Dr Louise Newson [00:00:00] I really want you to help, because we've found out that this podcast has been nominated for the Listeners Choice Award, which is with the British Podcast Awards. We need your vote, so if you go to the show notes and click on the link, and I really hope we can do this. So thank you.

Dr Louise Newson [00:00:18] Shelly Horton is the guest on my podcast today. She's a TV presenter, a journalist, and an author, and I've known her for a couple of years. She's really open about her perimenopause journey and how she thought she was better when she wasn't really and how now she's really inspiring so many people to take control of their hormones and to look forward to the future with a renewed positivity and extra health as well. So, enjoy it. So, Shelly, this is really exciting to have you remotely in the podcast studio. I feel like you're here with me. You've met everyone here. My daughter's here. So, it's all happening. You've put your makeup on, on a Friday night. So that'’s…..

Shelly Horton [00:01:03] Friday night. I need everyone to realise that it, is in Australia, it is 9.30 on a Friday night, and the last time I put on makeup at that time of night, I think, was a decade ago. So, this is what I'm doing for you. Louise.

Dr Louise Newson [00:01:15] I am very impressed. So, we first met, it's probably nearly two years ago now isn’t it. I came over to Australia with Rebecca Lewis, and we came to a big conference that Professor, Professor Jayashri Kulkarni who we both know and love. It was her first conference, and I was one of the guest speakers, and you were the Compare. I didn't really know you then, and you just did the most amazing job. Your energy was just incredible. But what you've done over the last two years is you've learned more. Your journey has changed, but also the people that you've connected with, the stories that you've heard, the sort of you've just become more kick ass, really, because you're like me, you're frustrated for the women that are suffering. You want to help. And actually, we can all help together. There's enough space for everybody in these conversations. And then, obviously, I saw you more recently when we did this incredible event at Sydney Opera House, which we can talk about, yeah, and, and, you know, I don't know how you've managed to have time, but you've also written a book, which has just come out as well. So…

Shelly Horton [00:02:23] Yes, I’m Your Peri Godmother. So yeah, I've been pretty busy, but I've got to tell you, from when we first met two years ago, I was still pretending I was okay, but I wasn't really.

Dr Louise Newson [00:02:36] I know.

Shelly Horton [00:02:38] I remember you giving me a cuddle. At lunchtime because I was having hot flushes. I was bleeding excessively, I was struggling with my depression, but I'd still get up on stage and perform and then come back. And I think a lot of women do that.

Dr Louise Newson [00:02:54] Of course they do.

Shelly Horton [00:02:55] And I now am pulling back that mask and letting people actually read in my book what was going on, so that they can be more forewarned, and also just to break the shame and stigma around it. I think, I don't think I could have written the book if I wasn't feeling well like I am now. I think you have to process it and get through it first. But I've got to say, I'm nearly 52 now, and I am feeling the healthiest I have in probably seven or eight years. It's pretty amazing.  

Dr Louise Newson [00:03:28] That's so cool because, yeah, it's so good because I'm very perceptive. You know, with being a doctor for many years, I can pick up on non-verbal cues as well, and I often can see people in ways that others don't. And I knew you were struggling, although you weren't admitting it publicly. And that happens to a lot of people, because you think that's as good as I'm going to get. You know, you hear all these stories you're worried maybe about whether hormones are the right thing, and if you're on hormones, a lot of people are told, well, you're on hormones, therefore it can't be related to your hormones. Of course, people aren't always on the right dose or type of hormones, but it's very difficult to know. And this has been part of the problem, actually, for, for decades, because if we just think about flushes and sweats, I can monitor those as a researcher. I can see you having the sweats, I can they can see you having the flush. And that's why it's been denigrated back to flushes and sweats, almost, because it's easy for researchers to see how easy or difficult is it to say, I'm just really, really flat, and I think I might fall in, you know, burst into tears. It's not so easy, is it to monitor that

Shelly Horton [00:04:39] No, it’s really not.  

Dr Louise Newson [00:04:40] And actually, is that just because you've had an argument with your partner, or is it because you're nervous you're on a stage, or is it your hormones? And no one can even tell you that. So that's why so often those symptoms that you can't monitor and see are just ignored, and it's blamed on us as women, really, that we're just not coping very well.

Shelly Horton [00:04:49] I went into perimenopause, and I had never heard the word before, so I'd heard menopause, so I thought that was grey haired old ladies clutching their pearls. Their period stopped and they got hot flushes. That's it. I had no idea there were other symptoms, and so when I started getting these other symptoms, I just put it down to stress. You know, I was having heart palpitations. I thought that was just anxiety. I had put on some weight, and I went into perimenopause in 2020. Don't ever have a pandemic and, and go into perimenopause, those p’s should never be seen together, but I put on a bit of weight and so and I felt hotter all the time. So, as well as those traditional hot flushes that you see in movies where, just like, you know, the sweat runs off you I was just running like, three degrees hotter all the time. And I just blamed my weight, and I just feel like it's important for people like me to, to speak out and speak out loudly. Because if I'd had other people speaking out, then maybe I wouldn't have written off my symptoms as just stress, or just me, or I've done this to myself. And I also think, I mean, I was never afraid of hormones. I was, I was just didn't know that I needed them. So, the first doctor I went to, the reason I went was I had a Mirena. I wanted to marry my Mirena, you know, the IUD, like, basically, I had terrible periods since I was 11, and the Mirena meant that I didn't have periods. And so I had had 12 years because I'd had it replaced a couple of times of no periods, and then all of a sudden, what I describe as an Armageddon period, like I flooded through my clothes. It was just horrendous, and that's why I went to the doctor. But I went to a female doctor. I was 45 she did not clock that it was perimenopause, she sent me off for an internal ultrasound, saying this sort of abnormal bleeding could be cancer. So that was the first thing that was in my head. And then she said, we'll do a blood test to test your hormones, which we now know are completely useless. And so, then I had all the stress of waiting for those results to come back. And then I went in there, she's like, great news. It's not cancer. You're just not managing you stress well, maybe you should take up a hobby.

Dr Louise Newson [00:07:26] Oh no! 

Shelly Horton [00:07:27] And so, because that was my first connection with a medical professional about my symptoms, I just went away blaming myself, and that meant that I just spiraled, and my symptoms got worse and worse, and I got to the point where I was crying every day. Now I am known on TV in Australia as that bubbly, you know, redhead, and I lots of energy. And I would still do my segments on TV, but I would be so drained afterwards that I would have to go to bed for the rest of the day. I got to the point where I wanted to quit my job, and I think that was when it was alarm bells. Because I love my job, I love what I do, but when I got to the point of going there's - something has to give, and I think it has to be my job. I can, I can handle. I just don't think I can handle doing live TV anymore. So that was when my husband sat me down and was said the kindest thing I ever think he has ever said to me, and he just said, I don't think there's anything wrong with you, but I think there might be something wrong with the chemicals in your brain. Why don't we go and see someone together? Isn't that amazing. So, he came to the appointment with me, and that's when I saw a GP who did have menopause training, who just went, oh, this is perimenopause. I'm going to…. but of course, even then, this is 2020 she put me on an antidepressant and HRT. And then I had to try, like, about four different HRT’s, like, you know, you had a kiss, a few HRT frogs before you find your prince. And then I remember meeting you, and I was on patches at that stage. And I remember at lunchtime, I was, you know, I was a sweaty, bleeding mess, and I pulled my shirt up to show you my patch, and my skin was all red raw, and the patch was peeling off. And you're like, you're not absorbing any of that. You need to go to the gel, or, you know, like you need to try so, and I was just like, oh, I didn't, I didn't even know that. So, then I changed to the gel, and I found my prince. And now I'm very, happy, but again, I needed higher doses, and I and I'm so lucky, because I got to be treated by Professor Jayashri Kulkarni who is an earth angel, and she was the one who asked me to have my Mirena removed so that my depression could be treated purely with hormones. And with talk therapy with her. She weaned me off the antidepressants, which was terrifying, and it was the best thing that ever happened for me. Not only do I want to share that there are some very dark times for for you know, one in three women in perimenopause, but also that there's not really a quick fix. I felt like HRT would fix me in a couple of weeks, and it didn't. But you persevere, you find the right one, and then you hit the jackpot, and all of a sudden it really works. And you do the work like I had to make some lifestyle changes. I had to do therapy. I had to, you know, really take some responsibility. And I think now I'm actually excited about making those changes rather than resenting it, which is, I think this is what, how I want to sort of reframe midlife is like, this is our opportunity to get well for the next 30 or 40 years.

Dr Louise Newson [00:10:53] Absolutely and I do feel we have the responsibility as women who are menopausal, perimenopausal, to invest in our future health. But you're absolutely right, and it's it's funny or not funny. Really, about 10 years ago, I was sitting in a professor's clinic learning more about menopause, and I remember sitting and saying to him, how do you know when someone's perimenopausal, like it's so obvious when they're menopausal, if they've not had a bleed a period for a year? Oh Louise, it's really obvious. And I went home, and I was thinking, oh, I wonder how many patients I've, like not picked it up on. And then, personally, for the next six months, I was having every single perimenopausal symptom. But I didn't join the dots, because this is even more embarrassing. I was writing my website. I was writing about the joint pain, the migraines, the irritability, the anger, the low mood, the sleeplessness, and I was having all those symptoms, but thought it was just because I couldn't cope, because I've got three children, and I was busy, and my job was getting busier, and I – no one really, my husband was just like, oh, you're so miserable. And of course I was, and I was very close to ending my job because my memory wasn't there. I could not remember anything. And then it really, I really, I really struggled to find a doctor who could, could help and listen and prescribe. And then I thought, oh, I'm going to come back really quickly. And my mother-in-law, who's on HRT, was going, oh are you feeling better? I was like, no, I'm not. I feel really awful. And I had to have my dose changed, and then I started testosterone, and then I waited, but it's what I found. And I know women do even for longer period of time than me, for those six months, I'd really let my exercise slip. I'd, you know, I couldn't be bothered to do yoga.

Shelly Horton [00:12:36] Because you don’t feel motivated

Dr Louise Newson [00:12:37] I had no motivation. I wasn't eating as well my, you know, so, so it's all these things together, and it's really easy when you read something that says, oh, this, these people need to improve their exercise. They need to improve their diet, yeah, sure, but give us our hormones first, and then we'll feel better, and then we can do all that.  

Shelly Horton [00:13:00] We might have the energy to do it. Yes, well, I am. My bleeding got so bad that last two, you know, it was actually the year I met you. That was the year that I bled for 42 weeks out of 52 and I was so drained, so exhausted, anaemic, all of that. And then I went in for an ablation, which ended up being the best thing I've ever done, because I have not bled since. However, me, being me, there were complications, and I ended up in the ICU, of course, I mean nothing simple with me. However, that was the real wake up call for me, where I'm like, I need to make some changes. And one thing I decided to do was that I would walk every morning. Now it's not, I'm not going to lose weight walking. That is not actually the goal, it was for my mental health. And sometimes, and I don't know if you've seen it on - it's often on Instagram, it's like, I'm going for a stupid walk for my stupid mental health and I do that, and I'm grumpy, and then I get home and I feel better. I'm like, oh, damn, it worked. Every time, but I feel like by making that commitment, and I've now, yeah, so I've now done it for nearly 18 months, and I know now having, you know, done the research for my book, it's not just the walk, it's the fact that I'm going to bed earlier because I want to get up early and do a walk. It's because I'm getting some sunlight in the morning, I was vitamin D deficient. And I live in Australia, and I just put I'd slip, slop, slap too much, like I had to get a bit more sunlight the walking. And I live on the Gold Coast in Queensland, so I walk by the sea like it's just there are so many more benefits. But I think I was in that mindset of, everything will be better if I'm skinny, you know, if I just lose some weight, I'll be fine, once I took that pressure off of like, I've got to lose weight and I've, you know, I need to do burn calories. If I'm spending time exercising, I really need to be burning calories. Things changed for me and I, I just developed a much healthier mindset. And then, very controversially, because I didn't think I would ever do it, but I have started strength training, and I am so proud of myself. I only go twice a week, but I love it now, and I now can do a dead hang for 40 seconds, which I am so proud.

Dr Louise Newson [00:15:32] That is very good!

Shelly Horton [00:15:33] I could only do one second. I would just fall. So just watching…..

Dr Louise Newson [00:15:38] Well, I was showing I was showing my husband that I can do nearly a minute. And then he comes along, and he's got the weights tied around his waist, and then he's doing these chin ups. And I'm like, oh my God.

Shelly Horton [00:15:48] Shut up!

Dr Louise Newson [00:15:50] I know. Like, yeah, I'll never do that so, but you've got to start. And I think you're absolutely right, you know, I, I, tend to do yoga nearly every morning. And this morning I was like, oh, I really. And I was and actually I was up a bit earlier because I woke up earlier, so I did 30 minutes instead of 20 minutes. And I, at the beginning, I felt like, Tin Man. I felt very stiff. And at the end, when I do a headstand, I'm like, yeah, bring it on. I can conquer the world.  

Shelly Horton [00:16:15] I think for your family, if Louise is not doing a headstand, that's a sign that something's wrong.  

Dr Louise Newson [00:16:21] It is - you're absolutely right. You're absolutely right. Actually, it's like, honestly, it's one of my things that I- I do it because I know lots of people can't do it actually, and that's like…And also like, I'm older now, so if I stop doing it for a few weeks, I worry that I'll never be able to do it. So, but, but it's getting into your routine. And you know, there's this whole thing out everywhere, actually in Australia, but also in the UK, that you either take hormones or you don't, and if you do, you do all this other things, whereas I'm very much whether you take hormones or not, you still have to exercise, you still have to eat well, you still have to look after yourself. And actually, we need to stop this binary message, really, that it's, you know, one or the other, because I don't agree with that.  

Shelly Horton [00:17:10] Absolutely I agree with you, and that is a bit of a message that is happening in Australia, that if you want a natural perimenopause, then you just make lifestyle changes. And I'm like, no, no, you have your HRT, and it's compulsory to make lifestyle changes. It's not an, an add on or a or one or the other. It has to be done both of them. And I feel I just get so cranky when people go, oh, I hate Big Pharma. Or I don't. I don't want to put chemicals in my body. And I'm like, oh, my goodness, this is just replacing your hormones that you're depleted of. And to me, I just know how well I feel now, and there's no way I would go back to 2020, Shelley. There is no way I would ever risk my mental health again. So, I'm like, super protective of of my mental health, and I hope that by sharing my story, maybe some women who are thinking they'll go through it naturally. Might go, well, I can do both, and understand that the you know, the benefits outweigh the risks. And for me, the risk for me was that if I didn't take these hormones, then I may not be here anymore, and that's how serious it was for me. So, I don't want other women soldiering through or pushing through because they don't want to take HRT when really, it's you wouldn't say don't put a plaster cast on your leg if it was broken.

Dr Louise Newson [00:18:40] Absolutely. And one of the things that you know keeps me going is, is wanting to make a difference to as many women as possible and giving them the knowledge so they can make choices. But it's about the mental health aspect. It really is, and it's become so stupid, that we're talking about the risks. Do we? Don't we? Look at the risks of antidepressants, they're far higher than the risks of body identical hormones. Yet in Australia and the UK, more perimenopause and menopausal women are prescribed antidepressants, than they are HRT. Now it doesn't make sense. Actually, we've got studies showing that women who take antidepressants with hormones actually do better than if on their own. And we just produced some work looking at the effects of testosterone on mental health. And what was interesting is those women who were already on an antidepressant actually didn't do as well in their symptoms and those that weren't on antidepressants. And is that because the antidepressants are blocking some of the or changing, really, the way that the neurotransmitters are working in the brain? That means that it's harder for the hormones to affect those neurotransmitters like we don't know. The research hasn't been done, but we shouldn't just be paralyzing people's minds by giving them antidepressants, if, if it's related to their hormones.  

Shelly Horton [00:20:04] I also, when I went on the antidepressants, I put on 10 kilos, you know, and that in itself, is has such a negative health impact so and I didn't the the doctor, didn't talk through all of the pros and cons about the antidepressant, but spent a lot of time about the pros and cons on the HRT

Dr Louise Newson [00:20:25] Yeah.  

Shelly Horton [00:20:25] So I'm just like that doesn't make sense to me. I also my libido just flatlined.  

Dr Louise Newson [00:20:30] Of course it does and that's a really common, really common, like, side effect.

Shelly Horton [00:20:35] No one talked to me about that, though, so it was just like, it was almost like, well, you have to put up with that if you want your brain to be okay. And it's just like; I actually deserve a lot better than this. So yes, that's where I was lucky that that Jayashri and she - we weaned me off the antidepressants very slowly, and removed my Mirena, and then upped my HRT at the same time. So, it was an absolute dance that was very delicate, and I was so lucky because Jayashiri was also in constant contact with my GP.

Dr Louise Newson [00:21:09] Which is perfect

Shelly Horton [00:21:11] I said, what I, what I loved about that is I felt like I had a team behind me, and that they cared about me, not just in out, here's a script. See you later. It was - I was treated as a whole person

Dr Louise Newson [00:21:24] Which is what it should be. We spend a lot of time deprescribing, so, you know, reducing and stopping antidepressants, antipsychotics, gabapentin, pregabalin, you know, painkillers, it's really rewarding, but we do it very gradually, and, you know, and the patient is central to those decision-making processes. So, when I was in Sydney, I like, honestly, I It's a pinch me moment, thinking that we were back there, you know, trying to warm up our voices, dancing and singing to pink pony club  

Shelly Horton [00:21:55] We were singing pink pony club at the opera house before we walked on stage. It was an absolute moment

Dr Louise Newson [00:22:04] Well, it was, it was really funny because my daughters tried to teach me the words, and I did it for my theatre tour, 34 dates, and I still can't remember all the words, and some of the Americans with us were like, oh my goodness, what's going on? And we carried on till the end.

Shelly Horton [00:22:19] We carried on – we were we were reading the lyrics off my iPhone, and my husband filmed it. And what I didn't realise when he first put it up is he had put the actual voice over it. So, we sounded great. And then he gave me the vision of us. Oh, we sounded like squeaky cats. It was great. But you know what it was? It was joyful.

Dr Louise Newson [00:22:44] It was, well, you can't, you can't sing that song and not be happy you see. So great. So, it got us going, and we had the most amazing time, honestly, the stage, the audience were incredible. We had a standing ovation. It was really inspirational. But to me, the best and the saddest moment was actually when I was leaving, I was walking out, and people recognised me, and they came up and they took selfies. But there were quite a few women who came up trembling and crying and saying, you have saved my life with your podcast, with the balance app, without that, I would not be here and I they travel for miles and like, isn't it lovely, but isn't it sad, Shelley

Shelly Horton [00:23:25] It’s so sad  

Dr Louise Newson [00:23:25] That they shouldn't actually be having to struggle listening to a doctor in the UK, the other side of the world about some basic physiology, talking about hormones in the brain, but it's allow, allowing women to be advocates for themselves, to stand up, but not just for them, for their partners, like your husband, helped you. And this is where, like your work and your book and your reach, we've got to like work together to amplify this noise so we can help more people.

Shelly Horton [00:23:54] Well, one of the people crying in the audience at the Sydney Opera House was my mum.  

Dr Louise Newson [00:24:00] Oh, she’s so lovely.  

Shelly Horton [00:24:02] She's such a sweetheart. I know you had your mum on your podcast, which I loved. My mum's 76 and she went into medical menopause at about 34, and she was on HRT doing really well. And then the WHI study came out, and they just ripped the hormones off her, and she was still having severe hot flushes at 76 and so it was because of the Opera House and listening to everyone there that she went back and she advocated for herself to her doctor, and she's now taking some HRT, and she's not having hot flushes anymore.

Dr Louise Newson [00:24:43] That's amazing. That's so cool.

Shelly Horton [00:24:46] And of course, the doctor was very nervous about it and, and she was just like my daughter's written a book. I've been listening to these people. I want to make the decision here, and she's doing well. But, you know, the other thing that I find really interesting talking to her, about her, is there's a there's a bit of grief in the 35 years that she has put up with this. And also, her generation, they just didn't talk about it.

Dr Louise Newson [00:25:14] I know  

Shelly Horton [00:25:14] They soldiered on. I say in the book, I used to be mad at my mum for not warning me, but now I'm mad for her that she was treated so shabbily, that she was never given the language to discuss how she was feeling, and that she was taught to silence everything. So, in a weird way, that opera house moment, which was bucket list for me, has become an incredible, indelible moment in my mum and I and our history, so that we have had this incredible bonding. It's a little bit of trauma bonding, but it's bonding.

Dr Louise Newson [00:25:53] Yeah, and it's amazing, but, but I hear it a lot in my clinic, and in fact, someone recently it’s a sad story, quite young lady. She's in her 30s, late 30s, early 40s now, but she's had PMDD, premenstrual dysphoric disorder for a long time, and then became perimenopausal, was given the wrong hormones by the wrong people, a lot of synthetic hormones, and she actually came to us. We didn't know she'd already planned how to take her life, actually, because she was so depressed. Anyway, within literally days for her, it worked very quickly, having some natural progesterone, actually, as a pessary, she's feeling great, and she's continued to do better. And I was recording something with her recently, and she said, but then I feel so sad because I made different choices about my job. I've made different choices about my relationship. I don't think I didn't even want to have children because I wasn't responsible to look after them the way my mental health was. So, I hear it a lot when people just really struggle because now they're better, which is wonderful. They're looking back, like your mum and thinking, what could be different. But, you know, I always say to people, you can glance back and look forward. You know, we can't change the past, and what we can do. And I think what we're trying to do is actually shape the future for millions of women, hopefully, with all the work that we're doing, the knowledge that we have, the experiences that we have, we're sharing, and people can choose to learn from them, or they can choose to be annoyed and ignore us. It doesn't matter either way. But I know that we're helping people.  

Shelly Horton [00:27:29] Yeah, absolutely, and I feel quite excited about younger generations, because they're not embarrassed about talking about periods. They're not like they I think they're going to have a very liberated time. I feel like it's this Gen X that I'm in that have, like we are fighting and shouting, but we're getting friction from from all sides.  

Dr Louise Newson [00:27:51] I totally and actually just very quickly. It's interesting, my 22-year-old daughter uses, usually has patches for her PMDD, oestradiol patches, but she's found them very hard to stick in the heat. It's very hot over here, and she's actually in Florence, where it's really hot. And so she said to the teacher yesterday. Oh, I'm sorry. I'm a bit slow. I've just changed the type of hormones that I'm taking because the patches weren't sticking. And she called her to one side and said, I don't think that's appropriate for you to be talking like this. Like yeah, well, I just think it might hold you back if you start to talk like that in your career. And it's like, hang on you know you can’t do that

Shelly Horton [00:28:28] Oh my God, no, no, no, no, no  

Dr Louise Newson [00:28:31] Precisely. So, they yeah, and this is the new generation. It's so important. So, I'm super excited for your book. I'm so grateful that you're in the podcast, but I want you to come over to the UK  

Shelly Horton [00:28:44] Yes, I want to be - and see you in person and get a cuddle yes.

Dr Louise Newson [00:28:48] Yeah. Yeah, for sure. So, but before we end Shelley, I just want to ask for three tips, three things that you want others to learn from in a quick way, like whether it's person suffering, their friend, their neighbor, their relative, you know, what three things do you think they can do that's going to make a difference to their future?  

Shelly Horton [00:29:08] I would almost cheat and say all three are the same. Educate, educate, educate, learn about it. I think, lean into the algorithm. I my social media is nothing but menopause like it has learnt what I want, and I am following my favorite experts, including yourself. And I just love getting the up-to-date studies, learning, going for the evidence-based information, looking at the science, so lean into that so. And then the other thing is talk to everyone. So, I'm sorry I would talk to that teacher, and I would just keep talking to them, but talk to everyone about it, normalise having conversations about perimenopause and menopause, take away that shame and stigma. And then my final thing would be, just be kind to yourself. It is a rough time for a lot of people. I was particularly hard on myself, and if I could go back, I'd probably give myself a bit of a cuddle and go, you didn't know what you didn't know, and now you've made some changes, and it's really working. It'll all be okay.

Dr Louise Newson [00:30:15] Yeah, absolutely it is a journey, but it should be a journey to good transformation and feeling better as well. So, I'm so grateful. Thank you so much. You can go and take your makeup off  

Shelly Horton [00:30:26] I can take it off. Yay

Dr Louise Newson [00:30:30] Thank you

Shelly Horton [30:31] I know I’m so excited. I know I can't believe makeup I've had it on for a total of half an hour. Now I'm taking it off again.

Dr Louise Newson [00:30:38] Thank you so much.