 

follow along on Instagram at https://www.instagram.com/middlingalong_podcast/

or subscribe to my Substack at https://middlingalong.substack.com/