Both from a personal point of view, (as a 43-year-old female, living locally), and from a professional point of view (as a CIMSPA-accredited perimenopause and menopause personal trainer) I am, of course, delighted that the Health in Menopause Centre has arrived in Sutton Coldfield.
After seeing some information on social media about the centre, I contacted Dr Sarah Ball a few weeks ago and arranged to see her at her clinic, where we talked all things perimenopause, menopause, the services available at the clinic, and what I offer as a personal trainer to support women at this time.
I am keen to spread the word about the amazing services on offer at the clinic. When Dr Sarah agreed to take part in this blog post. I was delighted to have the opportunity to go back and speak to her again, and this time, I documented our chat so that you can benefit from reading about this wonderful local service.
It's been important for me to make local links such as the Health in Menopause Clinic because I firmly believe that it is vital that women are aware of the range of different services that are available to them.
As you can see from the photos, it’s a stunning building. From the moment that you walk in the door, you are made to feel so welcome and at ease. And, I have to tell you, Dr Sarah makes a cracking cuppa, perfectly served in a ‘pause’ mug; a reminder that you have the opportunity to relax here. You will be listened to, you will be heard and you will be supported.
Health in Menopause Centre, The Moat House, Lichfield Road, Sutton Coldfield B74 2NJ
How did you develop an interest in the perimenopause and menopause?
My interest in menopause really goes back to when I first became a GP in 2001. HRT was very popular, and during my year as a GP trainee, I prescribed HRT frequently for women who had reached the menopause.
Then, the Women's Health Institute study came along. I remember the exact date as I was just about to fully qualify as a GP. It was the 9th of July 2002. The date sticks in my mind because of the fallout of the study. It was huge. Suddenly, there was all of this media coverage about HRT being harmful. Patients were very worried, understandably. But so were doctors. The majority of women who were previously on HRT, came off it.
HRT had fallen from favour as I began my GP career. The years went by and I was mostly seeing female patients because at the time, female GPs were still in the minority and women would tend to ask to see a female doctor.
In my practice. I was seeing thirty to forty patients a day, the majority of whom were women, predominantly aged 40 and beyond.
They were all coming in to talk to me about migraine episodes, joint pain, anxiety, low mood, insomnia, hair thinning, dry itchy skin, cystitis. And gradually with more and more experience you come to realise …this is all about hormones. Not only have we tended to ignore the symptoms that can occur for years leading up to the menopause, but in any part of the menopause journey, we have also tended to only recognise hot sweats and flushes as being symptoms of menopause. But what to do when so much fear still exists even years later relating to HRT?
People were talking about the risks of HRT, but what about the damage done to the women who came off HRT because of that study, and then were left to deal with the symptoms? What about all those women who didn't ever start taking HRT and didn't get the benefits of treatment for all those years? Because not only does using HRT help reduce symptoms, but it also reduces common future long term health conditions such as heart disease and osteoporosis.
The longer it's been since that study, the greater number of further studies have been done, and it has subsequently been found that that original study was flawed. The message that it gave to women was misguided and wrong. Sadly, the message had spread globally, and impacted the lives of a generation of women.
The more you work with and experience such a variety of patients, to just say that HRT is dangerous, doesn't look at the bigger picture. The rest of my career since then has been about not taking those original headlines at face value, and that has made a major difference to how I work with women. Yes, there is still a long way to go, but we have made a lot of progress.
So, what changed? Well. In 2015, NICE (the National Institute for Health and Care Excellence) issued menopause guidelines. The publication of these guidelines represented the first proactive step to try and redress the balance a bit. We now have much greater reassuring knowledge about the original study and subsequent studies since. And we now have even safer types of HRT and we understand more about the ways to use HRT in both menopause AND perimenopause to enhance women’s lives. Since these guidelines my interest in menopause was firmly reignited.
Dr Sarah Ball
Tell me about the Health in Menopause Centre. When, and how, was it established?
I met Dr Alice Duffy on a menopause training weekend in 2017. We were both GPs with a keen interest in women’s health and were both looking for a way to provide high quality care to women around the time of menopause. Within the NHS, there were no resources to make this happen. We both started working within the private sector and this enabled us to immerse ourselves fully into menopause medicine and to obtain even more valuable professional experience. We worked together, with some others, to create an educational training course for other health care professionals, so that we were able to help the NHS improve its provision of menopause care.
Dr Duffy founded Health in Menopause, a private clinic, in Nottingham in 2020. Gaining an excellent reputation, and a bit of a waiting list from women keen to have her expert help, she took the decision to grow her clinic a little. Earlier this year I joined her team so that we could spread the catchment area from the East to West Midlands. We were also joined by Dr Alison Macbeth. Between the three of us we have been doctors for 92 years!! We can carry out consultations via video or in person in Nottingham and now, from December 18th, in our new premises in Sutton Coldfield too.
The waiting area at Health in Menopause Clinic, Sutton Coldfield
What does holistic menopause care mean?
It means considering the patient’s reproductive hormones, but in the context of their own medical history, family history, their priorities for their life now and in the future, their lifestyle such as exercise and nutrition. It’s like gathering together pieces of a jigsaw, unique to each patient. And then, we put together the pieces of that, jigsaw, and work out what will be helpful to that person. Replacing hormones is a significant part of that for most women, but it's not the whole story. Its incorporating physical health, mental health, and sexual health when it comes to menopause.
Everybody’s menopause journey is different and the range of potential lifestyle adjustments and therapies that can be utilised to make that journey less difficult, and even enjoyable, are expanding all the time
Menopause is typically viewed as a negative experience for most. We need to ‘rebrand’ menopause as a positive experience. I call it ‘half-time’ in our lives – an opportunity to take stock. Why not use midlife as a proactive time to help reflect and consolidate? Because some of what we got away with in our first half in relation to our lifestyle, we can't necessarily get away with in the next half. We want to build on positives and make strategic plans for dealing with any negatives.
It’s a huge positive if you're supported and informed to know what choices you have and what support is available. And, as nobody born with ovaries escapes the menopause directly; and everybody else is impacted indirectly, we're all in this together.
I will have a conversation with anyone about menopause – it’s important to families, friends, workplaces - to anyone, who knows somebody going through it. For example, I was at a 50th birthday party recently, and I found myself in the bar talking to the head of a large company about menopause support in his workplace; and about the effects of perimenopause on his wife. He found it fascinating that he didn’t know anything about it before.
Having conversations about perimenopause and menopause is part of making it normal - this is what we need to do. There is too much historical stigma and taboo about menopause. We need to embrace this natural part of life with knowledge and openness and a sense of choice.
Take time to pause at Health in Menopause Centre, Sutton Coldfield
What would you like people to know about the Health in Menopause Centre and what can people find here?
The most valuable things that we give at our clinic are time and experience. Our initial appointments last for one hour. Patients have got time to explain - and you get an empathic ear - because we've heard it many times previously, or we have experienced it personally. We can arrange prescriptions if appropriate and signpost to other medical resources if needed, or to other therapists. We aim to empower patients and their GP to continue this help going forward if that is what our patient chooses.
Patients often make appointments with us if they are worried about things they have heard about risks of HRT. Our particular specialty is helping people who consider themselves as unable to consider HRT or have been told by others that they can't have it.
My colleague, Dr Alison Macbeth, who is a breast cancer specialist has a lot of experience of working with people with breast cancer, or with a family history of breast cancer. There are sadly many women who have experienced breast cancer, who think that they can't take HRT and that there is no help available for them. We are very experienced in this area.
If we could deal with menopause by lifestyle change alone, that would be great. Some people can achieve this but many are struggling too much with debilitating symptoms to be able to make the necessary changes (e.g., reduce sugar or alcohol, or exercise more). For many of these people, HRT is their passport to being able to actively make those changes.
We have a growing community of other practitioners like personal trainers, yoga/Pilates instructors, physiotherapists, nutritionists, psychologists, reflexologists, breathing therapists etc to introduce you to if necessary. And we have a wealth of resources to share with you if needed.
A cuppa and a chat with Dr Sarah Ball in her clinic at Health in Menopause Centre, Sutton Coldfield
What is the best part of your job?
Being a GP is a privilege. It is a license to be nosy and I am endlessly intrigued and humbled by the stories my patients share with me about how menopause is affecting them. The best part is the bit where patients feel heard, often for the very first time. Tears of relief are common at our new consultations, (we have lots of tissues). Once they have been heard and validated and a full history taken, I know it’s likely that I can help them feel substantially better.
There’s never been another area of medicine I've done where you can transform lives so completely. Women frequently say to me, “Thank you, you've given me my life back".
Is there anything else you would like to people to know?
In an ideal world menopause would be taken as seriously as it deserves to be by all; by medical professionals, by politicians and workplaces and the whole of society. Whilst there has been good progress in all those areas since 2015, there is still a lot of work to do. Sadly, still the experience of most women going through perimenopause and menopause and all the years beyond that (postmenopause). is that they don't know when it's happening to them or what to do about it.
And it's a shame that the NHS still isn't set up to adequately tackle menopause for most people. At the end of the day, money invested in menopause care is money well spent, it's not a short-term thing, therefore, anything you choose to do in terms of replacing hormones or adjusting lifestyle will be beneficial for future health, lifelong. Private healthcare might be out of many people’s comfort zone, but if viewed as a long-term investment, it may seem far more of a sensible choice. We want to live a long time, but that's only really helpful if you're living well. For women, the gap between life expectancy and quality of life has actually widened, compared to men.
It’s important to know that 80 to 90 % of women will experience some symptoms or issues related to menopause at some point in their life. There is no age limit to be able to seek help. For example, symptoms relating to genitourinary issues such as vaginal dryness or urinary tract infections are often problematic in our older age and often relate to being menopausal or postmenopausal. I've seen and helped many patients who are well beyond the menopause e.g. aged eighty plus. Menopause and perimenopause have a significant impact on lives, families, relationships, and jobs. There is help available if you choose to prioritise yourself for
a change.
The new Health in Menopause Clinic premises is opening on 18th December. You don’t need to wait until then to book. Online or telephone bookings are open now, (and you can even purchase an appointment for a friend or loved one - what a great Christmas idea!). Please click the link below to visit the Health in Menopause website.
It was a pleasure to chat with Dr Sarah, and I am really excited that the Health in Menopause Clinic is opening.
I have been back again since, for the wonderful Nutrition in Menopause evening, and am certain I will be back again, and I look forward to working with the centre in future.
As a personal trainer with an interest in the promotion of health and the prevention of disease, and with a CIMSPA (Chartered Institute for the Management of Sport and Physical Activity)-accredited specialism in training perimenopausal and menopausal women, I would love to hear from you.
You can find more information about the services I offer via the link below.
Best wishes
Tonia