0:00

oestrogen has a positive effect on

0:02

serotonin, which is our happy hormone,

0:04

and dopamine, which is our reward

0:06

hormone that gives us that motivation.

0:08

And oestrogen also makes us insulin

0:11

sensitive. And so when we've

0:13

got lower levels of oestrogen, we become more

0:15

insulin resistant. So a lot of women say,

0:17

oh, I eat exactly the same, I exercise

0:19

the same, but I'm putting this fat on

0:22

around the central wheel. And then progesterone with

0:24

that being lower, that causes us to

0:26

have low GABA, which is a calming chemical

0:28

neurotransmitter in the brain. So we too tend

0:31

to get a bit more irate, more angry.

0:35

That is the voice of Dr.

0:37

Millie Rosada. She is a lifestyle

0:39

medicine doctor who believes that understanding

0:41

our hormones can unlock the key

0:43

to our health. I'm Liz

0:45

Earle, and this is the Liz Earle

0:48

Wellbeing Show, the podcast helping us all

0:50

have a better second half. And

0:52

as I'm sure you know by now, I

0:54

am on such a mission to find ways

0:56

for all of us to thrive in later

0:59

life, not just survive, but thrive by investing

1:01

in our health and our wellbeing today. And

1:04

we do have more control than we might

1:06

think over our ability to thrive as

1:08

we age. You know by now that

1:10

I'm incredibly interested in functional and lifestyle

1:12

medicine. I love the fact that we

1:14

can take control of our health and

1:17

wellbeing, certainly up to a point, our

1:19

mood, our energy levels, resilience, resistance

1:22

to disease, so much more. All

1:25

this by how we actually live,

1:27

and I find that hugely empowering.

1:29

How we work, eat, sleep, move,

1:31

even down to what we think

1:33

about, all important elements

1:35

we largely have complete control over.

1:38

Well, amidst all of this, of

1:40

course, lies hormonal dysfunction, the root

1:42

cause of many chronic health conditions,

1:44

and hormones are just at the

1:46

heart of our experience of perimenopause

1:48

and menopause too. But

1:51

before we reach for a repeat

1:53

medication prescription, should we be thinking

1:55

about the power we already have

1:57

within us to impact our hormones

2:00

through lifestyle choices instead.

2:02

Dr Millie Rizada is a GP

2:04

and lifestyle medicine doctor and she's

2:07

written a book called Happy Hormones,

2:09

Happy You. In it she explains

2:11

why and how we have much

2:13

more power to make our hormones

2:15

work with us rather than against

2:17

us than we might think. Sergeant

2:30

and Mrs. Smith, you are going to love this

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The hate

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case powers the rules, miss, not case.

2:50

Here's the show that we recommend. This

2:54

is a perfect time to really kind

2:56

of give a perspective that Aileen and

2:58

I think that we have, we certainly

3:00

hope we have, on

3:03

using Apple products as

3:05

regular folks. And to really kind

3:07

of ask the question, how is

3:09

it really fitting in your life? Apple Vision

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everywhere. acast.com. Well

3:32

Millie, welcome. I love

3:34

the fact that you are so

3:36

incredibly passionate about lifestyle medicine and

3:38

hormonal health in particular. As

3:40

is often the case, you came to a lot

3:43

of this as a result of your own experiences,

3:45

didn't you? I did, yes. Thank

3:47

you so much for having me today Liz.

3:49

But yes, it has been a very emotional

3:51

journey with my hormones over the years and

3:53

that's kind of what propelled me on to

3:55

really dig deep into the science and what

3:57

we can do in our lifestyle too. improve

4:00

our hormonal health because I think a

4:02

lot of chronic disease is lifestyle driven,

4:05

80% of chronic disease is lifestyle driven. And

4:07

instead of trying to put a plaster on

4:09

the actual problem, it's trying to look at

4:11

the root cause and actually see what

4:13

we can do in our lifestyle to

4:15

not only treat it, but also prevent

4:17

and reverse if possible. And I don't

4:20

think that's what we talk about enough

4:22

on the NHS. And it's, you know,

4:24

the NHS is a great service that

4:26

we have. It's great from population health

4:28

needs, but in terms of reversing

4:30

and preventing conditions, I think a lot more

4:32

work on lifestyle needs to be done. And

4:34

it's very difficult in that 10 minutes that

4:37

we have to try and achieve it. Absolutely.

4:40

And I'm very interested actually in your

4:42

journey and you

4:44

say, you know, that you started your

4:46

periods young, you were eating an unhealthy

4:48

diet, you develop symptoms consistent with PCOS,

4:51

which I'd love to talk to you

4:53

about actually about the polycystic ovarian syndrome.

4:55

And, you know, your, your lifestyle

4:57

as a young medic, you know, didn't really help

4:59

you with any of this, did it? Can you

5:02

talk a little bit to that? Because I think

5:04

a lot of people will really relate to that.

5:06

Yeah. So I am, you know, went to university

5:08

age 18, very slim, very slender, relatively healthy

5:11

when I joined university. And

5:13

then with the long hours of going

5:15

to hospital placement, during the

5:17

night shift, I did eat a lot of unprocessed

5:19

food, so it was a lack of sleep. And

5:22

it's the culminating effects of multiple lifestyle

5:24

pillars that were working against me. So

5:26

I put a large amount of weight

5:28

on. Did you? Obesity was a problem.

5:31

And then got married at a young age. And

5:33

then I tried for children, but obviously I was

5:36

having a regular period. So I didn't have periods

5:38

for every, only every three

5:40

to four months because I have polycystic ovarian

5:42

syndrome. And so all these things, even though,

5:45

yes, I learnt them in a medical textbook,

5:47

it's when you're suffering them yourself. And when

5:49

you're actually in that moment, it makes you

5:51

realize what you need to do now at

5:54

that point in my life, because it was

5:56

so hectic. I was working full time trying

5:58

to get pregnant. We had quite a lot

6:00

a few miscarriages which was a problem relating

6:03

to not able to maintain

6:05

or have enough progesterone to support the pregnancy.

6:07

I had a bit of fertility assistance and

6:09

then had my children work all

6:11

the hours of God's hand after having the

6:14

children, being taken out very quickly and

6:16

then noticed that I mean I've

6:18

always been very hormonally sensitive, always

6:20

knew that in that luteal phase

6:22

and that two weeks before my

6:24

period I became quite emotional, very

6:27

erratic at times and so then my PMS

6:29

I noticed had worsened but it came to

6:32

a point where it was severe enough to

6:34

be diagnosed as PMDD and I remember seeing

6:36

a specialist at the time and he told

6:38

me about it and I thought what is

6:40

this, you know this is not something I

6:42

covered in my curriculum when I was at

6:44

school, done my exams, I did

6:46

very well, you know came one of

6:49

the top in the medical school and

6:51

this is not something I'd heard of

6:53

so they quickly induced a medical menopause

6:55

in myself, they gave me GNRH, yeah

6:57

yeah yeah I still

7:00

remember the day I phoned my husband at the

7:02

time and said he wants me to make a

7:04

decision now, what should I do and he said

7:06

oh you should have it and

7:08

I said really, oh it was, I

7:10

still remember and because I walked into the room and

7:13

it was a very pleasant male gynecologist and

7:16

I sat down and the first thing

7:18

I did was just burst into tears

7:20

and you know just that in itself

7:22

I think he just said look I

7:24

know what the diagnosis is straight away,

7:26

I explained what my symptoms were and

7:28

then I ended up having that injection

7:30

and GNRH is gonadotropin releasing hormones and

7:32

that basically stimulates your ovaries

7:35

to release an egg. Now

7:37

if you give such a high dose then

7:39

it can actually then regulate and suppress it, so

7:41

essentially it put me into a medical menopause

7:44

so all I can liken it to when

7:46

I first had it in the first few

7:48

weeks was not just one menstrual cycle, I

7:50

felt like I was having a culmination of

7:52

five or six, you know the heightened response

7:54

that I got from my hormones was just

7:56

intense, I remember emailing him saying not

7:59

really Is this normal? And

8:01

he said it will pass, you know, after a

8:03

few weeks. And it did, because then I

8:05

didn't ovulate after that. OK, so can we just

8:07

backtrack a bit here? Because there are a few

8:10

things that I'm really not aware of. PMDD,

8:12

first of all, what does that stand for? And

8:14

then what on earth is this injection? And is

8:16

it being given routinely? And to whom? And, you

8:18

know, what are the effects? Why is it

8:20

being given? And what are the side effects? So

8:24

PMDD is premenstrual dysphoric

8:26

disorder. And

8:28

it is a disorder which is a

8:30

cyclical disorder. So it occurs in that

8:32

luteal phase, typically the two weeks before

8:34

menstrual period. And premenstrual syndrome is, I

8:37

would say, a milder form. PMDD is

8:39

a very severe form of how we

8:41

react to our own hormones. And it

8:43

can cause a multitude of symptoms from

8:45

being very teary the way that we're

8:48

coping with things at the time, very

8:50

low mood. And

8:52

there's a very high risk of suicide

8:54

in people who suffer with PMDD. And

8:57

what's very interesting is

8:59

that when people are perimenopausal, when

9:01

the hormones are very erratic, that's

9:03

when incidents and prevalence of

9:06

the condition tends to be problematic. And

9:08

we do see it present a lot

9:10

more in that midlife phase. So women,

9:12

you know, from 35 onwards, we're

9:15

seeing an increased incidence of it because of

9:17

the erratic nature of hormones in that phase

9:19

anyway. Because some months we may ovulate, some

9:22

months we may not. And the levels of

9:24

hormones are going up and down. There's quite

9:26

a lot of research into the area now

9:28

about genes that may be implicated and epigenetic,

9:31

so our lifestyle and how that can interact

9:33

with our genes to make people more

9:35

susceptible, which is a very interesting area

9:37

of work. But the injection I had,

9:39

which is GNRH, which

9:42

sounds like a bit of a mouthful,

9:44

but it's basically the mastagland in the

9:46

brain that stimulates your ovaries to produce

9:49

an egg each month. The GNRH stimulates

9:51

that. But if you give it in

9:53

such a high dose, it will stop

9:55

that feedback and actually stop you from

9:57

ovulating because of the high dose. of

10:00

the injection, so that's how best I

10:02

can describe it. So when I originally

10:04

got it, had this flood of hormones,

10:07

but then it all got down regulated

10:09

and had to have them regularly every

10:11

three months, but

10:13

I basically stopped my periods and went

10:15

through this medical menopause for about 18

10:17

months it was. And you know, that was

10:19

the most stable really, I

10:21

felt, the most stable I felt was

10:24

during pregnancy when there was no massive

10:26

fluctuations of hormones and then obviously after

10:28

this injection. But then there came

10:30

a point when I'd had time to kind

10:32

of have a bit of respite and think, well, what

10:34

can I do? What can I do to help it? I

10:36

don't want to be on, I don't want to have this

10:39

injection regularly. What can I do in

10:41

my lifestyle? That's when I really started

10:43

thinking, what can I do in my

10:45

nutrition plan? What can I eat,

10:47

exercise? What is it in my

10:49

lifestyle that are triggering my symptoms to be worse?

10:52

So I have massively turned myself

10:54

around. I'm not on, currently, you

10:56

know, everyone's individual, everyone needs to

10:59

see the healthcare practitioner about what's

11:01

appropriate for them. But myself at

11:03

the moment, I'm on no medication

11:05

for my hormonal condition. It's mainly

11:08

managed through lifestyle and I'm a

11:10

huge advocate of the power of

11:12

lifestyle to help balance

11:14

your hormones. And it's not talked about

11:16

enough, it really isn't. And there's so

11:18

many people that aren't hormone intelligent, you

11:20

know, I know that you're an ambassador

11:23

for the menopause charity. And so you'll

11:25

know 90% of people aren't even

11:27

aware of menopause and

11:29

what that actually means. So education

11:31

is massively needed, not just

11:33

in that midlife, but actually

11:35

preparing people for that midlife. It's essential.

11:37

Can you talk to us a little

11:39

bit about PCOS? Because this is something

11:41

that I'm hearing more and more about,

11:43

I'm aware of more and more women,

11:46

younger women, and midlife women being diagnosed

11:48

with this. What is it?

11:50

And is this something that can also be

11:52

controlled or assisted with lifestyle

11:55

changes? So polycystic ovarian syndrome,

11:57

syndrome is a collection of

11:59

symptoms. So people can

12:01

have varying symptoms. I know

12:03

that they've recently changed the diagnostic criteria, but we

12:06

look at certain things. When anyone

12:08

comes in to us to see us, the

12:10

first thing that we do is take a

12:12

really thorough history. So you need to speak to

12:14

them and find out what the problem is. They

12:16

might be saying that the periods aren't regular.

12:18

They're getting problems whether, you know, because of

12:20

the irregular period, they're not, you know, they're

12:22

struggling to get pregnant. So there are some

12:24

problems that people may face. Other

12:27

problems, acne, excess hair, because you

12:29

can sometimes get increased androgens in

12:31

the condition. And then also on

12:33

an ultrasound scan, you know, putting jelly on

12:35

your tummy, looking at those ovaries, you can

12:38

see these cysts, which are basically eggs that

12:40

are wanting to try and be released from

12:42

the ovary that are kind of not fully

12:44

been released. And that's what those cysts are.

12:47

I know we call them cysts, but it's

12:49

just the protrusion of those immature

12:51

kind of follicles from the ovary.

12:54

So people have a

12:56

diagnosis based on certain number of criteria

12:58

because people are very different. Mine

13:01

was very much I was getting

13:03

a lot of acne, excess hair,

13:05

so hersthetism, and they had irregular

13:07

periods. You don't necessarily have to

13:09

have those so-called cysts on your

13:11

ovaries to have a diagnosis. So

13:13

it's based on multiple things that we

13:15

look at, and then we decide whether

13:18

people fulfill that criteria to have a

13:20

diagnosis. Now, no one

13:22

really told me when I was given that

13:24

diagnosis what I can do in my lifestyle

13:26

at all. You know, like I've mentioned,

13:28

I was overweight bordering on obese. No

13:31

one said, you know, are you having

13:33

a lot of processed food which is

13:35

driving an insulin resistance? No one mentioned

13:37

that at all. However, when I did

13:39

start eating a lot more whole, clean

13:41

foods that were unprocessed and dramatically lost

13:43

a lot of weight, my periods started

13:45

becoming every 28 days. My

13:48

acne started to improve, and I naturally

13:50

did fall pregnant, but there was issues

13:52

just like I mentioned about maintaining the

13:54

pregnancies. I did have quite a lot

13:56

of miscarriages. No one really talked to

13:58

me about what I should do. I was doing

14:00

a full-time junior doctor job, ground- doctor

14:02

every day, just constantly getting through the

14:05

day. And not

14:07

really, even though in our job it's very much

14:09

telling people what they should do to look after themselves,

14:11

not really looking after myself. And of

14:13

course, it's just so normalised, isn't it? The ultra-processed foods

14:15

are around us all the time. It's

14:18

become normal to have a bag of crisps every day and not think

14:21

about it, to go into McDonald's, to drink, I don't know,

14:24

artificially sweetened drinks. And just

14:26

anything out of a packet, chuck something in a microwave

14:29

and heat it up without any thought that that actually

14:33

could be driving so much of how we're

14:36

feeling from gut health

14:38

issues to hormonal health. And this message is

14:40

so obvious, isn't it? It's

14:43

like once you see it, you can't unsee it, and

14:46

yet it just hasn't filtered through. And

14:48

it's extraordinary that you, as a doctor, suffering

14:51

with these symptoms, and you're not going to be able

14:53

to do that, suffering

14:55

with these symptoms, and having

14:57

had all that medical training, we're still

14:59

blissfully unaware that you could actually help

15:01

yourself and make yourself feel and look

15:03

better. I didn't really know

15:06

the impact how significant lifestyle

15:08

changes in multiple areas would have on

15:10

me. And when I started

15:13

to look at that and noticed those changes,

15:15

it was phenomenal. You know, I was

15:18

so inflamed, there was so much inflammation going

15:20

on, had such poor gut health, such an

15:22

imbalance in my hormones, and just through looking

15:24

at what I ate, but not just

15:27

what I ate, but when I ate, you know, adding

15:29

a little bit of intermittent fasting in, exercising in a

15:31

closeness with my menstrual

15:33

cycle, not just doing five,

15:35

six, seven, nine, ten, ten sessions

15:38

every single week in the luteal phase

15:40

as well, which will drive cortisol. Yeah,

15:42

okay, so listen, let's cover off exactly

15:44

what hormones are, what we're talking

15:47

about, so that we can really understand if we're

15:49

going to hack into them and have happier hormones,

15:52

what hormones we're talking about. You know, you've talked about

15:54

things like the luteal phase, let's talk about what that

15:56

is. You've talked about things like cortisol, obviously, which is

15:58

associated with stress. Yes,

16:01

hormones, bottom line, what are they? What

16:03

are they actually doing within the

16:05

body, particularly for women? Yes,

16:07

so I mean hormones are essential to

16:09

men and women and they are chemical

16:11

messages within the blood that sends messages

16:13

from one place to another. And there's

16:16

multiple, multiple hormones. And in my book

16:18

I talk about the main ones that are

16:20

relevant, especially to the midlife women. When

16:23

we talk about female hormones, we typically talk

16:25

about estrogen and progesterone, but we do also

16:27

need to remember that, yes, we have got

16:29

10% of the testosterone levels

16:31

of men, but you know, 50% of

16:33

our testosterone is made in the ovaries. So

16:36

when we do go through that change, we're losing

16:38

50% of testosterone, so it's not fair enough as

16:40

well. So, you know, those

16:43

sex hormones, progesterone, estrogen, testosterone,

16:45

they're not just about making

16:48

babies, they're not just about,

16:50

you know, childbearing. We have

16:52

receptors for those hormones all

16:55

over our bodies. So if we start from

16:57

the top, we have them in our brain.

16:59

So we know that these hormones are so

17:01

important for brain health and we know how

17:03

important it is for skin health. You know,

17:05

a lot of women who transition in the

17:08

midlife and they get dry, flaky skin for

17:10

the musculoskeletal system. So the muscle, the joints,

17:12

they notice they get stiffness and pain in

17:14

the joints. There's so many things it's

17:16

important for. I mean, one thing I've noticed I've

17:18

got having flare up as recently is I've been

17:20

getting a lot of dry eyes, so I've been

17:22

getting a lot of blepharitis and, you

17:25

know, I've got an appointment later today with an

17:27

optician, but I said, like I said

17:29

to him, I said, this is occurring every single

17:31

month. It's hormonal driven. When I've had my LH,

17:33

it's hormonally driven. When I have my LH spike

17:35

and my testosterone is high, I get a blocked

17:37

up and it's like, I need my eyelids and

17:40

he just says, I think it might be because

17:42

you're stressed and I'm like, I mean, it's hormone,

17:44

which you know, cortisol may be

17:46

causing an imbalance there, but it's the fact

17:48

that it's just not a force of holistically

17:50

with that whole patient in front of you,

17:52

what is going on every

17:54

single month. I get another style, another

17:57

infected blepharitis in my eye and not

17:59

one person. said, oh yes, this

18:01

is hormonally mediated, not one person. So

18:03

what is this luteal phase then? You

18:06

talk about two weeks before your period.

18:08

Talk us through what is happening inside

18:10

the body hormonally. So the

18:13

first two weeks I think of is

18:15

the follicular phase. So that hormone I

18:17

mentioned earlier, GNRH, stimulates your

18:19

ovaries to make an egg

18:21

mature. So when that egg's being

18:24

matured in the first two weeks of your

18:26

period, what we're wanting to do is make

18:28

an egg so we can ovulate. The first

18:30

two weeks of your period, your oestrogen

18:32

levels rise. And then day

18:34

14, which is the mid cycle, is when

18:36

you get a surge in a

18:38

hormone called LH, which is

18:41

luteinising hormone and that stimulates that

18:43

egg that you've nicely prepared in those

18:45

initial two weeks to be

18:47

released and ovulated. So usually people who

18:49

are regular every 28 days, day 14

18:53

is when you would release that egg. And

18:55

how does that make you feel? Does that

18:57

have any physiological changes mentally or summationally? Well,

19:00

so I mean, obviously that LH spike will

19:02

trigger testosterone release as well. And that's why,

19:04

you know, mother nature, that's when people can

19:06

feel a lot more, the sex drive increases,

19:08

they're a lot more extrovert, they want to

19:11

be more sociable, because that's when people

19:13

are naturally meant to mate and reproduce.

19:15

So, you know, the follicular phase, I

19:18

am on top of the

19:20

world. I feel that's when I get all

19:22

my business, get all my business ideas. I

19:24

got my book written the majority of the

19:26

time in that follicular phase. It's a superpower.

19:30

You should harness the effects that

19:32

these hormones have on our health.

19:34

Now, once you've ovulated, you have

19:37

to ovulate for that egg then

19:39

to produce progesterone. Now that progesterone

19:41

helps support a potential pregnancy. So

19:43

then in that luteal phase, which

19:45

is the two weeks before your

19:47

period, it's called the luteal phase

19:49

because they run into the follicle

19:51

that's caused the egg to be

19:53

released. It's called the corpus luteum.

19:55

So it's called the luteal phase.

19:58

In that phase, your progesterone goes

20:00

up and down. nicely and that's

20:02

a really calming hormone, it's a

20:04

very anti-inflammatory hormone, very much

20:06

like estrogen, you know, when

20:08

you're metabolising it properly again is

20:11

very anti-inflammatory and so progesterone is

20:13

as well and it stimulates GABA

20:15

in the brain and it helps

20:17

with sleep and it's really

20:19

a nice calming hormone and

20:21

that's what we want in that phase, we

20:23

want to not be doing seven high intensity

20:25

exercise workouts per week, we want to be

20:27

nourishing and nurturing a baby

20:30

interestingly in this phase. The

20:32

study shows that we have an increase in our metabolic

20:36

rate right, you know, up to 9%

20:38

so people feel a lot hung, a

20:40

lot, not everyone but most

20:42

people do find that they're hunger increases in

20:45

this time because what we're doing is trying

20:47

to support a pregnancy, we're trying to nourish

20:49

it and nurture it with macro and micro

20:51

nutrients to support a potential pregnancy. Now

20:54

if it does not meet

20:56

sperm then basically your progesterone level falls, estrogen

20:58

levels are low and you shed the lining

21:01

of your room which will be day one

21:03

of the next cycle so that's

21:05

the way that the cycle kind of works. Okay

21:08

so now what about those

21:10

who are perimenopausal or menopausal

21:12

or postmenopausal, they're obviously not

21:14

releasing eggs so

21:16

are women still having the same

21:18

cycle of mood or do

21:20

we suddenly become completely stable? I

21:23

mean it's interesting isn't it so and

21:25

then if you add in hormone replacement therapy

21:27

and you're replacing those hormones that might otherwise

21:29

have been released, how is

21:31

that influencing the body and how we might

21:33

feel? So in the perimenopause some

21:36

people have regular periods, some

21:38

people ovulate every single

21:41

month, sometimes they miss a period

21:43

and if you're not ovulating then

21:45

you're not going to get that progesterone increasing

21:47

in that luteal phase so some people find

21:50

that they get a lot more anxious, they

21:52

get a lot more panicky

21:54

in that time. Because they don't

21:57

have the progesterone to keep them calm. Yes,

22:00

exactly. But everyone says a lot

22:02

of people find that sometimes because

22:04

if you don't regulate regularly, sometimes

22:07

you can have really quite big

22:09

surges in your hormones. Sometimes

22:11

there's a really lovely graph actually, which

22:14

shows how in that luteal

22:16

phase, your hormones can be very, very

22:18

erratic. Whereas normally it's quite smooth on

22:21

a graph, they can go very, very

22:23

high. And that can trigger people's migraines.

22:25

So that's why I do symptoms that

22:28

people suffer with in the perimenopause can

22:30

be so variable because of fluctuating hormones

22:32

more so than just the

22:34

normal phase. And then obviously

22:37

in the post menopausal period of someone's

22:39

life, you know, your

22:41

ovaries have gone into retirement. And

22:43

so the ovaries stop producing the

22:45

sex hormones. So you've now got

22:47

a lower level baseline level of

22:50

estrogen and progesterone. And estrogen, yes,

22:52

when it rises, it stimulates dopamine

22:54

and serotonin in the brain. So

22:56

important for brain health. So

22:59

obviously, levels of that

23:01

alone, people find that they've got no

23:03

motivation, limited energy. And

23:05

so it's very important to kind of differentiate

23:08

between actual, you know,

23:10

clinical depression, which is a psychiatric

23:12

problem, or is it hormonally related? Because

23:14

if it is hormonally related, then it

23:17

may be appropriate to replace people's hormones.

23:19

So it's, it's very nuanced

23:21

and everyone is individual about how

23:23

we should try and manage symptoms.

23:25

But there's so much in lifestyle

23:27

that we can do to hack

23:30

your hormones, really, you know, help balance

23:32

them, you know, and yes, HRT, if

23:34

people have a preference to take it,

23:36

and they wish to take it, and

23:39

it's appropriate for them to take, then

23:41

you know, that in conjunction with lifestyle

23:43

changes, you have a huge impact on

23:45

people's health. I absolutely hear you.

23:47

I mean, for me, HRT was completely transformational,

23:49

and I simply wouldn't be without it. But

23:51

it's not something that I would ever say

23:53

is going to work on its own. You

23:55

know, in fact, what I found from my

23:58

experience is that it gave me back my

24:00

motivation and my energy to

24:02

be able to then invest more time in

24:04

myself. I actually started hitting the gym and

24:06

I took up running and I felt happier

24:08

and more confident in myself and I got

24:11

out of a difficult relationship and I started

24:13

to kind of live my life more and

24:15

actually control things like sugar cravings and mood

24:17

and eating better than I've ever eaten

24:20

before because those hormones are under control.

24:22

So I would always, I think, concur

24:25

with you, say, yes, HRT, like you

24:27

to be very helpful, but it's not

24:29

just that, is it? You know, you do

24:31

need to then move on and look at all

24:34

these other factors, particularly things like

24:36

diet. What about things

24:38

like endocrine disruptors? Do you cover that in

24:40

your book? I do, yes. There is a chapter

24:42

on toxic substances and exposure

24:44

because this is again something that we

24:46

don't really talk about enough. So there's

24:49

lots of xenoestrogens which are estrogen mimickers,

24:51

for example. So that might be things

24:53

within our food. That might

24:55

be, you know, if we're not having organic food,

24:57

if there's foods that are pumped with antibiotics, that

25:00

can all disrupt our hormones.

25:02

A lot of our households and

25:05

beauty products as well, it's making sure that

25:07

there's, you know, there's a low level of

25:09

toxins within those because parabens

25:11

and other hormone and

25:13

endocrine disruptors can cause

25:16

an impact and mimic the

25:18

action of hormones and stopping the correct hormones

25:20

from latching on to the receptors as they

25:22

should. You know, whether it's

25:24

just even BPA and also Teflon and

25:26

the substances that can be produced from

25:29

nonstick pans, it's knowing what you can

25:31

do in your lifestyle and making little

25:33

changes in that that can reduce that

25:36

toxic load. And you know,

25:38

not only in the midlife do people

25:40

suffer with this decline in hormones, it's

25:42

the cumulative effect over those years, you

25:44

know, over 30, 40 years

25:46

of miniature exposure to these

25:49

toxic substances over years in

25:51

addition to the lack of hormones. And it's

25:53

just a magnitude of multiple things happening to

25:55

cause this perfect storm. And that's why so

25:58

many people are struggling in the midlife. life.

26:01

But it's fascinating about

26:04

a lot of the endocrine disruptors can

26:06

be obesity as well. You know, they

26:08

can cause obesity and it's not just

26:10

about excess alcohol and smoking and stopping

26:12

smoking. It's looking at what

26:14

can we do in our lifestyle to try

26:17

and avoid all of these toxic substances that

26:19

we're facing all the time. You know, there's

26:21

something called the Dirty Dozen which Michael Greger

26:23

talks about in terms of foods that have

26:26

got high pesticide kind of residue due to,

26:28

you know, farming and the changing in the

26:30

way that we farmed. And so it's just being

26:32

aware that in those foods, for example, we

26:34

should be buying those organic if possible. And then there

26:37

is the clean 15 foods which

26:39

is, you know, foods that aren't susceptible to

26:41

these residue pesticides. So it's

26:43

having this knowledge that when you're more informed, you

26:46

know, because I've seen yourself, you know, when you

26:48

go to the supermarket, look at the labels but

26:50

really things that are unprocessed don't have a label,

26:52

do they? You know, an apple is an apple.

26:57

It's 100% apple. So it's actually just

26:59

having that kind of knowledge when you're

27:02

going into that supermarket, being armed with actually what

27:04

you're going to buy. Okay, Millie, let's come back

27:06

in a moment and talk more about understanding

27:09

our hormones. We are going to drill

27:11

into that topic of estrogen dominance because

27:13

I do not pretend to understand

27:15

it and I'm hearing more and more about

27:17

it on social media. I know it's controversial

27:19

so I would like to cover it and

27:21

also helping us to better understand some of

27:23

our menopause symptoms, you know, feeling sweaty, exhausted,

27:26

snapping at people around us, you know, mood

27:28

changes and all the things that we can

27:30

also help improve hopefully with just a

27:33

few very simple lifestyle changes.

27:51

Well, welcome back and we have established, I think, that we do

27:53

want to be looking at the root causes here hormonally. I am

27:55

going to be talking about the root causes of the hormone I

27:57

am going to be talking about the root causes of the hormone.

28:00

to ask you straight up now Millie,

28:02

what is estrogen dominance, why are we

28:04

hearing about it now and why is

28:06

it controversial? Yes it does

28:08

spark quite a lot of controversy in

28:10

the health space. Estrone dominance hasn't got

28:13

an actual defined definition and that's one

28:15

of the biggest problems and because it's

28:17

no definition it's not

28:19

really been extensively studied. Some people do think

28:21

it is a real thing where other people

28:24

don't even believe it's an entity. Now what

28:26

we do know is that estrogens are

28:29

a group of hormones. There isn't just

28:31

one, there is a group of them

28:33

and the three main ones that we

28:36

look at are ostrone which is E1,

28:38

astrodiol which is E2 and then estriol

28:40

which is E3. Different ones

28:43

predominate at different phases of our

28:45

lives so when we've gone through

28:47

the change our ovaries aren't producing

28:49

the estrogen however our adrenal glands

28:51

still do produce testosterone

28:53

and kind of androgens which

28:56

get converted to estrone in

28:58

fat cells for example. So

29:00

that's why sometimes women find it

29:02

really difficult to get rid of that

29:04

belly fat because those fat cells are

29:07

an endocrine organ converting the androgens to

29:09

it is an estrogen and that gives

29:11

you that background estrogen as well. So

29:14

people who tend to feel like that

29:16

well people who were overweight and obese

29:18

will produce more of this E1 estrone

29:21

which can be quite inflammatory. So I

29:23

know I mentioned earlier that we're looking

29:25

at the correct proportions of estrogens because

29:28

estrogen is anti-inflammatory however if you're starting

29:30

to produce a lot of inflammatory estrone

29:32

from the fat cells that can drive

29:35

metabolic dysfunction if that makes sense. Yeah

29:37

it does so how do we then

29:39

prevent that from happening? I mean how

29:41

would we a recognize it within ourselves

29:43

and b prevent it? So estrogen dominance

29:45

I like to think of it

29:48

and within the holistic medicine world and a

29:50

lot of integrative and functional medicine doctors they

29:52

do see it as a concept because there's

29:54

people coming in you know having

29:57

HRT and saying look I'm not feeling better

29:59

and the reason The reason is, I like

30:01

to think of estrogen dominance as with

30:03

anything where there's an excess. Are you

30:05

taking in too much? Are you not

30:07

breaking it down? Or are

30:09

you not getting rid of it? So

30:12

there's three main components there. So you

30:14

can have an increase of, I mentioned

30:16

earlier, those toxic substances, the xenoestrogens. That's

30:19

adding to that load. If you're having

30:21

xenoestrogens, in addition to HRT, for example,

30:23

that's increasing your load of estrogen. Now,

30:26

estrogen, as with all hormones, they need

30:28

to be broken down and got rid of

30:30

in the body. They're excreted from the body. Now,

30:33

estrogen's broken down in three phases. Two

30:35

phases in the liver and one phase

30:37

in the butt. So you

30:39

need to have optimal liver health to be

30:41

able to break down these hormones. So people

30:44

who are drinking excessively, if they've got obesity

30:46

and they've got a bit of excess fat

30:48

fat on the liver, that's all going to

30:50

impact the function of the liver. So that's

30:53

why it's so important that we have optimal

30:55

liver health. Now, the two phases of detox

30:57

that occur in the liver is

31:00

the estrogen. Basically, the estrogen becomes water

31:02

soluble and then it renders it harmless.

31:04

They're the two phases. So it's

31:06

maculated and they add a source of group

31:08

to the estrogen. Now, to do that,

31:10

you've got genes that do this process and

31:12

then you need micro and

31:14

macronutrients to support those genes. So

31:17

you need B vitamins, you need

31:19

magnesium, you need compounds

31:21

in food, so sulforaphane, increase if

31:23

there is vegetables. You need all

31:25

of these substances to do this

31:28

process. So people who've got a

31:30

genetic susceptibility where they can't methylate

31:32

properly, for example, or they've

31:34

got issues with the way that they

31:36

process the estrogen in those pathways are

31:39

going to find they get a backlog and

31:41

an increase in estrogen. Does

31:43

that make sense? I'm trying to simplify it

31:45

as much as possible. Absolutely, and I'm fascinated

31:47

by this. And I've got a book coming

31:50

out called A Better Second Half. And I

31:52

look at longevity and midlife and hormone health

31:54

in that. And the word

31:56

methylation is something that we're hearing

31:59

more and more about. and it's becoming

32:01

hopefully slightly more widely understood.

32:04

And even just simple things like, even if you

32:06

don't want to understand all the biochemistry and the

32:08

science behind it, even things as

32:10

you say, eating the brassicas, eating your

32:12

broccoli, your cabbage, these sulfurous

32:15

vegetables is going to help

32:17

process estrogen and help improve the liver and

32:19

help with our methylation. Doesn't really matter whether

32:22

you understand it or not. We just know

32:24

it's a good thing, yeah? It is, yeah,

32:26

exactly. And we know broccoli sprouts

32:28

have got a really high source

32:31

of dim ansel, foraphane.

32:34

And I got mine from Abel and Cole, and

32:36

actually they're really nice on the bed of a salad. Just

32:38

pour a bit of olive oil. And I've

32:40

been eating a lot more cruciferous vegetables.

32:44

We've just had Christmas bristle sprouts, again, great

32:46

sauce. Great, love that. And you can,

32:49

there's so much, even if you just

32:51

add it to an omelette with a

32:53

bit of chorizo, there's so much that

32:55

you can do to make everything in

32:57

your food hormone healthy and balancing. You

32:59

mentioned DIMM, what was that? Just before

33:01

we move on. So DIMM is, it

33:04

stands for diindolyl methane, and it's

33:06

basically a plant compound of spino-nutrients

33:08

found in cruciferous vegetables, you know,

33:10

your cabbages, broccoli and cauliflower. And

33:12

it helps break down estrogen, you

33:14

know, in phase one and phase

33:16

two of the metabolism, which occurs

33:18

in the liver. If people have,

33:20

let's say, nutrigenomic tests, which

33:22

look at what's in- Yep, which I've done. Yeah,

33:25

which see what genes are working, if you've

33:28

got a faulty gene and you have a

33:30

predominance to drive estrogen in certain pathways, then

33:32

you know that perhaps you might need to take

33:34

something to drive it this way. And so

33:37

supplementation may be appropriate. So food

33:39

first is always something I advocate,

33:41

but supplementation in people who necessarily

33:43

might need a little bit of extra help. And

33:46

then the third phase of estrogen detox occurs

33:48

in your guts. Have you heard of like

33:50

a collection of organisms in your

33:53

gut called the estrobolo? Estrobolo, I have,

33:55

I've written about them in my book.

33:57

I mean, this is again, fairly new

33:59

science. I wrote one of the

34:01

first consumer books actually on gut health

34:03

many ten years ago called The Good

34:05

Gut Guide and the term the estrabolo

34:08

had not been created or discovered or

34:10

invented then and as I

34:12

understand it, it's this collection of

34:15

gut microbes that work on estrogen and work

34:17

on hormonal activity for women. It is yes

34:19

and it is like you said it's a

34:22

new emerging kind of science but we know

34:24

that that, so basically what happens is to

34:27

get rid of your estrogen you need

34:29

to make it water soluble and you

34:31

conjugate it. So once it's conjugated you

34:33

can excrete it in your urine. So

34:36

in the olden days we used to

34:38

use conjugated horse urine for the older

34:40

forms of HRT. Like

34:43

premarin, that's what premarin isn't it?

34:45

Premarin, exactly. Pregnant mare's urine, that's what

34:48

it stands for, premarin which of course is

34:50

not normally used now. Now

34:52

it comes from plants and wild yams

34:54

so no animals involved

34:56

thankfully. So in

34:58

that estrabolo you have a

35:01

group of organisms and if

35:03

there's organisms that possess an

35:05

enzyme called beta-glucuronidase it actually

35:08

unconjugates the estrogen and then

35:10

you reabsorb it back into the body and it adds to

35:12

the load. So what

35:14

you're wanting is to have a

35:16

diverse group of organisms in

35:18

that gut's microbiome so that

35:21

you're not decongagating. So have you

35:23

heard of something called calcium D-glucurate? No.

35:27

It's basically again found

35:29

in plant foods, it's

35:31

a phytonutrient but you can

35:33

get supplementation of this as well.

35:36

So if people are having problems

35:38

with the gut health where it's

35:40

causing reabsorption of these estrogens then

35:43

calcium D-glucurate will stop that organism,

35:45

deconjugating it and stop it being reabsorbed.

35:47

So that can be useful for some

35:50

people who suffer with what we say

35:52

estrogen dominance because the symptoms that people

35:54

suffer with, the tolls of all the

35:56

hormone levels are normal but they suffer

35:59

with migraine. difficulty losing weight,

36:01

belly fat, cellulite, so many symptoms

36:03

that people can suffer with with

36:05

this C-strogen dominance and like I

36:07

said it's because there's no widely

36:09

defined definition which makes it very

36:12

difficult to do clinical studies on

36:14

what it is. What we do

36:16

know from a physiological point of

36:18

view is that when

36:20

you break down estrogen it goes into

36:22

different pathways like you said you've had your you've

36:24

had some nutrigenomics as we know that to break

36:26

down estrogen it goes down different

36:28

enzymes and pathways and if you're

36:30

driving a certain pathway that might

36:32

be increasing for some people it

36:35

might be more damaging to yourself

36:37

because it's producing more pronounced results

36:39

and if you're driving it's a

36:41

bit insolent. So that information is really quite

36:43

useful but it's not something we test on

36:45

the NHS this is the problem. The women

36:47

are coming in complaining of you know the

36:49

symptoms of estrogen dominance and they're being set

36:51

you know if the GP does do some

36:54

blood tests and the restogen is normal they're

36:56

saying well your estrogen normal you know and

36:58

this is the problem we're not looking at

37:00

how the estrogen is being broken down and

37:02

that's where I think we need to focus

37:04

on. Okay so in a nutshell then if

37:07

your symptoms are not clearing if

37:09

you are menopausal and you are on

37:11

HRT and you're replacing a estrogen but it's

37:13

not being cleared properly adopting

37:15

some lifestyle changes don't even need to go

37:17

and do expensive tests you can just simply

37:19

you know do these lifestyle changes that

37:21

you talk about in your book you

37:23

know have your broccoli sprouts your brassicas

37:25

your cabbage and get

37:28

back in control with your guts and

37:30

your liver health in particular you know

37:32

look at fatty liver and we know

37:34

fatty liver disease is also such a

37:36

killer. Can we talk about more broadly

37:38

some of the symptoms that I mentioned

37:40

earlier so you know feeling sweaty

37:42

exhausted snapping at people around us

37:44

you know even that that stubborn

37:46

belly fat and just really feeling

37:48

out of control you know feeling

37:50

anxious and angry is is not

37:52

a comfortable place to be and

37:54

I think it's very helpful actually

37:56

to know that it's not our

37:58

default it's not our personal. personality that's coming

38:01

through but it's being hormonally driven.

38:03

But of course, we want ways to

38:05

combat that so that we feel calm

38:07

and happy and presumably there are some

38:09

lifestyle changes and decisions that we

38:11

can make that are empowering that we can

38:13

make on our own accord without resorting to

38:15

medication that will actually improve so many of

38:17

these symptoms. And

38:20

so, as I mentioned earlier about how

38:22

when we have lowering hormones, estrogen and

38:24

progesterone, they've got so

38:26

many functions other than just childbearing.

38:28

So, estrogen has a positive effect

38:30

on serotonin which is our happy

38:32

hormone and dopamine which is our

38:34

reward hormone that gives us that

38:36

motivation. And so, when we've

38:38

got low levels of that, we can suffer with poor

38:41

energy, lacking in motivation and

38:43

estrogen also makes us insulin

38:46

sensitive. And so, when we've got

38:48

lower levels of estrogen, we become more insulin resistant.

38:50

So, a lot of women say, oh, I eat

38:52

exactly the same, I exercise the same but I'm

38:54

putting this fat on around

38:56

the central wheel. And it's because,

38:58

as I mentioned earlier, as well,

39:01

the fat cells convert the androgens

39:03

from the adrenal glands into estrone,

39:05

that E1. It's really

39:07

difficult to get rid of and people

39:09

really struggle. So, sometimes eating a,

39:12

when I say lower carb, I mean, you

39:14

know, having the cruciferous vegetables and having nature's

39:16

carbohydrates to support the gut health. But

39:19

that move in itself can be beneficial and

39:21

actually the processed carbohydrates tend to be the

39:23

problem there. And then progesterone,

39:25

with that being lower, that causes us

39:27

to have low GABA which is a

39:29

calming chemical, neurotransmitter in the brain. So,

39:31

we do tend to get a bit

39:33

more irate, more angry. And

39:35

so, there's lots of foods that we can, you

39:37

know, progesterone, we need a lot

39:40

of magnesium, vitamin C to help support it.

39:42

So, it's eating the correct foods that will

39:44

help support the progesterone

39:46

development. So, you know, whether

39:48

it's just like, you know, squash, you know,

39:50

butternut squash and sweet potatoes, for

39:53

example, certain foods that can

39:55

help boost those hormones. And

39:58

again, we testosterone as well. We know strength

40:01

training, we know when we exercise in

40:03

the midlife, a lot of women find that

40:05

they go to spinning five times a week

40:07

and they come back and they say,

40:09

I'm eating well and I'm exercising five

40:11

times a week and I just can't lose

40:14

weight. And it's because they're doing the wrong

40:16

types of exercise. I would

40:18

definitely not do a spin

40:20

class. I will lift weights, I

40:22

will do push-ups, but I will not do a

40:24

spin class. I simply don't see the benefit of

40:26

it, to be honest. I know that's probably controversial,

40:29

it's going to trigger a few people, but that's

40:31

my view having researched it. I think we need

40:33

to be working smart and harder when it comes

40:35

to exercise because exercising and exercise, like

40:37

I've mentioned, can be damaging from a

40:39

hormonal point of view. It will increase

40:42

our cortisol levels. Cortisol will impact our

40:44

sleep. It will raise our blood sugars.

40:46

You know, it's a stress hormone which

40:49

should be raised in the

40:51

short term when we're facing stresses. But

40:53

in today's society, when we're stressed all

40:55

the time, it's chronically raised and it

40:57

can cause long-term health consequences from being

41:00

chronically raised. It will impact sleep. So

41:02

people tend to drink a lot more

41:04

to help them sleep, which will impact

41:07

the sleep quality in the architecture. So

41:09

it's just so interrelated, all of the

41:11

hormones in particular. But from an exercise

41:13

point of view, like you said, Liz,

41:15

you know, you do a lot of

41:17

strength training. We lose muscle

41:19

mass as we get older. People

41:22

have got a lot of mitochondria, which

41:24

is the powerhouses of ourselves in them,

41:26

in the muscles because they're so dense

41:29

with mitochondria that it's so important for

41:31

our metabolic rate. So if we're losing

41:33

that muscle, which is important for our

41:35

metabolic rate, it kind of slows down

41:37

because of the fact we're losing muscle mass.

41:39

So building that muscle mass is so important.

41:42

You know, Gabrielle Leon talks about it being

41:44

the organ of one of those things. Oh,

41:46

she's been on the show. I love her.

41:48

She's fantastic. Big fan. Yeah.

41:51

It is our largest organ. It's not our

41:54

skin. It is our muscle. It is our

41:56

largest organ. And so we need to support

41:58

that by strength training, the major muscles. at

42:00

least two times a week if not

42:03

more on nonconsecutive days and that will

42:05

help not just with building it'll

42:08

help increase testosterone but it also

42:10

increases BDNF which is like miracle

42:12

growth for the brain. So

42:15

many benefits to strength training. So

42:17

many. Now lastly before we finish

42:19

I'm just going to end hopefully

42:21

on a positive note talking about

42:23

love and relationships and there's increasing

42:25

evidence that healthy relationships, loving human

42:27

interaction are a key pillar

42:30

in the longevity story and I certainly have a

42:32

whole chapter in my new book actually focused on

42:34

love and relationships and sex as well

42:36

actually but that's another story. But

42:39

menopause obviously can affect so

42:41

many women with this and

42:44

from my understanding hormonal imbalances can

42:46

lead to that kind of distancing

42:49

you know, the social

42:51

isolation, the feeling angry, the

42:54

triggering arguments for example that we're

42:56

more likely to have. Will

42:58

all these things help regulate that

43:00

and actually help to improve

43:03

the outcome of our romantic life

43:05

as well? So it's really interesting

43:07

you've mentioned this and I'm a oxytocin which

43:09

is the love hormone that I call in

43:11

my book is you know at the top

43:13

of the hormone hierarchy for me I think

43:15

it's really important so

43:18

positive psychology, connectiveness and the

43:20

importance of trying to

43:22

boost the oxytocin in balancing the hormones out

43:24

below. And it's a very alkaline hormone

43:26

as well. There's so many benefits to

43:28

oxytocin. Like I said the hormones beneath

43:30

oxytocin include cortisol and then at the

43:32

bottom of that hierarchy I've got a

43:34

diagram in my book is the sex hormones

43:37

because if we're not feeling secure and

43:39

safe we're not going to want to

43:41

you know reproduce and that's why we

43:43

push people away. But I think

43:45

engaging in activities to try and boost it you

43:48

know whether it's as simple as patting your dog

43:50

or asking someone for a hug I mean my

43:52

11 year old says to me I need some

43:54

oxytocin will you give me a hug? She's 11

43:56

and I'm trying to make her form an

43:58

intelligence at this age. And

44:00

interestingly enough, as you know, she's 11,

44:02

she started a period. And

44:04

again, the school have asked me to

44:07

give a talk because they're exposed to

44:09

all of these xenoestrogens. And we're seeing

44:11

an alarming rate of girls so young

44:13

starting the period because of excess fat,

44:16

xenoestrogens, obesogens in the environment

44:18

that they're being exposed to.

44:21

But I'm a huge fan

44:24

of oxytocin and positivity, positive

44:26

psychology, social connectedness, and

44:28

what we can do to try and, you know, whether

44:30

it's just being grateful gratitude. I mean,

44:32

there's so much science that shows the

44:34

impact on all of those things. Absolutely.

44:38

And hopefully this message will spread far and wide

44:40

and we will have greater understanding of it. And

44:43

I think we certainly owe it to our

44:45

daughters and granddaughters and the generations coming beyond

44:48

us, as well as, of course, our current

44:50

community. Millie, thank you so much. I just

44:52

think that was a brilliant crash course in hormonal

44:54

health. And I'm sure we'll have resonated with a

44:56

lot of listeners. So I'm hugely grateful for your

44:59

time and very best of luck with your book,

45:01

which is very insightful. Thank you. Thank you

45:03

so much for having me. Well,

45:07

I sincerely hope that you feel

45:09

not only educated, but empowered after

45:12

that deep dive. And I

45:14

tell you, by the way, that we're

45:16

definitely going to be doing even deeper

45:18

dives into all things menopausal in the

45:20

not too distant future, including things like

45:23

intermittent fasting, time restricted eating that

45:25

Millie did touch on very briefly

45:27

earlier. And of course, they do feature

45:29

in her book as well. And

45:31

if you want to be able to hear that and all

45:33

future episodes ad free and 24 hours early, you

45:37

can now subscribe to the Liz Oh

45:40

Wellbeing Show Plus on Apple Podcasts for

45:42

a very small monthly fee. And while

45:44

you're on your podcast platform, by the

45:46

way, do please leave us a review.

45:48

I always absolutely love to hear

45:51

what you make of these conversations.

45:53

In fact, Lady Louvert left a

45:55

comment saying the whole story

45:57

of intermittent fasting has been her

45:59

quote, favorite So that

46:02

would have been the episode with Megan

46:04

Ramos. And Melissa says, love

46:06

this podcast. I'm always writing

46:08

down notes from your guests' hacks. Well,

46:10

you and me both, Melissa, I am

46:13

always scribbling things to go back

46:15

to literally as I am recording

46:17

and interviewing. Well, what do

46:19

you jot down from this conversation with Millie?

46:21

Do let me know on Instagram. We are

46:24

at lizalwellbeing. Oh, and why have you? Let

46:26

me quickly tell you a little bit about the new

46:28

book, about a second half that I mentioned. It is,

46:31

of course, everything that you need

46:33

to know to live a longer, healthier,

46:35

happier life. Literally ways to dial

46:37

back our age. Not

46:40

just all about beauty and how we look, but

46:42

much more importantly, how we feel and how we

46:44

can age well in our second half of life.

46:47

It is up on Amazon now to pre-order, or

46:49

of course you can pre-order it through bookshops as

46:51

well, which is actually really helpful because it helps

46:53

to get the word out that

46:55

these topics for midlife women and our

46:57

health are so, so important. Well,

47:00

until the next time we chat, go

47:02

well. Goodbye. The

47:10

Lizal Wellbeing Show is presented by me,

47:12

Lizal, and is produced by Nishika Tate

47:15

for Fresh Air Production with additional production

47:17

support from Ellie Smith. To

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47:24

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