#40 - Is it stress or is it perimenopause with Dr. Fionnuala Barton

Perimenopause and the symptoms of stress can overlap quite significantly, especially when it comes to mood, sleep and energy. And as Dr. Barton and I talk about in this episode, that overlap puts some women at a disadvantage when seeking care.

Dr Fionnuala is a GP, women’s health doctor, and member of the British Menopause Society. She is passionate about empowering women to optimise their physical and emotional wellness using a proactive, informative, and holistic approach to Perimenopause and menopause. Drawing on both clinical and personal experiences she provides consultations remotely via video or in person in Hertfordshire to integrate evidence-based and personalised HRT regimes in an empathetic and collaborative way.

Learn more about Dr Barton at www.themenopausemedic.com and follow her on Instagram at @themenopausemedic.

Looking to learn more about how stress and perimenopause impact your nutrition and relationship with food in midlife? Click here to learn more about The Midlife Feast Community!
https://www.menopausenutritionist.ca/coming-soon

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Transcript

Jenn Salib Huber 0:02
Hi and welcome to the midlife feast the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Salib Huber. Come to my table. Listen and learn from me. Trusted guests, experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. Welcome to this week's episode of the midlife feast. My guest today is Dr. Fionnula. Barton, a GP from the UK with a special interest in women's health, especially everything related to perimenopause and menopause. And I invited Dr. Barton to talk to us about stress and perimenopause in particular, because stress is something that we all experience. We can't escape it. And especially you know, if you, you know, if you have a family or other obligations either at home or outside of the home, we all know what stress feels like. But when you're in your late 30s, early 40s and are starting to go through perimenopause, how do you know if those heart palpitations or sleepless nights or anxious feelings or mood changes are stress and would happen to anyone? Or are they perimenopause? And more importantly, what can you do about it? So join this conversation and listen to some of the really practical things that Dr. Burton walks us through and just maybe to get a better understanding of how stress is showing up for you in midlife. So welcome, Dr. Fionnula. Barton, I'm very excited for us to have this conversation today. How are you?

Dr. Fionnuala Barton 1:32
I'm really well, thank you ever so much for inviting me on. It's a real pleasure.

Jenn Salib Huber 1:35
So we've connected on Instagram, which I feel like a broken record, because I'm pretty sure that at least half of my guests or people that I've met and connected with on Instagram would actually love I think it's, you know, an upside of social media that we don't often, I think fully recognize. But I wanted to bring you on specifically to talk about stress, because stress, you did a real about it and about how it overlaps with perimenopause and how so many of the symptoms I think can just make thing the whole picture really muddy. So tell us a little bit about how stress shows up for women and perimenopause.

Dr. Fionnuala Barton 2:16
So I suppose a bit of a bit of background might help a little bit here insofar as you know, I've been on my own pair menopausal journey. And so identified that actually, it was quite difficult to sometimes unpick, what was apparent menopausal symptom from what was a stress related symptom or a sort of burnout type symptom. And, you know, in the last five to 10 years of sort of working more specialist Lee with with women and around perimenopause and menopause, it was a theme that I've seen very, very frequently. How does stress show up for men and perimenopause in the same way that it does for you know, women and men in other stages of life really, because of stress response is a really powerful biological one. And it's a really important one, it's a protective one, you know, feeling stressed and having physical or emotional outcomes from that, that feeling is an important way of protecting us and helping to guide us, you know, through our lives. I think the difficulty is we are currently all experience experiencing a sort of pandemic of stress ultimately, you know, I think if you'd have asked three years ago, you know, how would you feel after a two year pandemic, plus, you know, global uncertainty from a kind of military and, you know, political perspective, I don't think people would necessarily believe that that was going to happen. So I think we have lived through an unprecedented period of, you know, a huge uplift in terms of baseline stress levels. And of course, for so many people, women, particularly throughout the pandemic, we were having to shoulder the responsibility in a different way to some of our male counterparts, you know, predominantly, homeschooling landed on the shoulders of others and working with us particularly, and, and it was an inordinate stressful time for everybody at a time, you know, in midlife, when actually, our responses to stress can be quite heightened. And so it was kind of a perfect storm, really, for women, you know, between the ages of sort of 35 and 60, or whatnot, this sort of midlife period, to be experiencing profound symptoms of stress, but that also could mimic symptoms of perimenopause. And so, you know, in terms of our stress response, cortisol and adrenaline are really important stress hormones, and they can give rise to symptoms like palpitations, like tightness in the chest, they can cause problems with fatigue, because if you're constantly stressed over a long period of time, it has a really fatiguing effect on the body. Likewise, you know if you've got emotional but also physical stress, like if you're doing a lot of it Exercise, for example, then that can have an impact on your physical health and well being that can cause problems with certain aches and pains in the body. But it also can interrupt your sleep. And if your sleep is interrupted, you're going to feel tired. And you know, if your sleep is interrupted, and you're tired, you're probably not being able to think straight. So you might feel a bit more foggy in terms of cognition, memory might become a problem, anxiety might build and mood might drop. And actually all of those symptoms are also symptoms that we recognize as estrogen deficiency symptoms or low estrogen symptoms. And so I think it is, it's almost impossible to unpick them actually. And I think what can happen is in perimenopause, the impact of stress perpetuates the problem and kind of generates all these perpetuating cycles of symptoms that are quite difficult to then break. And it's about sort of trying to work out which ways we can get in there and break those cycles to help alleviate some of those symptoms. And addressing the perimenopause aspects of it is as important as addressing the stress related causes.

Jenn Salib Huber 6:10
Yeah, there definitely is so much overlap. And I just want to back up a little bit and maybe talk a little bit about the difference between acute stress and chronic stress. Because often when I talk to people about stress, and I say, you know, tell me about your stress levels, they'll say, Oh, well, I don't really have a lot of stressors, but you know, life is busy. And so I think they're discounting the effect of that chronic daily stress, because they don't have a stressful event happening in their life. So they don't have a sick family member, they, you know, they don't have a deadline at work, but it's just life is busy. How does the body differentiate between acute and chronic stress?

Dr. Fionnuala Barton 6:49
But I don't think it really does. To be honest, I think it's the same physiological biological stress response. But, you know, in an acute situation, if something is really stressful and traumatic, obviously, you might see a more heightened set of symptoms associated with that. I think we are, you know, our bodies are incredible at coping, and, and, you know, making space for the circumstances that we're in. And so I think when we're, when we're under chronic stressful situations, our bodies adapt, and we get used to it, and we start living with it. And perhaps that's why we then don't see it as stress when it becomes chronic, because actually, lots of our bodily processes have adapted to that, you know, from a hormone perspective, from a sleep perspective, you know, from a nutrition and diet perspective, as well. And I think that you're absolutely right, I think so many of us would probably say, Oh, I'm not feeling terribly stressed. But just at baseline, I think, you know, most of us who've got to midlife, and who are women have experienced, you know, incredible stress throughout our lives at various different stages, you know, at the very least having to bleed on a monthly basis. You know, I think we often forget that it is quite sort of unpleasant, even if it's a light period, or, you know, not a terribly painful one. It is just one thing that we you know, we have to bear that our, you know, male colleagues and partners and things just, I don't think really ever really understand. And then as against that, all the other things that you know, as women we are subjected to over our lifetimes from being small girls to being teenagers to being young adults, and then being midlife women in midlife, we are often the people who are doing the most stuff. So holding down jobs, you know, primary carer for our family, often, you know, older relatives who are also needing us as well as younger children or other family members who, who was responsible for and although that might not seem acutely stressful, actually, it is having an impact in chronic or long term.

Jenn Salib Huber 8:56
Yeah, yeah, no, I completely agree. And I often use, you know, the analogy that our acute stress response is helping us to run away from the tiger. So it is diverting resources to our brains so we can think and to our arms and legs so we can run, you know, climb up a tree and get away from the tiger. But the chronic stress response is what keeps us alert to looking for the tiger so it is still operating in the background. And when it comes to midlife especially I think that we as women don't realize what an impact that can have on our hormones. So the stress can be causing symptoms, but the stress can also affect our hormone levels, meaning that you know, under enough stress your reproduction kind of shuts down because our body prioritizes survival over reproduction. And so it is in the later stages of you know, your pre menopausal years meaning you're still having a cycle and things are still you know, happening tickety boo, but you're having a lot of chronic stress. That's just life That's, you know what you were talking about the busyness of home and work and balance and, and trying to kind of, you know, juggle all of those, it may actually start to affect your hormonal symptoms, because you're kind of in that overlap of, you're kind of running out of reserves anyway. And you now have this added, you know, demand on your body's reserves, that it's really easy to see how the two can be happening kind of independently, but also together and just really making life not so fun. Yeah. And do you find that because women are experiencing a lot of this kind of chronic stress that their experience is dismissed, either by themselves or by other people? And maybe even perimenopause as a diagnosis is missed?

Dr. Fionnuala Barton 10:48
Absolutely. And I think actually, both of those are very, very true. So I think one of the, one of the biggest problems that we have is that quite a lot of women who recognize or have educated themselves and, you know, to the extent that they understand what's going on, they then go to their health care provider, and are being told, it's, you're just stressed, you need to de stress, you need to change your circumstances as if that's something that's easy to achieve, which it isn't. And, you know, there is, I think there is a point to that, I think that symptoms are often worse when we are chronically stressed, but there is so much practical things that we can do to help to, you know, reduce the impact of that. So I think, you know, I, my experience, women are finding it difficult to find clinicians and practitioners who are able to support them through that. And a lot of people are being turned away, particularly if they're younger. So there's sort of under 45 age group who don't sort of fit into that neat, perimenopause or you know, age group. But you know, my feeling is very strongly that, you know, this is something that can happen at any age, when you consider like, average age of menopause is between age 45 and 55, you're going to have your menopause at 45, the likelihood is you're going to be perimenopause and in your 30s. And like you said, yourself, actually, when you've got those sort of underlying hormonal changes with the stress overlap on it, then you are going to experience actually, estrogen deficiency symptoms, because one of the biological primitive reflexes that we have is when we are, you know, in constant fight or flight mode, because we're worried about the Tigers coming to the door. What happens is that inhibits our hypothalamic, pituitary and ovarian access, access. So because it's not favorable to be either pregnant or breastfeeding in a time of, you know, difficulty. And so that's, that's, you know, that there is this kind of really, you know, strong biological connection between stress and actually estrogen levels. But, yeah, I think the other thing that I, I suppose, that I'm even more passionate about is trying to encourage women who are experiencing difficulties and symptoms, to think about whether it might be perimenopause, or because so often, I see women at certain point on their journey. And they'll say, actually, if I think back, I think this might have started five or 10 years ago, but at the time, I just put it down to being stressed. And I think that's what we do. Because as women, we get on with things, don't we? And in order to get on with things, sometimes our coping strategies are just to accept what's going on, or to put it down to something and rationalize something away. And I think that that's okay, if you're able to cope with that, but I think anybody experiencing new ones that are a change in any of those kinds of stress symptoms, or they're responding to stress in a different way to how they're used to. And that should really alert them to the fact that there might be something else going on too.

Jenn Salib Huber 13:35
Yeah, I completely agree. And it's so interesting that you mentioned about the ages, because that is pretty much my experience exactly at 45. I'm in menopause. 99% sure asked me in a few months, but you know, I'm in menopause, which means that my perimenopause actually started at 37 or 38. But I didn't recognize it. And no one else recognized it either. Because I also had three children under the age of seven, I was running a busy practice and a business and you know, had all of the life stressors that could explain why I was having difficulty coping why I was feeling anxious, why I wasn't sleeping, why I was feeling stressed why I would like all of these things could fit very neatly into that life box. And yet, it wasn't until we started treating it as a pre menopausal symptom picture, that the hormones were you know, both cause and consequence of what was happening. Yeah. That it was really felt like I was being treated as a person, and not just symptoms, and it's so important. And you know, women and I hear this all the time, women and I'm sure you do as well who are dismissed because they're too young, and even sometimes at 45. They're told that they're too young to be in perimenopause, which is women in their 50s

Dr. Fionnuala Barton 14:50
being told they're too young and I'm like, I just don't understand anybody who's got any woman going see a clinician in any capacity around the age of su five upwards, I think she'd be asked about their periods and their menstrual health. Absolutely. You know, I think it should be a really integral part of how we assess, you know, that midlife people when you've just given me goosebumps talking about your experience, because I just, I recognize it. And I'm a little bit behind you in terms of journey. And I think if you and I have both had a similar experience, you know, the likelihood is there are hundreds of 1000s if not millions of women out there also having a similar experience. And you know, as a medical professional, I went to speak to several doctors, and the door was closed. And I was told I was too young. And I was told that I was overthinking it, and that I just needed to manage my stress, or did I want antidepressants. And to be honest, at some stages, they were very helpful. So you know, but it wasn't the root cause of the problem. And so, like you said, when you're addressed holistically, when actually you're looked at as a whole person, rather than just a set of symptoms that needs to be solved, actually, that's when the healing can really start to begin, I think,

Jenn Salib Huber 16:05
absolutely. just reminded me of a message that somebody sent me a couple of days ago, which I think also highlights some of the stereotypes and I would even go so far as to say stigma around midlife, someone sent me a message. They're 42, I believe, when they went to speak to their gynecologist, they're in the States about, you know, is this perimenopause, they were greeted with a very frustrated sigh. And they kind of put their pen down and they said, Why does every woman want to be in perimenopause? Don't you know that it's the beginning of the end? And I mean, I just, I couldn't believe it. I mean, why, why do we? Why do we want to make women feel like they don't want an accurate diagnosis, simply because society and culture have deemed this in unfavorable stage of life for women, which is ridiculous. Anyway, that's kind of an aside. But just reminder, it

Dr. Fionnuala Barton 17:02
is an aside, and I think it kind of touches on a bigger, wider issue about gender inequality and healthcare and the kind of consistent ignorance around the importance of women's health, instead of harking back to that issue. I mentioned earlier about, you know, the fact that women can endure profoundly debilitating symptoms throughout their menstrual years that are often completely ignored. So it comes as no surprise to me that when we start experiencing issues in our mid life, and we go to our clinicians informed and empowered, then they're going to perhaps not respond to that particularly positively. But we need a complete culture shift on it really. And, you know, we women can often feel ghastly, I certainly did, you know, and intimidated by people in the medical profession, and that really does need to change. And I think people in the medical profession and myself included, you know, sometimes there is this kind of jarring reaction to things like press coverage on something. So, you know, I've had similar reports of people, you know, they've gone to the doctor and run Davina McCall documentary again, you know, and, you know, that documentary was, you know, both of them were complete, you know, game changers, frankly, because they've got to a group of women who had otherwise not have their voices heard. And I think that can only be a positive thing. But it's going to take, I think, a longer time for the medical community to kind of accept, see, we've got a voice and we want to be treated fairly and equitably, at this really important stage of our life that isn't necessarily, you know, a terrible situation, actually, it's something that can be a really positive situation if you're supported through it.

Jenn Salib Huber 18:42
Absolutely, absolutely. Okay, so getting back to the topic of stress, because I think we could have a whole other podcast on on that. But yeah, talking about stress. So sometimes there are stressors that we can change. And sometimes there are stressors that we can't change, but we can still influence our body's response to the stress how we cope, our, you know, experience of living with or through stressful events. What are some of the things that you encourage women to, to explore, to try to try and maybe reduce the symptoms of stress that are happening for them and maybe making their experience of perimenopause more symptomatic than it needs to be?

Dr. Fionnuala Barton 19:26
Well, I think it kind of starts with that, that chronic stress piece in that way, you know, by the time we've got to this stage of life, after often we are in this kind of perpetual state of arousal of hyper arousal and awareness. And so our nervous system is pretty primed, actually. So that when even small things come by that aren't necessarily as stressful as you would think they might be, actually they can trigger a quite profound stress response. So I think one of the biggest things is to recognize that and often guide women to recognize that there is chronic stress perhaps of their situation, and encourage them to do things that might just down regulate that chronic stress situation so that their thresholds for then having more profound stressful reactions is lower. And I think that a big part of that is trying to, you know, connect minds and body try and get women more familiar with how to engage their parasympathetic nervous system to help override that very strong, powerful stress, sympathetic response. And regularly practice those kinds of things. So that actually, you know, their nervous system is coming from a Karma standpoint, I suppose. And then with that in mind, you have to stand back even further and say, Well, what are all of the things that are priming this nervous system into being sort of chronically hyperactive, and those can be really broad, but, you know, in really overly simplistic terms, looking at things like sleep quality, looking at movement, looking at the way that you're managing stress, and looking at things like diet and nutrition are really important. And so it starts with kind of stepping back and saying, What if I want my nervous system and I want my body to function? Well, I need to stop fueling it well, and I need to be giving it the resources that it needs, without there being any punishment associated with that. And I think in midlife, that involves a lot of protein that involves carbohydrates, you know, I think we just need to get rid of this whole low carb thing, okay, you need to choose sensible carbohydrates, and you need to eat them in a sensible way. But I think this starvation kind of narrative needs to just go. And things like, you know, healthy fats, and avoiding those substances in the diet that can actually be really pro inflammatory, alcohol included. And I think that that's another really important part of the sort of the assessment process to me is actually looking at are they are women using alcohol as a coping strategy, you know, it's the most readily available and culturally, you know, encouraged drug that we can use. And it does really help to make us feel calm in the short term, but what it's doing in the long term is really, you know, destabilizing the situation and putting, if you're drinking, you know, on alternative days, even if you're not drinking every day of the week, if you're drinking, you know, three or four days a week, you're still constantly either dealing with the alcohol or recovering from the alcohol, which puts you in a very stressed biological position. So that's another really important conversation to have. And, you know,

Jenn Salib Huber 22:28
looking is just to add, you know, alcohol is one of those things that I love all the conversations that are happening around it, it feels like in the last few years, I think, especially through the pandemic, there was more, you know, people in general, but women, especially who are kind of calling into question as a coping strategy, you know, I joke that it largely self selected its way out of my life, because if I have more than two glasses of wine, it's hot flash city for me, and terrible sleep. And that's rarely if ever worth it anymore. You know, but I think that a lot of women, like you said, are in a cycle of choosing it regularly enough that they don't actually have a baseline of how they feel without it, you know, so even if they're not having large quantities, even if they're only having a glass or two, if that's happening on a regular basis, it likely is impacting your sleep, your energy,

Dr. Fionnuala Barton 23:21
your moods, and all of

Jenn Salib Huber 23:24
that. And so I regularly got just to, you know, take a break for a couple of weeks and just really see how you feel, it's not to say that you have to cut it out forever. I don't I still enjoy it, you know, on occasion, but it's just not something that I want to choose much anymore, because I have a really clear baseline of what I feel like when I have it more than occasionally. But yeah, I think the alcohol conversation is a really important one.

Dr. Fionnuala Barton 23:50
And you know, like you said, yourself, you're not alone. So many people come to me, and they're like, I can't drink wine anymore. And I'm like, listen to your body. She's telling you something intuitive. You know, like you said a moment ago, there are some things in life that we can control, there are some things that we can't have a look at your life. Now, this is an opportunity to pause and to say, you know, what do I want to do at this stage? And how do I want the next 40 years of my life to look and some of that may be really uncomfortable having a conversation with yourself or with a professional or with your, you know, family members about, you know, changing things if you want to in order that you can feel empowered, rather than disempowered on a regular basis and, you know, making choices that are positive for you in terms of the life that is comfortable and productive for you. And, and that I think is something that can often be, you know, it can be useful to think about talking to a therapist or talking to a coach, for example, to help you, you know, discover and explore that in more detail. And I think that I'm a real supporter of proactive talking therapy rather than sort of waiting for a crisis to hit and then being provided with the coping strategies for how you And to deal with the problem. Actually, if we can have some talking therapy or some coaching, before, you know the proverbial hits the fan, then we might actually be better equipped, and have a broader set of coping strategies to help when these uncontrollable stresses do sort of start to take effect. You know, I think one of my big messages around managing stress is to actually have some self compassion, because I think that by the time we've hit midlife, we spent a lot of time, you know, punishing ourselves for behaving certain in a certain way to certain situations. And I think just sometimes having a feeling or an emotion sitting with it and going, that's upset me. And I'm allowed to be upset because that was an upsetting thing. Rather than that upset me, and I now feel like a failure. And I think that piece is really important is to just reset where we feel about ourselves, so that we can then be, you know, more positive in general, sleep is big issue, a whole podcast episode, I say, but you know, making sure things like alcohol are minimized looking at reducing caffeine, looking at other simple ways to help improve sleep quality, because if we're sleep deprived, then naturally our nervous system is pines, and everything is going to feel much more worth and everything's going to feel more overwhelming more quickly. And then movement, I think that nutrition and movement are two of the most underused sort of management strategies in this context. And I think, again, busy life means that often women either aren't exercising as much as they want to, or moving in a way that they wished to be. Or counter to that actually, they've got into a state where they're exercising, or maybe even over exercising on a regular basis, in order to maintain a preferred body image, for example, or in order to counteract the fact that their body is changing quite normally under the hormonal changes of midlife, and they're wanting to counter that. So the number of women I see who were, you know, doing loads of high intensity interval training, and other thing absolutely ballooned during pandemic, because what did we all have on our TV screens, and we were at home with the kids, we had hit training half an hour, you can do your exercise, and it makes your weight stay nice and normal. So we all started hit train, or lots of people did, and over the last 10 years, it's been a really sort of, you know, popular type of activity. But in midlife, it's not the best thing to be doing, actually, it's better to be doing slow, steady state stuff, or low into low intensity interval, training, but resistance work. So things like lifting weights or doing Pilates, you know, things that actually are going to help to calm our nervous system, as well as improve our, you know, metabolism and our strength and things like that. And so often, you know, thinking about exercise, either improving it if you're not doing any at all, or adjusting it if actually, there's a risk that that exercise is causing further stress to the system. And, you know, looking all of that, and then once we've got all of those ducks in a row thinking about what other medical interventions we can think about and HRT, obviously, is it really useful one from that perspective.

Jenn Salib Huber 28:03
Thank you for all of that. And I love the mention of carbohydrates, everyone who listens, and who knows me know that I'm a big fan. But I think that, you know, the people are always surprised when I tell them that there's actually quite a bit of research telling us that low carbohydrate and keto diets increase the stress response in a measurable way, cortisol goes up. That is the last thing that anybody wants ever. And that is in part likely, because that is a stress on how our body prefers to operate. glucose, which we get from carbohydrates is our brain's preferred fuel. It is the only fuel that it can really thrive on. And yes, you know, ketones can be used, but there's a break in case of emergency system. They are not what your body needs and wants to thrive. And I think that people forget that carbohydrates make us feel good. They increase serotonin levels, they give us energy, you know, and they are an important component, I think of healthy and balanced relationship with food, but so many women into midlife, and they're either scared or confused, or feel really conflicted about or that is as good as this bad and so just having, you know, the the permission to explore what feels good, and what is helping my body to do what I wanted to do. You know, with movements, I often suggest trying to match mood to movement. So if I'm feeling really stressed, then you know, maybe if I'm mad at something, maybe I want to do a kickboxing workout. Or if I'm feeling really tense and anxious, maybe I want to do yoga. If I feel the need to, you know, be social and connect with people, maybe I don't want to go for a long walk with a friend. When we start to connect kind of a movement to how we want to feel versus how we want to look. I think it really helps us to prioritize it as self care. and not as something that needs to be checked off, which is I think how a lot of people, especially our age have gotten to this point in life and how they think about exercise. It's something that's just on their to do list. It's not actually part of their health care and self care habits. But I agree it is. For me personally, it is my number one, you know, kind of defense against, you know, the stressors, especially the ones that I can't control is being able to move.

Dr. Fionnuala Barton 30:30
Yeah, and an intuitive way. And I think that another thing that I often see is we stop listening to our bodies, and we're doing what society and culture is telling us to do, not what our body is asking of us. And I think that intuition is it needs to be trusted, because we are so you know, women are so amazing. And I think if we just trust that process, often it can be a really enlightening experience, both from a nutrition, but also from a movement. And, you know, and stress response, really, I think, often we know what needs to change, but actually, we might be stuck either unable to make the changes that we need to make, or like you said, confused. And I think another word that I really liked, there is permission, giving people giving women permission that, you know, it's okay to be thinking about things differently at this point, I think is really important.

Jenn Salib Huber 31:20
Thank you so much. I've loved this conversation. And I know that, you know, women listening to the podcast will will certainly hopefully feel validated and feel that maybe their experience isn't as isolating because they're hearing their stories reflected in what you've shared. So I always ask my guests What is What do you think the missing ingredient in midlife is?

Dr. Fionnuala Barton 31:49
Self Compassion. I think that it's something that we we kind of are encouraged to weed out as we grow up from young girls, to teenagers, to young adults and into into midlife adults, I think that having love for ourselves is something that we often put by the wayside, or we become the bottom of the priority list or the bottom of the to do list. And I think that actually, if you can find that again, then actually sometimes lots of other parts of the of the puzzle will will click into place and just having that self compassion, understanding that it's okay to feel the way that you're feeling. But you don't have to keep on feeling that way. There are things that you can do about it is a really important step.

Jenn Salib Huber 32:32
Absolutely. Thank you so much. And I will have your website information and you have a perimenopause checklist for people that I will link to in the show notes as well.

Dr. Fionnuala Barton 32:44
Yes, yeah, I think it should be in the website, if not a link to it. I'm not very good at technology. And most of the information can be found on my website, or on my Instagram page. So yeah, and yeah, come and say hi. And join the lovely, you know, para menopausal supportive community that we have on the Instagram.

Jenn Salib Huber 33:08
Yes, absolutely. And you're the menopause medic on Instagram. And, and you share lots of great valuable info for everyone as well. So thank you so much for joining us on the midlife feast.

Dr. Fionnuala Barton 33:22
It's a pleasure. Thank you for having me. Bye bye.

Jenn Salib Huber 33:25
Hey there. Thanks for tuning in to this week's episode of the midlife feast. Season Three is just getting started and there is so much in store this season. Be sure to check the show notes and get on the waiting list for the midlife feast community, which is brand spanking new and registration opens in October for founding members only and then we'll be open again until the new year. And as always, if you find this episode helpful, please consider leaving a review and liking wherever you listen to podcasts so others can help find us