< Back Weight Gain and How to Avoid It Through the Menopause Diet, Exercise, Managing Weight, Menopause Advice, Stress We understand that hormonal changes can make it challenging to maintain a healthy weight. We have gathered some helpful tips to support you on your weight management journey. Let's explore them together. Weight gain is an issue that comes up regularly with women in the clinic and gaining weight through the menopause can increase our risk of developing type 2 diabetes and cardiovascular disease as well as increasing pressure on our joints, causing more pain. We understand that hormonal changes can make it challenging to maintain a healthy weight. We have gathered some helpful tips to support you on your weight management journey. Let's explore them together. Prioritise a Balanced Diet Adopting a balanced and nutritious diet is essential for managing weight during menopause. Focus on whole foods such as fruits, vegetables, lean proteins, whole grains, and healthy fats. Minimize processed foods, sugary snacks, and beverages high in added sugars. Pay attention to portion sizes and practice mindful eating to enhance awareness of your body's hunger and fullness cues. Aim to eat protein with each meal and it should account for 25% of our daily calorie intake. Watch Your Caloric Intake As our metabolism tends to slow down with age, it's important to be mindful of your caloric intake. Calculate your daily energy needs based on your age, weight, and activity level, and aim to consume a moderate caloric deficit to facilitate weight loss. This can be done by using smaller plates for your meals. However, avoid extreme dieting or drastically cutting calories, as it can have negative effects on your overall well-being. Stay Hydrated Drinking an adequate amount of water is vital for overall health and weight management. Stay hydrated throughout the day to support your body's functions and help maintain a feeling of fullness. Limit sugary drinks and alcohol, which can contribute to weight gain. Engage in Regular Physical Activity Regular exercise is key to managing weight and overall well-being during menopause. Incorporate a combination of cardiovascular exercises, strength training, and flexibility exercises into your routine. Aim for at least 150 minutes of moderate-intensity aerobic activity per week and include strength training exercises twice a week to maintain muscle mass. Focus on Strength Training Strength training is particularly important during menopause as it helps preserve muscle mass and increases metabolism. Engage in resistance exercises such as weightlifting, resistance bands, or bodyweight exercises. Consult a fitness professional or use reputable resources to learn proper form and techniques. Start with lighter weights and gradually increase as you build strength. Manage Stress Chronic stress can contribute to weight gain and make it more difficult to lose weight. Practice stress management techniques such as meditation, deep breathing exercises, or engaging in activities you enjoy. Prioritise self-care and create a lifestyle that supports emotional well-being. This can be easier said than done. Therefore, try to carve 10 minutes a day out for yourself. Get Enough Sleep Adequate sleep is crucial for weight management. Lack of sleep can disrupt hormones related to hunger and satiety, leading to increased food cravings and overeating. Aim for at least seven hours of quality sleep each night by establishing a relaxing bedtime routine and creating a sleep-friendly environment. Seek Professional Guidance If you're struggling with weight management during menopause, it may well be worth seeking guidance from a healthcare professional experienced in menopause. They can provide personalised recommendations, help you set realistic goals, and offer support throughout your journey. Remember, weight loss during menopause may be gradual, and individual results may vary. Focus on overall health and well-being rather than solely on the number on the scale. For tailored menopause care that looks at the whole picture - lifestyle, symptoms, and wellbeing - explore our range of resources on Bristol Menopause and Wellwoman Clinic Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Neurodivergence in Women: Why Late Diagnoses of ADHD and Autism Are So Common and the Role of Hormones Alternative Therapies, Managing Symptoms, Mental Health, Menopause Advice, Perimenopause, Post Menopause, Wellbeing For decades, neurodivergent conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) were primarily studied and diagnosed in men. This male-centric perspective has led to countless women receiving late diagnoses—or missing them altogether—despite struggling with symptoms throughout their lives. The delayed recognition of ADHD and autism in women is not merely a failure of awareness but a complex interplay of gender biases, masking behaviours, and the profound influence of hormonal fluctuations. The Underdiagnosis of ADHD and Autism in Women Historically, ADHD and autism were believed to predominantly affect boys, largely because diagnostic criteria were based on male presentations of these conditions. Girls often present differently, displaying less overt hyperactivity and more internalised symptoms, such as inattentiveness, anxiety, and social difficulties. Many neurodivergent women unconsciously learn to mask their symptoms from an early age. They develop coping mechanisms to fit into social and professional environments, mimicking neurotypical behaviours at the cost of significant emotional exhaustion. This masking leads clinicians, teachers, and even family members to overlook the true challenges these women face, delaying diagnosis until adulthood or, in many cases, leaving them undiagnosed altogether. The Role of Hormones in Neurodivergence Hormones play a pivotal role in how neurodivergence manifests in women, particularly in relation to ADHD and autism. Fluctuations in oestrogen and progesterone levels across the menstrual cycle, pregnancy, postpartum, perimenopause, and menopause can significantly impact cognitive function, emotional regulation, and sensory sensitivity. Menstrual Cycle and Neurodivergence Throughout the menstrual cycle, oestrogen levels rise and fall, influencing dopamine availability in the brain. Since ADHD is closely linked to dopamine function, the hormonal shifts that occur during different phases of the menstrual cycle can lead to noticeable changes in ADHD symptoms. Many women with ADHD report heightened difficulties with focus, emotional regulation, and executive function in the luteal phase (the period before menstruation) when oestrogen drops and progesterone rises. For autistic women, hormonal fluctuations can exacerbate sensory sensitivities, emotional overwhelm, and social exhaustion. This often results in increased burnout during certain phases of the cycle, making day-to-day functioning more challenging. Pregnancy and Postpartum Challenges Pregnancy introduces significant hormonal fluctuations, and while some neurodivergent women experience temporary improvements in symptoms due to high oestrogen levels, the postpartum period can be particularly challenging. The sharp drop in oestrogen and dopamine after childbirth can trigger increased ADHD symptoms, sensory overload, and mood instability, sometimes leading to postpartum anxiety or depression. Many neurodivergent women struggle with the expectations of motherhood while also managing the internal chaos of their neurodivergence, often without adequate support. Perimenopause and Menopause Perimenopause and menopause represent one of the most significant yet under recognised periods of difficulty for neurodivergent women. The gradual decline of oestrogen during this time directly impacts dopamine regulation, leading to worsening ADHD symptoms such as brain fog, forgetfulness, and reduced focus. For autistic women, sensory sensitivities, social anxiety, and executive function difficulties can intensify. This often coincides with increased stress from life transitions, such as career changes, aging parents, or children leaving home, compounding the struggle. Why Are So Many Women Diagnosed Late? There are several key reasons why women with ADHD and autism are often diagnosed later in life: Gender Bias in Diagnostic Criteria – Most diagnostic tools are based on male presentations of ADHD and autism, leading to missed or misdiagnosed cases in women. Social Masking – Women are adept at camouflaging their symptoms, making it difficult for professionals and even themselves to recognise their neurodivergence. Hormonal Influence – The impact of fluctuating hormones on symptoms means that many women don’t recognise their neurodivergence until they reach perimenopause, when oestrogen levels drop significantly. Cultural and Societal Expectations – Women are often expected to be organised, emotionally regulated, and socially adept. When they struggle in these areas, they may attribute their difficulties to personal failings rather than neurodivergence. Comorbid Conditions – Many neurodivergent women are first diagnosed with anxiety, depression, or borderline personality disorder before their underlying ADHD or autism is recognised. The Importance of Proper Recognition and Support Recognising the unique ways neurodivergence presents in women is critical for timely diagnosis and appropriate support. Women who are diagnosed later in life often experience a sense of relief and validation, finally understanding why they have struggled for so long. With a proper diagnosis, they can access tailored strategies, workplace accommodations, and medical interventions that improve their quality of life. Healthcare professionals must become more aware of the gender differences in neurodivergence and consider the impact of hormones when assessing symptoms. Additionally, workplaces and educational institutions need to adopt more inclusive policies that acknowledge and support the needs of neurodivergent women. The late diagnosis of ADHD and autism in women is a significant issue that affects their mental health, career progression, and overall well-being. As awareness grows and diagnostic criteria evolve, it is crucial to integrate a more gender-sensitive approach that accounts for hormonal fluctuations, social masking, and the distinct ways neurodivergence presents in women. By doing so, we can create a more supportive and inclusive world where neurodivergent women no longer have to suffer in silence. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Perimenopause and Lifestyle Medicine: Preparing Your Body for the Transition Managing Symptoms, Perimenopause Perimenopause is the phase before menopause when hormone levels begin to fluctuate. It can last several years, with symptoms often appearing in the late 30s or 40s. Many women notice irregular periods, sleep problems, hot flushes, mood changes, or increased fatigue long before their “last period.” This stage is not just a lead-up to menopause, it is a critical window for protecting long-term health. What you do in perimenopause sets the foundation for bone strength, heart health, and brain function in the decades ahead. Why Lifestyle Matters So Much in Perimenopause As oestrogen and progesterone levels begin to fluctuate, the body becomes more sensitive to stress, diet, and sleep disruption. Lifestyle medicine provides evidence-based strategies that can reduce symptoms and improve wellbeing: Nutrition: A balanced diet rich in fibre, lean protein, and healthy fats supports hormone balance and helps prevent weight gain. Limiting ultra-processed foods and excess sugar reduces inflammation and stabilises energy. Exercise: Strength training protects bone density and muscle mass, while regular aerobic activity improves heart health and boosts mood. Sleep: Prioritising good sleep hygiene, consistent routines, cool rooms, reduced evening screen time helps counter hormonal sleep disturbances. Stress management: Mindfulness, yoga, or journaling can reduce anxiety and regulate cortisol levels, which often rise in perimenopause. Alcohol and smoking: Reducing both lowers risk of hot flushes, poor sleep, cardiovascular disease, and bone loss. Early Prevention, Long-Term Gain The perimenopause years are sometimes called a “window of opportunity” in medicine. Research shows that changes made at this stage can influence health outcomes for decades. For example, regular movement and a nutrient-dense diet not only ease current symptoms but also reduce the risk of osteoporosis and cardiovascular disease later in life. Perimenopause is not just a time to endure symptoms, it’s a chance to reset, rethink, and prepare your body for the next stage. By embracing lifestyle medicine now, you can take control of your health and create resilience that lasts well beyond menopause. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Jenna Young Phlebotomist & Trained Health Care Assistant Jenna Young is a highly valued member of our medical team, serving as both a skilled phlebotomist and a trained health care assistant. With her dual expertise, Jenna brings a unique blend of technical precision and compassionate patient care to her work. Her proficiency in drawing blood and preparing specimens for testing is complemented by her broad experience in various aspects of patient support and clinical care. As a trained health care assistant, Jenna is adept at providing holistic support to patients, from assisting with daily activities to helping manage patient flow in our facility. Her calm and reassuring presence helps create a comfortable environment, making every patient feel understood and cared for during their visit. Jenna is known for her gentle touch and meticulous attention to detail, ensuring each procedure is safe, efficient, and as pain-free as possible. Her ability to connect with patients, combined with her strong commitment to maintaining high standards of hygiene and safety, makes her an invaluable asset to our team.

< Back Enjoying Better Sex in Menopause and Beyond Self-Care, Wellbeing, Perimenopause, Menopause Advice For so many, our sex drive and sexual pleasure change, when we hit perimenopause and menopause, but it doesn’t have to. A myriad of menopausal symptoms, from genitourinary symptoms that impact upon your vagina, vulva, bladder and urethra, vaginal dryness, itching, decreased sexual sensation or low libido can make any sex play feel painful or uncomfortable, your desire goes AWOL or what used to turn you on simply doesn’t work for you any more. Often people give up their sex life or continue to endure painful sex in menopause, which is neither pleasurable, good for their vagina health or their relationship. Those who previously had a good sex life get frustrated that the menopause has impacted upon their sexual pleasure in this way too. However, with a few tweaks to your relationship and to the way in which you enjoy great sexual health, intimacy and pleasure, you can have even better sex. Talk to your Partner This is one of the commonest reasons why couples give up on enjoying sex because they are unable to talk to each other. Your partner probably has no idea about how you are feeling and may think you no longer love or desire them, so it is important to tell them why you do not want to have sex or why it no longer feels pleasurable. If you’re in a long-term relationship, our sexual tastes, sensation, stimulation and attraction change, so explore new ways to enjoy intimacy. What might have worked for you in the past may not work now, so show your partner where and how you like to be touched, make sounds of pleasure to encourage them when they hit the right spot. Start off on the sofa, enjoy a teenage smooch which will hopefully develop into something more! Try new positions, use irritant free lubricants, prolonged foreplay, quickie sex, explore pleasure toys, enjoy hotel sex, whatever makes you both feel good. If you’re in a new relationship, it can be difficult to tell your partner what you enjoy. On the other hand, they may introduce you to sexual sensations that get your juices flowing. Tell them what works for you, use your irritant free lubes and always use a condom Share your fantasies, you may discover that some of them are the same. You might even want to act some of them out, too. Love Lube (but only irritant free lubes) Vaginal dryness affects people at any age due to fluctuating hormones, breastfeeding, side effects of medication, cancer treatments, stress, anxiety and the ageing process. One simple way to make sex feel pleasurable, last longer and promote vaginal lubrication is to use sexual lubricant. Using good lubricants can make sex feel great. But stop before you think about buying well-known lubes or the “menopause -friendly” products in the high street and using some products recommended on prescription because the vast majority of products contain ingredients including glycerin, propylene glycol, parabens, perfume and dyes in addition to “tingling” or “warming “ingredients which can irritate the tissues of the vulva and vagina, disrupt your friendly bacteria that keep your vagina happy, lubricated and healthy of the vagina. This can cause irritation, thrush or bacterial vaginosis, especially if you are prone to these infections. You may also experience urethral irritation too. Ingredients matter when it comes to your intimate health and pleasure. Always check the ingredients before you buy or ask your GP before they prescribe you a product and do a skin test before rubbing it over your clitoris, nothing worse than an itchy or stinging vulva or vagina! We only use, recommend and sell SUTIL Luxe and Rich, and YES, both brands are made with organic and botanical ingredients that are beneficial for your intimate health and pleasure. SUTIL can also be used as a vaginal moisturiser. No one needs an Intimate Wash Intimate hygiene products, wipes, sprays, bath bombs (aka thrush bombs) bubble bath, scented menstrual products and perfumed condoms are completely unnecessary as our vaginas are self-cleaning and all these products can cause irritation, an infection and make your vagina/vulva feel sore. Just wash with water. If you need to wash with a product, you can ask your GP to prescribe a gentle emollient or ask your local pharmacist. Enjoy regular orgasms Enjoying regular orgasms with a partner or during solo play using your fingers or a pleasure product increases your natural lubrication, reduces stress, decreases pain, helps to keep you looking young and exercises your pelvic floor muscles. Orgasms can also improve the quality of your sleep, a common problem during menopause, as the release of feel good endorphins induces a state of relaxation, helping you drift off. Sex is much more than just penetration and masturbating feels so good solo and with a partner. Exercise those Pelvic Floor Muscles Regular pelvic floor exercises, correctly performed, can make orgasms feel stronger and help incontinence issues. Some women who have a tight (hypertonic) pelvic floor, making penetration feel painful, can exacerbate symptoms by doing pelvic floor exercises and need to learn to relax the pelvic floor muscles. If you have a pelvic health issue, please seek advice from a pelvic health physiotherapist, they are my go-to pelvic health experts. You can ask your GP to refer you, you can self refer to some NHS trusts or find one in private practice here https://thepogp.co.uk/ Explore Pleasure Products Incorporating pleasure products into your sex play can help you enjoy new ways to be intimate and discover new sexual sensations, especially if you find yourself struggling to orgasm, or it takes longer due to decreased sexual sensation. A simple bullet vibrator is small enough to slip between you and a partner to enjoy clitoral stimulation during penetrative sex or foreplay. You can use it on yourself, get your partner to use it on you, or play with it on their body. If vaginal tightness is an issue, using a slim vibrator or dilator with plenty of lubricant can help stretch the vagina walls, making them more flexible and penetrative sex feel more pleasurable. Sonic wave and air pulse toys use sonic and air pulse waves to gently tease and caress your clitoris, they are my go to recommended toy for those who experience decreased sexual sensation too. Vibrating constriction rings are a great way to help a partner to maintain their erection, last longer, and offer clitoral stimulation at the same time. Some work really well as finger vibes too. You may want to explore bondage, which can be fun and offers a different dynamic to your relationship. Blindfolded sex heightens all your senses, boosting your arousal. It is important to only buy pleasure products from expert retailers like Jo Divine who only sell safe products from reputable manufacturers, can offer you advice and support about which product is suitable for your needs by phone, email and DM and dispatch in discreet packaging. Start Enjoying Better Sex Sex is not just penetration - there are so many ways to be intimate and enjoy pleasure. Explore sex toys, oral sex, bondage, nipple play, mutual masturbation, kissing and intimate massage. Perimenopause and menopause does not mean that your sex life has to stop, it can be even more pleasurable and fun. Don’t give up on your sex life, talk to your partner, use irritant free lubricant, masturbate more, explore sex toys solo or with a partner, watch or read erotica, listen to audio porn, be imaginative, adventurous and have fun in whatever way feels pleasurable for you! So if you would like advice, please get in touch https://www.jodivine.com/ We have many practical sexual health and pleasure articles on our blog including menopause. So if you would like advice, please get in touch https://www.jodivine.com/ We have many practical sexual health and pleasure articles on our blog including menopause. You can also follow me for advice, support and skin safe irritant free product recommendations https://www.instagram.com/samtalkssex/?hl=en BIO I’m Samantha Evans, a former nurse and co-founder Jo Divine, an online pleasure product company, with my husband Paul in 2007. As a sexual health and pleasure expert at Jo Divine I advise many women and their partners about ways to enjoy sexual intimacy and pleasure when they experience menopausal symptoms such as vaginal dryness, vaginal tightness, decreased sexual sensation and low libido and recommend our irritant free sexual lubricants and moisturisers, skin safe pleasure products and dilators to help them overcome sexual health issues and explore new ways to enjoy sexual pleasure solo or with a partner. Whoever you are, I passionately believe that it is always possible to enjoy sex by being imaginative, adventurous and making it fun, and I'm always exploring ways for both men and women to take control of their sexual health to increase their sexual pleasure and general wellbeing. I also work with many healthcare professionals, menopause experts and cancer charities by helping them to discuss practical ways to enjoy sexual intimacy and pleasure. At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back How Two of the Biggest Women's Health Studies Held Us Back Perimenopause, Post Menopause For decades, women’s health has been underserved, underfunded, and misunderstood. Yet two of the most influential studies in the field — the Million Women Study (MWS) in the UK and the Women’s Health Initiative (WHI) in the US were hailed as landmark contributions to science. They involved hundreds of thousands of women and were designed to clarify risks around hormone replacement therapy (HRT), particularly in postmenopausal women. But what if I told you these very studies, despite their size and scale, may have unintentionally held back progress in women’s health? As a menopause specialist, I believe we must acknowledge not only what these studies taught us but what they cost us. A Quick Recap: The Studies That Shaped Menopause Care The Million Women Study (UK) Recruited : 1.3 million women aged 50–64 (1996–2001) Focus : The effects of HRT, lifestyle, and reproductive history on cancer risk Key finding : Combined HRT use was associated with an increased risk of breast cancer, ovarian cancer, and endometrial cancer Outcome : A wave of caution across UK medical practice; many women were stopped or denied HRT, sometimes overnight The Women’s Health Initiative (US) Recruited : Over 160,000 postmenopausal women (1991–1998) Focus : Risks and benefits of HRT, dietary change, and supplements on chronic disease Key finding : Combined oestrogen-progestogen therapy increased the risk of breast cancer, stroke, and cardiovascular disease Outcome : A highly publicised 2002 announcement led to a global drop in HRT prescribing and lasting fear among women and clinicians Where It Went Wrong 1. Generalising the Risks — Without Context Both studies included mostly older postmenopausal women (average age 63 in the WHI), yet their findings were applied across the board even to younger women in their 40s and early 50s, the very group most likely to experience significant menopause symptoms and consider HRT. We now understand that age and timing matter greatly . Starting HRT near the onset of menopause carries different risks (and often benefits) compared to starting it a decade later. But this important nuance was lost in the headlines. 2. Risk-Focused, Not Quality-of-Life Focused Both the WHI and MWS prioritised disease risk: heart attacks, cancer, stroke. What they didn’t measure meaningfully was quality of life : sleep, energy, mood, mental clarity, libido, joint pain the very symptoms women seek relief from during menopause. This helped entrench a medical culture where symptom relief was viewed as optional or cosmetic, not worthy of risk. 3. Media Panic and Clinical Paralysis The WHI’s 2002 press release “risks outweigh the benefits "caused global panic. HRT prescriptions plummeted. Women were told to stop treatment. Doctors became fearful of prescribing. This fear endured for years. Research funding dried up. Pharmaceutical development in women’s hormones stagnated. It became easier to do nothing than to offer personalised care. 4. One-Size-Fits-All Conclusions The studies treated HRT as a single, uniform treatment. But we now know: Route matters : Transdermal oestrogen carries lower clot risk than oral forms. Type matters : Body-identical hormones may carry different risk profiles from synthetic versions. Dose matters : Lower doses may offer symptom relief with fewer side effects. These nuances weren’t explored. The result? An entire generation of women missed out on personalised, evidence-based care. What We’ve Learned and What We Must Do Today, slowly, the narrative is shifting. Updated guidelines from the British Menopause Society (BMS), International Menopause Society (IMS), and NICE now support: Individualised risk assessment Starting HRT around the time of menopause, not years later Recognising the role of HRT in improving quality of life Addressing the risks of not treating menopause symptoms (e.g. sleep disruption, bone loss, cardiovascular decline) But there is still much to rebuild. We lost years of progress to fear. We under-researched the complexity of hormone therapy. We left millions of women without support — not because the science told us to, but because it was misunderstood, misapplied, and overgeneralised. As Menopause specialists, Our Responsibility Is Clear We must: Demand better-designed studies that reflect the real-life diversity of women’s experiences. Push for funding in women's midlife health , not just reproductive or cancer care. Include quality of life as a meaningful, measurable health outcome. Stop treating women's symptoms as something to “put up with” and instead ask how we can treat them safely, effectively, and compassionately. Moving Forward The Million Women Study and WHI taught us a lot. But they also silenced important conversations, stifled innovation, and delayed progress in menopause care. Now is the time to reframe the conversation with better data, more respect for complexity, and a commitment to centring women in research that is for them, not just about them. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back NEW STUDY REVEALS: Diet CAN impact Endometriosis symptoms! Diet, Alternative Therapies, Wellbeing A ground breaking study from the University of Edinburgh found that cutting out gluten, dairy, caffeine & alcohol helped many women reduce endometriosis-related pain. ⁠ Endometriosis, a condition where tissue similar to the lining of the uterus grows outside the womb, affects approximately one in ten women of reproductive age in the UK. This often leads to chronic pain, fatigue, and fertility issues. A recent ground breaking study from the University of Edinburgh offers new hope, suggesting that specific dietary changes may significantly alleviate the pain associated with this condition. The Guardian Key Findings from the Study The international survey, encompassing 2,599 participants, is the largest of its kind to explore the relationship between diet and endometriosis. The results are compelling: The Guardian Gluten and Dairy: 45% of participants who eliminated gluten or dairy from their diets reported a reduction in pain. The Guardian+1AOL+1 Caffeine: 43% experienced pain relief after reducing caffeine intake. The Guardian+1MDPI+1 Alcohol: 53% noted decreased pain levels upon cutting back on alcohol consumption. Frontiers+6The Guardian+6AOL+6 Professor Philippa Saunders, senior author of the study and professor of reproductive steroids at the University of Edinburgh, emphasized the significance of these findings: The Guardian “It really feels like we are on the cusp of something pretty big with understanding how diet affects endometriosis symptoms. It is so important for women if they feel they can do something for themselves to tackle the pain of endometriosis – that is tremendously empowering.” The Guardian Understanding the Connection While the exact mechanisms remain under investigation, researchers propose several explanations for the observed benefits: Gut Health and Inflammation: Eliminating gluten and dairy may positively influence gut bacteria, leading to reduced inflammation—a known contributor to endometriosis pain. The Guardian Sleep Quality: Reducing caffeine intake can enhance sleep quality, and since pain perception is heightened with poor sleep, this could explain the alleviation of symptoms. Hormonal Influence: Alcohol can mimic oestrogen in the body, potentially exacerbating endometriosis symptoms. Limiting alcohol intake might help in managing these effects. A Holistic Approach to Management Traditionally, endometriosis management has relied on surgery or hormonal treatments, both of which come with limitations and potential side effects. The prospect of dietary modifications offers a non-invasive, self-empowering strategy for symptom relief. SpringerLink+1The Guardian+1 It's important to note that while these findings are promising, individual responses can vary. Consulting with healthcare professionals before making significant dietary changes is advisable to ensure nutritional needs are met and to tailor strategies to individual health profiles. Looking Forward This study marks a significant step toward understanding the role of diet in managing endometriosis. Further research is needed to establish definitive dietary guidelines, but the current evidence provides a hopeful avenue for those seeking alternative methods to alleviate their symptoms. Empowering women with actionable strategies enhances their quality of life and fosters a proactive approach to health management. As research continues to unfold, the integration of dietary considerations into endometriosis care holds the promise of more comprehensive and personalised treatment options. This is NOT a cure, but it may offer significant relief in helping manage the chronic pain associated with endometriosis! Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

Menopause follow-up consultations with specialist doctors. Review symptoms, adjust HRT safely and receive personalised ongoing support across the UK. Menopause Follow Up Consultation Review | £165 If you’ve already had your initial menopause consultation with us, this follow-up review appointment is the perfect way to check on your progress, adjust your treatment plan, and ensure you’re on track for managing your menopause effectively. Our experienced menopause doctor will guide you through any changes, improvements, or challenges, and provide ongoing support tailored to your evolving needs. What’s Included in Your 30-Minute Review Appointment: Progress Review with Your Menopause Doctor A detailed check-in to assess how you’ve been feeling since your initial consultation. We’ll review any symptoms, treatment effectiveness, and lifestyle changes. Treatment Adjustments if Necessary Based on your feedback and progress, we’ll adjust your treatment plan, whether it involves medication changes, lifestyle recommendations, or further investigations. Ongoing Support and Advice Receive expert guidance on any new symptoms or concerns that may have arisen, helping you continue managing menopause with confidence. Private Prescribing (if needed) If there’s a need for further medications, such as hormone therapy adjustments or new prescriptions, they will be issued during the consultation, ensuring you have the care you need without delay. Letter to Your GP A summary letter will be sent to your GP, outlining your progress and any changes to your treatment plan, ensuring seamless continuity of care. Please note: If you have not been seen within the past 12 months, you will be required to book an initial consultation. Book here Benefits of Booking a 30-Minute Review Appointment: Continued Expert Care Stay on top of your menopause journey with ongoing support from a menopause specialist who knows your history and understands your unique needs. Tailored Adjustments Your treatment plan will evolve with you. We’ll make sure you’re getting the most effective care, whether through changes in medication, lifestyle adjustments, or other interventions. Peace of Mind Regular reviews ensure that you’re on the right track, helping you manage menopause symptoms effectively and minimise any discomfort. Seamless Communication with Your GP Your GP will be updated on your progress and any treatment changes, promoting collaborative care and ensuring your full healthcare team is aligned. Confidential and Convenient Have a private, supportive space to discuss your progress and concerns, allowing you to feel confident in your treatment and decisions moving forward. Book Your 30-Minute Review Appointment Today Stay on top of your menopause journey with expert care and ongoing support. Schedule your 30-minute review appointment to ensure your menopause management remains personalised, effective, and up to date. £165 Please note: In line with our policy, you are unable to book with a doctor who is your registered GP or a GP at the practice where you are currently registered. This includes Dr Jo Burgin (Bridgeview Medical Practice) and Dr Danielle Calandrini (Newbridge Surgery). Thank you for your understanding. If you have not been seen within the past 12 months, you will be required to book an initial consultation. Book here

< Back Simple Nutrition Strategies to Ease Your PMDD Symptoms If you experience Premenstrual Dysphoric Disorder (PMDD), you know the cyclical surge of symptoms such as anxiety, irritability, depression, and fatigue is debilitating. While PMDD often requires clinical support there’s robust evidence that what you eat, sometimes alongside nutrition supplements, can fundamentally stabilise your body’s response to hormonal shifts. PMDD is closely linked to systemic inflammation and dysregulated neurotransmitter response (the hormones such as serotonin and GABA that help you to feel calm and motivated). By making targeted diet changes, you can help soothe these underlying biological stressors which are having such a significant impact on how you feel. Here are the most practical, evidence-based steps you can take today to help manage the challenging symptoms that emerge in the days/weeks before your period. 1. The Foundational Diet : Stability is Key The primary goal of a PMDD diet is stability. When your blood sugar crashes, so does your mood, and this instability fuels inflammation. To help anchor blood sugar levels make high quality, real foods, especially protein the centrepiece of each meal. Base each meal around protein foods such as eggs, fish, meat, pulses, tofu and dairy. Be aware of when you are eating. Specifically, how often you eat and how much you snack in the evening. Eating later in the day causes our blood sugar levels to spike more intensely which can impact sleep and severity of symptoms the next day. Cravings may be magnified with hormonal f luctuations, especially in the evenings. To help with this ensure you have plenty of protein at each meal-it’s been shown having at least 30-35g of protein at breakfast can reduce cravings right through to the evening. Source your B Vitamins from Food. B vitamins are critical for supporting brain chemistry which becomes even more crucial premenstrually. Research strongly suggests that high consumption of B Vitamins like Thiamine and Riboflavin from food sources (like beef, pork, poultry, fish, dairy and almonds) is associated with a significantly lower risk of developing premenstrual symptoms. Women who had the highest intake of riboflavin had a 35% lower risk of developing PMS compared to those with the lowest intake 2. Reducing the agitators Certain substances are agitators that can amplify PMDD symptoms, particularly anxiety, tension, and physical discomfort Caffeine is a stimulant that amps up your nervous system. If you are dealing with PMS or PMDD symptoms like anxiety, feeling jumpy, tension, or trouble sleeping, caffeine can make those feelings much worse. Because of this it’s often recommended women with PMDD experiment with cutting back or completely stopping drinking caffeine. Sugar and alcohol are known to make PMDD/PMS symptoms much harder to handle. Sugar: Eating sugar causes your blood sugar to shoot up quickly, then crash. These steep drops can severely worsen your mood swings and irritability. Plus, the crash can leave you tired and interfere with getting deep, restorative sleep. Alcohol: Drinking alcohol can throw your hormones out of balance and often leads to dehydration. This combination makes emotional stress, physical tension, and mood swings much worse. Even though alcohol can make you feel sleepy at first, it actually fragments and disrupts your sleep cycle, leading to poor sleep quality which isn’t restorative. Consider a short term reduction of alcohol/sugar or both. To make it feel easier to make this change f ind alcohol free alternatives you enjoy such as Mother Root or Trip drinks and get stocked up with alternatives to chocolate or biscuits to make things easier. For example dark chocolate Brazil nuts or Greek yoghurt with shredded coconut-warm frozen raspberries in the microwave to make them slightly oozy and tip over the yoghurt. Avoiding dehydration - being dehydrated can elevate blood glucose levels increasing feeling of anxiety and stress. It can also lead to tiredness, headaches, poor concentration, increased pain perception and make sleep more difficult. Give yourself a target for your daily water intake and include foods such as broth and watermelon to help with hydration. 3. Fill crucial nutrient gaps There are specific nutrients which can be particularly helpful for supporting you if you have PMDD. Calcium There is clear evidence that calcium can help ease premenstrual symptoms. Large studies confirm that taking extra calcium can significantly improve how you feel: Emotional Relief : It helps calm symptoms such as depression, sadness, and mood swings. Physical Relief : It reduces physical discomforts like fatigue and bloating. Oestrogen acts as the body's manager for calcium, and when oestrogen levels naturally drop before your period, this disrupts the body's ability to regulate calcium. It causes the flow of calcium in and out of your nerve cells to become dysregulated, disrupting the smooth signalling of mood regulating chemicals and directly causing PMDD symptoms like anxiety and irritability. Use a calcium tool ( https://theros.org.uk/information-and-support/bone-health/nutrition-for-bones/ calcium/calcium-rich-food-chooser/) to gauge how much calcium you are having at the moment. Aim for a consistent daily intake of 1000-1200mg calcium, ideally sourced from whole foods to prevent the cyclical dip in serum calcium associated with mood symptoms. Some people may benefit from a small, split-dose calcium supplement to support their symptoms, but consult your healthcare provider first. Calcium works in a critical partnership with other key nutrients: Vitamin D is essential for ensuring calcium is properly absorbed from the gut into the bloodstream; Magnesium helps regulate this balance, working as a cofactor to activate Vitamin D and promoting nerve relaxation to reduce anxiety and cramps; and finally, Vitamin K2 acts as a safety guard by directing calcium toward the bones and actively away from the arteries, mitigating the cardiovascular risks sometimes linked to supplementation. Therefore, addressing PMDD symptoms requires not just consuming enough calcium, but also ensuring adequate intake of D, Magnesium, and K2 for optimal absorption, regulation, and safety. Some food suggestions to increase your calcium intake : • Make seeded crackers with flaxseed, mixed seeds, water and salt - delicious with hummus, cheese or avocado • Snack on edamame beans sprinkled with sea salt and chilli flakes • Have Greek yoghurt as part of your high protein breakfast or instead of a sugary snack • Stir fry kale, and dress with olive oil, lemon juice and sesame seeds - serve alongside your favourite curry or a piece of salmon. Omega-3 Omega-3 Fatty Acids are highly anti-inflammatory and therefore can be helpful to minimise PMDD symptoms like anxiety, depression, and poor concentration. The active form is EPA, which excels at reducing inflammation and stabilising mood. • Why EPA? Plant sources like flaxseeds contain ALA, but the body's conversion to active EPA is highly inefficient (often less than 5%). ◦ Prioritize Oily Fish: Consume salmon, sardines, or mackerel 2–3 times per week for EPA. ◦ Plant Boost: Use walnuts, ground flaxseeds, or chia seeds as secondary support, but not as the sole source. • Supplement Note: If you do not eat fish regularly, discuss a high-EPA fish oil supplement with your healthcare provider Saffron Saffron has been shown to be an effective herbal intervention, with clinical trials demonstrating that a 30mg daily dose (during the luteal phase) can significantly ease PMDD mood symptoms like irritability and anxiety.
 Vitamin B6 Vitamin B6 is critical for supporting PMDD mood symptoms because it is needed for the creation of serotonin, the brain's key mood-stabilising chemical. Ensuring adequate B6 supports the body's ability to produce serotonin, which is often dysregulated during the luteal phase-the second half of your cycle. Clinical evidence shows B6 can significantly reduce emotional symptoms like anxiety and irritability. • B6 is readily found in foods such as chickpeas, chickpeas, salmon, potatoes, and bananas. e.g: a coconut chicken and chickpea curry • Safety Note: Seek individual advice on supplements as long term daily use exceeding safe amounts can lead to nerve damage. Nutrition is a powerful foundational tool you can actively use every day to take charge of your PMDD. By focusing on whole foods, stabilising your blood sugar, and ensuring adequate levels of key nutrients like calcium and B6, you are building a powerful base for mood stabilisation and inflammation control. Before starting any new supplement, especially if you are already taking medication, always speak with your doctor or a registered dietitian. Your healthcare team can help you integrate these nutritional strategies safely and effectively into a comprehensive, personalised treatment plan Written By Dr Rebecca Hiscutt Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

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< Back Can You Really Treat PMS With a Placebo… When You Know it’s a Placebo? Alternative Therapies, Managing Symptoms We’re used to thinking of placebos as tricks, pills that don’t contain any active medication disguised as real medicine, used in trials to test whether new treatments actually work. But a recent study published in BMJ Evidence-Based Medicine challenges that assumption. Researchers looked at whether open-label placebos pills that patients know have no active ingredients could still offer relief for premenstrual syndrome (PMS). And surprisingly, this study found that they could. What Is an Open-Label Placebo? An open-label placebo (OLP) is a treatment that contains no active medication, but the person taking it knows that from the start. There’s no deception. The patient is told clearly: “This pill has no medicine in it, but research shows that some people feel better after taking it.” The idea seems counterintuitive after all, isn’t the whole point of a placebo that it works because people believe it’s the real thing? But this growing area of research suggests that the ritual of treatment, the expectation of benefit, and the attention paid to the patient can be powerful enough to create measurable effects — even when the person is in on the secret. What Did the Study Find? In this study, women with PMS were randomly assigned to receive either no treatment or an open-label placebo over several menstrual cycles. The group taking the placebo with full transparency that it was inert reported significant reductions in symptoms compared to those who received nothing. That includes improvements in: Mood swings Irritability Fatigue Bloating and other physical symptoms Importantly, these improvements weren’t just reported casually the researchers used validated symptom questionnaires to track changes. So.. Is It All in Your Head? That’s the tricky part. The improvements were real, women did feel better but not because the placebo changed hormone levels or addressed the underlying biology of PMS. Instead, it highlights how: The brain and body are tightly connected Expectation and attention can shift perception Even being part of a study can change how you feel And no, that doesn’t mean the symptoms were "imaginary." PMS is very real, and for some, debilitating. What this tells us is that symptom experience is complex and how we think and feel about our health can influence how we experience it. Caution: Not a Cure It’s important to say: this isn’t a replacement for proper medical treatment. Placebos don’t address the hormonal imbalances, inflammation, or underlying drivers of PMS. For many people, PMS requires a more comprehensive plan which may include lifestyle changes, psychological support, or medication. But if you’re someone who wants to avoid medication or has found limited success with traditional options, OLPs might be one small, safe part of a wider toolkit. Ethical Questions & Real-World Use The study also opens up an ethical debate: is it okay to “prescribe” placebos, even openly? Some argue that as long as patients know the truth and consent, it could be a positive, empowering option. Others worry it might blur the line between evidence-based medicine and hopeful guesswork. Plus, in the real world, people aren’t in research trials. They’re navigating work, childcare, and painful symptoms. Taking a sugary pill every day because it might help isn’t exactly a strong healthcare strategy. Final Thoughts This study is fascinating not because it gives us a new treatment, but because it reminds us how complex and powerful our minds are. The placebo effect, even when stripped of secrecy, can still make a difference for some people. But it’s not a cure, and it’s not a substitute for better PMS treatment options, which remain too limited for too many women. If anything, this research should push us to ask bigger questions: Why are we still under-treating menstrual health? Why are women often told to “just put up with it”? And how can we create real, respectful, science-based solutions — with or without a sugar pill? Want to learn more about PMS and women’s health treatments that work? Subscribe to our newsletter or book a consultation with our women's health specialists. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us

< Back Menopause and Brain Health: What Every Woman Should Know Brain fog. Forgetfulness. Difficulty concentrating. Mood swings. These are some of the most common and frustrating symptoms women report during menopause. For many, the changes feel frightening. Women worry about early dementia or losing their edge at work. Yet brain health in menopause is rarely discussed openly. Why Does Menopause Affect the Brain? Oestrogen plays a crucial role in brain function. It influences: Neurotransmitters like serotonin, dopamine, and acetylcholine. Blood flow to the brain. Protection of neurons against inflammation and oxidative stress. When oestrogen levels decline, women may experience memory lapses, poor sleep, low mood, and changes in cognitive performance. Is It Dementia? The good news: for most women, menopause brain fog is temporary . Studies show that memory and concentration often improve after the menopausal transition. But there is a long-term connection. After menopause, women face a higher lifetime risk of Alzheimer’s disease and other dementias compared to men. What Can Women Do to Protect Brain Health? Exercise regularly — physical activity increases blood flow and stimulates new brain cells. Prioritise sleep — poor sleep worsens memory and mood. Eat a Mediterranean-style diet rich in vegetables, whole grains, fish, and healthy fats. Stay mentally active — learning, reading, problem-solving keep neural connections strong. Manage stress — chronic stress accelerates cognitive decline. Consider HRT — for some women, starting HRT around the time of menopause may support memory and mood, though evidence is still evolving. Menopause is a brain health milestone as much as a hormonal one. By recognising the connection and taking proactive steps, women can support their memory, mood, and long-term cognitive resilience. Talk to a specialist at Bristol Menopause Clinic about protecting your brain health during menopause and beyond. Get in Touch If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment. You'll be so glad you did! Contact Us