Episode 5: Heavy Periods, Weight Gain, and Navigating Your Patient Rights

Ever wondered why starting Hormone Replacement Therapy (HRT) can lead to heavy periods, or why perimenopause seems to come with unavoidable weight gain? Join Kate Grosvenor, our resident perimenopause expert and life coach, alongside her daughter Gabriella, as we uncover the body's surprising reactions to reintroduced hormones and the roles fat cells play in estrogen production. We share personal stories that highlight the unpredictable nature of perimenopause, making this journey relatable and informative.

Navigating healthcare for gynecological issues in the UK can be tricky, but we’re here to guide you through it. Learn your rights as a patient, including how to switch doctors and get referrals to specialists. Kate discusses a real-life case of a woman dealing with night sweats from an overprescription of estrogen and how alternative solutions like bamboo pyjamas and black cohosh offered relief. We emphasise finding a balanced HRT regimen and share practical tips on adjusting medications under medical supervision to ease your symptoms. Tune in for expert insights and advice that will help you manage your perimenopause journey confidently.

Transcript

Speaker 1: 0:06

Welcome to the Uncomplicated Perimenopause Podcast. I'm Kate Grosvenor, your friendly perimenopause expert and life coach.

Speaker 2: 0:15

And I'm Gabriella Kate's daughter, representing all the women who are nowhere near perimenopause but want to understand it better.

Speaker 1: 0:23

Whether you're just starting your perimenopause journey deep into it, whether you're just starting your perimenopause journey deep into it, or you're a loved one trying to support someone who is, we've got you covered.

Speaker 2: 0:32

We'll be answering all of your burning questions, exploring the ups and downs and sharing expert advice and personal insights.

Speaker 1: 0:39

So grab a cup of tea, get comfy and let's dive into the wonderful, sometimes wild, world of perimenopause together.

Speaker 2: 0:47

And remember, no matter where you are on your journey, you are not alone.

Speaker 1: 0:51

Welcome to the Uncomplicated Perimenopause. Hello, my darlings, and welcome to episode 5 of the Uncomplicated Perimenopause podcast. My name is Kate Grosvenor. I'm a perimenopause expert and life coach.

Speaker 2: 1:09

And I'm Gabriella, Kate's daughter, who knows nothing about perimenopause.

Speaker 1: 1:12

And, as always, we are here to answer your questions about perimenopause, menopause and all things midlife icky periods and all the nonsense that goes with it. So I have no idea as always, yes what is the question from our lovely listeners this week?

Speaker 2: 1:30

gabriella. So jane has texted on whatsapp. Jane started taking hrt a few months ago, okay, and she feels really upset because she started having heavy periods again. Okay, is this normal, and why is her body doing this? She thought she was getting better, so what's going on?

Speaker 1: 1:47

okay. Is it normal? Yes and no?

Speaker 2: 1:50

yes and no yes and no.

Speaker 1: 1:52

I had to say yeah, okay. So there's there's different reasons why it could be normal and different reasons why it's not normal, and you need to check which one it is. So your body is programmed for survival of the fittest Good way of putting it. Yep, okay. So your body wants to just give you that one last chance, that one last chance for a baby which most of us would rather stab a fork in. Oh for a baby.

Speaker 1: 2:20

Yeah, genuinely, we'd rather stab a fork in our eyes than have another child when we get to perimenopause age. Not everybody some women would genuinely love to have another baby, you know, and, and god bless you. That's the thing of beauty, and I do understand that not everyone has had the opportunity and I am very sensitive. That I'm just teasing, it's just for those of us who have had we've had your babies, had our babies and are going through perimenopause and just want all that nonsense to be over and done with. By now it can seem like we get to perimenopause and can we just be done? Yeah, so I'm presuming. What was her name? Sorry, jane, I'm presuming jane is at that. From her text it just seems like I'm at that point. Where can I just be done with it now?

Speaker 1: 3:00

So what happens when you go on hrt is that you're replacing hormones back into your body. So your body goes hallelujah and it goes fine, fantastic, I've got another opportunity to give you a baby, okay. So it starts to get estrogen again, it starts to get progesterone again and it tries to give you that last chance. And even if you don't take hrt, sometimes you can just be minding your own business and your body because it produces hormones estrogen from your ovaries but it also produces a secondary source of estrogen which is not as good but is a weaker form of estrogen from your fat cells. Okay, which is why it's not the end of the world for women of a certain age to carry a little bit of extra weight around your tummy when you're going through perimenopause, because and we're all like, oh no, I don't want to gain any weight, but it is a source of estrogen, okay.

Speaker 1: 3:54

And so sometimes, when you're going through perimenopause, you do tend to put on a little bit of weight around your tummy. A little bit of weight is not the end of the world. When you start clamping on weight and it makes you feel ill, that's another podcast for another day, because it means something's off balance yeah, I see a lot of women talking about the weight gain and stuff the weight gain is real yeah, but that's a whole other pod, a whole other podcast.

Speaker 1: 4:16

So your body will try and give you one last period, or one last, one, last spin of the wheel, right, so to speak, because it wants to do this thing for you. Oh, oh, sweetheart, let me just give you another chance. And you're like you, you clearly didn't get the moment. Yeah, like I'm sorry, we time went out and we're not playing that game. Yeah, and you know your name's not down, you're not coming in, not?

Speaker 2: 4:37

a chance. Is there an age where women will stop periods, will stop menopause, and that's whenever that is.

Speaker 1: 4:45

Yes, so I'm 50 years old and I stopped my periods about a year ago. Who showed up today? So Gabriella moved back in.

Speaker 2: 4:57

Of course you're going to blame me for it.

Speaker 1: 4:59

Well, who else's fault, is it? So Gabriella moved back in to my family home, was it two months ago? Okay, and until that point I'd had my youngest daughter in the house. My middle daughter came back from uni last week. Gabriella moved back in two months ago. Suddenly, the whole house becomes very female centric again and my period decided to make an appearance today. So I am no longer in the menopause, I'm back in perimenopause. Oh, back, yeah, that's a thing. Because, oh crazy, oh yeah crazy.

Speaker 2: 5:35

I was local, because menopause is one year since your last period, but it's been a year since your last, but then you had another one, but so you're back into thanks lol, lol, yeah, banter shits and giggles cheers babes.

Speaker 1: 5:50

You've got two others. It could be them. Rowan came back last week, yeah, and I'm on my period now, yeah that makes sense.

Speaker 2: 5:58

Is this a real thing, then, that women's cycles sync up?

Speaker 1: 6:01

every single woman that I speak to, yeah, at some point has synced up with a best mate, a daughter, a roomie. I do with my sisters over the summer. What is the biology behind that? It's woo-woo, it's not by. I don't.

Speaker 1: 6:15

That's beyond me, that's, that's the universe that's our next project so, basically, I'm doing a research project, um to ask you all about what changes you would like to see in the workplace to make the workplace a better environment for paramenopausal women. If you're interested, please email me at kate at kategrovercom, if you'd like to take part in the study. I'm looking for 100 women to take part in the study because I want to make changes at parliament level, like actually make changes to the law and to what workplaces should be providing that's really good.

Speaker 1: 6:52

I didn't know this no, I know, I was when I couldn't sleep last night. Okay, sorry, I digress. So anyway, back to periods. So I started my period again today, very, very light period, but it's just a slight bleed and it's because all the hormones in the house thank you very much for that one but your body will try and give you one last period and when you give your, when you give your body hrt, you're giving it the, the hormones back that cause period. So you'll give. So estrogen is the one that creates, you know, and progesterone is the one that that strips the uterus lining and what have you? So estrogen, as always is, is the, the grower and progesterone is the mower, and so when you have those two hormones back in your system again, you will have, the body will release an egg, and then it will, you know.

Speaker 2: 7:35

Yeah, she did say that she was on hrt now so that's what's happened.

Speaker 1: 7:39

So she's got the hrt back in in her system and so it's quite common for, at least at the beginning, to get periods again. Yeah, sometimes they will then stop again, okay, all right. So it's not always permanent. Sometimes they can stop again. Sometimes they'll then become regular, sometimes they'll then become lighter, and that's okay. However, sometimes, if they're heavy, it means that your oestrogen is out of balance with your progesterone.

Speaker 1: 8:08

Okay, because in general, when you have a heavy period, we're talking about the hrt scenario for now, because the heavy period is a whole. Yeah, of course I don't want to sound scary, but it can be different types of nasty, cancerous things. Okay, we're talking about HRT on this side. So when we're talking about HRT and we're looking at why your period's heavy, it can be that let's just say that your HRT is not very balanced. So it can be that you need to make sure that you go back and recheck your HRT, that it's more in balance. So it can be, if your oestrogen levels are high in comparison to your progesterone, you may find that you just need to say go back to your nurse practitioner or go back to your doctor and say to them listen, you know, I'm bleeding very heavily. I'm bleeding more heavily than I did before I was on HRT, obviously, but even more heavily than I used to as a regular thing before.

Speaker 1: 9:19

I had my periods in general, my periods in general, and I'm concerned because I think one of the things that women have to understand is that you know your body and, yes, perimenopause is a roller coaster. Shall we say, slash shit show. Um, you still know yourself. Yeah, and although you in perimenopause, you don't know because we're none of us have ever been through this before. Let's face it, this is something new for absolutely all of us. So, even though you don't know yourself in perimenopause, you still know you so if something feels wrong, there's a reason, maybe.

Speaker 1: 10:00

Maybe is enough to flag it. Maybe is enough to say I think I need to do something. I need to at least have the conversation yeah.

Speaker 1: 10:09

Okay, I think we can become too not intimidated, but we can become too worried that somebody is going to want to say well, you should know that. Or why are you asking me that? Why are you wasting my time, body, you need answers. There's a lot of us out here trying to give you the answers, but you also have the right to medical care and you have the right to have medical professionals give you the answers. Yeah, I'm not a medical professional. I'm a life coach and I'm a. I'm a mental health advocate and I'm a. I talk all the time about the mental health aspect of perimenopause. I'm a perimenopause expert because I wrote a book on it, because there wasn't enough books on it and nobody was helping me and I felt there was a lack of education.

Speaker 1: 10:58

So I became an expert to help people, but I'm not a doctor yeah so if you have medical questions, please go back to your senior nurse practitioner, by the way, are normally the most sensible humans, to be fair, because they're quite often of our age group. Yeah, or go back to your doctor. And if, by the way, you know, this is the other thing, as a woman in the uk and I presume it will be the same in other countries as well do you know how many people oh, I've got my phones up there. Um, do you know the podcast? We? I mean, we're on episode five right now. I'm like what did you call that? On episode five? Right now, the podcast is getting listened to in something like 20 different countries already. I was so blown really. Oh, my, oh, my babe, that's so lovely. Yeah, oh, it's like oh, that's so cool, that is cool. I love that. And if, if you want to write in and tell us where you're calling, where you're like calling're calling in from, we love that, we absolutely adore that.

Speaker 2: 11:55

You're famous over 20 plus countries.

Speaker 1: 11:58

I just love it. I just love the fact that everybody's tuning in. So I'm going to talk about in the UK, but find out where you are as well. If you go to your we call them in the UK general practitioners your doctor and you're not getting the help that you would like, you have the right to request a different doctor, do you? You do because, for example, when it comes to gynecological issues, you can request a female doctor. If there is no female doctor available at your gp, you can be. You can request a referral to the local hospital and you can request a referral to the local gynecological. So it's usually the obgyn which is obstetrician, gynecological something or other clinic at your or the family health clinic at your local hospital. But you can also request to to see someone different within the practice. Okay, it's your right. Will it take longer?

Speaker 1: 12:49

I can't answer that question depends how good your practice is, what their policies are. But we we don't want to upset people.

Speaker 1: 12:56

We're people pieces in the UK, we really are we really are don't want to make a fuss, you know, after you've been really like messed around, messed around yourself but it's your right to speak to somebody else and if you're not getting the answers that you want, and you're not getting the answers that you, you desperately need, you can say I'd like to book an appointment with a different doctor, please, or I'd like to book an appointment with a nurse practitioner. That's really good, yeah, and you should like, genuinely you should, yeah.

Speaker 1: 13:26

I even I've booked an appointment with the nurse practitioner very easy, very quick, within a get, because they're not as busy and now, if you download the NHS app, you can actually book, I think, your own appointments. Oh, okay, so it is much easier, pretty cool. So it's worth knowing that, and it is your right as a patient to say I'd like to see a female doctor, yeah, or I would like someone, because I don't know about you, but I wouldn't want to go to the mechanic who doesn't has never owned a car, no, so I'm a bit one of like I was talking to one of my clients today and she'd been to see um a private menopause expert, a doctor who had been prescribing a more and more and more oestrogen for her knife sweats.

Speaker 1: 14:10

And I got to the point where I was saying I think that I think the oestrogen is the problem. I think that the estrogen dominance is causing you to have these vasomotor symptoms and she said no, no, he keeps, he keeps upping it and I was like I really suspect that this is this is actually the problem and I think that she'd been way over prescribed the estrogen and I privately.

Speaker 1: 14:29

I said I think this is the problem. Yeah, because like you're not having other symptoms. And he prescribed this huge amount of oestrogen for the night sweats. And I said, listen, do me a favor, just for one week, drop down, yeah, dramatically, or stop completely. I know you're scared to do it, but she'd been having like the night sweats, were going on and on and I was like, really, I genuinely think this could be the problem because she had no other symptoms. Okay, stop taking the yeast gel, zero night sweats. And again, this is and I'm not saying, well, you know he, he doesn't own. That's why but do you know what I mean?

Speaker 2: 15:10

I'm not saying he doesn't.

Speaker 1: 15:11

He doesn't own his own, his own vagina, therefore he can't know what one. You know what's going on, but you know I would never dream of bashing the medical profession say I know more because I'm not a medical professional, but what I do know is how it feels and I do know the intricate workings of perimenopause because I've been living it for years and I speak to thousands of women, yeah, about perimenopause from a mental health point of view and I've had to go through different types of hrt to find my own solution. And I've spoken to so many women about how it feels when the hrt isn't in balance and it seemed like a logical solution to me. If she's taking more and more, more of something and it's getting worse and worse and worse, okay, yeah, stop taking it.

Speaker 2: 15:55

And see what happens. Was she not prescribed it in the first place because of her night sweats? She was Right.

Speaker 1: 16:01

I switched her to bamboo pyjamas. Oh, so she started having bamboo pyjamas and black hosh Mm-hmm, and that was enough to deal with the night sweats and she wasn't having other symptoms. That's really good, good for her. I know she's so thrilled because, then it. Just I'm happy you know she's she now, she's her very words to me today was, I now feel, balanced. That's a powerful statement and that's a very powerful statement for a woman. I now feel balanced is beautiful.

Speaker 2: 16:29

Yeah, everything inside is balanced. That's a pretty right, yeah, and it is that balanced feeling?

Speaker 1: 16:36

so yeah, let's go back to the conversation at hand. So if you are feeling like they're abnormally heavy, go back and have a conversation and just say can you check? So for if you are on I don't know, let's presume the oestrogel and the Mirena coil. Let's say, and they've told you to do three pumps of the oestrogel, you don't have to do this without their permission. But they may say, for example OK, drop down to two pumps of the gel and see if that makes the next period lighter. Or if you were on a patch and you were on the 50, you know patch they may say, okay, try a 25.

Speaker 1: 17:20

This is presuming that you're on, not a combination yeah if you're on a combination, they may then say okay, well, let's split it and try having the progesterone and the oestrogen separately, so we can manipulate the dose between the progesterone and the oestrogen and see if that helps. Now, in rare cases, what to do? If it doesn't help? They might ask you to do some smears cervical smears. All they're going to do at that point is they're just going to rule out there's no other underlying cause of heavy bleeding.

Speaker 2: 17:53

Yeah, as they would if you weren't in perimenopause you go for it once a year anyways, so yeah, so if you were having abnormally heavily heavily periods, heavily periods it's a very menopause type of day-to-day.

Speaker 1: 18:11

If you were having abnormally heavy periods and you were 24 and you went to your doctor, they would also do maybe an ultrasound. They would also do a cervical smear to check are there any underlying conditions. They would do exactly the same in perimenopause. So they would start with the HRT because that's the most likely cause of the heavy period. They would start with manipulating that first. If that didn't help, they like to do a smear and an ultrasound. If that doesn't help, they might ask you to wait three to six months, see if it settles down. If that doesn't help, go back to them and they may just say suck it up, buttercup, but I quite often it if I'm being super duper honest it might settle down by itself. Okay, because it's just your body's going woohoo hormones. Every time I feel good and it's just happy. It's just like, just feels like it's got the joie de vivre and it's dancing through the daisies and it's just happy it's got all these hormones back.

Speaker 2: 19:18

Do you want to then have sex and?

Speaker 1: 19:20

intimacy more. No, you might feel like an absolutely. If it's estrogen dominance, hell, no, okay. You're gonna feel grumpy, crampy, moody, bitchy, nasty. If your body's telling you let's have a baby, no, but, but it's not, but it's just your. The thing is, if it's each, it depends on what's happening. If it were naturally saying let's have a baby, yes, if it's eastern dominance, eastern dominance is horrible. Do you know those days in your cycle where you feel like you want to stab somebody, where you're really crampy, headachy, moody and you're at your bitchiest, nastiest, I will stab you every period on day two, eastern dominance. It usually comes, it's it's normally on the second half of a cycle, okay, but it's like the last two weeks before you, just before you come on, type of thing.

Speaker 2: 20:15

You know that kind of yeah but when we all know, a few days later you go, that's why?

Speaker 1: 20:20

yeah, eastern dominance. Okay, you know we had a conversation about xenoeastrogens in episode two. I think I don't even know um you're gonna have to. I think you need to do like notes from each show and keep them, because I I have menopause brain so I have no idea. But that kind of eastern dominance really doesn't make you feel good at all and very headache, headachy, really kind of gnarly, just not not okay. So no, you don't want to, okay, jump into bed with anybody, you just want to be left alone and kind of like, throw somebody, throw chocolate at you and you just 100% throw chocolate and then you, they need to bet.

Speaker 1: 21:01

You know, don't make eye contact. You know, throw it and run, throw it at you and you just 100% Throw chocolate and they need to. Don't make eye contact, throw it and run, throw it and run and step backwards. Don't make eye contact and just leave the room. Oh yeah, 100% Eye contact can make it worse. Why are you looking at me? Yes, absolutely Don't do that Nasty. So yeah, I hope that helps. So yeah, that's the point. It's just understanding that it can be scary, but it's not your body trying to go against you. It's just that it's been given all these hormones back darling and it's trying its best. It's just it's like that upheaval all over again. So it's like you know when, when you go through puberty and quite often when young girls start their periods for the first time, it can be really heavy right at the beginning, yeah, and then they stop, and then they come back and they come back lighter.

Speaker 1: 21:50

Or they start really, really heavy and they get gradually lighter. Yeah, it's that sudden onset of hormones that makes them heavy to begin with. It can be a bit like that. Okay, so it can be the sudden influx of hormones and that's what basically HRT is, because you don't know, we the thing is, we don't know how. Perimenopause is not like a switch on, switch off. It's been very gradual since about the age of 25. Don't panic, you're 24, 24.

Speaker 1: 22:19

I can you start at 25? Yeah, I can read it in her face. It's like because I'm a mum, like I just know what she's thinking she's like in her head went that's what the sea, that's 11 months away. What I'm saying it's tiny. It's tiny, tiny little, like the collagen yeah type of thing just starts slightly diminishing. But it's the tiny, tiny little bits at a time. You don't notice it. It's so gradual, tips like tiny little fairy zips and then it slowly picks up speed by like the 30s and gathers more speed by the 40s. So I'm saying it's so gradual. It's not like switch on, switch off, but we we just wake up one day and notice it. Right, are you with me? It's not like we everybody just goes, oh, what happened?

Speaker 2: 23:06

it's just that one day we notice it baby, having babies doesn't make it worse or anything, not that I'm aware of they haven't done any research that says it makes it better or worse.

Speaker 1: 23:17

It doesn't it. There's no even research. There is research to suggest I don't think it's conclusive that if your mum went through um early menopause, I don't.

Speaker 2: 23:28

I was like saying with periods so you might start the same age as your mum did, kind of thing.

Speaker 1: 23:31

But maybe, maybe not yeah, because the thing is as well is? You know, for example, that your body type is more similar to mine?

Speaker 2: 23:38

ronan jenner's isn't, yeah, so maybe you might have yeah, so then you all started periods at the same age. I didn't know. So actually, yeah, you never know who knows and I, I'm my body.

Speaker 1: 23:52

I'm more similar to my paternal grandmother not my, not my mother, yeah, so I mean it's all much for muchness.

Speaker 2: 24:02

They can't really, yeah, it's very hard to prove these things.

Speaker 1: 24:06

So yeah, so I hope that helps, my lovely as always. If you have any questions about paramenopause, menopause, all that shebang in midlife do feel free to WhatsApp us. The number is, as always, in the notes below. If you want to email me, can email me, kate at katerovercom, or you can pop to our perimenopause group on facebook. That's alsoa beautiful community where we love and support each other, and you can go in there and just hang out with the other perimenopausal women, which is actually really beautiful. I'm laughing because it sounds like hell, like I will be on other people that are going through everyone's so lovely, so cute, and they're lovely as well also in the show notes you'll find a link to my book and the lifestyle website.

Speaker 1: 24:50

So if you want to look at I don't know bamboo pajamas and healthy cleaning products and all that beautiful stuff, you can find it in there. All right, my darlings, have a beautiful day, take care and we will see you next week. Bye, thanks for joining us today on the Uncomplicated Perimenopause Podcast. We hope you found this episode helpful and inspiring.

Speaker 2: 25:17

Don't forget if you have any questions or topics you'd like us to cover, you can reach out through our Perimenopause group or on WhatsApp.

Speaker 1: 25:24

For more information on my coaching, perimenopause supplements, books or upcoming events, please visit wwwkategrovernercom.

Speaker 2: 25:33

And if you've enjoyed today's episode, please subscribe, rate and review our podcast. It really helps us reach more listeners, just like you. Until next time.

Speaker 1: 25:42

remember. Perimenopause doesn't have to be complicated. We're here to help you every step of the way. Stay uncomplicated, Bye, Bye.