Supporting Whole-Body Health in Menopause with Kath Berry

Kath Berry (BHSc, MSc, acupuncturist and female health specialist) and I (a women’s burnout prevention and leadership coach) discussed a range of topics around the transition to menopause from confidence to hot flushes and I am so grateful for her time, expertise and amazing metaphors. Kath has a BA in Traditional Chinese Medicine, 25 years of clinical experience and is the co-author of “Menopause: A Comprehensive Guide for Practitioners”. She speaks on women’s health (find her TED talk here), is a happily divorced mother of two, an avid sea swimmer (find her retreat offers here) and an all around awesome human living in Ibiza. Listen now to hear more about…

  • When the coping strategies don’t work any more

  • Personalised support plans and support team (and where Chinese medicine might fit in)

  • Capacity and priorities 

  • The grandmother hypotheses, deflating surfboards, the impacts of COVID and whales (they all make sense in the conversation I promise)

  • A practice to help with dealing with phones all day

  • Cancer and HRT

  • Identifying inspirations as we transition through menopause a.k.a the gate of life

  • The benefits of masturbation in menopause

Prefer to listen? Get the podcast episode here: Holistic health (and we talk WHOLE BODY) in menopause - a conversation with Kath Berry.

We are so lucky to have Kath Berry speak to us in this conversation. Kath is an acupuncturist, a female health specialist, an author, an acupuncture educator. So she teaches other people and she has over 25 years of clinical experience with working with women, particularly in the field of traditional Chinese medicine. She is a co-author, she runs swimming retreats and she's done such a fun Women's Health TED Talk around menopause and masturbation. So, so lucky to have her here in this conversation and be able to tap into her wisdom, her expertise and experience. And two things that really sat with me after this conversation is thinking about outgrowing, maybe ways of being, of behaving, of supporting ourselves, which is a theme that other people have mentioned too in our conversations. And that's really been something that I've been noticing in my one-on-one clients and my leadership groups as well is transitioning from something that used to work for us to needing to update that somehow.

The other thing that I loved around the way that Kath described human bodies is sacks of chemicals, right? Thinking of ourselves as these complicated, beautiful, complex mixtures of chemicals that are working through our bodies. And I think that really normalizes hormones for all humans, right? These messengers, these indicators, these transmitters. that are always operating behind the scenes. And so, yes, we can talk about estrogen and progesterone, but we've got a whole lot of other hormones that are working for us all the time. And I think for me, that really expanded my viewpoint of how I see supporting myself, how I see what's happening in my body on a day-to-day basis, as well as the kind of macro seasons of either an ovulation and a bleeding or a perimenopause and a menopause. So I'm so grateful to Kath for being here and sharing this time with us. And I am so excited for you to dive in. We talk about vaginal activation, we talk about holistic treatment, we talk about lifestyle, we talk about parties, we talk about baseline testing. I think there's going to be something you're going to take away from this conversation. And I'm so excited for us to dive in.

Kath, I am so excited to have you here and to be able to ask you lots of questions about transitioning into menopause. And I'm saying that because I feel like there's so much that comes before and goes after. So thinking about an introduction of who you are, where you are, what your work is, what your expertise is, let us know all the details.

Firstly, Maude, thank you so much for having me on your show and I feel privileged to be one of your clients and benefiting directly from your work. So I'm really excited to have this opportunity to share with your audience my work as well. So I'm Australian, you can probably hear it in my accent, and I started my degree in Chinese medicine in 1995. So I'm coming up to my 30 year anniversary of being involved in complementary and alternative medicine.

So back when I started, it was all looking at this idea of energetic flow through imaginary meridians, and it was a very esoteric type of medicine. In the 30 years I've been in practice, it's evolved enormously. We really understand now the science of acupuncture and how it works. But my career has actually tracked my life. I've been really fortunate that...

I went straight into a Chinese medicine degree in Sydney in 1995 as an 18 year old. And I got super interested in drug taking and the immersive sort of culture that was going on around me. So when I finished in 2000, I sort of started looking into acupuncture for drug and alcohol addiction. So, you know, 23, I became really interested in how can a medicine like acupuncture help people with things like cocaine, heroin, alcohol use. So I went on to do a master's degree in acupuncture for addictions.

And I sort floated along with that for around 10 years. And then around the time I got married and started looking at having a family, I became really interested in acupuncture for fertility. And then when I was pregnant, an acupuncture for pregnancy. And so now sitting here today at the time of recording, I'm just on the eve of my 48th birthday and I'm finding myself immersed in menopause. So that's how I sort of got really interested in menopause is, you know, as I've aged and gone through my professional career, I've been looking at what's going on around me.

But in parallel to that, that I was living in London for the pregnancy fertility part of my career, as well as raising a family, but I moved to this lovely little gorgeous Mediterranean island of Ibiza in Spain. And Ibiza being this super party island is famous for having a culture of people coming for really hedonistic behavior. So when I set up my practice here in 2015, I had a lot of women coming in.

And they were saying things like, I don't know what's wrong with me. Like I'm going out on these coke benders and I'm not, I'm just not recovering. And I was a bit like, well, that's weird. And like, yeah, ever since I hit 45, it's like getting really in harder and harder and alcohol is really hitting me hard. So I started sort of Googling, like what does men, how does menopause affect drug use? And what's this, you know, what does menopause look like for behaviors that we're used to? And so in 2015, that's when I started researching for an online course that I ran. I got experts from around the world and then through the recording of their material over a number of years, I then condense that into a textbook. So it's this sort of evolution of, that's sort of the short story of how here we are in 2024. At nearly 48, I'm sitting here thinking, let's look at how complementary medicine can help women in this menopausal transition.

I love that you're saying, number one, so much has changed within the industry, within the science, within the research, within the data in the time that you've been practicing and you've been supporting women. And number two, there's this piece of like, how do I support women who still want to party? How do I support their bodies to recover? What's that like when you're 45 plus and having that longevity and like fun and, you know, different kinds of behavior. When you think about the challenges. So you are a qualified acupuncturist yourself, and you're also have been working with different people within the sphere of traditional Chinese medicine. When you think about the challenges that you see within the body, within the complaints within women that are coming to you that are maybe in their late 30s to 50s, what would you say those are predominantly?

Well, the first thing that struck me more was that these women were having these really interesting responses to their normal life was that their life hadn't changed much, but all of sudden their behaviours weren't working for them anymore. And I was like, well, why can't I go out and drink a bottle of wine with my mates on a Friday night? And why is it, know, hammering me? So the thing that really struck me is that people weren't aware of what was happening in their body that there was, well, actually, you can't keep doing what you're doing, that your body's not behaving in the way that it used to.

And so the exploration that I went on is to sort of why is it that thing, what's changing? And the summation really being is we are just big sacks of chemicals. You know, there was a long time that it was considered that we were these sort of bony structures and that the spine held us all together. But we really are made up of soft tissues and chemicals and pathways which move those chemicals around. It's then looking at the idea of what's interacting within the chemistry of our body and all the external environment that we're going through. So there's a whole classic pattern of symptoms that people see and it's starting to, if I was to say one thing, it's starting to feel unbalanced and destabilized. That would be the most general thing. And that sort of starts creeping in. It's very different for everybody, but let's say mid -40s. And then other things like metabolic shifts. And a good example of I have clients come in and they say things like, it's really weird. I've just put so much weight, but I haven't done anything differently. So, you within 12 months or two years, all of a sudden, their physique has changed enormously. They're still eating the same amount and exercising the same amount and nothing's changing. Or alternatively, people have for most most women, I mean, I speak, you know, that we have this sort of bounce back idea of like, well, I'll just be a little bit hedonistic for a period of time. I'll just have a really lazy summer. And then I'll just eat soup and salad for a month and then I'll be back to me again. And this is what we know women will say, it's like, my bounce back techniques aren't working anymore. know, the juicing, the juice fast or all these little hacks that we once had to try and sort of accommodate other aspects of our lives just weren't working. And it's like, okay, this this like recognition, things are shifting. one thing I just want to, again, for your audience, and it may be an overkill, but I really want to just go back to the actual definition of menopause because you hit it on your head when you talked about menopause transition versus menopause. so menopause itself is 12 months after the final menstrual period. So it's when the period stops and then 12 months later, you're officially in menopause. The challenge of that, of course, is it means you're getting a diagnostic, you're being diagnosed retrospectively.

You don't know when menopause is going to happen until 12 months after it's already happened. And because of this lead up into the last stages of menopause, there's usually a lot of spot bleeding, the period becomes so irregular. For some women it's like, I can't remember when I last had my period, I'm sure it like six months ago, maybe 12, or this idea of it becomes so vague. And that's why menopause, we think it's this very finite thing.

But really your use of the term menopausal transition is more accurate. And that's around 10 years. You're looking at five years before and five years after. So given that menopause is generally 51, it means on somebody's 50th birthday, they can expect that their period will stop. And within 12 months that they will then officially be menopause. We're very, very generalized terms. So that means in real terms from about 45 to 55 you're in the menopausal transition. And I just think that's really important to understand. That's why, of course, menopause is huge everywhere at the moment. And that's because it is this 10 year window. It's not just an event. So I think it's really important to understand the definitions to then understand what it is we're talking about. Anything that happens in your mid 40s to mid 50s, it could be under that umbrella of the menopausal transition.

Right. And I think that's such an important thing to voice because not many of us were educated about menopause, right? When you think about the biology lessons that you receive at school, you know, there's a little picture of the uterus and there's some naming of things. And, know, in addition to my rants around the lack of pleasure education, there's also a lack of education around what that looks like at the close of it and how there is that really long transition period with a lot of different things going on in your body, in your chemical sack, as you called it. And I know that we were chatting just before this, it's also a time of life where women are holding a lot of things in their actual 3D world around them, right? They may be stepping into leadership in their career, they may be going through relationship transitions, they often have aging parents, they may have teenage kids. So there's all of the stuff on the surface that they're wanting to handle. And when you're saying, you know, their previous behaviors hadn't worked for them, or, you know, they're reaching a point where they starting to feel, can't cope, I'm not coping, or I'm not coping in the same way. There's that huge shift in who am I, what's my identity, and that can create so much anxiety in addition to what's going on physically and around us. So it's this big,

catalyst for us to emerge out the other side, right? Of different people metabolically, mentally and emotionally.

It's true. And look, I speak personally from that. I've got a 12 year old son and an 11 year old daughter, but I just wanted to spiral back to something you said a moment ago around not being taught this stuff. It's a bit of a segue, but my 12 year old son the other day was driving along and I said, he's doing the reproductive system. And so in the car I was quizzing him, telling him about the uterus, telling him about the urethra. I said, tell me about the clitoris. He's like, what? And I was like, what?  I looked at his little science book and Clitoris wasn't marked on the map and I just sort of thought, God, know, 2024 and they're still not teaching kids this stuff. But you're absolutely right, we don't have, we haven't got enough access to information that's really helpful for us. And the idea is that, as I mentioned earlier, that women are thinking that they're doing things that they've always been able to do, but it's not working anymore. And you talked about all that juggling plates. And so what I want you to visualize is a circus performer that has been doing it for 35, 40 years and all the plates. And the other thing, of course, is the plates get bigger. You know, as you get older, the responsibilities get bigger, the worries of a teenager are bigger, that the financial stress becomes greater, that there's all the plates themselves are not only spiralling in the air, there's more of them. And I guess the stakes get higher. And then I want you to imagine that circus performer, that they're actually just shift, they're changing themselves, all their chemistry is changing. It's a combination of potentially have burnout as a specialist yourself, you understand what that does to somebody. But then, you know, I want you to imagine a chart of this sort of, know, throughout one's lifetime from about 13 onwards around menarche,  the oestrogen continues to increase, around about 45, 46, 47, it starts to fall and then just pre -menopause, it falls off a cliff. Like this chart is not a gradual gentle slope down a mountain. It's like a cliff dive. And that's why people go from feeling kind of okay and having their shit together to quite literally overnight going, my God, I'm a fucking wreck because it's that massive fall in hormones. then what happens is being chemical sacks with systems that are in place to try and create balance that our body is trying to regulate itself so that we're of trying to constantly find, and this is really effectively what a hot flush is, is that the thermal sensors in the body start becoming really kind of hypersensitive, which is why they're triggered by getting into a hot car, stepping into a hot restaurant or stepping, know, changes in temperature. The body itself goes into, change of temperature, I'm going to regulate, but it starts to do a total flip. one way again, it's exactly as this pendulum starts swinging. And I always look at it as I was a former very keen surfer and the whole physics of surfing is a flat board of moving that what you don't want to be is on a deflating surfboard staying still. And that's effectively what menopause is. It's this idea of things are deflating and you're trying to get traction. So imagine trying to stand on a lilo we call them Australia, an inflatable in a swimming pool and just trying to get traction and more deflating. The harder you sort of to jump up and down to try and get balance. And that's what their feeling is for lot of people. It's this, I'm not coping. And you didn't ask me more what was the one thing that I was sort of seeing in my clinical practice. And everybody knows the hot flushes and the night sweats and the vagina, blah, blah, blah. What I wanted to share with your audience is one of the things I see which you don't see written down anywhere is lack of confidence. So it's not a medical diagnosis, but what happens is you get this lack of confidence.

And it's, only pick this up in seeing women and they're going, just, I just don't feel like, you know, I've just used to be really ballsy. I used to be able to run the show. I'm the boss. And now, you know, these young people are coming through and I'm managing this team and they seem to have their shit together more than I do. And it's this really indiscernible thing that losing confidence, losing confidence in yourself, confidence in how you look, confidence in, you know, this, it's sort of losing this inner, inner like radical woman.

And that's the hardest thing I think in this transition. It comes back, I think it comes back with a vengeance because it comes back as like, I don't give a fuck. So the shift is pretty dramatic, but it's just this idea that that can be a real struggle for someone that has all those plates spinning in the air.

Absolutely. I think that's something so in the work that I do around confidence building or stress management or how we think about ourselves or that self critical voice and how intense that can get and how people can question themselves and look back at themselves and say, I used to be different and now I'm like this. I think it's so interesting to bring that together here in, you the mental what's going on in our mind and the physical and what's going on in our bodies and to draw that connection because so many women that I'm working with when I'm asking them about their menstrual cycle or whether they've had their hormones checked, they are surprised of like, what's that got to do with anything? You know, and putting those two together can be so so useful and getting support on both sides. One of the things that you said, which was so interesting is that falling off a cliff, right? That's not a gradual decline. It's like from one day to the next, I can feel so different and there can be these huge fluctuations in what my body is receiving, what my chemicals are doing inside me. How does acupuncture support women and their hormones?

Acupuncture is one of those systems of medicine, like many, which really helps people to regulate the endocrine system. So it's sort of the process of actively invigorating the chemicals that are responsible for creating balance. So it's sort of, again, if you can imagine the Lilo idea that the body itself has inbuilt mechanisms for creating balance and it's sort of, but you can fast track those. And so acupuncture is one of those systems of fast tracking, you know, good sleep, diet.

Exercise is another really big one. So there's this lovely combination, but it's getting treatment, getting help. one of the things which is so beneficial about the way that you work is you put systems in place. The idea of your checklist and your notes, and it's that idea of putting a plan in place and having a record of being able go to that plan. it's really acupuncture would fit into that as having a treatment process.

But one of the things I'm also asked by people is, what are the things can I be doing? And what often happens is people start taking a handful of supplements for this or that. And so on top of this, trying to balance things out, there's a little bit of self -medicating that goes on and a bit of dipping in and dipping out of different things, which is, it's great to try things, but there's also, I think the most important thing is you've just got to name it for what it is. Just go, this is that thing called menopause everyone's talking about.

Because I think for a lot of people it's like, menopause is that thing over there or menopause happens at 51. And so therefore somebody who's in their like even early 40s, for example, is that they might not recognize that that's actually just part of this hormone shift. And to confuse everything even further, I, know, there isn't an answer for this, afraid. So I'm not gonna come up with a punch line at the end so much as just sharing, you know, being able to name it and go, that's what this might all be about is what we don't know. Menopause has only really come to medical attention in the last 10 or 15 years. For example, in Chinese medicine, it was only really recognized, menopause was only recognized in the 1960s. So it doesn't exist in Chinese medicine because it didn't exist as a condition. 

Yeah, we're really only starting to understand it. So we don't know as a population and what we don't know from medical science is, well, what's the interaction with a contraceptive pill? What's the interaction with assisted reproduction therapies? So we've sort of got the general population that may have aged through menopause. But then there's all these other different lifestyle choices around contraception or around family planning that we just don't really know these nuances. And another really big one. And I'm fascinated by this, but we haven't really dived into it as around menopause for people that have had conditions that have required them to take chemotherapies as well. So people with estrogen sensitivities and they're thinking, okay, then let's look at, that's again another sort of, if you can imagine a flow chart of having to work out what would work for somebody, working out what their oncology history may have been. So it's a really complex area. And this is where I mentioned starting my degree in 1995. I was of the first cohort of students to go through the university at the time that the World Wide Web had hit. So I was one of the last practitioners to enjoy a couple of years of clinical practice where I knew more than my patients, that I could sit there and go, I know stuff, and they didn't know, really? Now, you know, particularly when someone's got a condition on how they're feeling, that with the help and hindrance of the internet, people have gone and looked up everything. And, you know, I don't know how doctors operate because, you know, I remember this lovely time in my life where did, people came in and asked me questions that they didn't know the answers to. And now they're coming in and asking me, you know, of 50 choices, which one should they make? And I just, it's like, gosh, you know, that's, I don't have that capacity to make that decision for you in the five minutes I've known you.

So this is where I think the internet is an incredible resource, but it's also potentially really dangerous because it's in the absence of understanding what's going on internally. You can be Googling things like hot flushes, what should I do? And in your show, my colleague, Natalie Chandras Saunders, will be sharing a little bit more about that. But it's really interesting to, but everybody's looking for the answer and it's just the answer is very subjective.

One thing you mentioned right at the beginning, and I just made a little note of on my piece of paper here is looking at a kind of support plan for yourself over this phase, right? So thinking of maybe mid forties to mid fifties or early forties to mid fifties, whatever it is, when we're starting to notice changes in our body, whatever those might be, is seeing that as how do I call in support? How do I do things differently? How do I behave differently over this time to really support my body, whether that is looking at my alcohol intake or caffeine or getting a coach or a therapist on call, having conversation with my doctor, stepping up my exercise routine and seeing that as supporting myself through that transition. And I think that's such a useful thing for all of us to think about because I'm surprised at how some of my peers, colleagues and friends aren't looking at individual symptoms. Some of us are in our early 40s, some late 30s, some mid 40s, some 50s.

And that's not really something that they're putting together and thinking about as like, Hey, so for the next 10 years, if I'm going to be going through this, how am I going to be supporting myself? And that's something that can be so helpful. You also mentioned that aspect of writing things down or making a plan or coming back to something to provide that support for our brains as our cognitions or memories or things are shifting and changing. We're starting to feel insecure about that. That can be, you know, something else that I'm just relaying as a practical, helpful, tangible thing. You're also talking about a personalized plan, right? You're saying, well, what may work for somebody who didn't ever take the pill or what may work for somebody who has gone through chemo or what may work for somebody who is, you know, in their late 30s, maybe isn't the same thing or has a history of breast cancer or osteoporosis. Maybe there are different things that are working for them.

And I think one of the things that's so challenging, you're talking about, you know, all of the information that's on the internet and available to us, but also the lack of kind of in -person training when you're saying, it was only in the sixties that this was recognized, or it's in the last 10, 15 years that we're seeing this as something that's worth research. So then where do we turn to? Where do we go to, right?  And the internet's telling me all sorts of things. It can be so challenging, right? I think that's one of the big challenges within the general world is how do I support myself? What if I want to, but what is support? What does that even look like?

And again, it's different for everybody. But, I would always say, of course, my default would always say to see, you know, to have an acupuncturist that's just keeping on keeping on track. Somebody might check in once every month, once every three months, once a week when shit hits a fan. But the idea of having somebody that's going to sort of accompany you through that clinical journey. But it is, you know, I would always say to my clients as well, like, you know, find the thing, find an exercise that you love. To me, the number one is exercise. You find an exercise that you love and just keep doing it.

And of course, we all know that when we're busy, usually it's like, I'm not going to Pilates this week because I know it's not going to, you like I just, I'll drop that. And that's just like, don't, don't drop it. Hot yoga is another one that people swear by, my clients swear by. Yoga generally is an incredible form of, I was going to say treatment, but it's a form of exercise, however you want to call it, therapy. But it is, it's a regularity, I would probably say is most important thing. So it's, it's, know, often, you when you, know, again, you imagine sort of this idea of on the inflator, you try to dip in and out and you're juggling all these plates and they start dropping and smashing. It's finding something that's consistent. The body responds really well to repetition. That's, know, effectively what going to the gym is and that's what having a plan is. And it's, you know, looking at, and I would always sort of encourage someone to write a checklist of the things that bring them joy, the things that make them peaceful. There's a lot, and I know this is very much your work, Maude, setting really clear boundaries.

Actually just say no to stuff. One of the greatest gifts I was given a couple of years back was the ability to say NO. Even for invites to dinner. We tried to go for dinner in two weeks time. It's like, let me get back to you on that. Thank you for the invitation. Let me get back to you. Can you talk at a conference? Thank you for the invitation. Let me get back to you. So never saying yes or no on the spot. Giving yourself a day or two. Let me get back to you tomorrow. Let me get back to you at the end of the month, you know, depending on what the timeline is, but really giving yourself time to really think about do I have the capacity to do this? And also a little bit of forecast planning as well. Do I have the capacity right now? What's my capacity going to be like at the time? So really giving yourself permission to say no, because it's like there's enough plates going on. it's looking at yourself as a resource and a diminishing resource to a certain degree. And looking at the other thing is working at what's really important. If somebody said to you, your capacity is going to start to diminish over a period of time. You're going to have to drill down on all of the 25 things you're doing. You're to have to choose about 13 of them or five of them, or maybe just one, depending on how someone's feeling. It's just sort of really prioritizing. And again, I know that this is something that in your work, you're always looking at distilling down what's at the top and what's at the bottom and what can just be carved off entirely.

So, you know, it's around, I guess, those systems and order and planning and, you know, and also just the really small things that, you know, you've mentioned in just in your sort of review - the eat well, sleep well, reduce alcohol, reduce caffeine. It's all those little tiny things. It's the day to day things that really do make a difference. You know, we've talked about this falling off a cliff. It's like, okay, what's your parachute? What can you be doing to try and at least make that a soft landing? And recognizing that you might fall off a cliff for a period of time and then you'd be okay again. And then it might happen again. So just being aware. But I can't underestimate the value of just being able to call it out. Just go, this is the menopause. That's what it is. Because it can just get caught up in, I'm overworked, I'm underpaid, I'm stressed, my kids are being assholes, my husband or ex -partner is being an ass or ex -husband. know, it's like the idea that it can just be kind of blurred together with everything that's going on around. And we forget that it can just also on top of this, this chemistry, which is trying to work itself out. And there's this crazy thing. don't know who engineered this, but that menopause and all that crazy hormones is happening absolutely parallel with adolescents. Anyone with a family sort of from, you know, 10 to 20 who's going through their sort of late 30s to early 50s, it's you've got these two chemical sacks under one roof, potentially three, potentially four, where the husband's thrown in. So not with that, you're not a chemical sack in isolation. You're doing it within this, some sort of, if it's not within a family for those people, it's in their workplace that you're going to work and all these little kind of, everybody's on their little inflatables that are deflating or in the case of teenage kids, they're inflating.

And so, and there's actually, a scientific explanation for why menopause happens at the same time as menarche when they're a teenage or a young adolescent girl gets her period. And that is, it's called the grandmother hypothesis. It was a lovely sort of note to reframe all this as a positive that we are engineered to be wise women of our community. And the grandmother hypothesis comes from whales, the only other mammals that go through menopause.

And what the theory is, is that we go through menopause to stop reproducing children so that we can hand on our knowledge to our children's children, so that we are more effective for our tribe or for our species or for humanity, for our communities if we stop reproducing, because if we were, we'd be continuing to, our kids would become competitors with our grandkids. And that doesn't serve our community, that our knowledge, the grandmother knowledge is much better handed down to our offspring. And so that's why menopause occurs. Menopause occurs to make sure that we stop reproducing. We still have up to another 40 years of lifespan. A lot of other animals that go through some sort of form of end of, the end of reproductive years is actually the end of life. So it's really fascinating to see that we continue with this life after menopause. And again, for those women that don't have children, it's the grandmother hypothesis still applies for being politicians, leaders, on the community board, influential and running through their own family networks, becoming this leadership role. And I think we're seeing that. We're seeing women really evolving into being the most, I think the world is going to be able to place when women are the leaders of the world. We're seeing it. We're at the beginning of that. But that's biology taking over.

So many things that you said there. One of the things that I picked out right at the beginning was this consistency, right? And how do I support myself consistently in building healthy habits and building a lifestyle that is supporting my body? And I know that that can be such a shift and a change from maybe what I expected from myself or what I did to myself in my thirties or my twenties. And now I'm looking at how do I redesign that from a physical point of view in what behavior or what nutrition or know, what stimulants or tranquilizers I'm putting into my body, but you're also talking about seeing my health as a priority, right? Seeing my health as something that is important. And that's just something that we often neglect when we are rushing from thing to thing, as you were saying, it can often be the first thing to go. It also requires this radical reframe of how do I see myself in my career or in my family? How do I see my health is underpinning all of that versus my body is something that can be dismissed or negated and will just continue functioning for me. And I think that's, you know, that's the first radical reframe that you introduced here is my health is important. I can't do this without my health. How do I support that? And then this calling into boundaries. And I think something that happens in the forties that I see over and over again with my one -on -one clients is I've been saying yes to things that I don't want to do for so long.

And I'm at the point where I can't do that anymore or I don't want to do that anymore. So I'm, you know, I'm feeling that irritation or that frustration or that resentment. And I'm needing to learn from the beginning how to create those pauses from the beginning of identifying my boundaries, right? That's a process that I'm needing to learn. I wasn't taught that. In fact, I was socialized against it probably as a girl or a teenager or a woman in the world where service is, you know, a number one value of being quote unquote, a good woman.

And having that pause before I accept an invitation or before I put something else in my calendar can be so useful as a place to start thinking about boundary setting. I love that we are like whales. I didn't know that. That's a beautiful metaphor. And I think there's also something here in how we see that transition, right? So many of my clients, when I suggest to them, getting their hormones checked or that link between what's going on physically and themselves, they almost feel a little bit worried or maybe even insulted that it could be menopause rather than seeing it as, you know, some people call it a second spring or this transition into a leader, a wise elder, somebody who still has so much to give. And I think there's so much there around how we've been socialized as women to look at our own value and what's important and, you know, we could spend days talking about that separately. When you think about how menopause is seen in maybe a Chinese traditional sense or in that community, what is that like?

So it's interesting because there is, just before I answer, I just wanted to say that your point that you raised about people understanding health now is more important. I think COVID was probably one of the best things that did that for us. COVID broke the shit out of everything, but there were some really amazing things to come from that. And one of them was people's understanding of, my God, actually health is number one. In my, mentioned in this sort of, know, nearly 30 years in the game. That's the thing I've probably seen as the biggest change. The most dramatic shift, you know, is this idea of people reemerge from COVID going actually, I get it now, I am going to invest in my health. 

The challenge also with COVID, those technologies started to overwhelm us in a way that we weren't used to. Technology entered our home in a way, working from home, being on call 24 around the clock. So while COVID gave us this understanding of health being the most important thing, it also introduced this idea that we're on call 24 7, and that work doesn't stop, and that we're responsiveness as well. I'll send somebody a message and they'll say, sorry, I didn't get back to you sooner. And it's only been an hour.

You know, it's like, shit, did that become, when did we become sort of, you know, like on call in every aspect of our lives? And I think that, you know, the technology influx, so, you know, tech, you talked about setting boundaries, you know, the first one is the device, you know, working out how much you're going to use your phone, how available you're to be to your boss or to your clients or to your kid, you know, to your family or whatever, you know, this idea of boundaries really starts at the immediate access to you and that is your phone device. 

And I just wanted to take you through a sort of understanding of an exercise that you can do is that often when we're checking our phone, we're looking down and we're holding it usually just in front of us around the sort of the rib cage or the chest area. So you sort of putting yourself in this like, I'm checking my messages and I'm getting back to people. for most people, sort of use both our thumbs to type in the text message. It says, rapid fire, quick, I'm going to respond to a message or send an email.

That particular physical stance is our fight flight response. Shoulders come forward, arms come to protect our internal organs. If you ever see a boxer standing in the ring, that's usually what they're look like. Just put a mobile phone in their hand and that's sort of what they look like. So what we're actually doing is we're putting ourselves in our fight, flight, adrenal response. The moment we check a text message or the moment we drive a car or sitting on a computer. Those three things that we do a lot of are the three things that are stimulating a stress response.

So, I'm always sort of encouraging people to, you know, stand up straight. You get a text message come in, it's asking you to do something. You stand up straight. You hold the phone above you so that you're looking up as if it's sort of looking towards the sky. And then you feel into it and think, now how do I feel about this? know, it's like shifting the chemistry, shifting your physical sense of like, you know, moving into your strength. And, you know, often you see the, you know, the superhero poses and opening up the arms and opening up the shoulders and  this idea of really feeling to the solar plexus, pointing that towards the sun in the middle of the rib cage. 

All these little strategies are putting us back into our biological, I feel relaxed. And from that relaxed state, you might make a better choice. You might make a better decision. When we're in our fight flight, we have this sort of, it's like we're hitting tennis balls back. We're, you know, our quick, quick, we're defending ourselves. So, you know, the actual chemistry of that is really important to understand and the posture of that. And, you know, back to making really good choices, really good boundaries, delaying something.

Let me get back to you. Let me really feel whether that's something I want to do or can do. Because the other thing as well, let's say organizing a conference, I would like you to be a guest speaker at this really important conference and it's going to involve travel and being away from the family and all these activities. And often we're so flattered. God, I'd love to because thanks for asking. So you might say, yeah, I'd love to. But when you really think about it.

It's like, gosh, do I really have the capacity? it's the conference organizer would much prefer. I am so flattered to be asked, but I just don't have the capacity right now that that's not, you know, that in no way diminishes you to be able to say a really great, no, I can't do this or the time. You know, I'm really, you know, I feel privileged to be asked. I wish you all the success, but it doesn't fit with my timeline or it doesn't fit with my capacity, doesn't fit with my energy levels. 

It's working out a really good way to say no. And that's, you know, again, no hard nos are better than maybes, but maybes and uncertainty puts you also in a state of uncertainty. And it's it is it's sort of almost like this sort of intoxication from being no, no hard boundaries now and freeing up that space, receiving the compliment and receiving the praise, but also just being I just don't have the capacity to do that. And same with friends. Let's go out. Let's go out clubbing on Friday night. I'm living in Ibiza where that's part of everybody else's life.

That idea, you know, it's like, yeah, I'd love to, but I just don't have that capacity in me. don't, you know, what that really means is a really late night, you know, potentially I don't drink, but you know, the idea of having to drive and all these things. So what are the components of the invitation look like and do all the components fit? That's the fun part and the, you know, the 20 minutes on stage doing a talk or the, you know, whatever the invitation is, that's the easy part. But what's really being asked of me and do I have the capacity to do that?

I've actually got a checklist that is, you am I being paid amount? Is it going to fulfill me? Does it fit with my core values? Do I like the person that's invited me? Do I like what they stand for? You for me to show up and, you know, it's really, it has to fit with a whole bunch of criteria before I'll get to a yes. And that criteria is really helpful because it just helps to say a really thank you and no, or really polite no, you know, thanks but no thanks.

Where you started there and thinking about technology and that bleeding that interweaving of work and life is something that I hang out with all the time in my one -on -one coaching practice, right? Where do I create balance that looks and feels spacious enough for me and focused enough for work that fulfills all the needs? And I think that note around how are we using technology or not? How do I separate out? What are my boundaries in myself with myself around all of that? What habits have I fallen into maybe over the past four or five years and how can I bring more intention to the end of my day or the way I'm using my phone? In fact, I did a podcast session just around that and how people can bring attention to that, but it's so, so important. 

And I love that example that you gave of using our phone in a different posture. How do we change our habits of where we check and what we look and how our body is at that time. And I wanted to ask you, when we think about menopause and we think about supporting ourselves, one of the hot topics out there is, do I replace my hormones? Do I take pharmaceuticals to do that, or do I support myself in natural ways like exercise or supplements or nutrition or community or a coach or therapist or all of those, or do I do it all? Like what's my treatment plan? And often thinking about hormone replacement is something that is also done with and maybe in isolation or with differing sources or different qualities of information. Have you made a decision on what you're doing around replacing hormones?

It's such a personal choice. And for me right now, my position is I'm very, I'm pro women's choice. And the idea being I'm not sort of anti -hormone replacement therapy, but it's also recognising there's a lot can be done before you get there. So, you know, in terms of my game plan at 48 is to just do everything I can. And then also knowing it's like, okay, I've got understanding that it's at what point to make that decision. It's basically what point do I feel like I've done everything I can within my power. Now it's like looking to now go and see a gynaecologist and looking at, you know, so for example, think having regular blood tests is really important. Just get it because you get baselines. So I would encourage a lot of people to have a test around 46, 47, you know, I had them done earlier this year just to be able to sort of start tracking. It's very difficult again for a gynaecologist to turn up and go, she's hit the fan.

It's like, you know, we don't know what we're looking at. you know, there's a bit of a, I would say monitoring, tracking a period, keeping an eye on symptoms, keeping a little log of how you're feeling and then deciding as you go along. But yeah, I'm certainly not adverse to menopause hormone therapies and just looking at what that would look like. I'm sort of, to be honest, I'm in one of those unique conditions of having an estrogen sensitive tumor that, you know, I fall into the difficult category.

So I'm a little bit more wary of taking hormone because of my previous diagnosis and work with Marsden Cancer Hospital. I'm kind of, think this was actually in my personal journey, I mentioned my acupuncture career tracking my own experience. And so at 38, I was diagnosed with a rare and aggressive tumour. And I'd gone to a number of different hospitals, two hospitals here in our local Ireland of Ibiza and then ended up in London. And so through not knowing what it was, I ended up in Marsden Cancer Hospital. And so I, you it was this rapid growing tumor of which was told by my oncologist at the time. It's like, well, we don't really know much about these, but, we just sort of know estrogen has a part. And he said, so don't worry. We're thinking it's going to go away at menopause. was like, At 38, I'm looking forward to menopause. So, you know, that that was a little bit of my personal interest in my what is this all about? And that happened for me, you 10 years ago now. But, yeah, it's sort of recognising for everybody. I would say there's an element of talking to friends. I think that's really important, hearing people's personal stories. But the danger of that, of course, is everybody's different. But if you can feel that there's similarities in the way that somebody's experiencing something and then... And the problem, I guess, is a lot of people try things. Well, I tried that and it didn't work. 

It's actually one of the reasons why I stopped treating men in my practice, is men are, in my experience, very generalised, but notorious for going, yeah, I tried acupuncture, it didn't work.

I how many treatments did you have? Or one. What was the condition? I'd had sciatica for 10 years. I was like, that was a pretty wild expectation you had from that treatment. So it's a little bit the same. It's managing those expectations. And then the magic is like, wow, that's, you yeah, you're right. Acupuncture doesn't work for anybody because it didn't work for you fixing something you had for 10 years. know, it's just so that that idea of if you are going to try something, commit to it.

The magic wand, the magic needle.

I'm talking one to three months. Don't dabble with something. you found something, so for example, again, you're to hear from Natalie talking about mushroom products, supplements, give it three months of continuous, taking herbs, seeing an acupuncturist, give three months before you make a decision on whether that's going to work for you. Don't try once, yeah, I had acupuncture once. It didn't help my hot flushes, which I've had for seven years. It's like, you're looking at this idea that we're dealing with a very complex system, this complex chemical sack. It's going to take a while before it regulates. Chinese medicine is lovely. in your next podcast, you'll be hearing about the seasons and how they relate to not only we've got all our stuff going on with our home, within our workplace, this is what's happening on the planet within the globe. What happens in winter for menopausal women is very different from midsummer, particularly here in 35 degrees in Ibiza. Very different than lovely 10 degrees in our winter time. you know, there's all these environmental things as well. 

It's to be honest, Maude, that's actually why it's such a fascinating area to work in. You know, I have really loved this area of menopause because I've just loved understanding that. But you did ask about my personal journey. And so for me, it's exercise. For me, it's getting in a pool. I swim a lot. You know, that I'm just starting to look at running these swimming retreats for women with menopause.

The idea of sea swimming, cold water swimming, yoga in the morning, sea swimming in the afternoon, and using nature and using our bodies in the best way we can. And of course, you call in help, you call in your gynaecologist for your backup. That's your sort of emergency team, but your acupuncturist and your own choices that you're making are your forefront, sort of primary care system.

I can't wait to come and see swim with you in Ibiza. We're going to be planning a retreat shortly. the space. Three things that I wanted to pull out there. Number one is baseline tests, right? Having a look at what's my health like in my early forties or my late thirties. And do I speak to my gynae or my GP or whatever healthcare practitioner I have around, do we do some baseline tests around things like bone density or cognition or blood or where things are at with my body so that we have got something to come back to as I go through that transition.I  think that can be such a useful place to start.

And this is where the friends come in. This is where talking to friends and so the friends saying, I'm taking this and doing this, that's not as helpful, is have you got a good gynaecologist? So finding a good clinician and that's what the friends can help with. A good person locally that you can go and see and a good gynaecologist when you walk in and say, I'd like to get some baseline bloods done, will go, bingo, bongo, perfect, because that's somebody who I'm happy to take on this journey. And it's what it is, it's a journey, it's a 10 year journey.

And the other, doesn't have to be disastrous. We know we do hear it's terrible, but it's the idea of recognising it's moving into this new phase, this new role. It's understanding that people may lose confidence and may feel like you've lost your shit for a while, but it's to get to the other side. that's one of the things I love doing is I love in my community, love walking down the street, looking at women, older women, that they show up and the ones wearing bright red lipstick and they've always got short, crazy haircuts and...they've hacked it, they've gone through. So it's finding those role models as well, role models. Jane Fonda, she's one of my favourite women on earth. Look at her life, how she's travelled through her life. And it's finding those women that you can look up to and say, that's where I'm going, that's who I want to be.

Hmm. There's something there around community, not just in calling in expertise, but also where am I looking to for inspiration? Where am I looking to for role modeling and how we are so lucky in 2024 that we have people who are in the public figure and we have people who are on the cover of magazines with, you know, beautiful silver hair and strong and still out there and let us be part of that next generation. So I really love that.

The other thing that I was thinking about is you talked about tracking your symptoms, know, so thinking about what has been going on in your body. One of the things that I have created and send out to clients, maybe I'll link to it below is the 36 symptoms of this menopause transition that you might notice and actually making some notes against that. So you can go to your healthcare practitioner and say, Hey, I've been looking at.

You know, these, I'm suffering from these, this is when it's more severe, this is when it's less severe. So you're going with more information rather than, you know, expecting them to come to the answers. You're coming with your maybe family history, with your symptoms, with your knowledge of what your body's been doing.

And the thing with that more is just, know, segueing from that just for a moment is that it's the symptoms that we don't recognise as menopause, because everybody knows a hot flush as menopause, you but a hot flush is actually quite dramatic. That's like a volcano erupting, you know, that Iceland volcano that erupted in the World Chambers of Stans till, you know, 20 or 15 years ago, whenever it was. But the idea is it's the other symptoms of menopause that aren't often the checklist, the lack of confidence. The waking up feeling like your shit is quite literally falling apart. It's the soft edges of that that isn't being detected. There's almost like a medical checklist and then there's like a psychosocial checklist. 

And one of them, for example, is this feeling of, like libido, loss of libido. But it's, example, orgasm is changing. People's arousal changing going, I just don't get turned on anymore. It's like, you don't get turned on visually. Women don't look and feel somebody's attractive. But what happens is arousal becomes very tactile. It's like you're going to be turned on until you're quite literally being potentially touched for maybe 10 or 15 minutes. But it's not that your libido is dead. It's just that it's changed in what signaling it needs to get it fired up. So it's that recognition that it's the lack of confidence. And we just said that twice because that's part of being a perimenopausal. Forgetting what I've you know, it's you forgetfulness and forgetting words and that idea because you do feel clumsy and you feel, you know, for a moment, I had this talking to a friend the other day and I said, we're talking about menopause. And she said something. Yeah, yeah. Well, I'm dumb. And I said, wow, I'm so impressed. You've just said you're dumb. Like you've just owned it.

And she said, no, actually I said I'm done, as in I'm done with my periods, therefore I'm effectively menopausal. And I was like, I thought you just said, well I'm dumb. And I thought, God, that's great because it's such a get out of jail freak. We're all trying to pretend to be so smart all the time. And I thought, I'm just dumb. I was like, how liberating. And so was like, standing in the queue, for example, and you've forgotten your PIN number, you've got all the shopping, and you've forgotten your PIN number, rather than going, my God, I've got my PIN, I'm so flustered, what's going on with me?

How can I can't remember my pin? Just stand there and go, I'm dumb. And just be owning that space just a moment, you know, and calling it out. And I now often say to people if I'm talking and I, here's another one, you're running to someone that I know I know. And just going, I'm so sorry, I'm perimenopausal. So your name has fallen in my perimenopausal black hole. I know who you are and how I know you. But just that name part has gone in the perimenopausal black hole. Could you help me with this? They're like, it's Sally. sorry, Sally. Of course it's Sally. We're next door neighbors. But it is, that's what I when I lose words, words fall into black holes. So when they say, you know, when they talk about memory, they're not talking about remembering, you know, where you live. It's talking about remembering, you know, really basic stuff. You know, just yesterday, I put my coffee in the microwave to heat it up. And I'm standing in front of the microwave watching my coffee heat up and going, where's my coffee?

It's really bizarre. It's quite literally, I think I'm going mental sort of stuff, but I'm in a fortunate position of just being able to go, this is what this looks like. I'm just going to call it menopausal transition. so again, I'm lucky that I know, for example, the work you do, writing lists all the time and other systems in place. My keys are always on the back of the front door. I don't ever have to go looking for my car keys because I've trained my body to have know where everything lives in the house for the most part.

Mobile phone lives there, keys live over there, cars out the front. I can get myself to and from work if I know where I've put things. But here's a great example too, that my kids as they're moving into their teenage, you know, talking about this idea of chemical sacks all in one roof. My kids know that if I say to them, get off your phone, I'm going to take it from you. They know that I'm going to take it, hide it and forget where I put it. So if that's a real threat, because if I take their phones off them and I hide them somewhere, we're all looking for it for days and just the other day, I was a, a keen swimmer and I opened up my swimming bag and I found a Nintendo in it. I was like, that's where I put it. That's where that went for about a month, for about a month and a half. So I just said to my kids, you know, like get off your phone because you know that I'm a perimenopausal woman and you know that if I take it, you're going to, it's going to get lost. so because I do, have a tendency of hiding it rather than hiding it in the same spot because they know my hidey holes.

Pros and cons of the forgetting.

So I have to change my hidey holes and then I forget where they are. So it's a real threat. So it's, yeah, it's this idea of rapid recognising all them.

Yeah. And it sounds like also owning that and talking about it, both to your children, to, you know, people who you're forgetting their names of when you're talking about, how do I step into that? How do I just admit, Hey, this is what's happening. it removes that level of shame or I'm doing something wrong or something weird is happening to me and just makes it that kind of shared experience. And the last thing that I wanted to just pull out that you were talking about is giving things time when you're looking at supporting yourself. 

I see this too in coaching, you know, people, it's easy to have an aha moment or a recognition of something or to try something one time, but the real transformation or the real change in your life happens over time, happens with that consistency over time. So when you're saying, if you're going to try, you know, Chinese herbs, or if you're going to try whatever it is, estrogen, or if you're going to try shifting your nutrition to support yourself, give that three to six months, give it consistency and time before you make a decision of whether that's working for you or not. And maybe also that space to experiment. Well, do I tweak it a little bit or do I change it? Or, you know, what worked for my best friend may not work for me because I've coming with a different family history or I'm coming with a different medical background. And so giving yourself that attention and time and energy and focus to be consistent and to tweak, which is where you require the boundaries, which is where we require the confidence to set the boundaries, which keeps on going in that kind of circle of supporting ourselves and acknowledging that this is something that we're going through together and how do we make it as healthy, as full of ease, as full of support as possible.

And this is again where I would say, this is what an acupuncturist will do because it's a whole system of medicine. And so one of the lovely things about acupuncture is you have to show up to receive it. So it's not something you're taking, know, as you're drinking your coffee and heading out the door and on the phone, it's you have to give yourself that window of time with 40 minutes, maybe an hour, and you have to go there and you have to exchange that with a clinician. And that clinician is trained to understand all these different nuances. 

So one of the lovely things about a system like Chinese medicine is trained that every single person can be understood under a pattern of diagnosis. So while you feel like you've got all these different things that are all happening, an acupuncturist will just be able to identify, that all fits within this pattern. what I'm going to do for your pattern is this particular treatment. And what I advise for you is these types of foods, avoid these, eat these, drink that, stop drinking that, do more of this, do less of that.

So in Chinese medicine, the idea of yin and yang, it works in this idea of balance. So what we're trying to do is encourage, you know, hot and cold, up and down, in and out, sleep versus exercise versus rest. There's all these different, you know, opposing forces. And so I have spent 30 years basically saying, you need to do more of this and less of that. We need to do, you know, it's this idea of just trying to look at these two things that are going on and you'd see this in your burnout clients. They've done way too much activity and you're just saying you need to stop that, all that young activity, that young and you need to do more yin type stuff. So again, you know that we talk about yoga and I love the idea of yin yoga. 

You're just lying down and feeling really good but that's what yin is. Yin is the lying down, yin is the resting, yin is night time, yin is cooling, yin is nourishing and that yin energy is very feminine. Yang is very male and yin is very female. And so, you know, an acupuncturist will help women to navigate what more yang activities they need to do and what more yin. But just one of my favorite things to talk about, and I can't leave a podcast without throwing in sex and masturbation because it's one of my favorite yang activities. So I always talk about exercise, I've got, know, I've sort of coined the terms of sexercise as well. And it's really understanding that a lot of these hormones are tied so closely into the uterus and to the female gynaecology. And that what can set off an incredible pleasure cascade and healing cascade and stress release is having a really active sex life. And if anyone's ever looking on the symptoms of menopause is not medically trained, and you'll see the word vaginal atrophy, what basically happens is the vagina is soft tissue muscles and it's a tube. It's a tube which is long and it's also quite narrow. it's this lengthy tube.

Atrophy means dying off of the cells. So if they said vagina dying, maybe people might be a bit more alert to the importance of good vaginal care. But what it means is that the tube itself, the vagina muscles become narrower and they become shorter. And this is why if somebody can go with a period of time without having sex, sex becomes painful and then you don't want to do it anymore. 

Or there's another thing, vaginal dryness. So again, you lose that sort of natural lubrication. So, you know, I'm always really encouraging people like use it or lose it. Make sure that you really are taking really good care, you we brush our teeth every day, we take care of our face and you put as much care into your skin care as what you did into vaginal care. You there isn't any need to go through some of this suffering because once the vaginal atrophy is, it's quite difficult to reverse these types of things. So therefore prevention, you know, so it's I would always say to anyone, you know, in a long term relationship or really understanding the importance of sexual connectedness, of masturbating, vaginal masturbating. often, again, women will often masturbate clitorally, that it's actually understanding like it's penetrative masturbation that is really, really important for good vaginal health. 

That's really good for our biochemistry, which is really good for our mental health, which is really good for our families, which is really good for our work. It sort of all comes back to investing in the things that you can do and that there's so much that women can be doing that before it all falls apart.

But it is, it's recognising. It's like, I'm starting to fall apart. I'm losing my confidence. Can't seem to get my shit together. Dropping things, forgetting things, you know, just that feeling of coming unstuck. So maybe that's sort of what, you know, we need to understand menopause really is about before we get to the serious stuff and the hot flushes and the night sweats. So it's just, you know, giving yourself permission. Name it to tame it. Once you've named it, then you start looking at what the solution can be.

Yeah, I want to come back to sexuality and keeping our vaginal canals alive and blood circulating and muscular kind of structures working because I think one of the things that often goes hand in hand with being in our 40s and 50s is maybe a difficult time in our partnership or our marriage, right? It's not always easy.

At that particular time, we're busy, we're stressed, we're maybe growing apart, we might be going through divorce transitions as well at the same time. And I think often what I see in women is them almost handing over their sexuality or their power to others of, it's their responsibility to turn me on or if I'm not having sex with ex -partner that I'm not having any. And one of the things that I've done or educated on in the past is a Jade Egg practice. So using a jade egg internally to strengthen the kind of pelvic floor and musculature. And so it's really in line with what you're saying of how I also take ownership of this part of myself, right? 

How do I create pleasure or look after my body in ways that aren't so publicly talked about in ways that feel more undercover, but that can impact me dramatically when we think about conditions further on in terms of incontinence or in terms of having hysterectomies or in terms of general health and feeling of self. So thank you so much for bringing that in. That was courageous. And I think something that can be so, so useful for women out there to think about and hear about is what's my sexual health like? What's my relationship like with my body? What am I doing to support myself when we think about an all -encompassing transition plan and support plan over the next 10 to 15 years. How am I looking after that part of my body as well?

And it's funny too, know, I've written this medical textbook on menopause and people sort of say, well, you know, what was, what's the, what's the backstory? And I say, well, I'm really interested in masturbating for menopausal women. It's like, that's an interesting subset. And in my interest, I started sort of 10 years ago when I was sort of in my clients here in Ibiza. And I, you know, this is to give you an idea of how not talked about it is, is there at the time there's been this very famous website dedicated to female sexual pleasure.

So female safe, self sexual pleasure, masturbating for women. I'm not going to name the website, but it's a massive one. And it's been around for about 20 years. And I contacted them and I said, I am so impressed that you've dedicated your entire platform to encouraging women to masturbate. But I'm really interested in working with menopausal women. So could we collaborate? Because at the time I was interested in before the textbook came along, I was interested in doing a PhD. So I thought, well, can you can I collaborate with you on a PhD research? I'd like to do a masturbating for menopausal women and they replied back and said, sorry, it sounds interesting, sorry, seniors is not our market. I was like, I'm like effing G, I can't believe that a website dedicated to encouraging women to masturbate are calling 45 year olds seniors and effectively writing us off. 

And I thought, I'm not going to do a PhD because I can't do a PhD when there's no research out there. You know, it's really it's a really difficult subject to research if there isn't really much going on around masturbating for menopausal women. So instead, I went down this other journey, but it was there's a whole chapter in our book that was dedicated to research the benefits of masturbation, the benefits, the benefits, because we sort of understand the benefits of sex. But but I think sex as a divorced woman, I think sex implies too much of reliance on a know, a heterosexual partner, where sex can mean a whole bunch of stuff that it's what we really should be saying is, you know, vaginal activation. And that can be anything, as you say, the jade egg with a vibrate of a dildo with a finger with a partner, self, you know, it's recognising that this is and I'm not talking about lewd sexual stuff. This is not about, you know, horror. I'm actually quite prudish, but it's the science. I'm a scientist.

And that's what I'm coming down to. I'm a scientist and I like understanding muscles and how they work. And I like understanding the interaction of how if this part of our body does this, how does that affect our brain chemistry? And it's just looking at there is a direct connection between the vaginal tissues and the vaginal wall and our estrogen levels and our understanding and our testosterone and our sex drive. And it's understanding that those connections are so important. It's also about longevity and about maintaining sexual vibrancy. And I also feel there is an element of self -love and also, and this is probably another podcast episode and not one that I can talk about as an expert, but certainly there's a lot of work looking into women lose their sexuality and libido during menopause because it's a gate of life and sexual trauma, potentially from childhood and around the teenage years may show up then.

So not only is libido, that this idea of our bodies changing, that this is an incredible healing opportunity, that women that may have had sexual trauma at some stage in their life, that through these processes of re -establishing a healthy relationship with themselves and their sexual organs can actually heal what may have been an event that had happened say 40 years previously. And I think that that in itself is like, wouldn't that be amazing?

Wouldn't it be amazing to have another chapter of your life that didn't involve trauma, or didn't involve carrying a secret, or didn't involve hurt or heartache or feeling shame or guilt? And that seeing menopause is this incredible opportunity in life to just, everything that's come before can stop. And the gate of life theory in Chinese medicine is you're entering into a new gate. And so I'm going to leave the gate theory for my colleague, Natalie Chandra Saunders. She can talk about that. But certainly this idea of sex and sexuality through menopause, is a really exciting area and it's really just, know, for some women it might be the start of a whole new relationship to themselves and isn't that beautiful?

And there's something there about like stepping into sovereignty, stepping into autonomy around my bodies, which is so in line with when we were talking about thinking of that in terms of our health, thinking of that in terms of our time or our capacity, building that skill in setting boundaries. And how do I do that for my own body? What do I nourish my body and that looking at that holistically, not just my face or my wrinkles or my arms or my weight bearing exercise, but also my sexuality and my sexual organs and bringing that.care and level of attention and wanting to accompany each other for the next 40 to 50 years, right? It's like, I want to live a long, healthy, sexy, pleasure-filled, strong life, not just now, but to my 100-year-old self.

And also that idea of taking out seething resentment out of the marriage. You can have sexual tensions that just sort of build up over time and it's just this incompatibility. And I do give my clients, well, I'm just not attracted to him anymore. And I look at him, you he's not sexy and he's got his dad bod. And it's like, that's sort of taking on responsibility for your own sexual pleasure that then will benefit the relationship if you're in one.

And again, even with a female partner as well, it's an idea of just taking agency, you said, taking sovereignty and taking responsibility and not outsourcing that sexual pleasure belongs to something somebody else is going to do. It's if I can do this for myself, then I can bring this into the relationship. And that's just being a really important part of autonomy and feeling, again, feeling like in control, which is menopause is so much letting go of control.

Kath, I feel like we could carry on talking for days. I appreciate your time so much. Thank you for coming here, for talking to us about so many different topics. I have written a whole page of notes in addition to an hour of recording. So thank you so much. I appreciate you.

And to you, Maude, thank you so much for the way that you work, not just who you are, but the way that you work and just your ability to hold space for women as they're going through this. my God, my shit's falling apart. So it really is a unique skill that you have. It is, it is. it's, know, and I love, I love that we are, we're so fortunate to belong to a sisterhood. And, you know, as you said, I do look forward to seeing you here in person in Ibiza at some stage in our future when we get to that!

That is my actual literal pleasure. We're going to make it happen. Yeah. Beautiful. Thank you for the time.

We'll make that happen. I know between you and between me and between the people we're networked with, this is going to happen, which I'm really looking forward to.

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Maude Burger-Smith