Still slightly taboo in the workplace, and still often unrecognised by medical professionals, perimenopause is a long and difficult stage of life for many women. Lisa and Sasha are joined in the Today Radio studio by a dream team of guests to discuss this long-overdue topic — including a menopause coach, a preventative health entrepreneur, a medical and health management specialist in menopause, as well as a sexologist and perimenopause specialist.

Perimenopause and menopause are stages of a woman's life that are becoming more present in conversations socially and even in the workplace. But still, so many women go through perimenopause, suffering a multitude of symptoms, without realising it. It’s difficult to untangle symptoms from the heavy stressors of life sometimes, as perimenopause hits us during particularly intense periods of our lives, and continues for years. During this time, we many be raising children, managing a household with a career, caring for parents or other family members, living away from ‘home’,  and so there is very little time for ‘us’, to listen and feel what is going on inside our own bodies. The irony is that when life demands all of us, perimenopause can significantly diminish our natural capacity for work and resilience.
After a weekly news round-up with Sasha, my guests this week are Guy Brandenbourger, Diane Elsen, Annabelle Parkhouse and Victoria Honey.

Guy Brandenbourger was a Partner at PwC Luxembourg from 2011, led their healthcare sector including the government and public sector practice in Luxembourg.  Guy is now the founder and Partner of his own company called Health A Gesondheet, Luxembourg Blue Zone (HAG) dedicated to developing a preventative health care structure in Luxembourg, aiming to become the 6th blue zone in the world.
Diane Elsen is a certified menopause coaching specialist. After 26 years working within a European institution, raising 2 children, helping her partner manage a successful restaurant she was hit by post traumatic depression at 48, at the peak of her career. With no answers from her GP, Diane threw herself into researching peri-menopause.
Annabelle Parkhouse has just completed Medical School at Imperial College London. She also completed an MBBS diploma and an Intercalated bachelor’s in health management at Imperial Business School. Her thesis was on “Making Menopause Manageable, barriers regarding the safe discussions of menopausal symptom experience and management."
Victoria Honey, a sexologist and perimenopause specialist, supports female executives, who want to manage the emotional changes that come with peri/menopause so that they can flourish in their careers and live unshakeable lives.

Menopause is still rather a taboo topic in Luxembourg, and the symptoms of perimenopause are still catching women by surprise. It is frequently only after a woman hits menopause that they realise they have lived with many of the symptoms. 86% of women aged 50 to 65 experience at least one symptom (of a list of at least 34), and almost half have not discussed the subject with their doctor, 60% talk to their gynaecologist and only 39% talk to their partner.
As Annabelle says, going through the period of perimenopause to post-menopause is actually a privilege, but it’s not always easy for women.

Medication alters depending on where you live and who your doctors are. There is so much more to learn about the effects of menopause on the body and we are a long way from personalised hormonal treatment.
Although, we have moved on from the WHI study to disband the link between HRT and breast cancer. Moreover, HRT used at the right time can reduce cardiovascular disease and osteoporosis.
Diane Elsen talks about her own very difficult experience of perimenopause, not knowing what she was going through at the time, and nor did any of her healthcare professionals spot it. During her many years of research, Diane has found number of sources she would recommend to others, including Dr Louise Newson, the Balance app or Balance-menopause.com with the list of symptoms, Dr Lisa Mosconi (The Menopause Brain),  Dr Avrum Bluming & Carol Tavris (Oestrogen Matters), Dr Mary Claire Haver (The New Menopause) and guideline sources from  EMAS (European Menopause and Andropause Society), the BMS (British Menopause Society) and the IMS (International Menopause society). You can follow Diane on instagram (Womanhood Luxembourg).

Menopause can significantly affect women at work: those with symptoms have a 60% drop in productivity versus women without symptoms (FORBES 2019), 1 in 2 women say that menopause has negative effects on their work, and 21% have to stop working for several days
It turns out there are many risks too that so many women don’t realise are associated with menopause such as cardiovascular disease, osteoporosis and sleep disorders. Heat flashes, one of the more commonly known symptoms of menopause (70-80% of women), can lead to cardiovascular disease, night sweats may lead to silent nocturnal hypoglycaemia (type 2 diabetes), insomnia can lead to depression, muscular and joint pain to osteoporosis and fractures and brain fog can lead to dementia or Alzheimer's disease.
In Luxembourg we only have one bone density scanner, with a waiting list of 1.5 years. We really need to have about 7 such devises for this population.
Guy Brandenbourger is working hard to put forward a manifesto of very actionable steps in order to help everyone in society together.
An easy one is for GPs to conduct annual medical menopause check-ups. Guy also suggests that from the age of 40 women should have a complete cardiac checkup. From 50 (I would personally say younger, being personally affected by this) he suggests having a mandatory bone mineral density scan.
Of course, part of the issue is that medical practitioners are not very knowledgeable about menopause as the information and research unfolds.  There are personal issues we as women must take care of too: our own nutrition (with enough protein) to stave off sarcopenia, plus exercise for bone density and sarcopenia. 

Victoria works with women in leadership roles and also highlights the need for diversity and equality in all its forms. When women are suffering from perimenopause symptoms and lower self-confidence, she encourages them to put their own needs first, and then other things can fall into places in a pyramid behind this. 
Victoria explains that there are so many different factors which affect the way we experience menopause. These obviously include genetics, nutrition, race and ethnicity, but there are other factors such as our socio-economic situation and how we arrange our lifestyle (smoking, alcohol, sleep etc).  As part of her work with corporates, Victoria engages with the women and leaders to create menopause policies, workshops and to make small adjustments to the workplace to reduce a woman’s uncomfortableness.

Do let us know about your own perimenopause journeys.