# Why Doctors Keep Ignoring Women’s Symptoms | Dr. Nighat Arif

An episode of [Live Well Be Well with Sarah Ann Macklin | Health, Lifestyle, Nutrition](https://invisiblenetwork.ai/podcast/1508380100), 11 Mar 2026, 2 h 01 min.

Audio: https://anchor.fm/s/1033d1554/podcast/play/116732021/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-2-11%2F419785378-44100-2-ab18e368e0a07.mp3

Exciting news - pre-order my debut book https://linktr.ee/HealthySBTH?utm_source=linktree_profile_share This week on Live Well Be Well, I'm joined by the extraordinary Dr. Nighat Arif, NHS GP, women's health advocate, author of The Knowledge and the brand new The Family Health Bible, and one of the most courageous voices in medicine today. Dr. Nighat has spent nearly two decades in the NHS holding space for the women the system has failed and she's built an online community of millions by doing exactly what she does in her surgery: speaking honestly, clearly, and without shame about the things nobody else will say. Here's What We Dive Into: - How a dare from Dr. Nighat's sister during lockdown sparked a global conversation about vaginal dryness and why she chose to begin it in Punjabi. - Why perimenopause can begin as early as 38 to 40, and what the research says about Black and Asian women going through this transition two to five years earlier than average. - How medical gaslighting and medical misogyny show up in real consultations including Dr. Nighat's own experiences of being dismissed as a patient, both for PCOS and for lichen sclerosis. - Why Dr. Nighat now recommends that women start moisturising their vulva and vagina from the age of 20, and which ingredients to avoid. - How the vaginal ring works, why it's barely spoken about, and why the seven-day pill break has more to do with the Pope than with medicine. - Why Trump's defunding of women's health research and the framing of female bodies as a "business opportunity" is one of the most urgent issues facing medicine right now. Love, Sarah Ann 💛 *** This episode is sponsored by: NOWATCH: The compassionate health tracker Connecting body and mind with unique stress recovery insights so you can live fully today 15% off with code LWBW15 at https://nowatch.com/ Mojo: the app for expert-led courses in better sex. Learn from world-class sex therapists and relationship experts with courses tailored to your needs. 15% off with code LiveWell15 at mymojo.com/livewellbewell *** The Great British Veg Out How to support your gut, energy, and hormones by eating more — not less. 👉 https://sarahmacklin.substack.com/p/the-great-british-veg-out Reset Your Health If your body feels off after stress, travel, or burnout — this is where to start. 👉 https://sarahmacklin.substack.com/s/reset-your-health-in-30-days 👉 Practical beats perfect. Here’s a free 5-recipe PDF I use to support energy and stress during busy weeks. https://open.substack.com/pub/sarahmacklin/p/download-your-free-5-recipes-to-relieve 👉 If this resonates, you can join the thousands who read The Compassionate Cure each week. https://sarahmacklin.substack.com/ *** If You Enjoyed This Episode, You Might Like: Why You Still Can’t Orgasm (The Step-By-Step Guide) | Dr. Laurie Mintz, Sex Therapist https://youtu.be/gr6RWK2LFJE *** Sign up to Sarah’s Compassionate Cure newsletter: Science Simplified, Health Humanised. Join thousands in exploring actionable insights that prioritise compassion, clarity, and real-life impact. https://sarahmacklin.substack.com/ *** Intro (00:00) A Sister's Dare That Started It All (03:24) Your Hormonal Journey from Puberty to Perimenopause (09:45) When Your GP Won't Prescribe HRT (12:18) Gaslighting and Misogyny in the NHS (21:32) Why the NHS Wasn't Built for Women (26:59) Why Your GP Is Both Scientist and Human (35:09) Why Midlife Is the Bottom (And It Gets Better) (44:06) The Neuroscientist Who Reframed Menopause (47:45) Why Googling Your Symptoms Isn't the Enemy(50:36) Who Actually Owns the Vulva? (58:22) Vulva Cancer and the HPV Vaccine Gap (01:03:25) How to Moisturise Your Vulva (01:11:50) The Vaginal Ring Nobody Talks About (01:17:33) When Governments Defund Women's Health (01:28:58) Pockets, Suffragettes, and Silencing Women (01:34:56) Stop Doomscrolling, Start Living (01:40:11) Why Spiritual Connection Matters (01:50:09) The Fight…

## Transcript

[0:00] Do not prescribe antidepressants like smarties.
[0:02] Women aren't going crazy. What they need is their hormones
[0:05] back. Women feel like they lose
[0:07] themselves, they lose their self-confidence and they lose
[0:10] their joy. I genuinely have patients who
[0:12] sit in my NHS practice with me who say I literally don't
[0:16] recognise myself anymore. Oh my God, we're failing women.
[0:19] What was the moment that you decided to kind of bring this
[0:22] online My. Sister was just like I dare you
[0:24] to talk about vagina dryness on TikTok and I just thought Oh my
[0:27] God that is literally my USP. Before we get onto the let's
[0:30] just touch upon the gaslighting. Today's guest, Doctor Nigit
[0:34] Arif. I realise I think I've got PCOS
[0:37] and I went to my own doctor and she was just like, a lot of
[0:40] women in your culture have hairy faces.
[0:42] And then I went to my own gynecologist and she was like,
[0:46] yeah, you've got PCOS. I was a bit on a chunkier side.
[0:48] And she just went, you're fat. I don't even have to look
[0:50] further for medical gaslighting and also medical misogyny and
[0:54] also medical racism because I'm in it.
[0:57] There'll be so many women who are like, yeah, I went to the
[0:59] doctor and had a simple conversation, or I put down my
[1:01] symptoms and the doctor just went.
[1:03] A lot of women feel like that. It's not a system that's set for
[1:06] women around women. Not only did we find that there
[1:08] are changes to the female brain, but the female brain is more
[1:12] neuroplastic than male brains. We don't give a shit anymore.
[1:15] It's. Such a good way to put it.
[1:17] You know this phrase that they say never cross a woman of a
[1:20] certain age? I hate that so much because it's
[1:22] steeped in misogyny. Women of a certain age are so
[1:25] kick ass. Aren't they just utter Queens?
[1:27] If you look at every nice guideline for every health
[1:31] condition, the number one key thing is always going to be.
[1:36] For the last two years I have kept a secret from you and it's
[1:39] this. It's my new book, Healthy
[1:42] Shouldn't be this hard. And I think it is a problem that
[1:45] we are all feeling. And I was feeling it so much
[1:48] that I wrote a book on it. Now, if you've been a guest of
[1:51] this podcast for a while, you know that I am all about
[1:53] kindness, self compassion. But when I dug into the research
[1:57] of this, my mind exploded. The connection between the mind
[2:01] and body is so integral, but we completely miss out on all the
[2:05] conversations on health, on how we speak to ourselves.
[2:08] And that is such a driving factor on how our food responds
[2:12] to what we eat, to the choices that we make.
[2:15] And we are so overwhelmed right now in the $8.5 trillion
[2:19] industry that is the Wellness industry, which is predicted to
[2:22] be by 2027. So if you need a helping hand,
[2:26] if you want a new way to live and be well and buy my new book
[2:30] healthy shouldn't be this hard out on May the 28th.
[2:34] But you can pre-order it now. I'll pop the link below in the
[2:38] show notes. And I would love if you could
[2:40] support me on this. And I honestly think it will
[2:42] support you too. We got welcome to live well, be
[2:45] well oh. Thank you, it's such a joy to be
[2:47] here. I'm so happy you're here because
[2:50] I honestly believe every single GP surgery in the world needs
[2:52] you in it. Oh, that's so kind.
[2:54] And that's actually really my imposter syndrome goes crazy
[2:57] when I hear something like that, because that's actually not
[2:59] true. It is true.
[3:01] It's true for women because, you know, obviously there needs to
[3:04] come a lot of empathy with Women's Health.
[3:06] Women's Health is being talked about more than ever before,
[3:08] which is incredible. But you're AGP and you see so
[3:13] many people every single day, but you also speak up online
[3:17] about the inequalities, the mythology, like everything
[3:20] surrounding Women's Health and what you stand for and also
[3:22] where you believe treatment should go.
[3:25] So tell me, what was the moment that you decided to kind of
[3:27] bring this online and outside of the GP surgery?
[3:30] Was there something that hit you?
[3:31] There were two moments. The first one was it was a dare
[3:34] by my sister. The pandemic had hit and my
[3:36] sister was like stuck at home with me.
[3:39] She's a dentist, so she really couldn't see patients.
[3:42] We were all under lockdown, everybody had to be masked.
[3:44] Our consultation had turned into video consultations and
[3:47] telephone consultations and I was actually shielding with my
[3:50] son. My middle son has had a liver
[3:52] transplant and I've spoken about that quite openly.
[3:55] And I'd started talking about liver transplants in my
[3:58] community, which is such a taboo topic.
[4:00] I realised later on because the idea of donating your organs is
[4:04] something that was not in step with the Islamic beliefs.
[4:07] That is wrong. So there's a lot of
[4:09] misinformation about that. So I'd already sort of at a
[4:11] community level, done a bit of that work with my community to
[4:15] say actually we need to think about organ donation.
[4:19] So under lockdown in shielding with my sister talking about
[4:24] Women's Health and menopause constantly on my consultations,
[4:27] my sister was just like, I dare you talk about vaginal dryness
[4:30] on TikTok. She wanted me to learn this
[4:32] terrible TikTok dance and it was one of the weekend songs that I
[4:36] can't remember that song now, but it was everywhere.
[4:40] And I just thought, Oh my God, that is literally my USPI will
[4:43] start talking about vaginal dryness.
[4:45] And I thought I will do it in Punjabi.
[4:47] I'm bilingual. I speak Punjabi, which is an
[4:49] overlap with Urdu and Hindi. So there's a huge South Asian
[4:53] population that will understand that dialect.
[4:55] And literally it started from there being the conversation
[4:59] that came online, but actually where it really, I would say,
[5:03] started my spark for Women's Health.
[5:06] Because I have to be honest, I did not want to do Women's
[5:08] Health ever. My dream was to do medical
[5:12] school, come out as a junior doctor, and then become a
[5:16] gastroenterologist. I was going to be a hospital
[5:18] consultant running down the corridor, having an air of
[5:22] authority about me. God that that went fast very
[5:26] quickly. I did a bunch of nights and I
[5:28] was like, I'm not cut out for this.
[5:30] But I say I realized when I look at looked at the life of a
[5:32] medical registrar, God love them and the work that they do.
[5:37] I just thought, Nah, that's not for me.
[5:39] I'm checking out. And what ended up happening was
[5:43] I fell in love with general practice, one of my rotations
[5:46] that you end up doing as a junior doctor when you're
[5:50] training, particularly as you they put you out into community
[5:53] medicine. And it was in community medicine
[5:55] that I fell in love with the variety.
[5:58] Everybody was different. I'll see from day one or not all
[6:02] the way up to 100. And those patients that I saw in
[6:06] general practice and I was working in Slough at the time.
[6:09] So again, a large Sikh South Asian population and it's 3:00
[6:13] in the morning. I was in A&E and this woman had
[6:16] come in and she was grabbing the side of the bed, palpitations,
[6:21] sweating, and her husband had accompanied her.
[6:24] And he said, I don't understand it.
[6:26] Buglehorn, the which is translated as she's going mad.
[6:30] This woman who was about 48 years old, she was what now
[6:33] older Nagat knows that she was having hot flushes and night
[6:36] sweats. We did a panel of bloods.
[6:39] My senior registrar was with me who was also happened to be
[6:42] Pakistani at the time and she says run a set of bloods.
[6:45] All of these women come in in A&E complaining of hot flushes
[6:49] and night sweats and actually it's nothing.
[6:51] They're having a panic attack. Pack her up and send her home.
[6:55] This is not something that we need to deal with A&E.
[6:58] She was a little bit vitamin D deficiency.
[7:00] So we told her take some vitamin D levels and take your tablets,
[7:04] etcetera. And it was only then about a
[7:08] year later, I happened to be in the practice that that patient
[7:11] was registered in. And it's weird how things come
[7:13] around. So I'm doing my general practice
[7:16] training, happy as Larry, thinking, thank God I'm not
[7:19] doing nights anymore. And this patient came round and
[7:21] she said, you were the doctor that I saw at 3:00 in the
[7:25] morning. And I have got vitamin D tablets
[7:28] and I've been taking them for six months.
[7:29] Nothing is Guchni Badal dear. Nothing is changing.
[7:33] I think that God has left my side and and I just can't even
[7:37] pray hard enough to get better. And that's when like I took a
[7:41] step back and I was just like, Oh my God, we're failing women.
[7:45] We what is it? What what is she talking about?
[7:48] I don't get this because all her bloods and bloods are normal.
[7:53] She's still getting her period. She's 48 years old.
[7:56] She's got a good job, she's well educated.
[7:58] It's not even like English is not her first language.
[8:01] It is, but I speak Punjabi, she speaks Punjabi.
[8:04] She's able to converse with me in a dialect that she feels most
[8:08] comfortable. And yet I had no clue what she
[8:12] was talking about was perimenopausal symptoms.
[8:15] And that's where the penny dropped for me and I went on
[8:18] this journey. I mean, that's quite an
[8:20] emotional story to hear actually, just because it's not
[8:22] even just that she felt that she was going mad, which is a very
[8:25] big form of like, you know. But everybody around her thought
[8:28] she was kept telling her that. But also, she felt like she was
[8:31] losing her faith. Yeah.
[8:34] That's like a double. It's a double here.
[8:36] Women feel like they lose themselves, they lose their
[8:39] self-confidence and they lose their joy.
[8:42] And I genuinely have patients who sit in my NHS practice with
[8:46] me who say I literally don't recognise myself anymore.
[8:50] I used to be this vigorous, like person.
[8:52] Now I'm forgetful. I've, I have brain fog, I'm
[8:55] irritable. I have so much rage.
[8:57] I could strangle my other half. Even though I'm in like, I'm
[9:00] besotted with my other half. I've generally had women who
[9:03] will come in and say to me in my NHS client practice that, you
[9:07] know, sex is so difficult. I now it's a it's an act of
[9:11] kindness, say to say to my husband, I'm happy for you to go
[9:14] and have an affair, which, you know, in other circumstances,
[9:19] this is a conversation that would be probably abhorrent in
[9:22] that relationship because they adore each other so much and
[9:25] you've got the partner sitting there going like Leslie, I'm not
[9:28] going to have an affair like that is something I'm not going
[9:30] to do. I know that this isn't you, but
[9:33] this is really impacting our marriage.
[9:36] So the fact that relationships, careers, it's all in cumbersome
[9:39] is affected. That's what I think.
[9:42] Women, I feel carry a lot of sadness.
[9:45] Well, it's also the point where women now feel like they also
[9:47] have to do it all at the same time.
[9:51] And so it's like a heavy load, you know, be the the perfect
[9:54] wife and go back to work and help the household and do
[9:57] everything. And it's, it's a lot.
[9:59] So what do you, I mean, I can't imagine how much that must take
[10:02] a toll on you every day. What do you say to them?
[10:05] Like when they get to that wits end?
[10:06] Like what advice do you give women?
[10:08] So the first thing is I'm always a glass half full person.
[10:11] I love it. I, I say, look, you've got to be
[10:14] able to say and rationalize that this is normal.
[10:18] So if we're thinking about the biological journey that we as
[10:21] women go through, we are born, we're born with the number of
[10:24] eggs that we have and that's actually determined by our Nan.
[10:27] So it's our we're like Russian dolls amongst Russian dolls.
[10:32] Then we come out and we go through our puberty years,
[10:35] that's when we start our periods and we've got oestrogen,
[10:38] progesterone, a little bit of testosterone that's up and down.
[10:41] And then we go on our fertility year journey.
[10:44] And it's actually much earlier than we think.
[10:46] We now know from data that possibly as early as about 38 to
[10:50] 40 that women start having a fluctuation of oestrogen and
[10:54] progesterone. And the key thing that we always
[10:56] miss is about testosterone as well.
[10:59] And so this is a biological journey, if you face it like
[11:03] we're not meant to be on God's green earth.
[11:05] We are mammals, we reproduce, and then we're meant to like,
[11:08] piss off. Yeah, and die.
[11:09] But die. Yeah, Go away.
[11:11] Why are you here still on this earth?
[11:14] But we do. We stick around because we've
[11:16] got great healthcare, great public healthcare, great
[11:18] awareness, and also because we are resourceful as humans.
[11:22] Yeah. So perimenopause starts around
[11:24] the age of 40. You're having periods and
[11:27] hormonal fluctuations and this is normal.
[11:30] We don't have a blood test for it.
[11:32] So even if your panels are normal, ignore it.
[11:35] You treat the patient in front of you and you follow their
[11:37] symptoms. And so we go through the symptom
[11:40] list and I say, look, we have solutions for this and here is a
[11:45] sort of concoction of holistic things that we can do.
[11:50] And it's not a one-size-fits-all.
[11:52] And I'll be your GP, I'll hold your hand and we'll find what
[11:55] works and tweak things along the way.
[11:57] And I think having a plan actually is just so reassuring.
[12:01] And that's lovely. And I tend to always have a
[12:03] plan. Well, I also think that knowing
[12:05] that your life isn't going to be unhopeful going forward, you
[12:10] have solutions. It is really important.
[12:12] I get any part of life knowing that there's a solution to a
[12:14] problem is kind of the like the end of the tunnel.
[12:17] But do you get, and the reason why I said every GP surgery
[12:20] needs you in it, do you ever get them coming to see you saying,
[12:23] well, you know, my GP wouldn't prescribe me these solutions.
[12:27] I'm, I'm guessing like hormone replacement therapy, HRT is one
[12:30] of those solutions. And you said holistic.
[12:32] So there's lots of others. But do you ever get people
[12:35] coming to you and saying, well, I was just told that I was fine
[12:39] because I've had conversations with friends who have started
[12:42] the conversation, called me and said, what should I do?
[12:44] And I'm like, go and see your GP talk, talk through like what
[12:47] you're suffering with, and they'll be able to hopefully
[12:49] help you on that journey. And a lot of them have kind of
[12:52] been stopped at that first kind of moment.
[12:56] So if someone's listening to this and going, OK, well, that
[12:58] sounds great. But I did that and I was
[13:00] rejected or not given those options.
[13:03] Like, what do you say to those people?
[13:05] I'm really hoping that that's not the case now because of the
[13:08] amount of awareness and the content that we put out and the
[13:11] British Menopause Society puts out.
[13:14] I'm hoping that there's a lot of guidance that's going into
[13:17] general practice. The NICE guidelines, which is
[13:19] the National Institute of Clinical Excellent Guidelines.
[13:22] They're the gold standard guidelines that we have in this
[13:24] country when we're practising medicine in general practice.
[13:28] I'm really hoping that my colleagues are looking at them,
[13:30] because they were updated in November 2025 yet again, when we
[13:33] looked at what was going to do, what's going to happen in
[13:36] regards to management of perimenopausal and menopausal
[13:39] symptoms. I need to caveat the fact that
[13:42] we're talking about perimenopause, normal biological
[13:45] journey and our bodies are fantastic are adapting.
[13:49] So a lot of people. So if I had four women, so four
[13:53] of your mates, Sarah who was sat with you over dinner, one would
[13:56] probably go. Actually I not, I didn't notice
[13:58] anything. I had maybe a hot flash or
[14:01] actually we know 20% of women don't get hot flashes.
[14:04] I probably had a few sort of brain foggy moments.
[14:07] My periods went out and killed her and then they just
[14:09] completely stopped. I'll have two out of four who
[14:11] will have a whole load of whole body symptoms.
[14:14] So self esteem, confidence, tinnitus.
[14:17] We know from data that Turkish women or those the communities
[14:21] who have a lot of oral symptoms can be affected.
[14:24] So like a metallic taste. And we tend to see that in like
[14:27] data, I think in the Middle Eastern countries as well.
[14:30] We also know from the SWAN study that was updated in 2022, black
[14:34] and Asian women go through their perimenopausal journey two to
[14:38] five years earlier as well. So we can't say 45 is now too
[14:44] young because that's where I now have started saying 40.
[14:47] Because being a South Asian Punjabi woman, I know that my
[14:51] changes have started to happen a lot earlier than what the
[14:54] textbooks have historically said.
[14:56] Also alongside that, it's like your hair, your skin will all
[15:00] become affected and your body's built to survive that.
[15:03] I just need everybody to know it is a normal transition.
[15:06] Your body will literally adapt and make your hormones
[15:10] elsewhere. So a solution such as HRT is not
[15:13] for everybody. And I say that someone who
[15:15] prescribes HRTI also need to caveat the fact that there is a
[15:19] group of people who go through their menopausal journey
[15:22] earlier. The youngest I'm looking after
[15:24] is now, well, she's now 18 years old and she has got premature
[15:29] ovarian insufficiency, which we used to think was one in 100
[15:33] women below the age of 40. I actually think it's more than
[15:35] that. I think it's probably 2 to 3 in
[15:38] 100 who will go through their biological journey early.
[15:41] And that's essentially so POI is when your ovaries stop
[15:45] functioning and we think that the probably genetic factors to
[15:47] that which pushes you into an early menopause, that doesn't
[15:52] mean that you can't fall pregnant.
[15:53] That's a whole different conversation that we have with
[15:55] women who are picked up early or girls, actually young women who
[15:58] are picked up early. I originally looked after this
[16:01] patient when she was 15 years old and she came in with like
[16:04] extensive hot flashes and night sweats and we did all her bloods
[16:07] and we found out that her follicle stimulating hormone was
[16:10] really high. So she's been married by managed
[16:13] by a specialist. Then we got a group of people
[16:15] who are surgical menopause. Surgical menopause is when your
[16:19] ovaries are taken out because of a procedure that you had to have
[16:23] all for the right reasons. But by taking out your ovaries,
[16:27] that means that we've pushed you into surgical menopause.
[16:29] And the youngest I'm looking after in my NHS clinic at the
[16:32] moment is 28 years old. She had, she won't mind me
[16:37] saying this because I, you know, I often talk about her.
[16:39] She's had huge uterine fibroids and endometriosis all wrapped
[16:44] around her womb and her bowel. And it was decided then actually
[16:48] she'd done with her family and she'd got 2 beautiful children
[16:53] and it was time to stop the pain and stop the horrific
[16:58] debilitating symptoms that she was having.
[17:01] So she's had her ovaries and her rumor removed, but the age of
[17:04] 28. So now she's in surgical
[17:06] menopause. And those patients have their
[17:09] own guidelines and they must have hormone replacement therapy
[17:12] as POI must have hormone replacement therapy.
[17:15] Then we got a group of women who are say chemical menopause, and
[17:18] these are individuals who might have had hormonal treatments,
[17:21] but typically gonandotrophin releasing hormones, GNAGNRH.
[17:27] And these are medications which basically switch off your
[17:29] ovaries from working for a little while.
[17:31] So classically, we'll see this in treatment, say PMDD or women
[17:35] who've had breast cancer and they need to switch off their
[17:38] estrogen receptors. And so we give them some
[17:40] medication to do that. And that again puts them into
[17:44] like a false early menopause as well.
[17:46] And as you know, breast cancer is getting younger and younger.
[17:49] So it's really important that I need to, for this podcast in
[17:52] particular to those listening is to say I'm talking about what
[17:56] the normal biological journey is, which is perimenopause.
[17:59] But I'm not discounting the fact that those menopause means
[18:02] different things to different people.
[18:04] And we have specific guidelines for individuals who have the
[18:07] subsections and the ways that we manage that.
[18:11] But if you're looking at your mates who are sitting with you
[18:13] going, I've gone to the doctor and they've said everything's
[18:15] normal. You need to always be making
[18:18] sure that you're tracking your symptoms and having a symptom
[18:22] diary, which I know that you advocate for a lot.
[18:24] And it's always about ruling out other diagnosis.
[18:28] The symptoms of perimenopause and menopause overlap with a
[18:32] whole load of different conditions under active thyroid
[18:35] anemia typically can also psychological symptoms.
[18:40] So stress and anxiety throughout your whole day as well can also
[18:43] overlap with vitamin D and vitamin B deficiencies as well.
[18:46] I see that liver conditions so a whole gambit of of stuff to all
[18:51] the way up to God forbid cancers, which I'm constantly
[18:54] worried about with my patients. So it's about having a symptom
[18:58] diary, knowing what's your normal and then even if bloods
[19:01] are normal going, I will still pursue this diagnosis and see
[19:05] what else we can rule in or rule out.
[19:07] And that, you know, is a good doctor.
[19:10] I attended Ted earlier this year, and I found myself in
[19:13] conversations with the founders of no watch.
[19:15] You've probably seen me wear something on my wrist, and lots
[19:18] of you have messaged me asking me what this is.
[19:21] It looks like a classic watch, but it's actually quietly
[19:24] tracking something much more meaningful, your autonomic
[19:27] nervous system. This is the system that governs
[19:30] everything from how you respond, from excitement to anxiety, calm
[19:34] to overwhelm. Most wearables just give you a
[19:36] score, but if you're anything like me, that score can
[19:39] sometimes make you feel worse, like you're already behind
[19:42] before your day even begins. No watch works differently.
[19:46] There is no judgement and there is no dopamine chasing
[19:48] dashboard. It simply reflects what your
[19:51] body is already experiencing and also helps you notice what it
[19:54] might be missing. It gives you minute by minute
[19:56] timeline of your stress responses and your recovery.
[20:00] The recovery is the most important part and it's the part
[20:02] that no one talks about and it is often the most revealing
[20:05] marker of our long term health. In just five days it calibrates
[20:09] your body and it builds your personal health fingerprint.
[20:12] You can try for free now for 30 days and if you use the code
[20:16] LWBW you can also get 15% off. If you want to understand your
[20:21] body, not just through performance but through
[20:23] self-awareness, then this is where I'd begin.
[20:29] Yeah. I also think when it's an
[20:30] empathetic Dr. as well, which I know that you have so much, just
[20:34] even hearing you speak about this, I think so many women are
[20:36] going to feel heard. And I think touching on this
[20:40] before we go into kind of more of the symptomology and I know
[20:43] there's a round ball here and the shape of a vagina that we're
[20:46] also, I can't wait. I'm looking at it going.
[20:49] We need to get to this conversation and it's colour.
[20:51] Yeah, colour. That's such a good point.
[20:55] How often do you see Never Vulva?
[20:57] Never. Well, I mean, if I was brown,
[20:59] I'd say every day, but I'm not so.
[21:05] But you do every day. Every day and I'm very happy
[21:08] with my brown vulva. Actually I see all different
[21:10] colours of vulva. You know, that's going to be a
[21:14] short no. So before we get on to the brown
[21:17] velvet, which I'm very excited to kind of dissect with you,
[21:21] which actually isn't the first one we've had on.
[21:22] This is the second. 1. And it was brown.
[21:26] So, you know, maybe we should have these back-to-back because
[21:28] they're two very important episodes.
[21:30] Woman's health. But before I do like, let's just
[21:32] touch upon the gaslighting because how long have you been
[21:34] AGP for now? Now you're asking me.
[21:37] This is making me feel so. In August this year it will be
[21:40] 19 years service in the NHS and I've been AGP for my son is now
[21:47] 15, so 14 years he's. AGP, Classy.
[21:50] Just thank you for supporting the NHS and supporting public
[21:54] health and supporting so many people, not just women, men and
[21:56] women, but also highlighting women in that time.
[22:00] I mean, obviously social media in the last kind of four years,
[22:03] you've also elevated this message more so, but talk to me
[22:07] a bit about the gaslighting, the misogyny like this space,
[22:10] because I don't think I think one, many people have been
[22:13] scared to speak out about this for the maybe the risk of their
[22:15] job. And also like hush hush, this
[22:17] probably shouldn't be spoken out about.
[22:19] And I just have so much admiration that you are strong
[22:22] enough to do this. Like it's it is amazing.
[22:24] I know you probably don't think it is, but it is not many people
[22:27] do do it. And two, I think maybe from who
[22:30] aren't in the system might not be aware that this is even a
[22:33] thing and happening. So I'd love for you to to tell
[22:37] us, you know what the landscape is.
[22:39] When I was training, I have to be honest, I didn't know that
[22:44] medical gaslighting and medical misogyny was a thing.
[22:48] And I trained not too far from here where we're sitting.
[22:50] So Bart's in the London and spent five years doing my
[22:52] medical degree just learning. And like I say, my, my mindset
[22:56] was I'm going to do gastroenterology.
[22:58] And I hadn't realized that the curriculum is set out in
[23:01] systems. And it's just like, Oh yeah, but
[23:03] the female body is a bit like male bodies, but just has boobs
[23:08] and a vagina and and that's it and has a womb as well.
[23:12] It was always added on. So you do the systems of say,
[23:15] neurology added on a little bit of Women's Health.
[23:17] At the bottom it was cardiology. So you learn about the heart
[23:20] added on a little bit about OK, maybe women have a few different
[23:24] symptoms. And it's only as I went through
[23:27] the health that my training, and then I had lots of varied
[23:33] symptoms that I put down to PCOS.
[23:35] And I realized, I think I've got PCOS.
[23:39] And I went to my own doctor. And she was just like, yeah, but
[23:43] a lot of women in your culture have hairy faces because you're
[23:47] South Asian. So that was the first thing.
[23:49] And you're just like, OK. That I mean, I just sat back
[23:52] when you said. I know, I know.
[23:54] And it's really, it's really cute that you.
[23:56] No, not cute. I apologise.
[23:57] I said that. I think it it shows you who has
[24:00] got such emotional intelligence to make that sort of face.
[24:03] At that time I accepted it because there was no term as
[24:07] gaslighting. There's no term as like medical
[24:10] racism or systemic racism in medicine, that it just wasn't a
[24:13] thing at all. So I just looked around at all
[24:16] the women in my family, my mother and I was like, yeah, we
[24:19] are. We're actually quite hairy.
[24:20] We've got lots of bum fluff and hairy backs and acne and the
[24:24] hair falls out. And then I went to my own, like,
[24:28] gynecologist, got tests, etcetera.
[24:31] And she was like, yeah, you've got cysts in the ovaries, your
[24:33] hormone profile, you've got PCOS.
[24:35] I was a bit on a chunkier side. And she just went, you're fat.
[24:38] She had to lose a bit of weight. Yeah, There's no cure for PCOS,
[24:42] which is true. And I was like, but I'm really
[24:44] struggling to lose weight. And she went, yeah, but you just
[24:46] need to eat better and lose weight.
[24:48] And I was like, but how do I do that?
[24:50] And she, she goes, well, you just need to eat less.
[24:53] And I said, but I can't eat less because you just told me that my
[24:56] hormones from my PCOS will make it harder for me to lose weight.
[24:59] She went, yeah, but you're fat, so you just need to eat less.
[25:02] So we went in this consultation. So I left that consultation and
[25:06] bearing in mind, you know, I've got a brain and I'm sort of on
[25:11] my journey to becoming a medical student at this time and, and
[25:14] within my training. And I put it to the back of my
[25:17] mind and it's sort of something that I manage.
[25:20] And I restricted my diet. So I don't even have to look
[25:23] further for medical gaslighting and also medical misogyny and
[25:28] also medical racism because you're in it, I'm in it.
[25:31] And I and I guarantee anyone listening to this podcast,
[25:34] there'll be so many women who are like, yeah, I went to the
[25:36] doctor and had a similar conversation, or I put down my
[25:39] symptoms and the doctor just went, A lot of women feel like
[25:42] that. Yeah.
[25:43] You just have to pop up and grin and bear it.
[25:46] And then the other thing was, was that I then many years ago
[25:49] down the line, as the other bit of my training was I was doing
[25:52] gynecology and I sat in a consulting room.
[25:55] So the hierarchy in medicine is such that you have the
[25:58] consultant, you have the nurse, but you have like registrars and
[26:01] SH OS. So I'm like the bottom of the
[26:03] bottom. I'm like scraping the floor at
[26:05] this stage of my training when a woman comes in and she'd gone
[26:09] through quite a few consultations.
[26:11] She brought up the courage and she goes to the consultant.
[26:14] Sex is really painful. And I'm like, I don't know who
[26:18] to discuss this with, but it's really affecting my marriage.
[26:21] And he just went have two glasses of wine, love.
[26:25] It'll be fine. A lot of women at your age feel
[26:28] like this. And this is a woman who's, like,
[26:30] in her 50s. That's awful.
[26:31] It's. Awful.
[26:33] So I'm a witness to it. The biggest issue comes is when
[26:36] you call it out. And when you call it out and you
[26:38] put your head above the parapet, it is so freaking hard.
[26:42] Like I'm not like anyone who is in this space who talks about
[26:46] it. I commend them because I've been
[26:48] at the the coalface, but I've been at the blunt end of, or the
[26:53] sharp end should I should say, of people who are not happy with
[26:57] me. And I know people aren't happy
[26:58] with me, but you can only change a system if you stay within it
[27:02] because fundamentally I believe the NHS is an incredible system.
[27:07] I will continue to work for the NHSI, love working for it.
[27:10] It saved my son's life. It birthed my three children
[27:12] with me in the NHS. So it works beautifully.
[27:16] But it's not a system that's set for women around women.
[27:19] It's set for the male bodies. And then it's just like, Oh,
[27:23] yeah, but women just need to scatter around.
[27:26] Then came Tony Blair, if you remember Tony.
[27:28] Blair. Yeah, I remember Tony Blair.
[27:31] He was like, we're going to get GPS to become specialists as
[27:35] known as Gypsies, so GPS with specialist interests.
[27:39] And that is the acronym that we used.
[27:42] And I cottoned on to it. I was in general practice at the
[27:44] time and I was having consultations with women going,
[27:47] oh, I don't think HRT is great for you because of breast
[27:50] cancer. There's a WHI study that's come
[27:53] out and now we know that's fundamentally flawed.
[27:56] So all of these little bits along my journey as a clinician
[28:00] was stacking up going, God, it's horrible being a woman like we
[28:04] we are, we are born in pain. We have pain with our periods,
[28:07] we have pain with breastfeeding, we have pain with birth.
[28:10] And then now we come to no periods and people are going,
[28:13] here's a bit of antidepressants love.
[28:15] And two glasses of wine. And two glasses lie back and
[28:19] think of England. And he was just like, what?
[28:21] What like am I going crazy? Is is there something that I
[28:26] should be doing and changing this?
[28:28] And I thought, hang on, mate, I'll be perimenopausal at some
[28:33] stage. And then I'm going to sit in
[28:35] front of a Doctor Who blesses cotton socks will be exactly the
[28:39] same as me with having no no knowledge about this.
[28:43] And the first step is, is without shame and taboo going, I
[28:47] don't know enough about this, please teach me.
[28:51] And I was so lucky that I had a brilliant GP trainer who did
[28:55] Women's Health. She inserted coils.
[28:57] She was pro HRT at a time when it wasn't and everybody was
[29:01] scaring women about breast cancer.
[29:03] She was like, look, I know that there's risks, but look at the
[29:06] study. So we went through the study and
[29:08] she encouraged me and said do not prescribe antidepressants
[29:11] like Smarties. Women aren't going crazy.
[29:14] What they need is their hormones back.
[29:16] And that confidence just over time grew and that's what came
[29:20] out on social media. I think also you can tell
[29:25] someone who does this day in day out when they're talking about
[29:28] something on social media and if it's something that they don't
[29:30] do everyday and they're not seeing real life patients, you
[29:34] can actually work out that there's a bit of bullshit there.
[29:36] But I think you can. And I very much stick to my area
[29:40] of expertise. I'm a generalist, a Jack of all
[29:43] trades, master of absolutely nothing but the area that I have
[29:46] a great passion about and I work in and I do a lot of clinical
[29:51] work in that because I'm physically touching patients,
[29:54] seeing patients looking at vulvers, the amount of boobs I
[29:57] touch, I won't let you know. And it's a great privilege that
[30:01] women have that comfort to be able to allow me to do that.
[30:05] But it's, it's, you can then tell that someone is really
[30:09] advocating for their patients. And that is a role that I think
[30:12] we need to come back to. So I constantly say to my
[30:15] friends, my GP colleagues, the role of a doctor is literally
[30:20] just to be an advocate for the patient.
[30:22] I will not cure them, I will not fix them, but to hold their hand
[30:25] and go, I'm here for you. I'm going to back you to the
[30:28] hilt. And if something doesn't feel
[30:30] right for you, that's all I need to start investigating.
[30:34] And my GP trainer who's this amazing woman, actually, she'd
[30:37] say, you know, Viv Carter, Dr. Viv Carter, if you're watching,
[30:41] she said to me, really, I did a home visit and she was just
[30:44] like, you get 10 minutes in a patient's life, That's a
[30:48] privilege because that person tells you and pulls out their
[30:52] soul to you. And there's no holds bar between
[30:56] a doctor, patient, relationship and everything remains
[30:59] confidential. So patients do come out and tell
[31:02] you everything. And I'm really nosy.
[31:04] I'm like, who you're having an affair with.
[31:07] That's a good GP who asks you that.
[31:11] No, jokes aside, but she was like, you are literally a guest
[31:14] in a patient's life. So just like you'd go into a
[31:17] home and be a guest and take off your shoes and be respectful,
[31:20] that's how you need to be. And that's really something that
[31:22] stuck with me. And I continue to do that and
[31:25] then be the advocate. So I can talk about medical gas
[31:28] lighting and I can talk about medical misogyny and medical
[31:31] racism because it happens. Now we've got terms to express
[31:35] that because we've got the lexicon.
[31:37] And So what we need to do is just say, look, I validate your
[31:41] medical gas lighting. I validate it.
[31:44] Because. I see it.
[31:44] And that I think is the biggest step forward because once you
[31:47] get validation, you can move forward to go right without
[31:49] shame. How can we fix this problem?
[31:51] And that's where I am. I want to talk about something
[31:53] important to you guys. People today are lonelier than
[31:57] ever. Most long term relationships
[31:59] aren't happy ones, and 1/3 of people under 30 haven't had sex
[32:03] in the past year. Sexual issues among young people
[32:06] have surged over 3000%. But what most people miss, the
[32:11] vast majority of relationships and intimacy struggles aren't
[32:14] physical problems, they're psychological.
[32:17] And yet, most people never get traditional therapy because it
[32:20] feels awkward, expensive, or just impossible to access so
[32:24] much about Live Well Be Well's mission is aimed to reduce
[32:27] stigma around health and help us understand ourselves better.
[32:31] And that is exactly why I wanted to tell you about Mojo, an app
[32:36] for dating, sex, and relationships that I am
[32:39] genuinely excited to tell you about.
[32:42] They are partnered with the world's leading experts in
[32:45] sexology, including some that you're actually here on this
[32:48] podcast, to create expert LED courses.
[32:52] Now, their AI personalizes everything to your specific
[32:57] situation so you can work through it privately, at home
[33:01] and on your own time. Suffering in silence doesn't
[33:04] help anyone. And I don't say this lightly
[33:07] because I've believed in Mojo so much that I've personally
[33:10] invested in the company. Now any of this resonates.
[33:13] Go to mymojo.com/live Well, be well and use the code Live Well
[33:19] 15 for 15% off Our sexual well-being matters, and everyone
[33:25] deserves support. Yeah, I think that's amazing.
[33:28] I mean, you keep having massive imposter syndrome saying I'm a
[33:31] Jack of all tribes and master of none, but you're such a master
[33:34] of being able to see people like that is an amazing gift.
[33:38] And I think sometimes, and I get it, people are stuck on a convey
[33:42] about the stress, the system's broken.
[33:44] You know, they're trying to do their best, but you sound like
[33:47] you really see people. That's an amazing strength.
[33:50] And that's actually what's the biggest thing with a medicine
[33:52] because we can give all the knowledge that we get, but if we
[33:55] don't emotionally connect to a patient or someone doesn't
[33:57] emotionally connect to this podcast listening just going to
[34:00] go over that head. One of the things is I'm
[34:02] dyslexic, so we talked about that as we started, and I can't
[34:07] see numbers, but I see humans, if that makes sense.
[34:12] And I can see. It's really lovely that you said
[34:14] that. Yeah, I've never actually,
[34:15] that's the first time I think I've ever reflected on that.
[34:17] So thank you. And I think that for me, because
[34:21] I'm dyslexic, I can't see words and I can't see numbers.
[34:25] So, but I so data, et cetera, which is why like I'm amazed
[34:29] that I'm a doctor and I'm not. No, but I do see it as my
[34:34] superpower because I can read stuff and distill it to the most
[34:38] common denominator in my head and go right now I can relay
[34:42] this to a patient. And if a pay, if I understand
[34:44] it, then the patient understands it, which is why I never went
[34:47] into research. I like academics scare me.
[34:50] Yeah, so. Much I well, when I sat down to
[34:53] you, I said how did you get through biochem?
[34:55] Because I struggled with that. I struggled.
[34:57] Me, yeah, I I think I probably fibbed it don't tell my like to.
[35:04] I mean, I had to really remember, but it was just, you
[35:07] know, everything fell backwards. But I remember when I finished,
[35:11] you know, my, my, my degree and going, OK, I have all this
[35:15] knowledge, but if someone comes to see me, what do I do with it?
[35:18] And that's the magic that you have is that you take things,
[35:21] you distill them into really simple ways to someone sat in
[35:24] front of you and you see the person you actually help that
[35:27] person. That's like the biggest route to
[35:29] entry in medical healthcare that I think that we need.
[35:32] And I think that's where we lose it because we're, we're such
[35:35] different personalities in medicine.
[35:37] And over the years. My colleagues don't mind me
[35:40] saying this. I have some colleagues who are
[35:42] brilliant, brilliant academics. But I'd be like, their bedside
[35:46] manner isn't great, who Or they are brilliant bedside manner,
[35:50] but I'd be like, they don't read the data and the research or
[35:53] they're not up to date yet. And I think that's where it
[35:57] comes when you're AGP because the whole idea is like I say,
[36:00] I'm a Jack of all trades. I sometimes need to refer out to
[36:03] specialists. So you sort of, I would say
[36:06] collect geniuses along the way. And I've collected so many
[36:09] genius and it's such a privilege that I've got that I and social
[36:14] media has really helped with that along the way.
[36:16] So I've got fantastic pelvic health physios, fantastic
[36:19] nutritionist. I've got amazing colleagues who
[36:22] do holistic care, acupuncture, you know, reflexology, the
[36:26] Reiki. I know people are going to go
[36:28] Reiki. Well, I mean.
[36:29] Really love Reiki. I love Oh my God, thank God for
[36:31] that. It's.
[36:32] Brilliant, brilliant. I'm probably like the only GP
[36:36] that's always banging on about sort of, you know, complementary
[36:39] therapy. And I think that's the bit that
[36:42] we're losing in Western medicine because at my, in my house, I
[36:46] grew up with grandparents, my grandmother.
[36:49] That knowledge of our ancestors is so instilled in my mother.
[36:52] And then my mother passed it on to me.
[36:54] So when I had my babies, my grandmother, my nanny, like,
[36:58] yeah, my nanny saw my mum's mum's.
[36:59] God rest herself, She's not with us anymore.
[37:01] She phoned my mother from Pakistan and said nigat needs
[37:05] all of this. And there's something called
[37:06] Binjidi, which is this concoction of butter and nuts
[37:09] and all the good sauce, seaweed. It's like amazing iodine,
[37:13] Iodine. It's brilliant.
[37:15] And you look at that and it is, you think, gosh, it is like a
[37:19] village to raise a child. And so but not just that, to
[37:24] manage your after birth as well. And I stayed at my mum's house
[37:28] for three months afterwards. My sister, my brothers, I mean,
[37:32] we're by no means living in a mansion or anything, but it was,
[37:35] even though I'm a doctor, I had that level of support, which I'm
[37:38] ever so ever so grateful for the privilege to be able to have
[37:42] that. And I think that's the bit that
[37:44] we're missing. We're missing what our ancestors
[37:47] handed down to her. My mother's banging on about
[37:49] turmeric. You know, now you get, like,
[37:50] ginger shots. Yeah, like my nanny said that
[37:53] like decades ago. And I bet that she is.
[37:56] Now suddenly having a moment and you're like, what?
[37:58] Howdy is something we put in everything.
[38:00] Exactly. Well, I, I mean, I cook with so
[38:03] many spices and herbs, but The thing is when you're cooking
[38:06] from kind of any ancestor, they're actually making it with
[38:10] their hands. Whereas sadly what you buy in
[38:11] the shops is like 1% ginger and 99% apple juice.
[38:14] Yeah. And that's a scary bit.
[38:16] We've become so removed from our, our roots and that that
[38:22] real ground experience and that knowledge and we've put so much
[38:27] emphasis on Western medicine. So when you said do you like
[38:29] Reiki, I was like, great. I love it.
[38:31] We're. Going to be mates.
[38:32] My and we are I knew that moment I sat on that panel with you.
[38:34] I was like, this woman is a like a beast and I love her.
[38:38] She stands for what she believes in with the most empathetic way,
[38:42] which is so hard to be empathetic, to stand for what
[38:45] you believe in. Like it's a very hard mix and
[38:48] you do it so beautifully. And that whole room that we were
[38:51] just for people that we did a talk in Waterstones.
[38:53] So it's for at 50 women and I actually felt really sad when I
[38:56] left that panel because so many women felt confused or ashamed,
[39:01] like they were let down or they weren't as full as abundance of
[39:04] knowledge as someone else they knew.
[39:07] And I was like, we really need to empower women that they're
[39:09] doing the best they can. Yeah, for those listening to the
[39:12] podcast, it was Millie Hill's book Unprocessed Women, and it
[39:15] was looking at the nutrition of how the ultra process, sorry,
[39:19] ultra processed women, not unprocessed, ultra processed
[39:21] women. And it was looking at how the
[39:23] ultra processed food conversation actually isn't
[39:27] possibly relevant to female bodies.
[39:28] And so she went on her own exploration.
[39:30] Fantastic book. She's worth reading.
[39:34] Really worth reading and I really read that cover to cover
[39:37] before I came on the panel because I knew I'd have geniuses
[39:40] and experts on the panel with me.
[39:43] Because when it comes to general practice, nutrition isn't
[39:46] something that we focus on. We are very much part of the
[39:49] medical program and the medical treatments and prescribing and
[39:53] knowing what to give, when to give, what tests to do.
[39:56] But if you look at every nice guideline for every health
[40:00] condition, the number one key thing is always going to be
[40:03] nutrition and lifestyle first. First line is always going to be
[40:07] diet, nutritions. We're talking about, you know,
[40:09] perimenopausal symptoms. So the management of that
[40:12] actually even before HRT comes into conversation is how much
[40:16] alcohol are you drinking, How much are you smoking?
[40:18] What is your stress levels like? How much sleep are you getting?
[40:21] We talked about sleep a lot. What are you actually putting on
[40:25] your plate and then putting in your mouth?
[40:27] Are you having screen time, which we talked about as well,
[40:30] the distractions that we get, mindless eating that we're doing
[40:33] at the same time? Or are you having an argument
[40:35] with somebody So your cortisol's going sky high while you're
[40:38] trying to eat something and all that's doing is pushing your
[40:41] insulin resistance. And then actually the food that
[40:44] you're looking at, do you know if it's ultra processed?
[40:47] Is it just a little bit processed?
[40:49] So she brought out these little jars.
[40:50] Didn't she? That was amazing.
[40:51] Amazing as a as an example, and it's really refreshing actually.
[40:55] You said that because you left quite sad.
[40:57] I left quite happy. Thank you.
[41:00] I was thinking this is good because actually we're a phase
[41:04] where we're having these conversations.
[41:07] I left empowered going. I can only go up from here
[41:10] because we're down here. We can only go up.
[41:13] This is me. I think I just, I think my thing
[41:17] was I didn't feel that women were asking it from empowerment.
[41:20] I felt that they felt that they were already depleted, that they
[41:23] were already behind. And that made me feel sad where
[41:26] I was like, no, actually with the resources you have, you're
[41:28] doing really well. And it's, I mean, the fact that
[41:30] everyone went to this panel for me showed a massive commitment
[41:34] to want to educate themselves and be involved and be around
[41:37] other women. So already for me, they've got
[41:39] like this huge tick because they're being active in their
[41:42] choices of where to spend their time.
[41:44] But then the questions they were asking me was, you know, it all
[41:47] felt that they weren't doing enough.
[41:49] And that's when I felt sad because I was like, no, that's
[41:51] when I brought self compassion into the conversation because I
[41:54] was like, you've got to have self compassion for everything
[41:56] that you're going through and you're, you're doing the right
[41:58] things. And that's a bit that really,
[42:00] really maybe that's why I left. So I'm just thinking about
[42:02] that's why I left so happy because it was about self
[42:04] compassion. But also we talked about mental
[42:06] load a lot. The, you know, 90% of household
[42:09] groceries are bought by by women, right?
[42:12] And that it's something there's a ridiculous figure from the
[42:15] Fawcett study that's a society that shows that 95% of finances
[42:20] in the household bills are even looked after by women, which I
[42:23] didn't think that growing up, it was always dad that had the
[42:26] money, but actually the purse strings were controlled by my
[42:28] mother. So, and I'm probably exactly the
[42:34] same as well. And I should just caveat, God
[42:37] love her. I love my mother so much, but
[42:39] she never went past Grade 5 at school in Pakistan.
[42:43] And so then to be handed over the the household purse and the
[42:48] strings to that, it was just utterly amazing.
[42:50] And she managed to have five kids and run a household with
[42:54] it. And for me, I left with the fact
[42:56] that the mental load that women carry is so important to share
[43:00] that because a lot of it was the the unit of OK, what are the men
[43:04] in the fact? What are the fathers doing with
[43:05] their children? What are we thinking about in
[43:08] regards to soil to plate? I've forgotten that lovely
[43:10] lady's name, Catherine. I think it was from soil.
[43:13] Association. Association saying this is what
[43:15] happened from the soil right up to the plate.
[43:18] And I just thought to myself, this is the stuff, those basics,
[43:22] stuff from our ancestors and we're just coming back to it and
[43:26] we're coming having those conversations again because
[43:29] we've realised rooted in that is self compassion is empathy.
[43:32] Taking the load off so that other people can do it and it's
[43:36] not just the woman's job to worry about what goes on the
[43:38] plate. No, because now women have to do
[43:40] so much. Yeah, That's, that's I'm in that
[43:42] sandwich generation. Yeah.
[43:44] I'm 42 years old. I'm a perimenopausal woman.
[43:46] I've got a 15 year old teenager at home.
[43:48] And I've got parents who are now in their 60s and 70s.
[43:52] I'm pulled in both direction and they're they're all.
[43:56] I will not lie. Even this morning I had to tell
[43:59] my parents off like they were children before coming here.
[44:02] You see it flipped, the roles reversed.
[44:05] So flipped. Well, I spoke to Paul Donald on
[44:07] those podcasts years ago. He's like a researcher of
[44:09] happiness at UCL. And he was like, you know,
[44:12] there's this bell curve that happens where the most
[44:14] unhappiest part of your life is in like midlife because
[44:18] everything, everything becomes more chaotic.
[44:21] You know, you've got children that are growing up finally get
[44:24] into that part of your career. So there's more pressure.
[44:26] You've got aging parents. You didn't mention about women
[44:29] also going through perimenopause.
[44:30] That's also another added layer. I mean, you're literally
[44:34] juggling. And then when you get out the
[44:35] other side around 60 plus, the happiness curve starts to go up
[44:39] because your parents, you know, might have passed.
[44:41] And you've gone through that phase and your kids have got
[44:43] older and you've got less responsibility.
[44:45] And you've got to part in your work where you maybe feel like,
[44:48] OK, I've done the hard labour now and it's less about the
[44:50] grind. I just don't think about that.
[44:53] You can't. I don't ever think about that.
[44:54] I want to caveat that because I've been looking at brain data
[44:56] for women who are post menopausal and the research.
[45:00] Her doctor Moscone, if anybody follows her, follow the work.
[45:03] Oh my God, she's incredible. She's amazing.
[45:05] And Professor Mackey as well, you know, Claire, Mary Claire
[45:09] Havers, there's Doctor Karen Tang, Dr. Louise Newson.
[45:13] There's a lot of doctors that, you know, we, we follow
[45:16] etcetera. And everybody's got their own
[45:17] nuances and understanding, but what Lisa's been doing is she's
[45:22] been looking at MRI scans of the brain and she's been looking at
[45:25] sort of women who went through early, so early menopausal
[45:28] symptoms. Not only did we find that there
[45:31] are changes to the female brain. And I think we've got to caveat
[45:34] that with the fact that we are living in an age now where we
[45:37] have to think about dementia care from birth, not just
[45:40] dementia care later on in life. So level of education,
[45:44] cardiovascular disease, type 2 diabetes, but the female brain
[45:47] is more neuroplastic than male brains.
[45:51] And I know you've done an episode on this.
[45:52] It's Doctor Sarah. Yeah, yeah.
[45:55] So, yeah. Oh, God, Sarah's an Angel and
[45:57] she's a dear friend. And so the neuroplasticity of
[46:01] our brain means that as we go through midlife and our parents
[46:04] probably have passed on, but we get into our postmenopausal
[46:07] phase, the new neurons that we're forming because of that
[46:09] neuroplasticity, it's just we don't give a shit anymore.
[46:14] Like such a good way to put it. It's.
[46:15] So true, right? It's like our brain literally
[46:19] rewires and the hormones settle down and we've gone through the
[46:22] rocky phase of our perimenopause and now our periods are
[46:24] completely stopped. And they, you know, this phrase
[46:27] that they say never cross a woman of a certain age.
[46:32] I hate that so much because it's steeped in misogyny but also it
[46:37] is sort of right because women of a certain age are so kick
[46:40] ass. Yeah, it's true.
[46:41] Aren't they just utter Queens? I just adore them so much and I
[46:46] could be totally surrounded by them for a whole day because
[46:49] they've got to a point where stuff that I used to get hung up
[46:51] about, like, Oh my God, my hijab's not falling right?
[46:54] And I'm like, doesn't matter. Doesn't matter.
[46:56] The stuff that you would think about, what people thought about
[46:59] your confidence and self esteem and all of that just completely
[47:03] goes out the window. There's a great book that guy
[47:06] says that when I'm in my 70s, I'm going to dye my hair purple.
[47:09] And it's a, it's a, it's a, it's a phenomenon that women do do
[47:12] this. And I think that, you know, they
[47:14] get tattoos and start becoming bikers.
[47:18] Please can you do that? Oh my God, I would like like if
[47:22] I got a tattoo I think my mother would kill me first but.
[47:25] Mine would too. But there was real neurological,
[47:29] biological science to show that the female brain is so
[47:33] phenomenal that that neuroplasticity means that
[47:36] actually, instead of being scared of the postmenopausal
[47:39] years which we're in for the rest of our life, I again, I'm
[47:43] glass awful. It Let's embrace that.
[47:45] When I did that episode with Doctor Sarah McCabe, she flew to
[47:48] London. She just on the Mount Robins
[47:50] podcast and then she came and did did mine and I sat there and
[47:53] I was thinking, I feel like I'm going to feel really low after
[47:57] this episode on menopause. And it was one of the highest
[48:00] episodes I've ever done because she just made me.
[48:02] She reframed how I saw approaching all of this, which
[48:06] is ahead of me. And my sister is 8 years older.
[48:09] So she's like shared a lot of her journey with me.
[48:13] And I have a lot of friends that are 10 years older than me.
[48:14] So I'm always like talking to people about like what their
[48:17] journey is and also wanting my friends to share in their own
[48:19] friendship group so you don't feel so alone.
[48:22] And when I spoke to Doctor Sarah McKay, she was like, no, this
[48:24] isn't, this isn't a depressing symptom.
[48:26] Like your brain is going to change, but it's also going to
[48:29] be sometimes for the better and you're going to be more
[48:31] stronger. And I was thinking about people
[48:33] that go through like really hard times in their life.
[48:36] It's really shit. Like when you're going through
[48:39] maybe you've got PTSD, maybe we're going through something
[48:40] horrific sometimes and you can come out even stronger and you
[48:45] can be an even better person because your brain, the
[48:47] resilience that you have formed during that really hard time has
[48:51] actually made you into this. Like, I don't give a shit
[48:53] anymore. When this stuff, I was like, I
[48:55] just don't care. And I think that's kind of what
[48:58] women go through. We just go through so much and
[49:01] our brains are literally wired to go, do you know what?
[49:04] You've got this. Because I'm 42, my thing is, is
[49:07] that I look at like 20 year old and 30 year old nigat and I
[49:10] reflect back and I'm like the sort of damn care attitude I
[49:14] have now. Oh God, I wish I had it in my
[49:16] 20s. And you know, and I think that's
[49:18] where I keep going back to like, don't be scared of getting older
[49:21] in your 20s. I mean, I, I get 20 year olds
[49:24] who are going, I've had Botox and I'm like, what?
[49:26] Because the aging, the aging thing, is social.
[49:28] Media. Fear of getting old, you know
[49:30] Fogo. That's is a Fogo.
[49:33] Terrifying. There's a, there's a similar to
[49:34] FOMO, but yeah, similar to that. And I just think, actually, no,
[49:38] it's such a blessing to age and age well.
[49:42] Helen Mirren. Look at her.
[49:43] I mean, isn't she just a queen? And.
[49:45] She's amazing. Gorgeous and we've got so many
[49:48] examples of women who are embracing it and even really,
[49:51] really quickly sidebar conversation.
[49:53] But Hamlet everyone haven't seen it yet, but they were talking
[49:56] about Jessie Buckley, the actress and she's had no nothing
[50:00] done to her face. And they were like you could
[50:02] actually see her frown lines. I mean that's the kind of that's
[50:06] actually it's terrible. Like, how did we get to a point
[50:09] where it was you have to airbrush everything out?
[50:12] And I think we're coming back to the fact that whatever you look
[50:16] like, however you present yourself, if you're confident,
[50:19] those hang ups just can get in the bin.
[50:22] Those are the things that I wish I could have passed on to sort
[50:26] of 30 and 40 year olds. And so it's great that we're
[50:29] having these conversations about Women's Health and perimenopause
[50:32] so openly on social media. Well, I think that that is like,
[50:35] it's such a big thing. Like this podcast has changed my
[50:37] life. For five years, I've been
[50:38] speaking to three people a week about all different topics of
[50:42] health. And then you speak more off air
[50:45] and then people write into you and tell you their experiences
[50:48] and you actually just feel so much more or less alone and you
[50:52] feel so much more normal than actually thinking what is this
[50:56] that I'm going through. Whatever it is, whether it's
[50:58] emotional, physical, like being able to share stories, I think
[51:01] is one of the most powerful things.
[51:03] I know people downplay social media and say, oh, you shouldn't
[51:07] Google this. But I've lived through the as a
[51:11] clinician when I was a very, very baby doctor, I would get a
[51:15] patient coming and waving a Daily Mail article in front of
[51:17] me or Good Housekeeping magazine and going, I read this and, you
[51:21] know, do you think my symptoms could be vitamin D deficiency or
[51:23] could it be a thyroid condition? And I'll be like, oh, yeah, OK.
[51:26] And there were genuinely colleagues who'd be like, thank
[51:29] you so much. We're not going to look at that
[51:31] today, Roger. We're going to look at this.
[51:33] And that's awful. That's not a good consultation.
[51:36] And then I've gone through doctor Google.
[51:38] I googled this today and they googled stuff, told me this, and
[51:41] I'm going to die tomorrow. So I've gone through that phase
[51:43] and now I'm going through the age of AI where I've got like
[51:47] Grok and Chachi TP, who are much better clinicians than I, having
[51:52] never laid a hand on a patient, but apparently much better than
[51:54] me. And it's as good as what
[51:56] information you put into. And, and don't get me wrong,
[51:58] actually some of the information that the AI tech is bringing
[52:01] back is pretty solid. But the thing that I think that
[52:05] is so important, what you've just said is validation.
[52:09] I think social media, having these conversations, having
[52:11] these podcasts validates a lot of people like your listeners
[52:14] probably are going, oh gosh, I'm exactly like that with my mother
[52:18] like that. I think it's a like this.
[52:20] And I think that when you realise that we're all human,
[52:24] we're going through, regardless of your race, your class, your
[52:27] creed, your upbringing, your background, your religion, your
[52:30] faith, sexuality, whatever bracket or intersectionality you
[52:34] want to put someone in, we are at the bare bones of it.
[52:38] Because I see it is with blood. With the same blood, we have
[52:43] exactly same colour. We are absolutely the same.
[52:46] Under, underneath all that skin to everything else is just
[52:49] aesthetics. And getting that validation
[52:52] makes you feel so let alone. And that is the one thing I am
[52:55] actually really grateful for social media for validation now
[52:59] that people aren't suffering in silence.
[53:01] I mean, we could still do better and we need to tackle
[53:03] misinformation. I totally get it, but I'm in one
[53:06] of those group of doctors that I'm not against people Googling
[53:09] their stuff as long as they double check it with a credible
[53:12] source. Well, that's the thing, right?
[53:13] It takes you one step closer to feeling because a lot of people
[53:15] feel like, oh, maybe this isn't anything and I won't go and do
[53:17] anything about it. And that can also be a friction,
[53:20] right? To get people just sitting in
[53:22] front of you if they can go, oh, actually, well, this is telling
[53:25] me that potentially these could be symptoms of something, then
[53:29] you're more likely to go and see your doctor.
[53:30] And it could not be what Google's telling you, but she's
[53:33] got you in front of a doctor. But also because people are
[53:36] sharing their symptoms, we as clinicians or those that are
[53:38] listening, although it should be listening to those, you know,
[53:42] the symptoms that they're reading.
[53:44] As a clinician, I think it's a duty of care to know what my
[53:47] patients are consuming. So I need to be on that platform
[53:50] for misinformation, but also because patients are sharing.
[53:53] So for example, I followed some great accounts and they're like,
[53:56] this is what my skin looks like. I don't have all the reference
[53:59] points of what skin stuff looks like in different skin tones
[54:03] because when I was at medical school, it was always line
[54:05] drawings or white skin. So now there's great clinicians
[54:10] who are posting about actually because they, that's the breadth
[54:13] of patients that they see. So actually, it's becoming a
[54:16] learning tool for us. I have vulva lichen sclerosis
[54:19] and I got my diagnosis in my 40s because I had a biopsy and it's
[54:23] taken me a long time to openly talk about it because it is
[54:27] quite an embarrassing thing. So vulva lichen sclerosis is a
[54:30] lifelong chronic inflammatory skin condition.
[54:33] And it's similar to, not exactly the same to say, eczema and so,
[54:38] but you get it around the vulva. Did I find any pictures, even
[54:42] though I'm a clinician, of what it looked like on brown skin?
[54:45] No. So I would repeatedly go back
[54:48] and I genuinely thought that having the discharge that I did
[54:53] was normal. And now I've had treatment and
[54:56] I'm on vaginal estrogen as well. I spoke to my colleague who's
[55:00] also a Volvo specialist and I said to her God lover, she's
[55:03] amazing. She's Elaine Palmer, you need to
[55:06] follow her. She's amazing.
[55:07] And I said to her, Elaine, I thought this was normal.
[55:10] I the like using a panty liner every day.
[55:13] It was just regardless of whether you're on your period or
[55:15] not or thin one was something that was normal.
[55:17] She was like, no. And I was like, but I would
[55:20] repeatedly go back and I'd either be told this is normal,
[55:23] it's OK, get an STD check and you're like, but I've never been
[55:27] with anybody other than my lovely husband and it's just
[55:30] every STD test. You still have it though, don't
[55:33] you? Just to be sure.
[55:34] And they're all normal. Nothing ever used to come back
[55:37] with something. And they'll be just like we
[55:39] don't know what to shrug your shoulders and how many women
[55:41] will relate to that. And also just to say, you're
[55:43] also AGP feeling this. You're like one of the most
[55:45] informed people out there. Yeah.
[55:47] I didn't know what it looked like on brown skin.
[55:50] Wow. What's the difference between?
[55:52] What is the difference between? Yeah, so vulva like.
[55:55] And white. Browns you'll get different
[55:56] things since so you can get thickening which is much harder
[55:59] to see on say darker skin. But also you can get these white
[56:03] patches but actually on darker skin they might appear pale.
[56:06] You can get these red patches which might not be seen on
[56:09] darker skin as well. Because the melanones are much
[56:12] higher. Exactly, exactly.
[56:14] And then but you do get symptoms, so itching, high
[56:17] vaginal discharge as well, which is one of the symptoms,
[56:20] recurrent urinary tract symptoms.
[56:21] So I sometimes say to like the the list is it's not an actual
[56:26] UTI. We dip your urine and it's not a
[56:27] urine infection and your urine just feels spicy.
[56:30] The symptoms get slightly worse a week to 10 days before your
[56:33] period because we think there's a hormonal picture because your
[56:37] immune system uses estrogen to look after itself and to
[56:40] replenish and your vulva vagina has its own microbiome.
[56:44] There's a whole episode we can do about the.
[56:45] Microbiome, but the. Microbiome is incredible because
[56:49] it's what keeps all those good and bad bacteria in our vulva,
[56:52] vagina and the acidity and the pH of it at a reasonable level.
[56:58] And it's a condition which can be sort of worse when you're
[57:02] younger. It appears for me just like
[57:05] eczema when you're young. So the youngest I've diagnosed
[57:08] is about four years old and she came in because her mum said
[57:13] that at school she would sit on the carpet and scratch herself
[57:18] using the carpet and everybody thought that she had behavioral
[57:21] issues. Bless her.
[57:22] Or worms. Or worms exactly.
[57:24] So treated for worms and then that got better and that's not
[57:27] worms now anymore and then it goes away.
[57:31] So as soon as your period starts, as your oestrogen
[57:33] increases, because I say oestrogen is like this
[57:35] lubricating hormone, then your symptoms go away.
[57:38] And then you might notice some symptoms after birth.
[57:41] So I used to get fluoride thrush at the last couple of months of
[57:45] my pregnancy, like to the point it was just this constant itch
[57:49] and I couldn't get it down. We'd swab it and it's thrush and
[57:51] they would give me some thrush treatment and it would work.
[57:54] And it's because Caniston has a little bit of steroids in it.
[57:57] I have one friend who's also South Asian who is constantly
[58:00] going antibiotics for a recurrent UTI.
[58:04] So think about vulva lichen sclerosis as a diagnosis because
[58:07] it we don't have the reference points.
[58:09] So what we do is we look at skin, knowing the signs and
[58:13] symptoms is really important. So lichen sclerosis guide is
[58:16] something we put together. It's free website.
[58:18] So I'm on the board of directors for well-being a Women, which is
[58:21] a women's charity. There's also The thing is, and
[58:24] this is again, coming back to that medical misogyny, no one's
[58:27] taken ownership of the vulva in medicine.
[58:30] So they went to the dermatologists many, many, many
[58:33] years ago, before even. And the dermatologists were
[58:36] like, yeah, it's about the skin on the vulva, but it's related
[58:40] to the reproductive places. So they went to the
[58:42] gynecologists, and the gynecologists were like, yeah,
[58:45] but like, actually, we don't look in the outside.
[58:48] We just look at the vagina, the inside bit.
[58:51] And that's where we're mostly focused on.
[58:53] But who looks after this? Because also you've got the
[58:56] urethra, which the urologists look after because that's where
[58:59] we pee from. So do the urologists look after
[59:02] it? No.
[59:03] So actually things like vulva skin stuff, HPV infections,
[59:08] warts, and then is that sexual health?
[59:10] So do you go into that? So no one's really looked after
[59:14] the vulva as the outside bit properly.
[59:17] And hence why we end up finding women get these whole host of
[59:20] symptoms and they go different avenues.
[59:22] I unfortunately ended up having a tear with my first as well.
[59:27] And the recovery of that took a long time and it was only now
[59:31] into my 40s. Now I'm perimenopausal.
[59:33] So I was 38 years old. I was getting recurrent urinary
[59:36] tract infections. I did a conference.
[59:38] So painful. In Sweden, talking about equity
[59:42] in women's healthcare with a Florida UTI.
[59:45] And there's actually a YouTube video of me delivering this
[59:47] conference and to look at me, you would never know that I've
[59:50] got a UTI because we are so good at masking things that
[59:53] resilience that you talked about, aren't we brilliant?
[59:56] So I'm delivering this conference talk talking about
[59:59] equity, what we're doing in the UK, about the Women's Health
[1:00:01] strategy. And I've got a UTI.
[1:00:03] As soon as the questions finish, I come off stage and I go to my
[1:00:06] husband. I need to freaking find a
[1:00:08] pharmacy because I am in like it's like fire and I need to we
[1:00:13] but there's nothing to we. Luckily, just a isn't that the
[1:00:16] worst feeling? Like every woman that's
[1:00:19] listening to this, it's horrible.
[1:00:20] It's like razor blades. So I'm running, I leave and I
[1:00:24] find my, my husband's got the kids and I'm like, I need to
[1:00:27] find a lovely pharmacist. But the thing was I'd had one
[1:00:30] not too long ago where I was given a three course antibiotics
[1:00:35] and now I've got another one because I've travelled and I've
[1:00:38] become dehydrated. That's one of the things.
[1:00:40] But also my skin changes like it's not great on the flights
[1:00:43] when you're going, except it's not the same.
[1:00:45] You're just. Maybe a bit stressed, but a bit.
[1:00:46] Stressed, but with a big talk as well.
[1:00:49] Your diet changes, so there's that.
[1:00:52] And then I was like, I need to go on a longer course.
[1:00:55] So I came back, I spoke to the GP and I was just like, I need
[1:00:59] to talk to you about something because either it's vagina or
[1:01:01] atrophy or there's something else going on because I don't
[1:01:04] know what it is. But I keep getting the symptoms
[1:01:06] out. I was 38 and bless him, he was
[1:01:09] so cute, very young. And he was just like, yeah,
[1:01:13] you're just a bit too young for all of that, Doctor *** And I
[1:01:16] went, I've written a book on this.
[1:01:18] I've never used that line. That's my job to come out.
[1:01:23] I was like, I've written a book on this, let me tell you some
[1:01:26] stuff. And actually, it was a lovely
[1:01:28] conversation and it turned into like a teaching.
[1:01:30] Well, you got to educate someone.
[1:01:32] Exactly. Great that he was open to it,
[1:01:33] right it. Was really, really good and I
[1:01:35] think that's why I would say there's never any shame not
[1:01:38] knowing stuff. We only know what we know and
[1:01:40] what we come across. Started on vaginal estrogen.
[1:01:43] Some of the symptoms got better, but still this itch would always
[1:01:46] come back. And then I was just like, right,
[1:01:48] I need a referral. So I got a referral into
[1:01:50] secondary care. Lovely, lovely GP, like shout
[1:01:53] out to amazing colleagues out there.
[1:01:55] But it took me a year, which I didn't mind, you know, because
[1:01:58] I'm not urgent. And I said, can I have a biopsy
[1:02:01] please? And it was one of my biopsy that
[1:02:02] they found lichen sclerosis. So it's, and I now I reflect
[1:02:06] back and I'm just like, oh, 20 year old and 30 year old negat,
[1:02:10] you know, post Natal negat that was dealing.
[1:02:13] So you think about all this stuff that women deal with.
[1:02:16] And at those times when I would never, there was times when
[1:02:18] doctors were never allowed to share the stuff that they're
[1:02:20] going through. But I've started using my
[1:02:23] platform to go look, I get it. I think that's where a lot of
[1:02:25] the empathy comes from because I've lived it.
[1:02:28] I've probably put my finger in it at some point.
[1:02:30] I've probably looked at it, probably, you know, reviewed it.
[1:02:35] That's the job of a doctor, right?
[1:02:36] There's nothing that's off balance.
[1:02:38] There's nothing off limits and there's no shame.
[1:02:40] I'm really keen to take away the oxygen that we give to shame.
[1:02:45] And people could tell me all the time on social media this is
[1:02:47] Haram or this is Bisharam, don't talk about this, I don't care.
[1:02:51] Like guys, I cannot tell you how many lives are saved because
[1:02:55] people know the symptoms. And as you just said, right now,
[1:02:58] Oh my God, I've got so many mates.
[1:03:00] And imagine if their life was turned around, because actually
[1:03:03] that could be their diagnosis and they were able to get
[1:03:05] support because the data shows that if the lichen sclerosis
[1:03:09] gets bad enough, it can actually change the architecture of your
[1:03:14] vulva and vagina. And that's irreversible.
[1:03:17] So we see that and there's a small, very, very small chance
[1:03:20] of vulva lichen sclerosis turning into vulva cancer.
[1:03:24] And that's the other thing. People don't know that vulva
[1:03:26] cancer exists. I didn't even know that was a
[1:03:28] thing, and that's something pretty versed in this area.
[1:03:30] Well, not just involve health, but in just health generally
[1:03:33] from this show. Vulva cancer is a thing and now
[1:03:36] beyond cervical cancer, the cervix because we get our smear.
[1:03:40] Stairs had mine yesterday at the GP.
[1:03:43] Surgery, Good, good, good, good. So proud of you.
[1:03:46] But we are now seeing more and more anal cancers in women and,
[1:03:52] and men and, but women mainly because we think we've done our
[1:03:55] job because of the HPV vaccine. But that's looking at the
[1:03:58] cervix. HPV also sits around your anus
[1:04:00] as well. So anal tissue will get cancers
[1:04:03] around there. I'm interrupting for one moment
[1:04:06] to ask one small favour. Please subscribe to the show.
[1:04:10] This helps it grow more than you know.
[1:04:13] And I'm so bad at asking this from you.
[1:04:15] I'm so bad at thinking about this.
[1:04:17] But you know, my goal was 100,000 to get to on YouTube and
[1:04:21] I really want to bring you more content and bigger episodes.
[1:04:24] And we can only do that with your help together.
[1:04:27] So please do hit subscribe. Thank you.
[1:04:30] OK, well you have to show me the vulva.
[1:04:31] I have to show. You the vulva.
[1:04:34] Make sure everyone. Can So I have to say this was a
[1:04:35] gifted model, so I'm not branding or anything.
[1:04:38] This is a lovely gift that was given to me and this is the
[1:04:41] other job that I get now. I get women across the current
[1:04:43] world and my biggest consumers of my content are mostly on
[1:04:46] Instagram and they will go. I love this so much.
[1:04:51] I've made a model. Can I send it to you?
[1:04:52] I'm like, thank you very much, that's amazing.
[1:04:54] But I'm not going to because I don't do any brands I work with.
[1:04:56] No, I'm an NHSGP like I don't work with any brands.
[1:04:59] So this model is really important because not only has
[1:05:02] it got hair, like hair is normal.
[1:05:05] You don't need to wax, shave or take out any hairs before you
[1:05:08] come and see me. I don't care if you've not done
[1:05:10] your legs mate. I've seen it all, like there is
[1:05:13] nothing shameful about hair and I'm I blame the porn industry.
[1:05:17] I know so much blame the porn industry for.
[1:05:21] Yeah, you don't need a Brazilian wax.
[1:05:23] In every like third conversation I have by the way on.
[1:05:25] Thank God do you do you talk about that and condemn the porn
[1:05:28] industry for taking away the hair you like?
[1:05:31] This is normal. So I love the fact that it's
[1:05:33] still got all its hair and it I see all different types, less,
[1:05:36] more. It could be a beautiful Bush.
[1:05:39] It's absolutely fine. You're going to crop that,
[1:05:40] aren't you? That's going to be a zoom.
[1:05:45] Damn. It it's.
[1:05:49] A beautiful Bush. Yeah, exactly.
[1:05:51] And then, right, we've got the clitoral hood.
[1:05:54] So this is our clitoral hood at the top and then we've got labia
[1:05:57] majora and our labia menorah and then we've got the urethra.
[1:06:01] So this model actually shows the urethra as well.
[1:06:04] And the great thing is, is this bit down here is known as the
[1:06:06] posterior forchette. And the posterior forchette is
[1:06:09] something that's so under researched and we know very
[1:06:12] little about as well. But the posterior forchette is
[1:06:14] the bit of the skin that extends and allows anything to go in.
[1:06:19] So when you feel pain down here, it's because we're stretching
[1:06:22] the posterior for shet. So if you're having sex and the
[1:06:25] foreskin has to go over the posterior for shet and you can
[1:06:28] get micro like paper cuts or fishes as we call them.
[1:06:31] Oh yeah. And that can be exquisitely
[1:06:33] painful. So using lubrications is so
[1:06:37] important. Like loo, blue, blue, blue.
[1:06:41] You can see your face. You're so cute.
[1:06:43] I literally can see how you think now, Sarah, but blue,
[1:06:47] blue, blue, like no shame. And that's so important to do it
[1:06:50] down here right at the bottom. The perineum, which is the gap
[1:06:54] between the anal tissue as well. So the perineum is so important
[1:06:59] because actually if you have a tear, so there's different
[1:07:02] grades of tears. There's, you know, Stage 1 all
[1:07:04] the way up to stage 4, and stage 4 is when we actually tear
[1:07:08] around the anal tissue. I mean the things women go
[1:07:10] through. Gosh, there's a lot of women had
[1:07:11] this after childbirth. Right.
[1:07:12] Yeah, vaginal birth. So if you get an anal tear, then
[1:07:18] that can render you fecally incontinent, really difficult to
[1:07:21] have sex. But the thing that we don't tell
[1:07:23] women is that, you know, stage, like if you've got a third
[1:07:27] degree or a fourth degree, particularly a fourth degree
[1:07:29] tear. I've now started saying to
[1:07:31] women, these are lifelong tears. They're not just for a little
[1:07:34] bit you AC section. I think we've now come round to
[1:07:38] the fact of going, oh gosh, yeah, a caesarean section is a
[1:07:41] lifelong scar. Yeah.
[1:07:43] Right. And so you rehab that scar, you
[1:07:46] massage it, you put your lovely sort of moisturizer on it, you
[1:07:49] look after it. Take a bit of Annika.
[1:07:51] Exactly, do we do that with this?
[1:07:53] No Wow. You should rehab every scar.
[1:07:56] If you had a knee scar, you would rehab it so you don't get,
[1:07:59] and especially if you're from someone who gets keloid, which
[1:08:02] is an over thickening of scar tissue, that can happen as well.
[1:08:07] And I've seen. That wow, I don't think women
[1:08:09] look at their. I mean, maybe I'm completely
[1:08:11] speaking correctly, but I don't think women look at their
[1:08:13] vulvas. No.
[1:08:15] Get a long handle mirror and then look between your legs.
[1:08:18] Take about a good 10 minutes and what you want to do is look at
[1:08:21] the key area. So you want to look at the
[1:08:23] outside for any skin tags, any new like grocer skin, think
[1:08:27] about warts, etcetera. Then split your lips.
[1:08:30] Have a look at the labia majora, which is the outside lips, labia
[1:08:33] minora which is the inside lip. Find where your urethra is and
[1:08:37] your urethra is going to be like a little hole, which has another
[1:08:41] little hole. That's where you pee from.
[1:08:43] See where your clitoris is. If you've got a partner, show
[1:08:46] him where the clitoris is. That's important.
[1:08:48] A great episode we've got for Laurie Mintz, all about the
[1:08:50] clitoris. Great, great.
[1:08:52] And then like we look at your posterior and then look at your
[1:08:55] look at your anus guys. Yeah.
[1:08:57] Look at it. Also very important for gastro.
[1:09:00] Health so important for gastro health.
[1:09:02] We don't look at our buns enough.
[1:09:04] No, we don't. Really important to look at that
[1:09:06] because anal cancer is now a rising cancer that we're seeing
[1:09:10] in the NHS and, and globally as well.
[1:09:13] And this is just the vaginal opening.
[1:09:16] The vaginal opening is what you're looking at because then
[1:09:18] the vagina has loads and loads of different rings.
[1:09:21] Now the great thing about this model is that it does.
[1:09:23] Oh. Wow, comes off.
[1:09:25] It comes apart so this is the size of a female clitoris.
[1:09:29] Looks like a little Penguin. It really does look like a
[1:09:31] Penguin. Oh my gosh, this matches your
[1:09:34] outfit. It does match my outfit, but it
[1:09:36] sits just above the urethra. OK, so that's where you pee
[1:09:40] from. Doesn't that look like a Willy?
[1:09:43] Yeah. I mean, I think that looks.
[1:09:44] I mean, if you look at. The end.
[1:09:45] Oh yeah, it. Does and that is essentially
[1:09:47] what it. Is that's what it is.
[1:09:48] Isn't it? That is what it.
[1:09:49] Is I was told on that podcast. That's exactly what it is.
[1:09:52] And then this is your vagina. We hear about the vagina a lot,
[1:09:55] but the inside of your vagina is is impressive.
[1:09:59] And the clitoris. So if you, if I just have that,
[1:10:01] it's so interesting. Yeah.
[1:10:02] So it's got a whole body to it. But this bit, this bit we used
[1:10:07] to think had about 8000 nerve endings.
[1:10:10] I know you've got a whole podcast, I'm not going to talk
[1:10:11] about it too much, but up until recently, as recent as say
[1:10:15] 2024-2025, we realized actually there's more nerve endings
[1:10:19] because medical misogyny. Again, we started researching
[1:10:22] the women's clitoris. And so we've actually realized
[1:10:27] there were over about 10 1/2 thousand nerve endings.
[1:10:31] Why more than a man? I mean, that's crazy that we
[1:10:34] have that. And so it just shows that
[1:10:38] actually our anatomy is really thought about in regards to pain
[1:10:43] and sensitivity, but pleasure. And I think female pleasure is
[1:10:46] something that is still so taboo and taboo in medicine.
[1:10:49] Like I was never taught about this at medical school.
[1:10:52] I knew about it like the words of stuff, but I never actually
[1:10:55] understood the anatomy because why would I bother with female
[1:10:59] pleasure? So when you get a patient who
[1:11:00] comes in going sex is really painful, you end up getting
[1:11:04] these responses because no one's thought about, say, vulva
[1:11:08] vaginal atrophy or something known as genital urinary
[1:11:10] syndrome of the menopause. So that happens as young as,
[1:11:14] say, 38 or 39 years old. So actually, what we should be
[1:11:17] doing is should be educating women about their vulva or
[1:11:20] vaginal tissue and their pelvic health, tissues and muscles.
[1:11:24] Because your pelvic health is literally your universe.
[1:11:28] If you look after your pelvic health, it's going to do you so
[1:11:30] much good into your 60s and your 70s and your pelvic health and
[1:11:34] your vulva in your vagina is not just for sex.
[1:11:36] It's for your genital urinary health.
[1:11:38] So where you pee from where you. Yeah, your bladder health.
[1:11:41] Exactly. So we have to think about
[1:11:43] moisturizing that area. Oh, really?
[1:11:46] So now my recommendation has started.
[1:11:48] I've really changed my recommendation.
[1:11:50] I say from the age of about 20, start moisturizing your vulva in
[1:11:54] your vagina. But with what?
[1:11:55] Type of stuff, because anything that's.
[1:11:57] Stupid, right? Could make.
[1:11:58] They also give you a UTI. So it's so important to have
[1:12:01] stuff that don't have parabens in them.
[1:12:02] A lot of them don't. A lot of the High Street brands
[1:12:05] do unfortunately have flavorings, etcetera.
[1:12:07] Don't do that, especially if you're thinking about like lubes
[1:12:10] for sex. Condoms also have lots of
[1:12:13] flavours and lots of power which are not needed, which is really
[1:12:17] irritant for vulva vaginal health.
[1:12:19] Make sure doesn't have glycerin in it because glycerin, if
[1:12:22] you're prone to thrush, can make your thrush symptoms worse.
[1:12:25] Alcohol is incredibly drying. So really read what there are.
[1:12:29] I don't do any brands, but if I could just talk about two brands
[1:12:33] because I'm not promoting them and I have no affiliation with
[1:12:36] them at all. But I would say yes, vagina
[1:12:38] moisturizer that you can buy off any High Street or you know,
[1:12:41] brand etcetera. And Sutil Rich is pretty good.
[1:12:45] So Sutil is a really good brand because that doesn't have any of
[1:12:49] those chemicals in there. And it's really important to, if
[1:12:54] one gives you an it, just jot it down, no, and then try another
[1:12:57] one. Unfortunately, we can't say this
[1:12:59] particular brand is going to work for this particular person
[1:13:02] just yet. There's quite good other ones.
[1:13:05] There's Replens. Replens can actually make your
[1:13:06] itch a lot worse. So, but in others it works
[1:13:09] really well. Replens is on prescription.
[1:13:11] We now can prescribe the yes vagina moisturizer as well.
[1:13:14] So there's quite a lot out there and it is really overwhelming.
[1:13:18] But if it is about your vulva health, it's really important
[1:13:22] that you start researching in that, especially because
[1:13:24] remember your vagina is its own separate organ.
[1:13:28] So this is the vagina. Oh wow, that looks like a.
[1:13:32] Shoe it does. Do you know what I showed this?
[1:13:35] Sorry, I showed this. So again, a lovely, lovely woman
[1:13:44] on the Internet reached out to me and said, can I send you a
[1:13:46] model of the vagina? And I was like, mate, I don't
[1:13:50] you don't have to ask me twice. Yes, thank you.
[1:13:54] And it's 3D printing of a real life vagina.
[1:13:58] Wow, so. Wait, where's the entry point
[1:14:01] here? OK, so this is what we see.
[1:14:04] So this is your vaginal opening. Do you remember I said yeah, so
[1:14:08] it is an organ. I know, forget.
[1:14:11] About that, yeah. See, even you were like, really?
[1:14:15] I know I had to. I had to think then.
[1:14:17] It is true. So it's got its own microbiome,
[1:14:20] just like your gut is an organ, it's got its own ecosystem.
[1:14:24] It looks after us. So it's got all these ridges.
[1:14:25] So I'll let you feel. So all of these ridges.
[1:14:28] And this has the capacity to increase to about 3435
[1:14:32] centimetres and the cervix. So the this is what I see.
[1:14:36] So when I put a speculum in to do a smear.
[1:14:38] So you went for your smear. This is what the nurse was
[1:14:41] looking for at. The That's what she's getting.
[1:14:43] That's what she's getting. That's what she's taking off of
[1:14:45] the womb. No, So this is the neck of the
[1:14:47] womb, the cervix, that's the hole.
[1:14:49] And that hole, the opening of the neck of the womb, has the
[1:14:51] capacity to open to about 10 centimetres to allow the head of
[1:14:55] a baby through. Course that means it never, like
[1:14:59] always fascinates me. Crazy a baby can come out of
[1:15:01] that. So we are literally put on God's
[1:15:04] green earth to reproduce. So I get a lot of women who have
[1:15:07] like unexplained fertility. And I would say look, please
[1:15:10] always look at male factor. You can't just look at women as
[1:15:12] well. You have to look at the male
[1:15:14] factor. And I get like friends and
[1:15:17] patients who go, we're really struggling to fall pregnant.
[1:15:19] And I say, look, unless there's a real reason that we can, I
[1:15:22] promise you, you are put on this God's green earth to reproduce,
[1:15:26] you will we do we know that fertility issues are on the
[1:15:29] rise, but that's obesity, that's cardiovascular disease, there's
[1:15:33] loads of other factors, stress, etcetera.
[1:15:35] High Court. And the man?
[1:15:37] And the man as well. So it's so important to look at,
[1:15:39] you know, mental health and cardiovascular disease in men,
[1:15:42] as well as full fertility, you know, just as important.
[1:15:45] But actually our anatomy, unless there's any genetic functional
[1:15:49] thing that's going on or there's endometriosis, adenomyosis or
[1:15:52] PCOS or uterine fibroids, we are pretty much here to reproduce.
[1:15:58] And our vulva is able to accommodate that.
[1:16:01] And at the back of the vulva, there's a little nook, right,
[1:16:04] This little nook at the end. And that literally just holds
[1:16:08] sperm for up to five days. So that's always the one that
[1:16:12] really fascinates me. 5 days that you can stay in there.
[1:16:14] Yeah. Oh, no, they're hanging on.
[1:16:16] They're ready. I showed this.
[1:16:20] I showed this to a colleague who's a gastroenterologist, and
[1:16:23] he was just like, oh, wowzers. And he went.
[1:16:27] It looks like the stomach. It does look like the stomach.
[1:16:30] He went. That is the esophagus and he
[1:16:34] goes, the stomach is a bag. He does ERCP.
[1:16:37] So he looks into the gut all the time and he takes out, you know,
[1:16:40] cancers from the gut and he goes, when I do endoscopies,
[1:16:44] that's exactly what the stomach looks like.
[1:16:46] The hole here is then the Judeanum goes off into the
[1:16:50] pancreas. I was like, mind was blown.
[1:16:55] See the stuff I'm learning? I'm learning.
[1:16:58] And he was like, no wonder he goes the replication of our
[1:17:01] anatomy. Like there's this is, oh, I love
[1:17:05] the human body so much because it's fascinating.
[1:17:08] And I had no idea that he, and that's the first thing he said
[1:17:11] to me. I mean, he was fascinated by,
[1:17:13] but like, have a feel of the ridges on that.
[1:17:15] Wow. Have a feel of ridges on my
[1:17:17] vagina. Hey guy, I'm feeling your vagina
[1:17:19] right now. And you know what I learnt from
[1:17:23] yours as well, which was something interesting because a
[1:17:25] lot of people talk about contraception and you talk about
[1:17:28] different types of contraception and you talk about the ring that
[1:17:32] I don't think that many people. So my mum worked in sexual
[1:17:35] health for the NHS. So I grew up great being told
[1:17:40] all of these. I mean she was amazing, you
[1:17:41] know, she was also very medical in it.
[1:17:43] And this is, you know, this is 1 formal contraception, this is
[1:17:46] the coil, this is the injection, this is the pill, this is the
[1:17:48] mini pill, this is the non mini pill.
[1:17:50] And I would have all of these. I'd go into the clinic to see
[1:17:53] her after school. My friends would come in as well
[1:17:55] and duck if they saw my mom because I got coming in to get
[1:17:57] condoms or something and they duck and then my mom would
[1:18:00] happily walk past. But I kind of grew up learning a
[1:18:04] lot about it because my mom was in it.
[1:18:07] But then you explained it so well that I think many people
[1:18:09] don't know about the ring. And it's only because you
[1:18:11] mentioned the back of the vulva. I thought this might be a
[1:18:13] perfect time to say where you actually slip the ring in at the
[1:18:17] back and you can keep it in during sex.
[1:18:19] Yeah. And your period and a tampon.
[1:18:22] And that's what stops the sperm, when you said goes out for five
[1:18:25] days, Right. So it obviously causes a Ridge.
[1:18:27] Yeah, so there's a barrier, so #1 So it causes a little Ridge.
[1:18:31] That's exactly why. So you put it up right up near
[1:18:34] your cervix. You put it in just like a
[1:18:35] tampon. I've got a little model that I
[1:18:38] use in my surgery, but no one knows about the vaginal ring.
[1:18:41] And it's because it just blew up on social media and I got tagged
[1:18:44] into so many conversations. I'm like, is this a thing?
[1:18:46] I was like, it is A and it's available on the NHS so it's for
[1:18:49] free. It's covered in the.
[1:18:51] The other thing is the patch, and you do actually have a HRT
[1:18:54] patch as well. That's true.
[1:18:55] We didn't talk about that. Now and but the ring is even
[1:18:58] less talked about. There's certain there's
[1:18:59] different brands. The Nova ring is the most common
[1:19:02] brand and it's available on the NHS.
[1:19:04] So again, no brand promotion at all.
[1:19:06] And the ring, literally, you squeeze in the middle and you
[1:19:09] pop up and it just sits around the cervix and it's got 2
[1:19:13] hormones on it, estrogen and progesterone.
[1:19:16] So the estrogen is the form of a synthetic estrogen and the
[1:19:19] progesterone is a synthetic progesterone as well.
[1:19:22] It works brilliantly if you want to bypass the gut.
[1:19:25] So great. The only thing we've got to be
[1:19:27] careful with is, I mean, I've never had anybody really worry
[1:19:30] about it. But if you've known to suffer
[1:19:32] from migraines or you've got a very, very strong family history
[1:19:36] of breast cancer or a personal history of breast cancer, we try
[1:19:38] and say not to have estrogen. But a lot of that data around
[1:19:43] that is actually the oral combined contraceptive pill.
[1:19:46] And we know that they're synthetic hormones, but actually
[1:19:49] anything that's transdermal like a patch contraceptive or a
[1:19:53] vaginal ring that has got contraceptive, I think the data
[1:19:56] there is actually much more lenient and in the regards to
[1:19:59] safety compared to the oral contraceptive pill which we know
[1:20:02] is linked to. A very, very small risk, I
[1:20:05] should just say, a very small risk, yeah, to breast cancer,
[1:20:09] very, very small risk to clots, a very small risk to migraines.
[1:20:13] We've got to be really careful with those that are overweight
[1:20:16] as well because again, that risk of clot increases.
[1:20:19] Blood clotting factors. Blood clotting factors as well.
[1:20:21] So if you've got factor 5, lidane or Von Willebrands, yeah,
[1:20:24] we've got to be really careful with that.
[1:20:26] So the ring actually we we think because it bypasses the liver
[1:20:31] where all your clotting factors are made.
[1:20:33] I have given it to my patients with factor 5 lied in.
[1:20:35] Really. Yeah.
[1:20:37] Oh, wow. If I'm really struggling in
[1:20:39] regards to giving them a progesterone.
[1:20:41] Progesterone. Although recently we do have a
[1:20:44] new type of progesterone called Desro Panenon, which is the
[1:20:47] sister of all these progesters that we've got and it's called
[1:20:50] Slind and it's great, but it's still pricey.
[1:20:53] So we're struggling and with the post code lottery in the NHS,
[1:20:56] who is able to get access to that?
[1:20:58] And contraception is now varied so much.
[1:21:00] Diaphragms are coming back. Oh yeah.
[1:21:02] Do you remember these are old school?
[1:21:03] The only diaphragm reference I always think about is Monica
[1:21:06] from France. We should put in the Cliff in of
[1:21:10] this right now. Exactly.
[1:21:12] Honestly, when she goes Monica and she goes, yes, mother and
[1:21:15] she was like, I found your diaphragm.
[1:21:17] I think Richard has been that's all I can have a room.
[1:21:20] I think it's something like that.
[1:21:21] Honestly, it's etched into my memory about her diaphragm.
[1:21:25] They are interesting to look at they're.
[1:21:27] So radical, right. So you put a bit of spermicide
[1:21:31] in and you leave them in and I don't know, but they are coming
[1:21:34] back and they're actually made it a lot easier.
[1:21:36] I remember with the biggest factor was that you'd have to go
[1:21:39] and get sized for it. Yeah.
[1:21:40] But yeah, coils are really cool. How do you get?
[1:21:42] The ring out What's this up? That's just.
[1:21:45] Like a tampon. So you put your finger.
[1:21:46] So if I show you on here, I don't have my ring with me.
[1:21:50] I mean, it's a lovely little tip, but basically.
[1:21:52] So lots and lots of Lube or moisturizers.
[1:21:55] The best thing to do is if you can squat down in the bath when
[1:21:58] you're having a shower to use. Technically the manufacturer say
[1:22:02] take in, put it in for three weeks and then take it out for
[1:22:06] seven days to have a break so you have a bleed and then pop it
[1:22:09] back in again. But you do not need to have a
[1:22:12] break. Oh wow.
[1:22:14] Yeah, that seven day pill break from your combined oral
[1:22:18] contraceptive pill is more to do about the Pope than actually a
[1:22:22] medical reason. Really.
[1:22:23] Yes. Oh my God, that's wild.
[1:22:25] It is wild. So back in the 50s, we tried to
[1:22:29] get the pill out. By the way, the greatest
[1:22:30] invention I still believe. Liberation for women.
[1:22:33] For women, Amazing. But the pill, the history of it
[1:22:37] is utterly fascinating #1 because we're in the initial
[1:22:40] trials, in fact, women died and still got FDA approved.
[1:22:44] Women had clots, still got FDA approved.
[1:22:47] Yeah, now we wouldn't even dream of that.
[1:22:49] Like, you know, the male contraceptive pill I'm still
[1:22:52] fighting for because. It's in.
[1:22:53] Trial. It's in trial.
[1:22:54] I know I spoke about it. It is in trial, but we're just
[1:22:57] going to see. But then the first couple of
[1:22:59] trials kept failing because men got headaches.
[1:23:03] Poor. Them poor little lambs.
[1:23:05] No, I shouldn't downgrade. I shouldn't be flippant about
[1:23:08] that. Headaches are horrible.
[1:23:09] But it just shows how actually, because of the Geneva Trial
[1:23:14] Convention and the ethics that we have, we are thinking about
[1:23:16] side effects a lot more. But I suppose it's just like,
[1:23:20] where were these self, you know, safeguarding stuff for women?
[1:23:23] How many different fluctuations women go and they put like
[1:23:26] something they've lost their mind Yeah, yeah, yeah, some go
[1:23:28] on the. Vito goes down, you get vaginal
[1:23:30] dryness, you know, suicidal thoughts, makes you put on
[1:23:33] weight, etcetera. And you're just like, OK, where
[1:23:36] are we with that mindfulness for female medications?
[1:23:41] Because actually all of these drugs that still come out to
[1:23:44] market have those side effects even now.
[1:23:48] And for the male factor fertility issues, we're not
[1:23:52] bringing any to market because actually the side effects of
[1:23:55] say, GI stuff like vomiting and nausea is just too much and the
[1:23:59] trials get stopped. And I think, I suppose the, the,
[1:24:02] the counterbalances to that. Well, a man doesn't fall
[1:24:05] pregnant, whereas there's a bigger risk for a woman, she'll
[1:24:08] have an unplanned pregnancy. But I still think that that's
[1:24:12] because fertility is very much at the foot of the door of the
[1:24:14] woman, which again, we come back to patriarchy and medical
[1:24:17] misogyny. But if you've got the coiling
[1:24:20] coming back to that, the sorry, the vaginal ringing, and then
[1:24:25] you put you squat down in the bath, run your fingers up, and
[1:24:28] then you'll feel something that feels like your ring is a little
[1:24:31] bit Ridge. And then you tug on that between
[1:24:33] your fingers and you just pull it out just like a tampon.
[1:24:35] Oh wow. Yeah.
[1:24:37] So it gets a bit of. Get lost.
[1:24:39] Can't get lost. No, it doesn't go wondering
[1:24:40] anyway, because look, it's got to stop.
[1:24:42] Well, this is really. Helpful to see now, but I think
[1:24:45] initial can't. Like there's no wondering womb.
[1:24:47] You can't go anywhere. You can't.
[1:24:49] It can't go anywhere, it literally cannot get lost, and
[1:24:51] it can't even get tucked behind anything because it's big enough
[1:24:54] to stay. Exactly.
[1:24:55] Where it needs to stay. The other really good tip of
[1:24:58] doing it? So if you can't squat down,
[1:25:00] etcetera, it's light on your bed and then pop your legs to the
[1:25:03] side as if you're on a clinical couch and then go up that way.
[1:25:07] Or if you're going to stand up because that's where you are
[1:25:09] caught, then to stand up and then raise one leg on a stool or
[1:25:14] something and then try and go up.
[1:25:16] At an angle. At an angle.
[1:25:19] But yeah, if a lot of my patients now, I just say to
[1:25:22] them, just keep the ring in for three weeks, don't have the
[1:25:25] break because we don't want you to have a bleed.
[1:25:27] And actually, the ring works really well and they just have
[1:25:29] it back-to-back. So interesting, this was like
[1:25:31] never really spoke about it was always just the pill.
[1:25:33] Yeah, I know. And it's really annoying because
[1:25:36] actually long acting contraceptives such as the
[1:25:40] implant and the coil, whether that's a copper coil or a Marina
[1:25:43] coil are just so good. I think they're really good.
[1:25:46] And I say this from personal. Experience.
[1:25:47] You have to think about it. Yeah, I insert coils.
[1:25:50] I've been inserting coils for about 12 odd years and I know
[1:25:53] they are painful. So I do a lot of content around
[1:25:57] what pain relief you're entitled to on the NHS and you should ask
[1:26:00] for it. So we do have local anaesthetic
[1:26:03] that you, you know, you shouldn't have to ask for it,
[1:26:05] but it should always be discussed.
[1:26:07] But I know that it's very patchy throughout the country and there
[1:26:10] are campaigners who are trying to make sure that hysteroscopies
[1:26:13] and also Colin Sessions are done with good pain relief.
[1:26:16] And I'm one of them really advocating for that.
[1:26:19] Cost factor is the issue that comes into it and the idea it
[1:26:22] comes from like the old, which I'm really hoping we're done
[1:26:26] with myths that the cervix doesn't have nerve endings.
[1:26:29] I just want to say that is utterly rubbish and there's no
[1:26:32] data behind that. It came from a lot of procedures
[1:26:35] that were done historically. Historically from the father of
[1:26:39] gynecology, Dr. Sims, where we would get the same speculum
[1:26:42] where he did a lot of unethical, horrific trials on black women
[1:26:47] without their consent, putting in spatulas and etcetera to have
[1:26:51] a look. And that's where we also get
[1:26:53] sort of from slavery times, the theory that black bodies are
[1:26:56] strong or the strong black woman.
[1:26:59] And I can't abide that. It's horrific, it's horrific.
[1:27:02] I can't abide, it's awful. And so we've got a lot of
[1:27:05] unlearning to do when it comes to gynaecology, because
[1:27:07] gynaecology, even if you look at abortion, they've all come from
[1:27:11] backstreet abortion medicine. They've come from quite
[1:27:14] nefarious understanding of our the female body.
[1:27:18] Like for example, Leonardo da Vinci dug up female pregnant
[1:27:22] bodies who'd probably died and then did biopsies and anatomy on
[1:27:29] them and drew them. So it there, there's real
[1:27:33] nefarious and, and I'd say that from the Renaissance time, but
[1:27:37] not too long ago, we were still experimenting on female bodies.
[1:27:40] I mean, if you look at the Bill Gates Foundation that the ethics
[1:27:43] around what they're doing in Africa in regards to the HPV
[1:27:47] vaccine, that's just up until recent times.
[1:27:50] So we've got real issues about what we're doing about research
[1:27:54] when it comes to female bodies and the intersectionality, and
[1:27:57] also different lived experiences, as well as access
[1:28:00] to education. That's a big one.
[1:28:03] A big one, but taking away the dehumanizing of the female body
[1:28:07] because it's been hypersexualized.
[1:28:09] Yeah, and also if a, if a male is performing on it, it's also
[1:28:13] you. I mean, I say it's from a woman.
[1:28:16] You feel way more shut down. Yeah, I mean, the original pill
[1:28:18] trial, I've done a, a, a, a post about it and I've written about
[1:28:22] it. But you know, there were two
[1:28:23] doctors from white middle class doctors from America went to
[1:28:27] Puerto Rico, really poor apart of the world at that time and
[1:28:34] dished out the pill to St. workers and prostitutes.
[1:28:39] And they it was given as a way out so they could carry on doing
[1:28:43] their work because these are women who are destitute,
[1:28:46] desperate. So where are the ethics about
[1:28:49] that? Gave them the pill And some did
[1:28:51] die out of that trial. So I've never made that.
[1:28:55] Google it, it's really horrific where it's come from.
[1:28:58] So where do you think like all of this is going to be in the
[1:29:01] next 5 years with like now we're talking about it.
[1:29:05] Funding in some countries has completely gone in Women's
[1:29:08] Health. It's yeah, Trump.
[1:29:09] Has been a sledgehammer to Women's Health.
[1:29:11] Yes. I mean, anything that's got the
[1:29:13] word female in it now has been taken off.
[1:29:15] Well, yeah, because I but I would say any like the whole
[1:29:20] conversation about genders is really to me quite sad because I
[1:29:24] deal with however anyone identifies themselves right,
[1:29:26] whether they're trans, non binary, etcetera.
[1:29:30] And the bare minimum, you just need to respect them.
[1:29:34] We come back to that whole piece about validation as well as a
[1:29:38] clinician in my first book, which is the the knowledge, your
[1:29:42] guide to female health. Actually, I've got a whole
[1:29:44] section on trans health in that and LGBTQ plus, and I thought I
[1:29:49] would get a lot of backlash because I'm a Muslim Doctor
[1:29:51] Who's writing about LGBTQ plus etcetera, but actually I was
[1:29:55] really amazed that I didn't I'm. So happy that you didn't.
[1:29:58] And I'm so glad that it was received well.
[1:30:00] But my American publisher, when Trump came in and said there's
[1:30:04] only two genders, male or female, they went.
[1:30:07] They removed that section about LG about trans health.
[1:30:11] That's really sad. And it's really sad because I
[1:30:14] think that not only are they the smallest minority in our
[1:30:17] community, not only are they massively like Hanford in
[1:30:21] regards to research, they are put under a mental health
[1:30:24] diagnosis, which is abhorrent or should have antidepressants
[1:30:29] thrown at them. But it means that we're not
[1:30:32] learning. We've stunted our growth of
[1:30:34] learning and by making sure that we are so specific about our
[1:30:39] genders. Yes, biologically there's the XY
[1:30:42] chromosome and The xx chromosome.
[1:30:44] I get that. But if someone has that,
[1:30:49] identifies as a trans man and is bleeding, you know, because they
[1:30:53] are still having their periods, I'm not going to deny them
[1:30:56] treatment. I'm still going to go through
[1:30:59] all the treatment options that I've got.
[1:31:00] I mean, that's just basic humanity, I think.
[1:31:03] Well, that is what it is. It's not gender, it's humanity.
[1:31:07] That's it. That's exactly what it is.
[1:31:09] And that's what we need to keep coming back to.
[1:31:12] But but the, the funding of healthcare really worries me.
[1:31:14] And, and recently Trump's just taken the US out of the World
[1:31:18] Health Organization. I think the thing that concerns
[1:31:23] me is when there's, I know when the thing that concerns me is
[1:31:26] that when you've got individuals who are pulling out like
[1:31:30] countries and. They're the biggest funder.
[1:31:32] They're the biggest funder pulling out.
[1:31:34] What happens is, is that you get billionaires stepping in.
[1:31:37] So you've got the Bill Gates Foundation stepping in to fund
[1:31:40] 200 and like £25 billion into women's research.
[1:31:45] And I read that very carefully. And if you actually read the
[1:31:49] paper that's coming out about it, what that funding is, He's
[1:31:52] actually said it's a business opportunity, not research.
[1:31:58] So he's looking it in a biotech type of way.
[1:32:01] And when you come on, come on with it come you've.
[1:32:05] Got we're too. Dyslexic.
[1:32:07] The dyslexia is really kicked in, but you see female bodies
[1:32:12] because you're not talking about male bodies here.
[1:32:14] By the way, when you're talking about specifically female bodies
[1:32:17] as a business tool, that concerns me and it's a bit
[1:32:21] handmade tale ish. Yeah, that is very hands made
[1:32:24] tale. Isn't that scary?
[1:32:26] Because then there's already an issue if you look at Elon Musk
[1:32:29] going, but birth rate is declining in the world.
[1:32:31] Look at Japan. The birth rate is declining.
[1:32:34] But there was a big thing happening on social media about.
[1:32:35] That. Yeah, exactly.
[1:32:37] So you've got that, but then you've got an AI app with Elon
[1:32:42] Musk, and he owns that called Grok.
[1:32:45] And let's face it, let's be absolutely true.
[1:32:46] It's not people or the AI app, it's men.
[1:32:50] Men going on that app and declothing women and children.
[1:32:56] It's horrific. It's not the app because the AI
[1:32:58] app has no feelings. It's not a gender at all.
[1:33:01] So it's men doing that and then you've defunded the Natalie and
[1:33:07] research. You go back to that sort of
[1:33:10] handmade tale and hypersexualisation of female
[1:33:14] bodies again. And they're a commodity.
[1:33:15] That's the word I was trying to say commodity.
[1:33:18] And that really scares me as a healthcare professional because
[1:33:21] it means that we're not going forwards, we're actually going
[1:33:23] backwards. But I'm, I'm really hopeful
[1:33:26] again, the glass half person coming back to that, because I
[1:33:29] never like to think that it's all doom and gloom and it's not
[1:33:32] the the good thing is, is that we've got incredible advocates.
[1:33:36] You've got podcasts like this who are giving platforms to
[1:33:38] people like me. You know there would.
[1:33:41] You wouldn't normally see a hijabi woman talking about her
[1:33:43] vagina. I love it.
[1:33:45] That's why we need one of you in every GP clinic.
[1:33:47] Just clarify, it wasn't mine, it was the model.
[1:33:50] We're talking about the model. If someone's watching this, if
[1:33:53] someone's not watching this, they're really like, is she
[1:33:55] getting out of her vagina to? Show us that's the one.
[1:33:57] Exactly. I'm so glad those are visuals
[1:34:01] with this as well. Actually, that's probably a bad
[1:34:03] thing, those visuals, but it means that we've we're having an
[1:34:08] equitable conversation taking into account all different lived
[1:34:13] experience, so people of colour see, feel seen and heard.
[1:34:17] That's really important. Really important people who have
[1:34:20] different sexualities are seen and heard and validated.
[1:34:24] And I feel going forwards with the introduction of AI, there's
[1:34:28] enough good people, good humans, good humanity out there to go
[1:34:33] right. I'm going to push back at this.
[1:34:34] So you look at Grok like there was a huge push back from so
[1:34:37] many organized governments, like push back against that, that
[1:34:40] you've got a billionaire to change that.
[1:34:42] I think that it just keeps people advocating and not
[1:34:47] putting their head below the power put because it's too
[1:34:49] scary, because you allow terrible things to happen if you
[1:34:53] stay silent. 100%, I don't, yeah.
[1:34:56] My mum will always say the suffrage accidents fight for
[1:34:59] nothing. It's so important.
[1:35:01] You've got to remember like where this all started, you
[1:35:03] know? And I still, every now and then
[1:35:05] I'm reminded because I wear dresses a lot with pockets.
[1:35:10] And I'm, I'm like, you'll never meet a woman who doesn't show
[1:35:13] off her dress with pockets, right?
[1:35:15] Especially if they're deep pockets and your iPhone can fit
[1:35:17] in there. I mean, I'm just like, I'm
[1:35:19] living the dream and I, I read, I read back why I constantly get
[1:35:24] excited and I put a post up of going I, I think I did like one
[1:35:28] of my TV shows and I was like, I'm wearing this dress.
[1:35:31] And it's got actually, don't worry about the dress.
[1:35:32] It's got pockets. And there's a an incredible
[1:35:35] person who wrote that when the suffragettes were really
[1:35:38] fighting for their 'cause they made sure that all female
[1:35:41] clothing had no pockets because they couldn't send notes to each
[1:35:44] other. Whoa, I didn't know that.
[1:35:46] Yeah, that's why female clothing.
[1:35:48] So that's why we've been reduced to a little handbag or the man
[1:35:52] has pockets because women couldn't wear trousers, right?
[1:35:55] Yeah, of course, because if you did dresses.
[1:35:57] Yeah, they were all dresses with tight corsets, and so they took
[1:36:02] out them on purpose. Fashion to stop feminism and
[1:36:07] women having a voice. They took away our pockets so
[1:36:11] that we couldn't share information.
[1:36:13] So now I'm going to have to have way more pockets.
[1:36:15] Exactly. I didn't know that was a thing.
[1:36:17] That was and so I look at society now and I'm like, do you
[1:36:21] know what? We've just come around to making
[1:36:23] women smaller again. Have you not seen this trend
[1:36:25] that making women smaller and quieter the less pockets that
[1:36:29] they have? I mean, it starts with pockets.
[1:36:30] It's a big thing. It's a big thing.
[1:36:32] I said to a guest the other day on the show, I didn't fully
[1:36:35] agree with all of his views. And I think that's a great
[1:36:38] thing. I don't think you should just
[1:36:39] get people on your show that you agree with their views on.
[1:36:40] I think you should have all different people on your show
[1:36:42] and you should be able to air views because we're all
[1:36:45] entitled, right, to what we believe in.
[1:36:47] But I did say, do you think there's more men having these
[1:36:49] types of conversations than women?
[1:36:50] Because I feel that. And I feel just even in the
[1:36:53] podcast sector and the health sector, it's way more dominated
[1:36:57] by the male voices. And we need the male voices, but
[1:36:59] we also need way more women's voices because otherwise it
[1:37:01] becomes hyper unbalanced. And what I see is a lot of
[1:37:06] content getting overshared and underlooked because it's just
[1:37:09] all surrounded by dominant male voices.
[1:37:13] And then that feeds into the societal conversation on what
[1:37:17] people end up looking more towards.
[1:37:19] And I think that's that's just is what a worry for me.
[1:37:22] I still. Think we haven't moved away from
[1:37:24] the fact that when a man says something, we listen?
[1:37:29] Take it seriously. And take it seriously.
[1:37:32] And I see that constantly. What you've highlighted there is
[1:37:35] a, what you will say as a female podcaster that will probably be
[1:37:39] ignored or downplayed still, whereas a male podcaster saying
[1:37:43] exactly the same thing as you are will be taken so much more
[1:37:47] seriously and it will blow up. So I see this with my content a
[1:37:50] lot because I'll talk about, you know, menopause or endometriosis
[1:37:55] and Women's Health, stuff that I've been entrenched in for 14
[1:37:58] years. And I'm talking about.
[1:38:00] And that same information that I've done is now being taken up
[1:38:02] by a male doctor and he's got millions of views, whereas mine
[1:38:07] sitting on about, you know, a couple 100.
[1:38:09] And I'm not complaining that like it it.
[1:38:12] I'm just glad the information is getting out there.
[1:38:14] But I still think our psyche is oh, but the man said it and I
[1:38:18] need to pay attention to this. And oh, he understands me.
[1:38:21] And that is so entrenched in our psyche because if you look about
[1:38:25] just at Women's Health and gynecology and a lot of like
[1:38:28] what I cover in my health, which is a whole family health aspect,
[1:38:31] midwives would be hands on. They would be doing so much of
[1:38:34] the birthing. Men realise, oh, I can make
[1:38:36] money here. I can and then I will be there.
[1:38:40] But they couldn't examine the women.
[1:38:42] So because it was too much. So the and they would downplay
[1:38:45] or say that women were witches. The midway, you know, the and
[1:38:49] they were awful. And so actually, if you paid a
[1:38:51] bit more to the man, and I think that's why we still have a lot
[1:38:54] more male gynecologists. Well, that's so.
[1:38:57] It is interesting that you have more male gynecologists than
[1:39:00] females. Male gynecologists are amazing.
[1:39:02] I work with so many of them. But I think if you look at the
[1:39:05] history of it and just our psyche.
[1:39:08] Well, history, fact. A big teller, strong because
[1:39:10] history repeats itself. But again and again and again.
[1:39:12] That's what we all need to like. Absolutely.
[1:39:15] But I still think the patriarchy is very, very strong.
[1:39:19] We're walking and moving the dial towards equality.
[1:39:23] We still haven't got anywhere near equity.
[1:39:25] No. Like, you know, if you're
[1:39:27] looking at people who have lived experiences or living with a
[1:39:31] disability or hearing dislike neurodiversity, if you're
[1:39:35] looking at sort of people who like in the prison system, you
[1:39:39] know, there's no equity in regards to how we deal with
[1:39:41] healthcare in those sectors. So we've still got a lot of work
[1:39:44] to do. And I keep saying that the
[1:39:46] patriarchy has a lot to answer for.
[1:39:48] It does. I'm in agreement with you there
[1:39:50] 100% I think. What did I repost the other day?
[1:39:54] Will Ferrell saying women can you just rule the world?
[1:39:58] And I had to repost that about 10 times.
[1:40:00] Yes, yes, because I feel like it's a bit of a dumpster fire at
[1:40:05] the moment, but I was very much alike.
[1:40:08] If we're down here, we can only go up because we can't.
[1:40:11] I'm hoping we can't get any further lower than we are than
[1:40:14] the standards that we have. But it's so important to stop
[1:40:19] doom scrolling to come off socials, go back to real life,
[1:40:23] go out into nature. You know, if you're listening to
[1:40:26] this podcast, take this podcast on your walk with you.
[1:40:28] So you're out in nature and listening to podcasts and having
[1:40:30] a laugh with us. And that all those little bits
[1:40:33] means that actually it's not all doom and gloom.
[1:40:35] And the world is so beautiful because in real life, guarantee,
[1:40:39] guarantee. In real life you'll just meet
[1:40:41] beautiful. Yeah, I agree.
[1:40:42] Beautiful. Humans and I constantly put my
[1:40:46] phone down. We've come to this agreement
[1:40:49] with me and my husband that after 8:00 PM, no screen time
[1:40:53] for anything. That's it.
[1:40:54] We're winding down for bed and the kids are off screens for
[1:40:58] meal time and we're winding down for bed now.
[1:41:01] And that has been a game changer in regards to our mental health.
[1:41:04] And my husband would constantly watch the news at 10:00 before
[1:41:07] he went into bed. I used to do that and I stopped.
[1:41:10] Did you? I stopped.
[1:41:12] That's why I started this podcast because I was so
[1:41:14] terrified to listen to any news outlet because I was living on
[1:41:17] my own. I was too, I couldn't go and see
[1:41:19] my parents even though you could still travel.
[1:41:21] I was too scared because my dad was high risk and I was like, I
[1:41:23] just would never trust myself or forgive myself if something ever
[1:41:26] happened. So I basically never left my
[1:41:28] flat and I just worked 24/7. And then I stopped listening to
[1:41:32] the news because I it spun me out and all I listened to every
[1:41:35] morning was the FT news briefing, which was like 2
[1:41:37] minutes long. And that's all I could listen.
[1:41:39] And then I thought, you know what, I'm going to start a
[1:41:42] podcast and talk to her professionals and actually try
[1:41:45] not feel scared and try and like educate and talk about lifestyle
[1:41:48] interventions that we can do and things that we can kind of
[1:41:50] control because there's so much that you can't control.
[1:41:53] But if we know things that we can control and we can trust
[1:41:55] people who come on the show, then actually it gives us a
[1:41:58] little bit of autonomy back. That was the whole reason why,
[1:42:01] because I was sad watching it at 10:00 at night going, I'm going
[1:42:04] to die by tomorrow. If I go to the shop and get
[1:42:06] COVID, I will die. But you live back to that moment
[1:42:10] now. And it, I mean, it was real.
[1:42:12] Like everyone was terrified. And I That's when I decided to
[1:42:15] stop watching the news at. 10 That's so good because that's
[1:42:17] the other thing we forget that we have autonomy.
[1:42:19] So I often say to my friends and like my my siblings and my
[1:42:23] sister and even myself that if you're following someone, an
[1:42:26] influencer or even a health content creator like myself or a
[1:42:29] doctor and they make you feel worse, unfollow.
[1:42:32] Them 100%. That like you have the power to
[1:42:35] unfollow. Like I constantly say to people,
[1:42:38] don't follow me at the end of my video.
[1:42:41] I sometimes say share this because this is an important
[1:42:43] video. I always say ask me questions
[1:42:45] like if there's any questions, leave them at the bottom and
[1:42:48] I'll try and answer as many as I can.
[1:42:49] Like I'm like a real life doctor.
[1:42:52] But you literally can just scroll past.
[1:42:54] That's the most important thing. We forget that we have to scroll
[1:42:56] past. You don't have to write a meme
[1:42:57] comment. Follow someone.
[1:42:59] I know that really upsets me when people do that.
[1:43:01] But unfollow really like I'm will not take it personally.
[1:43:05] I've never great friends of mine who don't follow my my, none of
[1:43:09] my family follow me on socials. And thank God for that because
[1:43:13] this whole sort of like Beckhams have unfollowed each other.
[1:43:16] Oh God guys, get a life. Oh, who cares?
[1:43:20] It's just so important. Imagine 20 years ago, the family
[1:43:23] feuds are about unfollowing. Exactly.
[1:43:26] We wouldn't have believed it and we're we're invested, though I
[1:43:30] can't totally invest. I invest in the memes.
[1:43:33] I'm so invested in the memes. I was so do you know what I get?
[1:43:36] I got invested in Gary Barlow's son's height.
[1:43:38] Those were my memes. I was so invested from there.
[1:43:42] And then I, it was just like, now I'm invested in everybody's
[1:43:45] family. But it's so important to know
[1:43:48] that if someone makes you feel worse about you after you've
[1:43:51] seen their content, even if they have the most pristine content.
[1:43:54] Yeah. Like, people only show their
[1:43:56] best version of themselves. I only ever put up content.
[1:43:59] There was a point in my content that I was sort of like, you
[1:44:02] know, this is where I'm on holiday.
[1:44:03] There's a short period where I went through that.
[1:44:05] I definitely don't post about my kids.
[1:44:07] I talk about them, but I don't post about their faces.
[1:44:10] And there was like, what? Look at this dress that I'm
[1:44:12] wearing in this studio that I'm at.
[1:44:14] And then I realized, who cares? Like, it's lovely and all my
[1:44:19] stuff is gifted. You do not have to like I, I
[1:44:22] literally shop at F&F. By the way, F&F are amazing.
[1:44:26] Like the boots I'm wearing today are from Sainsbury's from about
[1:44:29] 10 years ago. And recycling.
[1:44:31] Exactly, I re wear so much of my clothes as well again and again
[1:44:36] on telly shows and I'm like, it's so important just to the
[1:44:42] aesthetics really worries me because we've got consumed into
[1:44:45] the aesthetics alongside that. And for some people that's their
[1:44:48] bag and I love it and I get it. But if that makes you feel bad
[1:44:51] about your life, Oh yeah mate, stop following that person.
[1:44:56] Stop it. Yeah, that's thing.
[1:44:57] You gotta have the self-awareness.
[1:44:59] You gotta be like, wait, this is making me feel this way so I
[1:45:02] need to unfollow it. But sometimes we're not realise.
[1:45:04] The courage to meet your friend. Because.
[1:45:07] If they're posting about the third, the holiday that they've
[1:45:09] gone in and you're like, I'm stuck in my jammies and I
[1:45:12] haven't brushed my teeth for three days.
[1:45:14] Yeah, And you're like, I feel like crap or, you know, I have a
[1:45:17] lot of friends that went through horrific breakups, and then
[1:45:20] their best friends were getting married or getting pregnant.
[1:45:22] And I was like, don't compare your life cycle to anyone.
[1:45:25] Oh. Comparison monster.
[1:45:27] The worst, The worst. It will eat you up and I'm like,
[1:45:31] you don't know, in five, in five years I might be divorced.
[1:45:33] They might have the best marriage in the world that you
[1:45:35] just don't know what someone's life is and you're on your own
[1:45:38] life course. But it's hard because you get
[1:45:40] the best highlights of people's lives but you don't realise what
[1:45:43] happened to get. There No, do you know, there's
[1:45:45] off the back of I think it was the Grammys and I forgot the
[1:45:48] comedian. She made that joke about sort of
[1:45:50] Leonardo DiCaprio and she was just like, man, we don't know
[1:45:53] you like you just like young women.
[1:45:56] That's all we know about you and your movies.
[1:45:58] And I thought to myself, Oh my God, because do you know what?
[1:46:01] He's actually a star, like a movie star.
[1:46:04] He's not like us underlings who has to post about what he had
[1:46:08] for breakfast that day and what underwear he's wearing or what
[1:46:11] wristwatch he's got because his is about work, his platform is
[1:46:15] about his movies. And then we don't know much
[1:46:17] about him. So we have to make stuff up
[1:46:20] about him that he likes younger women.
[1:46:21] I mean, he might like younger women.
[1:46:23] No judgement. We listen, we don't judge.
[1:46:26] Yes, good point. So, so for example, if that's
[1:46:31] what we know, isn't, I actually thought that's really
[1:46:33] refreshing. Why do we have to know about
[1:46:37] everything? And so it's so important to
[1:46:40] share, even if you can, the bad bits about yourself.
[1:46:43] I mean, my platform's totally different.
[1:46:45] It's all about healthcare. And at the end of it, I'm not
[1:46:47] selling you supplements. Yeah, this is the thing.
[1:46:50] That's the other thing. Yeah, and I that's why I talk
[1:46:52] about self compassion, because my journey is Daphne not being
[1:46:55] straight. It's been up, down, backward,
[1:46:57] forward, diagonal, all over the place.
[1:46:59] Sarah with her followers, People are like the comparison monster
[1:47:02] comes in, right? Yeah, you people are like, oh,
[1:47:05] oh, I don't have that many followers as Sarah has.
[1:47:07] I mean, look at her. She's incredible.
[1:47:08] She's gorgeous and looks like a little doll and beautiful.
[1:47:12] I mean, sorry, that's my inner voice.
[1:47:14] But has literally suffered with like horrific self criticism and
[1:47:17] like self doubt and like, you know, watching different people
[1:47:20] go through different life stages, not wondering why she's
[1:47:22] not got that herself. You know, there's so many things
[1:47:25] where you take risks and you think, oh God, this is going to
[1:47:28] really backfire on me. And it you and I think you
[1:47:31] always see end products of people, but you don't see the
[1:47:33] journey to getting there. And I think that's what we
[1:47:36] forget about social media. I said this to a friend last
[1:47:38] night. I said you've got to stop
[1:47:40] comparing because you don't know what that person's been for the
[1:47:42] last 10 years. Completely different journey
[1:47:44] maybe. And you're seeing that end
[1:47:46] product and that end product is what you're comparing to.
[1:47:49] And you also don't actually know the truth of, you know, they
[1:47:52] might look something really good marketers and look like they're
[1:47:55] thriving, but they're also breaking inside.
[1:47:58] But what you've just said there is totally rooted in emotional
[1:48:01] intelligence and self-awareness as well.
[1:48:03] And I think that's the and the critical thinking to be able to
[1:48:06] look at content and go, that's not my life or actually that's
[1:48:10] OK or I'm doing better than that.
[1:48:12] So there's that phrase, that phase that you're going through,
[1:48:15] but also because you've moved yourself away from the 10:00 PM
[1:48:20] news that you're watching and you've got back to connectivity.
[1:48:23] So if you look at the Harvard Study of Happiness, that's my.
[1:48:26] Favorite. It's my.
[1:48:26] Favorite study Because it's not about money, it's not about
[1:48:29] travel, it's not about world aesthetics, it's not about
[1:48:31] having the best house or the best marriage.
[1:48:34] Actually, it's about connectivity.
[1:48:35] So what we've done here today? Yes, relationships.
[1:48:38] Completely having a nuanced conversation with light and
[1:48:43] shade in it. There's happy times, bad times,
[1:48:45] stuff that I would say that you like people listening to this
[1:48:47] will have will not agree with me.
[1:48:49] Some people will be like nodding along going actually, I agree
[1:48:51] partially with that. And then having the insight to
[1:48:54] go, I can step away from this and be connected to my emotions
[1:48:59] and think about myself as this holistic all being all breathing
[1:49:05] blood pumping vessel and then having that connectivity,
[1:49:09] whatever way that is for me, it's spiritually now I've really
[1:49:12] come back to. I mean, faith has always been a
[1:49:14] huge part of my life, but I really for me, I've, I try to be
[1:49:19] good about that personal connectivity, but having when I
[1:49:24] have none of that around me, but connectivity with the all
[1:49:28] knowing, all being. For me it's Allah.
[1:49:29] Obviously it's God. Even when I'm sat on the
[1:49:33] underground and on the tube on my way home after clinic, I have
[1:49:36] a few moments to reflect and pray for the patients that I've
[1:49:39] seen that day. For some people, prayer doesn't
[1:49:41] work. That's absolutely fine.
[1:49:43] But I think having that spiritual connection, in what
[1:49:47] shape or form that is, even if you're atheist, is I've really
[1:49:50] realized is fundamentally an important part.
[1:49:54] So we talk about exercise, diet, nutrition, emotional
[1:49:59] intelligence. Big one.
[1:50:01] Yeah. So keeping in touch with your
[1:50:03] emotions. And then I think spirituality,
[1:50:05] which we need to just come round to extend.
[1:50:07] I agree. So much with that.
[1:50:09] So I think you have to believe there's something bigger than
[1:50:12] just you and this are. Absolutely for me, I do.
[1:50:14] Too. And that you could be in
[1:50:15] anything, that could be in any type of religion, faith, spirit,
[1:50:20] anything. But there's got to be.
[1:50:22] Otherwise it's like we just had to live and die.
[1:50:25] There's got to be a deeper connection.
[1:50:27] I feel in some way shape or form.
[1:50:29] Also gives you so much empowerment with such a small
[1:50:32] speck in such a huge multi universe.
[1:50:35] Yeah, and that's why I sort of we're coming back full circle
[1:50:38] because what you're saying you're like, you know, everybody
[1:50:40] wants you as your doctor. I've I cringe personally when
[1:50:45] that hurt someone says that. And I know it comes from a place
[1:50:48] of great sort of of love and compassion and things like that.
[1:50:52] The reason I cringe is, is because you've just hit the nail
[1:50:54] on the head. I am literally that tiny speck
[1:50:56] and I'm a cog in a massive machine.
[1:50:58] I mean, the NHS is a huge machine and my job isn't to be
[1:51:04] famous or have loads and loads of incredible people.
[1:51:07] I love jotting down what I'm learning, which is why I've got
[1:51:09] two books and the Family Health Bible is for that because I just
[1:51:13] want to encourage people to do that.
[1:51:15] I mean, that book has nearly destroyed me.
[1:51:18] Because it's beautiful. Though I've put down the whole
[1:51:21] of family health into each single page.
[1:51:24] So it's essentially I'm a general physician and I've tried
[1:51:28] to jot down all the stuff I've learnt as AGP into one concise
[1:51:32] book so that you have it as a recipe book for the whole of
[1:51:35] your. I mean, look at that, isn't.
[1:51:36] It isn't that beautiful. So beautiful.
[1:51:38] I did think the. One, it's a lovely illustrator
[1:51:40] called Liliana and she is incredible talent.
[1:51:44] Follow her on socials as well. I did think this one when I was
[1:51:47] reading out, I was like, she's basically just done like a full
[1:51:49] medical degree in a book. Yeah, but it's later so that my
[1:51:54] dyslexic brain is telling me anyone can pick up this book.
[1:51:57] But also I'm hoping it's the antidote to cyberchondria.
[1:52:01] So you go on Internet, you look at all the cyber information,
[1:52:04] you know the AI, ChatGPT. The new health one, the.
[1:52:08] New health one. Exactly.
[1:52:09] And then you can be like, no, actually let me just come back
[1:52:11] to what are the basics, what I should know and then this is
[1:52:14] what I need to take to the GP. But coming back to the fact that
[1:52:18] I need to know someone that's bigger than me is really
[1:52:21] important because what I put out there, once it's out there, it's
[1:52:26] not mine. So once that book's out there
[1:52:28] and it's in bookshelves, etcetera, I don't even want
[1:52:31] people to buy it because if it makes you anxious, unfollow me.
[1:52:33] Don't buy my book. Like I'm, I'm in that place now.
[1:52:36] I'm comfortable enough to say that because I think that we all
[1:52:39] grow and we will come to whatever we need to at a certain
[1:52:43] time. And your tribe and the people
[1:52:45] that want to resonate with you or the people that feel actually
[1:52:48] this individual validates how I feel.
[1:52:51] They will come to you when it's the right time for them.
[1:52:53] So don't select the small stuff. No I agree, I think that's why
[1:52:57] my biggest thing was the self compassion piece for me.
[1:52:59] Like when I finally like forgave myself and gave myself a bit of
[1:53:02] empathy actually everything to sell a lot I just let go of
[1:53:06] stuff. I was like, it doesn't matter
[1:53:07] anymore. And actually if you can't look
[1:53:10] after yourself then you can't look after anyone else.
[1:53:12] At the end of the day you've got to fill it up from the bottom.
[1:53:14] But I mean, I think you shouldn't be offended by
[1:53:17] thinking you should be in every single GP office.
[1:53:20] I'm just like, they're such great clinicians.
[1:53:23] There is amazing. Clinicians out there, but
[1:53:25] imagine if we. Just had the women doctor when a
[1:53:28] woman goes in and there's always one person they can point to in
[1:53:31] that GP. That's the dream, that's what
[1:53:33] you want. That is the dream and that is
[1:53:35] what we're working towards. So the Women's Health Strategy,
[1:53:37] which is this 10 year strategy, all parliamentary groups have
[1:53:40] been involved. I've been working on it from
[1:53:41] year one with Professor Dame Leslie Regan, who's the Women's
[1:53:44] Health Ambassador, which I know you know, and as part of that,
[1:53:48] one of the key strands running through it is equity in
[1:53:50] healthcare. We don't just want equality now,
[1:53:53] we literally want equity. So we know that.
[1:53:56] I mean, I, I say as a woman of colour, but I'm not a Black
[1:53:59] woman. I will never be the voice of
[1:54:02] black women because I'm, I, they have their own struggles.
[1:54:05] I will never be the voice for say, someone who is living their
[1:54:09] life with a disability because I don't have one.
[1:54:11] And vice versa, all these other, I have limitations that someone
[1:54:15] who's South Asian will never. You need those individuals from
[1:54:18] those communities. So we're year 3 into it and
[1:54:22] Professor Leslie and I, we put together the Health Collective.
[1:54:25] So what we've been doing is been mapping all the grassroots
[1:54:27] organisations in this country, finding women who are doing the
[1:54:31] grassroots because let's face it, women do the work right?
[1:54:33] And they're incredible. But their lived in experience
[1:54:35] has burnt that fire of passion to go.
[1:54:38] I want this change. So we've got individual like 5
[1:54:41] times more inherent birth, which is women from Somalian
[1:54:43] communities who have complications after birth.
[1:54:46] We've got Sisters, which is a large South Asian group up in
[1:54:49] Birmingham in the Midlands, and they look after a whole LGBTQ
[1:54:54] trans community with gynecological conditions like
[1:54:57] endometriosis, adenomyosis, but particularly in the ethnic
[1:55:00] minority communities, so. Amazing.
[1:55:02] If you want to do a research project, then go what is the
[1:55:05] lived experience of endometriosis in Sikh women?
[1:55:08] Well, sisters would be going right.
[1:55:10] We've done a project on this and they are really embedded in
[1:55:12] research. But all of that needs to come to
[1:55:16] our policy makers are. So I'm really hoping that our
[1:55:19] collective just gets bigger because the more voices that we
[1:55:22] have, the more chairs we're pulling out at tables and
[1:55:25] lifting those voices, the more equity we'll have because by
[1:55:29] seeing the limitations that they've got, we can go, Oh my
[1:55:32] God, we never thought of that. I didn't even know that was a
[1:55:35] How many times have you said to me?
[1:55:36] There so many times. I didn't even know that was a.
[1:55:38] Big. I feel like I'm pretty versed a
[1:55:40] lot. Various.
[1:55:41] But there's no, there's no shade because that's just not your
[1:55:44] lived experience. So I have a completely different
[1:55:46] lived experience and that is something that's so fundamental
[1:55:50] to how we get every GP surgery and every secondary care and
[1:55:56] primary care and even tertiary care to think about Women's
[1:56:00] Health. Yeah, it shouldn't be something
[1:56:01] that's just stuck on at the end of a system.
[1:56:03] Absolutely not. Like I think it needs to be a
[1:56:06] prime focus with any training. With 52% of the population.
[1:56:09] They no, it's more more. This is why women need to rule
[1:56:14] the world. I agree with that, really.
[1:56:17] Ingrid, right, I'm going to send it to you.
[1:56:19] It's amazing. I hope this podcast gets shared
[1:56:22] wide, loud, proud from men and women as there are so many
[1:56:27] amazing men that listen to this and share it and are really big
[1:56:29] backers of women as well and also want the equity and
[1:56:32] equality and all of it. So, you know, I'm obviously
[1:56:36] massive champion of women, huge champion, huge champion of you,
[1:56:40] huge champion of this book. Congratulations.
[1:56:43] Well done on writing it. The second one, it's honestly, I
[1:56:47] opened it and just thought, yeah, that definitely evolved
[1:56:49] the breakdown. It was a mad cap idea where I
[1:56:54] was like, do you know what I did the whole of Women's Health in
[1:56:57] lay term. I think I can do the whole of
[1:56:58] family health and it took me two years to pin it down.
[1:57:02] Lots of rewrites with specialists who were like, you
[1:57:05] know, because when they're specialists, they want a whole
[1:57:07] book on that thing. And I'm like, guys, I've got a
[1:57:09] page. They're like, what?
[1:57:11] I'm like, yeah, I've got a page and I need to distill it down.
[1:57:15] So it's like a reference thing and then people can take it.
[1:57:18] But at the end of it, that's what I I lost a little bit of my
[1:57:22] sanity over it and now it's out. I am so happy.
[1:57:25] It's definitely that second difficult album.
[1:57:28] I totally feel like the Spice Girls now.
[1:57:30] Like I get one. I love that that reference just
[1:57:33] came up. You know that's gonna be the end
[1:57:35] of my trailer. I go.
[1:57:36] How did she get to the Spice Girls?
[1:57:37] Where do we call the go? Well, they always said this
[1:57:41] second album was hard. Well, I'm any on my first album
[1:57:46] right now, so I have massive admiration for doing your
[1:57:49] second. I can follow in your footsteps
[1:57:51] one day, but thank you. I want to put all of these
[1:57:54] links. So you send me all of the links
[1:57:55] that you spoke about so everyone listening can get in touch with
[1:57:58] the different research projects that you're doing and helping
[1:58:01] even just share the links. And the awareness of all of that
[1:58:04] is what makes difference. So let me know what you want.
[1:58:06] It's it's all available for free.
[1:58:08] And when does this book come out?
[1:58:10] What's the? Launch date out on the 12th of
[1:58:12] March. It'll be in all great book
[1:58:14] shops, online, online retailers. It'll be everywhere out in the
[1:58:18] wild soon. My little baby is going out in
[1:58:20] the wild. Well, I've got to leave you the
[1:58:22] final question. I don't know if you know what
[1:58:24] this is, but I asked this to every single guest, so in over
[1:58:27] 500 episodes we've only had the same answer twice.
[1:58:31] Oh wowzers. OK.
[1:58:33] And this is kind of how I see success, really.
[1:58:35] This is my definition of success, which is what does live
[1:58:38] well be well mean to you. OK, so two things to be
[1:58:43] physically and mentally well. So that's actually that's one
[1:58:45] thing and to be spiritually well that's what live well and be
[1:58:49] well means. Everything else is an added
[1:58:53] bonus. How I look that day, what dress
[1:58:55] I'm wearing, whether I've got make up on or not.
[1:58:58] And if if I'm well, I can then deliver Wellness to others.
[1:59:05] And that's when my kids are well because they are the my world.
[1:59:08] I have three boys and my husband is well and then my family and
[1:59:13] my extended family. I am the eldest of five
[1:59:15] siblings. I'm a daughter, I'm an aunt.
[1:59:18] I've got nieces and nephews. I've got friends like the, it's
[1:59:22] like I always see every woman being the core sort of tree
[1:59:29] trunk with all these branches that come off her.
[1:59:31] And the same with men as well. You know, they, we've all got
[1:59:34] these lovely branches that come off and there are people that
[1:59:37] you might have touched and not touched along the way or, you
[1:59:40] know, they just walked past and rubbed against the leaf that's
[1:59:43] coming off your branches. And I think that if we just
[1:59:48] invest well in each of those tree trunks and feed them well
[1:59:54] spiritually and physically, mentally, then that means that
[1:59:59] everybody else does really well. I still fundamentally believe
[2:00:02] that the household is well when the woman is well.
[2:00:04] And I know that's that's. You know, it should be both men
[2:00:08] and women, but let's face it, at the moment it is that and that's
[2:00:11] what that means. I love that.
[2:00:13] I think that's a beautiful one that we've never had the tree
[2:00:15] drunk analogy and they was thinking of the mycelial or
[2:00:18] looking at all your. Roots.
[2:00:20] And I bet like your roots go down to your ancestors. 100% or
[2:00:23] we forget about how important they are.
[2:00:25] They're in our DNA. That's what I mean.
[2:00:27] Like your roots are so embedded in ancestors, so you're not just
[2:00:31] here. Like if you there's a millions
[2:00:34] of reasons why you shouldn't be here.
[2:00:36] That's the way we've had a blinking parrot pandemic, I
[2:00:39] know, ensuring that we're not here and we are here.
[2:00:42] I know which is beautiful. And, and incredible humans have
[2:00:47] made that possible that we got out of a pandemic and we did it
[2:00:49] safely and we so when we need to pull together, we can pull
[2:00:52] together. We just need to find that
[2:00:54] camaraderie and that spirit back again, I think.
[2:00:56] What beautiful way to enter comrade and all together in
[2:01:00] spirituality. Thank you so much, I love the
[2:01:04] conversation.

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