SPEAKER_01 0:17

Hot flushes, night sweats, mood swings, brain fog, irregular periods, we've all heard of those menopause symptoms, right? But what about waking up with a metallic taste in your mouth or having an itchy scalp when you haven't changed your shampoo? Or feeling as though you've got tiny insects crawling all over your skin, even though there's absolutely nothing there. Or the ringing in your ears, burning tongue, frozen shoulder, dry eyes, foods you've happily eaten for 30 years, suddenly deciding they don't agree with you. And seriously, what the hell does your shoulder have to do with your ovaries? Apparently, uh, depending on which website you visit, there are 34 menopause symptoms, or 50 or 70, or more than 100. And at this rate, I'm pretty sure that we're going to start seeing losing your car keys and swearing at the dishwasher on that list pretty soon. Although, to be fair, it could be related. So, welcome back to Empower Your Menopause, the podcast all about health, happiness, and hormones for women 40 and beyond. I'm Coach Julie Medacy.

SPEAKER_00 1:22

And I'm Coach James Ellis.

SPEAKER_01 1:25

So today we're going to go down a little peculiar rabbit hole, right? The strange, surprising, and maybe sometimes actually bizarre things that women report experiencing during their menopause transition. So some of these have are recognized hormonal conditions, like clinically recognized. Others have a lot of emerging evidence to support them. And some are things that women have reported along the way, maybe without a clear scientific explanation. But that doesn't mean they aren't real. So today we're going to talk about some of the differences, hopefully, have a few laughs and talk about why it's important to understand what's happening in our bodies without blaming absolutely everything on menopause. Sometimes it is related to hormones, and sometimes it might be something else entirely. So, long-winded way to say how many menopause symptoms are there anyway, James?

SPEAKER_00 2:22

Well, like you said, Julie, I mean the list is constantly growing, right? I was looking back today at one of the freebies that we offer people and have been offering people for quite a while. And we first put this together seven, eight years ago. And it's actually called 17 signs urine perimenopause or the menopause transition. And you know, that is probably about the number that are the key sort of things that most women recognize, but then there's about another 17 on top of that on a list of around 34 that's widely circulated. And the problem is that you know the list's not exhaustive, it's not universally agreed. Sometimes clinical classifications can get in the way, and you know, it expands and expands and expands. Many coming from anecdotal experience, so that doesn't mean that anecdotal experience isn't real. If somebody's living it, you know, who wants to take away from somebody's lived experience, right? We don't do that. Um but you'll see online lists with like 50, 70, or 100. Um one of the things that we did with 17 signs when we first started doing it was we kind of batched some of them together. 17 seemed like um a good number to have because you know nobody likes round numbers around 10, 15, 20 or whatever. It's kind of boring. So so 17 by grouping a couple together, um, that kind of helps us get to that number. The thing is, is that some of those lists have actually probably taken those and expanded them. I don't mean taking the 17 signs that we have, but taken sort of like other things so closely related symptoms, and they've divided them into multiple entries, and that's why you're getting up to 100 plus now. Um I'd hate to be the person who tries to put an app together who's gonna monitor sort of like a hundred symptoms and try and work out what exactly is going on, because that is quite a quite quite a lot, right? Um the other thing, as well, is that some of them have got things like underlying conditions, different hormonal interpretations or consequences rather than a distinct distinct symptom of itself. So, one thing that we do know for absolute sure is that while there is a commonality in some experiences of menopause, there's also vastly huge differences in how women experience things, right? So this is not just about you know, you get a checklist, however many that could be 30, 50, 70, 100, whatever it is. The number's actually not important because nobody is ticking off every single one of those, however small the list may be. Even if you go back to our original 17 signs, I don't think anybody ever came back to it and said, guess what? I ticked off all 17. The clinically um tested and relevant menopause intensity score that we use with some of our clients. This has been tested in loads and loads of different scientific um experiments and studies. I think that actually has 12, and they're kind of like the 10 or I say the 10 or 12, I can't quite remember, they're the 10 or 12 core ones uh that you get there. So, of course, then you've uh aside from whatever number you dec decide to try and record, then other things vary as well. Intensity, you know how strongly are you are you feeling that? I've come across some women who have been in the menopause transition and they literally can flip on a switch, an invisible switch, and imagine uh uh uh not a real switch, obviously, but suddenly they will go from being feeling absolutely normal to absolutely flushing, red in the face, sweating as though you've just taken them into a you know a thermal heat chamber in a in a in in a scientific gym that helps people uh climatize to to a hot climate. And then other women won't even feel a single hot flush at all. So intensity varies, duration varies, you know. Some people um say that they're hot flushes come and go. So that's why in American the American literature you mostly see them written, you see it written down as a hot flash, and then somebody said, Well, hold on a minute, you know. For many women, this isn't actually a flash, it's not just sort of like happening for a second or two and then going away. And that's where where the term we use in the UK more hot flushes tended to come from because people started to appreciate that it was a longer duration thing. And then you've got kind of like the impact as well, that maybe some things that some people are quite happily or quite will quite happily live with, you know, is you know, not forgetting or forgetting where your sunglasses are and then realizing they're on the top of your head, you know. I mean that that happens to me as well. You know, I'd like to think that why I have while I have lots of empathy, I'm not actually menopausal. So, you know, it it it and I think for for many people that would be the kind of thing that is almost one of the ones, you know, those momentary lapses in concentration or a little bit of tiny brain fog that it's not even a massive impact. For many people, they will actually be quite humorous, and so they might not even um be something that impacts them massively. So some people might somebody might say, Oh, do you know what? The other day I was looking for my glasses and then I found them on the top of my head. Or I was into a room, couldn't remember what was there, and then I walked out again, and then I walked back in and I remembered what it was for. And they might think that has very little impact. There are other people who may be really being challenged by um brain fog and forgetfulness, and it having a really severe impact on their life, particularly women who might be in a working environment. So, you know, if you're if if you're in an office and the expectation in that office culture is perform, perform, perform whatever's going on in your personal life, you know, that can be quite a challenge for some women to actually even be able to admit that they're feeling brain foggy or slightly forgetful. So things will will change, and I I I suppose the thing is what we're looking at this. Some things can be reported during menopause, or some people will say that that's what's happened to them. Some are actually associated with menopause, and some are caused by hormonal changes. So they're not really equivalent claims. I guess a symptomist can prompt some useful questions, but what it can't do is diagnose the cause of an individual woman's experience, despite the fact that you know, for most women the official diagnosis of menopause comes from or or perimenopause at least comes from from symptom load until cycles start to change and you can get to the actual medical definition of 12 year 12 months since uh last period. So here's a question for you then, Julie. At what point does a symptom list actually stop being useful and start becoming just a catalogue of anything that can happen to a woman over 40? And if we are going to count every possible experience, where do we stop? You know, I'm sure that yourself yourself and many of our listeners could probably add a few extra things of their own. And I suppose the other thing as well that we need to recognise within all this is that historically women have had some real symptoms dismissed because they didn't fit a familiar pattern. So Julie, what do you think? Where does a symptom list stop being useful? And and and does it become just another tool that women get overwhelmed by? What was your experience like?

SPEAKER_01 10:18

Yeah, I think I think it can become very overwhelming because we're trying, we're already trying to figure out what's going on. And then you see this massive list of symptoms, and maybe you aren't experiencing most of them. And all of a sudden you're you're worried now because you see all the things that could happen, and then pretty soon you start thinking about every every twitch, everything that you're you know, everything that enters into your brain. Oh, I gotta go check the list. You know, it can become we we become obsessed with diets and calories, and we look for labels to understand what we're going through. And so I think some of those really long lists can be maybe not quite as helpful as they're intended to be. So I think we need to just take that with the proverbial grain of salt and say, you know, there are going to be some of these things that may happen, at least if you have a list, it's a referral point. So if you are experiencing something strange, it's a reference point that you can then take to your doctor. Um, but yeah, I think it can be certainly for me, as I look at those lists, and I'm post-menopausal now. I look at those lists and I get overwhelmed.

SPEAKER_00 11:30

The last day or so you've been looking at some of the more weird and wonderful um symptoms. Why don't you talk us through some of the things that you actually found when you're looking into this? Because some of these seem pretty crazy, right?

SPEAKER_01 11:52

They do. So let's start with my favorite. Have you heard of formication?

SPEAKER_00 11:59

I have not, unless I misheard. But I'm hoping you didn't say fornication.

SPEAKER_01 12:13

No formication with an M. Concentrate here. It's it's a weird sensation that feels like insects are crawling on or under your skin, like ants. Um, and it's interesting in in Italian, formica is the is the word for ant, so formication probably has some Latin roots. But um, there's nothing actually there, right? And that's considerably less entertaining than what you thought you heard, but it it can be a really strange sensation. And some women report experiencing this during their menopause transition, and it it can be related to menopause because our hormones, as we've talked about in the past, have they they have an influence or an impact on every cell in our body, just about there are hormone receptors in so many different systems, body systems. So they can influence sensory function and the way our skin behaves. But formication isn't specific to menopause. There are actually other explanations, like different side effects from different medications, neurological conditions, and other medical problems. So this is different from ordinary, like itching or dry skin, which also are related to menopause as far as symptoms go. Um, but that isn't net, it doesn't necessarily mean that it's it's specific to menopause. So it is important to go over these things that you're experiencing with your doctor because I I know women who don't mention these really strange symptoms to their doctor because it feels so peculiar. But remember that unusual doesn't mean imaginary, it it doesn't automatically mean hormonal, so it's important to rule out um to rule out other causes. So one of the other ones that uh we see fairly regularly is a burning mouth or a metallic taste. So imagine sitting down to your favorite meal and suddenly everything feels like you've just licked a handful of coins. There's a nice graphic illustration, right? Some women are reporting altered taste in their in dry mouth or burning sensations of the tongue, even in oral discomfort around menopause. So changes in saliva can be caused by you know hydration levels and another thing, and oral tissues can be quite sensitive to changes in pH, changes in the amount of saliva and the enzymes in your saliva. So burning mouth syndrome has been quite studied in middle-age and older women, but it does have complex causes or it can have complex causes. So things like nutrient deficiencies, effective medications, again, enter in there, dental conditions, oral conditions, or other health situations. But persistent burning or taste changes should be assessed rather than automatically assuming they're menopause, because again, you know, it's it's really important to clear these things with your doctor so you know what's actually going on. But I find it interesting that, especially in menopause, we talk so much about vaginal dryness, but how often do we talk about dryness affecting our other tissues and our body? Is hormone changes have an impact on all of those things? But again, it doesn't necessarily establish the cause, so we can't use that to diagnose ourselves. And then we've got things like tinnitus or tinnitus, as we say in the UK, which is ringing in your ears. That's one that really surprised me when we were studying for our menopause certifications, because why it just seems like such a strange thing. So it might sound like ringing or buzzing or humming or hissing, and it's really common now to notice that around midlife, around that menopause transition. So researchers are exploring different possible hormonal influences on our auditory function, but we don't have a direct explanation for that. Um, but notice um notice if these things are happening. If you have a lot of exposure to heavy and loud noises, you experience hearing changes. Again, medications can have an impact on this. Actually, there are quite a few medications that are connected to tinnitus and other ear-related conditions. So it it really does deserve attention, especially if it only affects one ear or comes with hearing changes. So make sure that you are talking to your to your doctor about these things. And and the the question is, you know, what happens when you start having several of these symptoms all at the same time? You know, it it's so tempting to connect them all to one explanation, right? But we can't quite always do that. So I'm gonna stop talking for a minute and hand that over to you, James.

SPEAKER_00 17:16

Well, I I mean, some really interesting one things there, interesting things there. The um the metallic mouth seems quite quite a challenge to me. Um, I know that that can be can be quite concerning for some of our clients. But one of the ones that you've talked about, Julie, that affected you, which totally blows my mind, and I've heard this again from a couple of our different clients is you know, frozen shoulder. What's that all about? Loads of women are reporting that at the moment, yeah. So, what have your ovaries got to do with your with your arm? What's going on there?

SPEAKER_01 17:52

Yeah, we are very strangely all interconnected, we women. I mean, all of us are as human beings, but we have uh special qualities with our hormone receptors everywhere. And I I find this really interesting. I've had plenty of shoulder issues, so I appreciate what it's like to deal with shoulder pain. It's really not very much fun. So, frozen shoulder, or if you want to get technical adhesive capsulitis, uh, it it causes a lot of pain and a huge restriction in your shoulder movement. So you basically can't move your arm very much, if at all. And it's unusually common, I mean, it's unusually common, it's really common in middle age. So there's a lot of research going into how and whether the hormonal changes around menopause influence the risk or affect connective tissue function, because it it really has to do with that connective tissues, the connective tissues in your joints. But a lot of women experience joint pain as a regular symptom. So that in itself doesn't make the frozen shoulder unusual. But, you know, there are again, there are other risk factors. We're trying to find more research into this and why it happens so frequently in midlife. Um, but there are other things like diabetes and thyroid disorders that are established risk factors, which, you know, lucky me, I have Hashimoto's as well. Um, but frozen shoulder is not the same as every pain that you feel in your shoulder or stiff shoulders, right? So it's important to get an accurate diagnosis. I mean, I I have dealt with these and I know it really affects your day-to-day life and the quality of life and what you're able to do. So if some if a woman is developing shoulder pain around the same time as other menopausal symptoms, we have to make sure we can see if there's actual connection rather than just jumping to the wrong conclusion, right? So investigate the root cause of the symptom, not just assume that it's related to your hormones. And then I've got one more that is I can relate to personally. I feel like the poster child for menopause and postmenopause, but dry eyes is is really big. And I I had issues with dry eyes for quite a while, and my functional medicine doctor actually actually um upped my hormone replacement dose because he said it was related, and that that went okay for a while. But just over the weekend, I spent the whole weekend in in uh AE emergency room here because I had sudden new like flashes and floaters in my eye, and I didn't know what was going on, and everything I could find was pointing to a retinal tear. But what happened was that um PVD, the the um the vitreous fluid that's inside your eye dries over time and shrinks over time, and it can often come away from the retina. The eye comes away from the retina. It doesn't affect your eyesight at all, most of the time, but it is possible if it doesn't come away cleanly that it can tear or detach your retina. So um, you know, these changes that we experience, dry eye is a different condition from PVD. But we can experience these things not only in paramenopause, but long into postmenopause. And you know, we talk to women who think, oh, I've been through my menopause day, I don't have to worry about that anymore. But hormonal changes can influence your tear production, they can influence the the surface of your eye, and these dry eye symptoms can continue to develop in you know throughout postmenopause. So, again, it's not the only factor. Autoimmune conditions can play a role, environmental factors can play a role, aging, medications, all that sort of thing. So we we need to Remember that menopause isn't finished business just because you're period style, but it is um it is important to to make sure you understand what's causing these different things, and that's why it's helpful to have those lists. So, James, I have talked about so many things now. What about what about others that you've heard of?

SPEAKER_00 22:23

So I think one of the ones that many of our clients talk to us about, um, and I see a lot. Uh, those of you who live local to me will know that occasionally I do some. So like uh I hang around a place called the Functional Drinks Club where people come to uh look at foods and drinks that can help with their gut health. So, one of the things that I do talk to a lot with women who are in there is food sensitivities and digestive changes. They're looking for a solution, which is why they tend to go into somewhere like a functional drinks club that sells things like kombucha and kimchi and all those kind of things that can help with your gut health. Um, and the strangest thing I find about this is that you tend to get people saying, Oh, I could eat this food my entire life. Now it suddenly doesn't agree with me for some reason. So, you know, there are lots of different, I guess, interrelated somewhat symptoms around this that occur in midlife. Um, some that will be menopause related, some that are just a factor of ageing and gut health tending to deteriorate as we age, anyway, as a species, but maybe that's exacerbated more when estrogen starts to fall off. So I'm thinking about things like bloating, constipation, digestive, digestive discomfort, changes in appetite, they happen a lot, and then of course, you've got other contributing factors as well when it comes to your gut health. You know, what your stress levels like. We've all heard of the kind of expressions like butterflies in the tummy and things like that. You know, stress directly affects affects your gut. One thing that we do know is that almost hardly anybody that we speak to tells us that you don't feel any stress at all. Sleep can affect your gut, so that can be a massive change. Uh medications affect can affect your gut and your gut health, you know, particularly things like antibiotics and things like that. Um and then other conditions as well. So, what what else might be going on in your body? Um, so hormonal changes definitely contribute to some gastrointestinal changes, but there's no real evidence, I don't think, that links menopause directly to new food intolerances. Um, feeling a bit uncomfortable after eating something's not automatically proof of a new allergy or intolerance. Um, but it's worth saying that if you do have persistent or worsening digestive symptoms, you know, get them checked out whether you think that they're uh menopause related or not. Especially if they're accompanied by some kind of concerning change, sort of like bleeding, unexplained weight loss, something like that. Um, we do offer a a gut health uh reset mini course that um can help people deal with this. So if you want a link to that, then do uh ask for it. Just bring us an email and we can send a link, and we'll also stick it in the show notes as well. But the key thing is sometimes yeah, we see a lot of people just eliminating foods for the sake of it without really investigating what's causing the problem. Um so be curious before you come back restrictive, and like I said, that go to health course, super cheap, four weeks, um and we'll help you do a little bit of a gut reset if you think that's the right thing to do. I think having discussed all these, sort of like some of the some of the adjacent symptoms, let's say, or the ones that are getting added to these wider lists. Um one thing to think about is just trying to find ways of connecting the dots somehow and recognizing that symptoms can influence one another even when the cause is not the same. So, yeah, I'll just try and give a couple of examples of where this might be affecting some women and how it might cause a cascade effect. So, you know, there's a dominant effect when it comes to sleep, right? So sleep's disrupted for some reason, whatever that may be, it may be menopause related, like night sweats. You may just be having a stressy time at work, or the kids might be playing, I don't know. Yeah, but once you get disrupted sleep, whatever the cause it may be, then you've got fatigue. Fatigue is also a symptom of menopause, but is that hormonally related or is it related to the night sweats and disrupted sleep? If you're fatigued, it's likely that you're gonna have poor concentration, you're gonna feel pain more because you're not rested. You're certainly gonna have less energy for movement, and when that happens, you get changed in your mood and your coping, and then when you've gone through that whole cycle, you know, like you're almost back at bedtime again, you know, back to more night sweats, back to more disrupted sleep, back to more fatigue, back to foot poorer concentration. So it can go around in a circle and not really stop. So I think that illustrates that there can be multiple different things that come into this, and then other things spin off from them. So, you know, it's a good idea if you're starting to map symptoms out and trying to think about what they do, and whether you do that with us, a coach, or you're doing it on your on your own through an app or something like that, just trying to work out what might be interconnected, what might not be, what the contributing factors might be. So instead of looking at all those things individually, you know, disrupted sleep is one issue, fatigue is another issue, poor concentration, another issue, lack of motivation to exercise, another issue. Try and look for those things that are causing that domino effect and that cascade of symptoms, and then you know, there's lots and lots of different ones that you can look at. You know, look at the joint pain thing we're talking about before. You know, you get shoulder stiffness, you get muscle aches, you get fatigued because of that. There's loads of things could actually play into that. We discussed some of them earlier when Julie was going through that. You know, you've got the menopause-related changes, thyroid dysfunction can have an effect, diabetes can, other inflammatory conditions can have an effect, reducing your movement or changing the way you recover might be an issue as well. You know, one of the things that I tend to see a lot in both clinics that we run and in the past with clients in my personal training business, when people feel an ache or a pain in a joint, they tend to go straight to restricting movement in there, and often that can just exacerbate the problem. Now, I'm not saying, of course, if you've had a huge muscle tear, you want to start doing sort of like some kind of shoulder presses or or um bench presses or something like that, but it may just be that keeping some gentle movement going in to all your joints can actually be more um productive than actually just stopping moving because of that. So you know I suppose the key message in this is that idea of looking for patterns before we decide that one thing is responsible for for one thing because lots of things tend to be disconnected. So, Julie, we've talked quite a lot about all these different symptoms, how they can be interconnected. Why don't you um take it home for us?

SPEAKER_01 30:07

Sure. And I I just have to uh I guess for the my final uh diatribe here, I just want to talk about something that gets under my skin a little bit. Because menopause is a normal biological transition, it's a life stage, it's not a disease. And sometimes the conversation makes it sound like a woman reaches a certain age and suddenly everything about her is a medical issue. And I don't want you to misunderstand me here because symptoms can be debilitating. I've lived through that myself and I understand, and treatment absolutely can be appropriate. You know, hormone therapy and other medical treatments can make an enormous difference for a lot of different women going through this. But when you when you step back, recognizing a natural life stage and supporting women through it isn't the same as treating aging itself as a disease. And we tend to do that quite often. We go to a to a doctor because we're experiencing these things, and suddenly we go home with a, and I was saying we love labels, we go home with a label and a medication, and you know, it's not necessarily always the first step. And just as importantly, we shouldn't tell women that suffering is simply the price that we have to pay for getting older, because that's not right either. So, you know, when something is normal, we say it's a normal part of menopause, it doesn't mean it it's easy. Um, medical care is important, but if we can get away from looking for pathology um for every single symptom, because you know, medical care and a holistic view of healthier lifestyle and and such through menopause, those things can coexist. Um, because some women have very few symptoms, as James said earlier, and other women are their lives are so disrupted they feel like they almost can't function. So I just really want to avoid turning every midlife change into some kind of deficiency that needs fixing. Once we understand it better, we can understand, as James was saying, how these things are interconnected, what we can do to change our lifestyle. So, you know, to help us get better sleep, to help us reduce our stress load, to help us do the things that that we can do ourselves, that we have the control over to help us feel better, so that we're not medicalizing every single aspect of menopause. And at the same time, we're not normalizing suffering either. Because, you know, if you're one of those lucky people who gets to go through menopause and not experience very intense symptoms, that's fantastic. It it doesn't mean you don't need to focus on your health, but not everybody gets to do that. So that's that's what I've got to say.

SPEAKER_00 33:01

Awesome. So if you've been affected in any way by this conversation and you want our help, why not get in touch? Julie and I have just reintroduced a big push for one-to-one coaching in the business. Now we've always tried to make our group programs as personal as possible we can. But the truth is nothing quite matches working one-to-one with a coach who gets to know you, your health, your life, what's getting in the way, and what you actually want to change. So the key thing to think about is that we're putting highly personalised one-to-one coaching back at the heart of what we do, bringing together all the skills and experiences we've built over the years. So whether you come to us because your weight has become harder to manage, because you're exhausted, because you're not sleeping properly, because your gut is playing up, because you've ticked off 85 of the latest hundred symptoms that have been put your way. Yeah, or you just want to get stronger and feel better in yourself, whatever brings you to us, we always start in exactly the same place, and that's with you because you're an individual, your health deserves more than another cookie-cutter programme. So, our one-to-one coaching focuses on your health, your goals, and a plan built around you rather than cookie-cutter solutions that you may be finding elsewhere. So, if you would like to check that out, just visit coaching.fabulousbeyond40.com. You can see exactly what it entails. Uh, and if you want to chat to us about it and see if it's right for you, you can book a free 20-minute call. It's no pressure, just to see if it if it's a good fit for you and it's a good fit for us. And then we can take it from there. So it's coaching.fabulousbeyond40.com. And I think that's probably as far as we're gonna go this week because we've already overrun a little bit. Um so we will see you next time for episode 100. That's our hundred.

SPEAKER_01 34:55

Woohoo!

SPEAKER_00 34:57

Um, I think we may have miscap naturally already be on a hundred, but you know, let's pretend that we haven't and that we we are actually properly on a hundred. I think we might have numbered two of the same as or something at some point in the past. Um, but we will see you next time we're out for that one. In the meantime, we've been James and Julie reminding you to stay strong, stay fabulous, and we will see you next time. Take care.

SPEAKER_01 35:20

Bye, everybody.