Learn More About The Menopause

NHS data estimates that 34% of UK women are living with urinary incontinence [NHSE, 2018]. That’s right. One in three women will experience bladder weakness in their lifetime, and bladder changes often begin earlier than expected.

Despite 14 million people in the UK living with this problem, a reluctance to speak about it, especially with their GP, means that many women are struggling alone.

I’m sharing these numbers not just because they’re powerful, but because it grounds the mass-quiet around women’s pelvic health in reality.

I repeatedly hear that bladder issues are “embarrassing” but in an area that’s underserved and underrepresented, if we can harness awareness and acceptance of those “embarrassing” conversations, our collective voice can affect change. I’m one of these women who’s struggled too. It’s one of the reasons I founded Jude, to offer science-backed daily support for the muscles behind pelvic health and bladder muscle control. 

Bladder incontinence doesn’t discriminate, but the menopause can trigger or exacerbate bladder issues. For many of us, it’s around this time that urgency, leaks and incontinence can become unmanageable.

The Menopause Wake-Up Call

Menopause can be the best years of a woman's life, but my feeling was always that current resources weren’t good enough to guide women through all the changes it brings, with continued optimal strength and control.

Bladder Health and Menopause

Jude’s resident GP, Dr Masarat Jilani, explains the science behind why hormonal shifts during the menopause can be a tipping point for bladder health:

“During menopause, approximately 45-77% of women experience genitourinary syndrome of menopause (GSM), which includes symptoms affecting the genital area, bladder, and pelvic floor. Urinary symptoms such as urgency (a sudden, difficult-to-control need to urinate), frequency (needing to urinate more often than usual), and incontinence (loss of bladder control or leaking urine) are common components of GSM.

Oestrogen receptors are present throughout the vagina, bladder, urethra, and pelvic floor muscles. Oestrogen deficiency is associated with tissue changes in these areas, including alterations in tissue strength and elasticity.

These changes likely contribute to stress urinary incontinence (leaking with coughing, sneezing, laughing, or exercise) as well as urgency incontinence and overactive bladder symptoms.”

Three Steps to Strength

No woman should need to hold in their laughter or shrink their lives for the sake of their bladders. Navigating the physical realities of a weakening pelvic floor needs the right support, and it all starts with muscle management. Here are my three practical ways to support your pelvic floor health.

1. Use Science-Backed Tools

Build strength from the floor up with formulas grounded in research. Jude’s daily supplement, PelviTone, can help to support the pelvic floor muscles.

2. Reframe Pelvic Health as Strength Training

Muscles stay toned with targeted effort, and your pelvic floor is no different. By adopting a strength-based approach, we bridge the gap between effort and real-life results.

To support you here, Jude has teamed up with Baz Moffat, former Team GB rower at The Well HQ.

In a free, short series of videos https://www.wearejude.com/strength-method/videos, Baz shares proven ways to develop a mind-bladder connection and ways to feel more connected to your pelvic floor muscles. Baz explains, “research shows us that integrated moves are 56 percent better than squeezing alone.”

3. Leverage Collective Power

There’s a massive amount of collective power when women support women. Our safe and supportive Jude and Friends Community now has over 32,000 members.

Talking with friends proves how feeling more supported in our bodies is an ongoing collective goal, informed by science, but lived by real women with active lives who plan to stay active, through the menopause and beyond.

The Stark Reality

A staggering “five in ten women are thinking of leaving employment altogether due to their experiences of menopause”, according to 2023 research undertaken by Royal London.

Leaving the workforce can have profound implications for a woman’s psychological and financial wellbeing. This data implies that women either don’t feel comfortable asking for support, or they aren’t getting it when they do. The same research indicated that “82% of women… said they would be more likely to stay with their current employer if they were better supported”, but that many are uncomfortable discussing menopause with their managers, especially if that manager is male. 

Essential Flexibility

Jane Galloway, award-winning life coach and Founder of Quiet The Hive, has helped many women through this transitional period. “The return to pre-pandemic working patterns may mean we see increasing numbers of women walk away from work” she asserts. 

“Long commutes can become nightmares with symptoms like hot flushes and anxiety, and many other symptoms can be more comfortably dealt with a home office environment. Simple flexible adjustments could make all the difference”.

Lisa, 58, Founder of Eight Coaching, suffered with sleep issues. She negotiated a flexible working agreement that allowed a later start on days when she’d had little sleep - if her diary allowed. 

Lisa revealed “Going through the experience gave me the impetus to become a menopause coach, so I can help organisations make things better for women experiencing symptoms. This kind of flexibility is something I wish for women, to enable them to balance the impact of menopause whilst still working."

Be the Change You Want to See

Rupa, 57, suffered from severe anxiety during menopause.  This made holding a senior director role incredibly challenging.  Although her position didn’t offer formal flexible hours, her supportive line manager allowed her to take time off when she needed to.  

Rupa tells us “That understanding made all the difference. It enabled me to continue performing at a high level, stay in a job I loved, and prioritise my wellbeing without compromising the career I had worked so hard to build.” 

Rupa is now a menopause champion in her organisation and helps women going through similar challenges. Rupa explains “I’ve learned that sharing our stories not only empowers us but also creates space for others to thrive."

These examples illustrate that advocating for your wellbeing and having a supportive employer can make a huge difference. 

The New Way of Work

Galloway explains “Organisations that take flexibility seriously avoid losing skilled and experienced women from the workforce. Arrangements don’t need to be formal or complicated; simple adjustments and compassionate approaches make all the difference. However, this understanding can vary from manager to manager and having good menopause policies in place ensures that everyone benefits equally”. 

Jemma Forrest is a director in the Employment, Immigration and Pensions team at Scottish law firm Anderson Strathern, and an active member of the firm’s equality, diversity and inclusion committee.

She says: “Compared with health issues like periods, menopause has only recently begun being openly discussed. Women impacted by menopause can and should be able to make flexible working requests, including working from home or asking for reasonable adjustments, although there is no guarantee these requests will be accepted”. There is guidance from The British Standards Institution on menopause in the workplace, although sadly it’s not enshrined in law. 

Forrest affirms “Employers needn’t find supporting employees with menopause daunting. Simply by creating a culture of empathy and understanding, they can help their people feel more comfortable - both about going through menopause and talking about it.”

Galloway suggests having the right support in place for women is a win-win. “Flexible and remote working can increase psychological safety, productivity and engagement - things that successful organisations really need.” 

Separating Myth from Fact

“Have you tried ashwagandha? Omega-3 changed my life! Sage was a gamechanger for me. What do you mean you don’t take magnesium?”

Sound familiar? Are you already overwhelmed in menopause? Does this well-meant advice simply add to this feeling? Let’s see if together we can find a way through all this noise. Let’s look at what we mean by supplements and adaptogens, what advice is out there and how you can decide what is right for you.

What is a Supplement?

A definition of supplements points to ‘any product that is used to supplement a diet and to maintain, enhance and improve the healthy function of the human body’, for example magnesium and omega 3. Adaptogens ‘are natural substances from herbs, roots, and mushrooms that help your body manage and adapt’ like sage and ashwagandha.

You’ll have heard numerous supplements and adaptogens recommended to you by experts and influencers. But which are the ones that most agree we need?

Well, vitamin D comes out on top to support bone health, regulate mood and support our immune health. Omega-3 supports heart and brain health, reduces inflammation and is believed to ease joint pain, mood swings and brain fog.

Magnesium is also constantly mentioned. However, choose your magnesium carefully. There are different types to support different issues. For digestion choose citrate. For sleep and anxiety look to glycinate/bisglycinate. For joint pain look to malate. If you simply grab a pot labelled ‘Magnesium’, chances are you’ve picked up Magnesium Oxide which is poorly absorbed by the body and most used as a laxative.

What About Adaptogens?

These are natural substances considered to help the body adapt to stressors. And in menopause and midlife, they can seem like an attractive option for supporting the myriad symptoms women can face.

They’re a challenging area to navigate, with many claiming a certain herb is life changing and others feeling no benefit whatsoever. Word of mouth also has a big part to play in creating the impression that adaptogens are a miraculous cure-all. Ashwagandha can supposedly support sleep, reduce anxiety, regulate blood sugars and boost energy. Sage can wondrously reduce hot flushes, reduce inflammation, support brain heath and digestion (according to some).

I recently interviewed a leading HRT specialist who pointed out that many women tell her that adaptogens seem to work for three months and then are no longer supportive. This has led her to believe they are simply placebos.

Another recent interview, with a functional wellness expert, backed this up to a certain extent. She explained that the body builds up a resistance to adaptogens after about three months, so a break is needed.

Keep in Mind…

The key take away must be that we are all individuals. We don’t all have the same symptoms, and our bodies don’t all react in the exact same way. Only you can feel when something is supporting you and when it is not - or it has stopped. One size does not fit all.

Do your research and give an adaptogen or supplement a try. Remember to always to check with your doctor for any contraindications with existing medication or issues. And if taking supplements isn’t for you, that’s also fine. Get your vitamin D from getting outside and your magnesium and your omega-3 from your diet. Do what works for you. Remember, you are the expert on you.

A Seismic Shift

As life changes go, this one was seismic. And unlike a hair colour switch, career pivot, or relocation, something it felt impossible to put a positive slant on. 

It was a marriage break up. And not one of my choosing. It involved infidelity, a tsunami of snot and tears and, eventually, divorce. 

Full disclosure, I had no choice in my marriage’s dissolution. I had desperately hoped to keep our family together, but my ex wanted out and so, after some very undignified pleading, I ungraciously accepted.

I was broken.

After twenty-six years of us, of feeling part of a team of two, I felt very alone. 

Suddenly there was no security net, no sounding board. No... him. 

I was discombobulated. Devastated. Distraught. 

Navigating More Change

Professionally, I was at a low ebb. After I’d had children, I’d gone part-time to look after them and had traded a beloved and hard-won staff position at Red Magazine for a freelance career to be there for the school pick-ups and drop-offs, doctors' appointments and school plays. I loved my job, but as my industry was seemingly more flexible than his, I became the primary carer. 

This reduced my earning power and, if I’m honest, my career confidence. When self-employed I always felt like an outsider. I liked the freedom but found the income instability and the fact I had to constantly push myself forward, hard. 

Then on the same day my husband left the family home (no forwarding address), I got a call from my main employer saying my services where no longer required.

I was floored. Again. 

It was without doubt the lowest I’ve ever felt. 

Finding the Light

Yet even on that dark, dark day there was some life force within me that meant I knew I had to pull myself up and propel myself forward. That nothing good would come from anger, bitterness or resentment.

I met with the editor of Red magazine and told her everything. She asked if I wanted to write about my experience and I told her I did. As I typed my story out it felt cathartic. Helped me process what had happened and make a bit more sense of it. 

I felt sick emailing it off. Worried that by talking publicly I would expose my children to more harm, make myself look mad, sad or bad. But I did it anyway. 

It was the start of my climb out of the pit of despair. People messaged in their thousands. They empathised, told me their own stories. Then editors and TV and radio producers got in touch wanting to interview me. Eventually a publisher asked me to write a book.

Suddenly I was front page news (literally!).  My Instagram account grew quickly and became a place that women could tell their stories.  Sharing experiences helped us all. When people have affairs, they often behave in unexpected ways. The cognitive dissonance that arises from them acting against their moral code can make them angry and cold hearted. 

Understanding this is key.

I often muse on why people’s best creative work comes from crisis (hello Adele and Lily Allen) and it’s to do with an alchemic mix of vulnerability, authenticity and hope.

So, for anyone suffering from heartbreak, sadness or grief, I feel your pain. Keep going, one step, one day, one micro improvement at a time. I promise this crappy experience will make you stronger, more resilient and more empathetic. And quite possibly happier. It did me. 

What is Neuro Linguistic Programming and Mind Coding?

NLP (Neuro Linguistic Programming) and Mind Coding are both methods of examining what beliefs we hold in our subconscious, understanding how these impact our day-to-day life and behaviours and learning how to change these behaviours if they are not serving us.

These are extremely useful tools if you are currently anywhere in the menopause journey, regardless of whether you have decided to take HRT or to manage your symptoms alternatively.  Tools and techniques that help with your mindset during this time can make a big difference.

The Way We Think in Menopause

During perimenopause, the brain is being ‘updated’ to enable it to deal with this stage of life. This also happens during puberty and pregnancy, to cope with the resulting changes and responsibilities. These updates, combined with hormonal changes, can result in many of the symptoms experienced during perimenopause. Techniques based on NLP and Mind Coding help with the underlying feelings and beliefs that can make symptoms feel much worse.

The Power of the Pause

We are often most embarrassed by whichever symptoms happen when it is least convenient for them to do so, e.g. a hot flush or ‘word finding’ during an episode of brain fog. Our instinct is to tense up and maybe even panic, which can exacerbate discomfort, so it is very helpful to pause and breathe. By focusing on a slow out breath (exhalation), allowing the in-breath (inhalation) to happen naturally and then breathing out slowly again, you can re-set your nervous system, making everything feel like it’s easier to deal with.

Reframe Your Thoughts

We have, on average, 60,000 thoughts a day. 95% of those thoughts are subconscious, compared to a mere 5% of conscious ones. Our subconscious thoughts are based on (usually) negative self-beliefs, and most people live their lives masking their insecurities while juggling their responsibilities. However, because of the hormone changes that happen during perimenopause and onwards, these insecurities can become harder to hide from yourself. Therefore, Catch the thought, Challenge it, and Change it.

Next time you find yourself thinking you are incapable for not being able to remember a word or having missed an appointment, re-frame it into something more positive e.g. ‘calm means capable.’

Your Best Next Step

We all know what we should be doing as far as life management is concerned, but sometimes it all feels too challenging, which leads to non-completion and feelings of failure. Next time this happens, consider what your best next step could be. If you have promised yourself you were going to go to the gym but couldn’t face it, try getting off the train a stop earlier and walking more, or taking the stairs instead of the lift. After all, nobody ever reached the top of a mountain by jumping - they took it one step at a time.

Practise Makes Perfect

The more you respond to menopause symptoms using mindset techniques, your subconscious will learn your default setting is calm, making any symptoms (and recovery from them) easier to manage.

Menopause is now classified as an inflammatory transitional period in a woman’s life, and this is one of the reasons our heart health stats can be affected by menopause. Our risk of heart attack increases significantly post menopause and becomes the same as a man’s. Our blood pressure can also increase. However, it is estimated that a whopping 80-90% of our cardiovascular risk is preventable through diet and lifestyle shifts, which is a HUGE percentage! The Mediterranean Diet was first researched in the 1950s due to low instances of cardiovascular disease in the region. Key components are included below and also include polyphenol rich olive oil, lycopene rich (a potent antioxidant) tomatoes, pulses and wholegrains.

Here are five key food groups to add into your diet to help support your cardiovascular health during menopause and beyond:

1. Add in more Omega-3 rich foods which are known for their anti-inflammatory affects and to help keep our blood vessels healthy. Omega 3 is an essential fat which we must get from our diet. These include oily fish such as salmon, sardines, trout, herring (kippers anyone?) and mackerel; and vegan sources include linseed/flaxseed oil and nuts like walnuts and almonds. 

2. Turmeric and ginger are potent anti-inflammatory foods known to benefit our cardiovascular health. Add sliced ginger to hot water on waking. Grate it into your porridge or overnight oats. Same goes for turmeric - buy fresh and keep in the freezer and grate it into curries or tagines or pop it into juices.

Hot Or Cold? Why Not Both!

Unsure how best to deal with a menopausal hot flush, night chill and other hormonal fluctuations? Don’t sweat it as we look at the benefits of hot and cold therapies that will keep you feeling cool when things are heating up. From cold showers and swimming to hot baths and heated pads, there are ways you can help alleviate symptoms such as hot flushes and mood swings.

Much has been written about how cold therapy offers a natural way to support your body through this hormonal transition, but heat can also be hugely beneficial too. In fact, a combination of the two can often provide multiple benefits if used sensibly.

Feeling the Chill

“Menopause affects the body’s internal thermostat, making temperature swings feel far more intense than before,” explained pharmacist and health expert Thorrun Govind, who is also a health expert for the UK-based advocacy group Menopause Mandate. “With some simple hot or cold techniques at the right moment, you can take back some control and feel more comfortable.”

Cold therapies, she explains, are especially useful during a hot flush or night sweat. Products such as a cooling gel, cold pack or handheld fan can quickly reduce that sudden wave of heat and help you feel grounded again. As for cold water swimming - that many women experiencing menopause symptoms swear by - don’t jump into the deep end if you are new to it. According to Thorrun, it’s “something that you need to build up slowly, so your body gets used to it.”

In agreement is menopause specialist and women’s health GP, Dr Rachel Hines, who says many of her patients have spoken of the benefits of cold water swimming in helping with not only hot flushes, but anxiety, mood swings and irritability too. This is because cold water boosts our levels of dopamine; the brain chemical that helps stimulate the release of our happy hormones beta-endorphins and serotonin.

Warming Up

If you don’t want to try cold water swimming, Dr Hines suggests “having a cold shower in the evening, something which can help with sleep that can be particularly helpful if having insomnia.”

As for when heat therapy can come in use, if you suffer from joint pains, aches and stiffness - common symptoms in menopause - adding warmth to the area can provide comfort.

“Ignore the myth that you should avoid all heat therapies during menopause,” explained Thorrun. “Yes it is not your friend when you are having a hot flush and will make symptoms more intense, but gentle controlled heat can be soothing and beneficial for aches and pains or as an aid for sleep.”

Alternating Temperatures to Work For You

A warm bath before bed for example can relax your muscles and support better sleep, while saunas are also a good choice as they can help stimulate circulation, promote endorphin release and contribute to a relaxation in your muscles. Other heat therapies like an electric blanket, hot water bottle and warm compresses can also work to relieve body pains, tension and stress which in itself can indirectly help ease menopausal symptoms.