Transcript
UKRunChat: Hello, welcome to the UK Run Chat podcast. I'm Michelle, and if you're new here, this is the podcast where we explore the stories, the science and lived experiences behind running and everything that helps us run for longer and be happier.
UKRunChat: Today, we're talking about a topic that affects millions of runners, but until relatively recently, hasn't been discussed nearly enough in the running world, menopause.
Juliet McGrattan: Thank you.
UKRunChat: Joining me is a familiar voice on the podcast, Dr. Juliette McGratton. Juliet's an award-winning author, speaker, runner and a former GP. and She has a new book out, The Runner's Guide to Menopause, which looks at both sides of the story really, how menopause can of impact your running, but also how running can be a powerful tool to support physical and mental health as well during this stage of life.
UKRunChat: so We'll be chatting all about it and whether you're approaching menopause yourself, going through perimenopause or supporting someone who is. Perhaps you're a coach who wants to understand it more um or you just want to understand your body better as a runner. This is a really important conversation. So welcome, Juliet. Thanks for coming back onto the podcast. It's been it's been a while since we last chatted, hasn't it?
Juliet McGrattan: Oh, thank you so much, Michelle. I love coming on and having a a good chat with you. So yes, hello. i can't remember when it was, but yeah, good a good number of months.
UKRunChat: Yes, you were promoting your event with um Katherine Switzer last time we spoke.
Juliet McGrattan: Oh yeah, so last last, yeah, must be last summer then.
UKRunChat: Yeah.
Juliet McGrattan: Yeah.
UKRunChat: Yeah. So it has been a while, hasn't it? And that all went well?
Juliet McGrattan: It went really well. Thank you. Yes, it was an amazing day. Just getting the chance for so many people to hear Catherine Switzer tell her story firsthand is was very special.
UKRunChat: Yeah, fantastic. What an inspirational lady. and So we're chatting about menopause today and I'm quite excited to talk about it because I'm kind of i'm experiencing perimenopause at the moment and it is having a huge impact on my running. So I'm sure there are lots of other people out there who are also feeling the same. Can can we just start by kind of explaining kind of what what menopause is? Maybe we should start there because I think a lot of people still don't fully understand the terminology behind it, do they?
Juliet McGrattan: No, absolutely. And really, when we say menopause, we actually mean a kind of a spectrum of time, because menopause itself is one day.
Juliet McGrattan: It's the day when you haven't had a period for 12 consecutive months. And anything before that is pre-menopause, and anything after that is post-menopause. Now, the perimenopause is the time leading up to that day of menopause when you start to get symptoms of the hormonal changes of menopause. But I think more generally, when we say menopause, and certainly in the book, when I say menopause, I mean kind of perimenopause through that day of menopause and into postmenopause too, because right through that that time, women can experience symptoms as a result of the hormonal changes that are going on in their body.
UKRunChat: Yeah, so really, it's it's quite a long period of time we're talking about, isn't it? Because we can start to experience perimenopausal symptoms quite early, can't we? In our late thirty s early 40s.
Juliet McGrattan: Yeah, I mean, they say up to about 10 years before. So the average age of menopause in the UK anyway is 51. So 10 years before that is 41. But it's still normal to have a menopause at 45.
Juliet McGrattan: Or if you're having an early menopause, you might have it at 40. So 10 years before that, yeah, we are into into the low 30s. So, and I think most women in there in their mid 30s aren't really thinking that their symptoms might be in any way linked to menopause.
UKRunChat: No, no. So what sort of symptoms might people be noticing first then that they might not be aware and linked to menopause?
Juliet McGrattan: Well, I mean, typically when you think of menopause, you think, well, your periods are changing. But actually that, and that can be the case, but for many women, that's not the first symptom that they experience at all. And things like hot flushes that we definitely associate with menopause often come much closer to the day of menopause rather than in those early days. So for many women in those early days, it's actually mental health symptoms, things like anxiety um or even sort of palpitations.
Juliet McGrattan: Which again, you you just might think, and I speak personally, you know, I experienced a time of stress and anxiety and out of the blue, never had it before. And I thought it was all work related. i I'm sure some of it was. But when I look back now, I think, oh my goodness. Yeah, I was in my early 40s. I bet some of that was hormonal menopausal change that I didn't even identify.
UKRunChat: Yeah. um So there's there's a lot of symptoms, isn't there? that we we i think some of them we sometimes just put down to getting older, but
Juliet McGrattan: Yeah, and that's a really important point, actually, because there it's really hard to determine what is aging and what is menopause. So it's very easy to either put everything down to menopause and think that you can find an easy solution with hormone therapy um when actually it's more of an age-related change and vice versa too.
Juliet McGrattan: So it can be really tricky to work out what's what and you you may not actually never know ever know for lots of the symptoms.
UKRunChat: No. So which, which symptoms, I mean, the book is absolutely it's, it's full of, there's there's a different chapter tackling different area of the body, isn't there? It's, it's a really good overview of everything, but which symptoms would you say tend to impact running performance the most?
Juliet McGrattan: When it comes to running, and this is why I was really keen to write this book, because there's so much about menopause symptoms.
UKRunChat: Hmm.
Juliet McGrattan: But when you're a runner, everything, even small things can affect you more. And there's not generally a lot of advice about how to translate symptoms and what to do and turn it into the context of running. So as a runner myself going through perimenopause, I suddenly became aware of all these things and thought, oh, my goodness, this is awful. There has to be a solution for this. And what can I do for that? So I think in terms of running.
Juliet McGrattan: ah it It is very broad. Menopause can affect every system in the body. I think maybe the main ones are firstly, mental health things. So sometimes women lose motivation, lose a competitive streak, and that might just be competing against yourself for personal bests.
UKRunChat: Yeah. Yeah. Yeah.
Juliet McGrattan: And if you're losing motivation and you're losing that competitive drive, then that can really have a knock on effect as to whether you can get out running in the first place. um and that can often really change your relationship with running and sometimes make you start to dislike it even more or find it even harder to get out of the door so I think definitely mental health things but also i think particularly aches and pains I think as runners we're sort of used to feeling a bit sore you know you go to bed after a long run you get up the next day and you got a bit of aching, you can't get down the stairs very well or a bit of DOMS.
UKRunChat: young
UKRunChat: again
UKRunChat: Yeah.
Juliet McGrattan: But suddenly you can get that feeling almost every day in perimenopause, not for all women. Some women experience a lot of aches and pains. And even then, you know, it's hard to make yourself think, oh, well, a run is going to make it feel better because you genuinely feel so achy and stiff and you maybe haven't slept terribly well as as a result of it.
Juliet McGrattan: So I think probably, i mean, you could list any of them and turn them into how they affect running, but I think maybe the mental health things and just the way your body can hurt more and take longer to recover um really can affect your ah you're running in perimenopause.
UKRunChat: yeah
UKRunChat: Yeah, so what what's causing that? What's going on in the body to cause these changes then? Because it's quite dramatic in some people. I know I've had it. i feel like I've had it hard. i've probably There's probably people who have had it even worse than I have, though. What's what's going on internally?
Juliet McGrattan: Yeah. So what happens in menopause and perimenopause is that the the function of your ovaries is declining. And the ovaries are the main productor, is that a word, creator of estrogen and progesterone, the the main two female sex hormones. And testosterone has a role in this too, but that that that's less important than this bit. um So estrogen and progesterone levels are gradually reducing as the ovarian function declines. but they don't go down in a steady gradual way over time. They go up and down, up and down. They fluctuate. it's a bit of like a bit of a roller coaster. The trend is downwards, but the ups and downs can be quite significant. And it's often the fluctuations in those hormone levels that tend to give you the symptoms that
Juliet McGrattan: And we know that there are oestrogen receptors, for example, in so many parts of our body, in our brain, in our muscles, in our tendons, in our digestive tract, um all over the place.
Juliet McGrattan: So it makes sense that if there's a change in those levels and those levels are fluctuating, that it will have ah um an effect on anywhere that there are estrogen or progesterone receptors in the body, which is why the symptoms are so widespread.
Juliet McGrattan: A lot of it we don't really understand because there has been a lack of research.
UKRunChat: Thank you.
Juliet McGrattan: There is a lot going on at the moment, which is brilliant to see. But we are a bit behind in terms of knowledge and how to ah take that knowledge and turn it into treatment options and things for women.
Juliet McGrattan: So we are we are still finding out more. And there's a lot we don't understand. But I think generally the concept that these hormones are reducing, fluctuating, um and they will then have a knock on impact to areas of the body where estrogen and progesterone have a role.
UKRunChat: Yeah, and I guess that can impact your energy levels a lot as well, can't it? Because there's a lot, your body's going through a lot. And I guess you were talking earlier about motivation declining. I remember feeling just so tired all the time.
Juliet McGrattan: Yeah, absolutely. and And that is a big barrier for runners as well, just not having the energy. i mean, that can be that can be a direct thing. the The hormonal changes themselves directly making you feel more tired.
UKRunChat: Yeah.
Juliet McGrattan: But it can also be an indirect thing because. Women suffer terribly with sleep problems during menopause. It's one of the most common symptoms. I think about 84% of women struggle with their with their sleep during this time in some form.
Juliet McGrattan: And as a runner, obviously, sleep is really important, not just for giving you your energy, but for helping you to recover as well. So things that might affect your sleep, it can just be, again, directly affected because of the hormonal changes.
Juliet McGrattan: They can affect things like melatonin, which is your sleeping hormone in your brain, can affect how much of that is produced. um It can also affect it if it's making you have hot flushes or night sweats. Some women are really badly affected by night sweats and wake up multiple times a night. If you need if it affects your bladder, you need to keep keep getting up to having a pee.
Juliet McGrattan: have a pee if it's making you feel achy and uncomfortable when you turn over in bed your hip hurts and it wakes you up so so many so many things can indirectly affect your energy by affecting your ability to sleep
UKRunChat: Yeah, wow. there's that Yeah, there's a lot going on there, isn't there? I think, yeah, I think hot flushes was my first kind of clue that I might be entering this different stage of life.
Juliet McGrattan: m
UKRunChat: And it certainly does impact your sleep, actually. and
Juliet McGrattan: yeah it can and i think generally
UKRunChat: So, yeah.
Juliet McGrattan: ah for runners a body thermostat issue can be a big deal because you kind of get used to what that you look at the previously you look at the the um weather forecast you'd see oh it's 14 degrees okay i know i'm probably going to be okay in a t-shirt um Or or it's six degrees, I'm going to need it a thermal layer.
UKRunChat: Yeah.
UKRunChat: Yeah.
Juliet McGrattan: And in perimenopause and menopause, your your body thermostat just becomes a bit more sensitive. um the The thresholds change and it can sometimes sometimes fire off kind of inappropriately.
Juliet McGrattan: which is why you get these symptoms like hot flushes. So as a runner, suddenly you just find that you oh you can overheat quite a lot. and you might just suddenly want to be in a vest top all the time.
UKRunChat: Yeah.
Juliet McGrattan: So it really, and then you then you then you but then you get cold and you need another layer. So this kind of these kind of kit issues and what to wear can be something you've not really had to deal with before and they can come out of nowhere.
UKRunChat: Yeah, it's difficult and it's frustrating, isn't it? I know ah I'm experiencing a lot of sweating on the run at the moment and it's frustrating because it's causing my skin to feel like really sensitive. But having read that chapter in your book, I'm like, oh, it's actually normal. It's not just me. So it's kind of nice to know that we we can, there are things that will help with this, isn't it? and And you recommend in every chapter kind of how running can help with certain symptoms.
Juliet McGrattan: Yeah, I just really didn't want the whole thing to be a book of moaning.
UKRunChat: No, which it can be, can't it? I mean, we do we did go through a lot.
Juliet McGrattan: Yeah. Yeah, definitely.
UKRunChat: Yeah.
Juliet McGrattan: I think ah there are so many issues. I mean, it's really important to say that not all women are affected. Some women are absolutely fine. About 25% of women, I've met yet to meet many of them, but some of them, um that's what the stats say, that don't have very many symptoms or have any symptoms.
UKRunChat: yeah
Juliet McGrattan: And you know, kind of go through this phase of life without too many problems and doesn't really affect their running. And that's, that's, that's brilliant. But I am aware that that every new, almost every female runner I speak to who's in this stage of life has something or other, which is a problem, but I didn't just want to list all the problems and woe is us.
Juliet McGrattan: And I want to say, actually, you know what, this is a, this is, there are things that you can do. They may not make things go away, but they might help them to be more manageable. And it's so important that, for us to keep running that we need to try and do what we can.
Juliet McGrattan: So I wanted to come up with some ideas and solutions and practical practical things to try.
UKRunChat: Yeah, and it's it's nice. Just give us a few examples, Juliet, kind of of of how running can help our symptoms then.
Juliet McGrattan: um Well, we know it can help sleep. We've just talked about sleep. We know, you know, if you've had ah if you've had a good amount of exercise, especially if you've had exercise first thing in the morning and you've been outside in direct sunlight, that can affect your sleep.
UKRunChat: Yeah.
Juliet McGrattan: So that can help improve your sleep. So that's really that's a really important one. We also know that although you might feel stiff and achy and sore, running and and exercise in general help.
Juliet McGrattan: can actually help to loosen things off. It can pump the synovial fluid around your knees to stop them feeling so kind of creaky. They say motion is lotion, and that's really, you know, really, really true as part of this.
Juliet McGrattan: Hot flushes, it's debatable, actually. i think the evidence is saying really that...
UKRunChat: Okay.
Juliet McGrattan: Regular exercise, particularly something which is sustained and at sort of a more ah continuous moderate intensity, can actually help to reduce hot flushes. Suddenly going out and just doing a sprint might trigger ah a hot flush in some women. But the evidence is really that probably if you're exercising regularly, you're likely to have fewer or less intense hot flushes, particularly if you're increasing your fitness. There are some studies that say no. So it's a bit of a, that we'd still need more research on that. But that's that's just a few examples of how it can help.
UKRunChat: Yeah, that's that's reassuring to know that running can be good for us then, because it it can be tempting tempting as you feel yourself slowing down as well and perhaps not being able to run as far. It can be tempting to say, oh, maybe that's not for me anymore. But that's reassuring to hear, actually.
Juliet McGrattan: Yeah. And that's so important. I think when you, if you find that running's hard and you end up running a bit less, you can end up on this sort of downward spiral of thinking, oh, well, my running doesn't really matter. It's not that, you know, I'm not running like I used to. it doesn't count as much. It's not that important. I'll do, so I'll do something else. And actually, I just want to say, you know, please stop. Just wait for a minute. You know, just, just have a think about this. it, you're running really, really matters. And this is a point in life where It matters more than it ever did, even if you're only doing smaller amounts or you're not going as quickly. It actually has so much potential to help you through this phase of life, but also to kind of future proof your body for for many, many years to come.
UKRunChat: Yeah, that yeah that's that's really important. I feel like I'm having to look at my own running differently now and change, check check not change my goals as such, but kind of change how I feel about running and what running gives me. So like you were saying earlier, like i'm I'm possibly not as competitive with myself anymore. Like I'm not, I don't feel like I'm running for PBs now. I'm kind of running for fun and to give me a bit of enjoyment.
UKRunChat: And i think I think that's important, isn't it, to have a maybe a shift in perception about it.
Juliet McGrattan: if you If you need it. Yeah, if you need it.
UKRunChat: Yeah.
Juliet McGrattan: I mean, I think there are, say, some women who who are fine and still want to to get better and faster.
UKRunChat: Yeah.
Juliet McGrattan: um And I've ah tried to to really make the book really inclusive of all levels. So there are some quite advanced training plans in there for women who are okay and um want to progress, et cetera.
UKRunChat: Yes. us
Juliet McGrattan: But I agree. For me personally, I'm similar to you. i can still see improvement.
UKRunChat: Yeah.
Juliet McGrattan: But ah ah that's not where my focus is now. At the moment, and I know that, I'm hoping that that will change and because there is an end to this. You'll come out the other side.
UKRunChat: Yeah.
Juliet McGrattan: um That it is much more about what do I need? oh actually, I need... um and a run where I'm not focusing on what stats I'm producing and and just enjoying or going out with friends and socializing but that I do still want to improve so and we know that actually if you can add some speed work into your running that that that has benefits because it helps to to build muscle and helps to keep those all those neural pathways firing and things so I'm trying to maybe look at my running in a way how can I use it to help me get through this but also to set me up for a future of of great running too when when the focus maybe switches again which I'm sure it will
UKRunChat: Yeah.
UKRunChat: Yeah, i'm I'm sure it will as well. So do runners need to change how they train during perimenopause? Or does that, it obviously depends on the person, doesn't it, I guess.
Juliet McGrattan: Yeah, it does. but I mean, not necessarily. If everything feels good and it's suiting you and you're enjoying it and you can do it consistently, then crack on. You know, don't feel any pressure that you have to do this, that and the other.
Juliet McGrattan: I think it is important to know that there are the changes that are going on in your and your body. You can help to address those by ah approaching your running a little bit differently.
UKRunChat: Yes.
Juliet McGrattan: But these are things that actually apply to lots of runners generally anyway. As I say, throwing in a speed session every week. In the menopause context and midlife context, that is helping to preserve our fast twitch muscle fibers, the ones that produce sprinting, explosive movements, fast sprints, so etc.
Juliet McGrattan: And they're the first ones to be lost because we do lose muscle mass from about the age of 30, 35 onwards and particularly around um midlife. um So by introducing a speed session, you can help to preserve those fast twitch fibers. which if you are someone who is struggling with their running performance and is getting frustrated, actually throwing in a speed a short speed session every week could help could be the thing that helps you to get your running back to where you want it to.
UKRunChat: Yeah.
Juliet McGrattan: um The other thing is to to think about the the slow running and to actually probably even run more slowly. And I like to think the fact that I'm slower than I have been for many years is actually my body saying, this is what you need right now.
Juliet McGrattan: You need lots and lots of zone two running where you can chat and you feel really comfortable to kind of build the mitochondria, build the engine um and to to really focus on that type of running, which is actually a little bit less pressured as well.
UKRunChat: Thank you.
Juliet McGrattan: It's not only for your mental health, it's actually because it's helping whatever distance you run. in the future um having that real strong base of lots and lots of of zone two slow running will will help you so i don't think you necessarily need to change your running but it's a good opportunity to think what what do i want to achieve and what might my body benefit from so if you've never done any different kinds of running activities then this is a good chance while everything is in change to to make some changes too
UKRunChat: yeah yeah that's that's a good way of looking at speed work actually i i don't particularly in enjoy speed work um but now you said it can help my muscle fibers maybe that's the kind of motivation i need to get out and do some yeah yeah yeah it's over quickly
Juliet McGrattan: and It's also quite a short workout, which is always good if you, yeah.
UKRunChat: but
Juliet McGrattan: Yeah. Um, but it can feel, it can feel quite um empowering as well. You know, just, yeah, just running. It but kind of makes you feel a bit like if you've never done it before, it can make you feel a bit like a child again.
Juliet McGrattan: And kind of, you know, when you were just used to run and run for the sake of it and run away from your friends and playing TIG and this, that, and the other. So, um, yeah, it has health benefits as well as making you feel a little bit awesome.
UKRunChat: yeah that's Yeah, that's good. So you mentioned that menopause, and during perimenopause, we'll lose muscle mass. What what about bone density? and Can running help with that?
Juliet McGrattan: yes
UKRunChat: Because we know it we we know we'd lose bone density as we get older, don't with the lack of oestrogen. Is that right?
Juliet McGrattan: yeah absolutely so again bone mass is around 30 35 and we lose a little bit every every year and that speeds up around the time of midlife menopause and and sort of continues on so if you do nothing then it's likely that your muscle mass and your bone mass is going to reduce.
Juliet McGrattan: But in in in terms of bones, it's just I'm just so grateful that I'm a runner. And I'm so grateful that I've now got, how was my daughter? She's 18 now. So I've got 18 years of high impact activity under my belt.
UKRunChat: Right.
Juliet McGrattan: And we know bones love to be, so like they love to be stressed. And when your foot hits the ground and a jolt goes through your bone, it it It makes a shudder and that stimulates the osteoblasts, which are the cells that create new bone.
Juliet McGrattan: So high impact activity is excellent for that. And running is is perfect. It is also possible and important to improve your muscle your bone density through resistance exercises as well.
Juliet McGrattan: um Because we know that when the muscle tugs on the bone, which it does via the tendon, That, again, stimulates muscle bone production from the from the osteoblast. So a combination of the running and the strength training is is really important for bone health.
Juliet McGrattan: And also, sorry, I'm on a I'm on a I'm in the flow.
UKRunChat: You'll go for it.
Juliet McGrattan: When we think about bone health, we also need to think about our potential to fracture bones.
UKRunChat: Yeah.
UKRunChat: Yeah.
Juliet McGrattan: And as we get older, we lose balance and coordination. So if we want to look after our bone health, not just in terms of how strong the bones are, but our likelihood to falling, tripping, stumbling, et cetera, then we need to think about balance and coordination and and again, doing resistance work, strength exercises, exercises on one leg.
Juliet McGrattan: to to really help us to be strong and stable when we're older as well. And one in two to one in three, depending on where you read it, um women over 50 will fracture a bone in their remaining lifetime due to osteoporosis, which is condition where bones are thin.
Juliet McGrattan: So this is a huge problem. And as runners, we should be so glad and so grateful that we we can help to reduce our w risk really effectively.
UKRunChat: yeah
UKRunChat: yeah that's got to be an incentive to keep running hasn't it it's funny i was talking about this with my friend this morning i've just i've been on a room with my friend and both of us tripped over um this week like she she tripped over something on the ground i managed to trip over my long jeans you know the long trendy jeans that are in um but both of us managed to stay upright And we put that down to running because we've got that balance, haven't we?
Juliet McGrattan: There you go e
UKRunChat: So, yeah, it's so, so important.
Juliet McGrattan: go.
UKRunChat: and Does injury risk increase or is that just down to loss of balance?
Juliet McGrattan: Could be down to loss of balance, could be down to muscle weakness if we're not keeping the muscles around our our joints strong and stable and potentially due to some hormonal changes as well because ligaments which keep our joints stable and stable.
Juliet McGrattan: tendons as well everything does everything does change a little bit around around this time so it is possible that our injury risk can increase a little bit too uh either say from being from being clumsy but also because of the musculoskeletal changes there that are happening in the body
UKRunChat: Yeah. Okay. So you've got a whole section on strength training in the book, haven't you? if if people have never done any before, you kind of take them through with.
Juliet McGrattan: yeah well i won't say i take them through because i have got some amazing experts in this book and i need to give them Absolute credit.
UKRunChat: Yeah. Yes, you have.
Juliet McGrattan: So I've got Claire, Claire Clark, who's a personal trainer and strength and conditioning coach in Newcastle. And she, she did all the strength exercises for me because she's really, the reason I asked her was because she's very, she's a runner.
Juliet McGrattan: So I think sometimes when we see strength training in menopause, we just see people lifting very, very heavy weights and that, that there's there's a role, there's a place for that. But when it comes to running, we it's not just about how heavy you lift it's about using and training the right muscles that are functional for daily life but also for your running activities so strength training for runners can can be a little bit different so uh and i knew she really understood that so uh that's why i asked her to do it and she's done an amazing amazing job created some workouts that we can all we can all use
UKRunChat: Yeah, yeah, it's it's a really thorough a section, actually. So you've got you've got a whole chapter on kind of how to do all the strength training and exercises. And then you've got a very detailed and lot of half marathon and marathon training plans in there.
Juliet McGrattan: So that's another expert, um another Clark, but they're not related.
UKRunChat: Yeah.
Juliet McGrattan: Irene Clark, who, um again, I just, I knew, i knew who i wanted to write them because she really has done so much work around menopause. She's a sports scientist by by background.
Juliet McGrattan: And what what, because your trait, because your body can change the way that you train might have to change too for for lots of women. So you need a plan which really understands that and reflects that, which is very flexible.
Juliet McGrattan: So each run has got a priority so that if you're not feeling good, you can figure out which run or which runs to miss sort of that week. It's got extra um sort of step back weeks to allow more recovery time.
Juliet McGrattan: It's got a mixture of different types of runs, lots of slow running, some shorter, faster interval runs and really is a plan that that or plans that work with our body at this time of of life but also flexible enough for you to sort of change it up and change it down so there's half marathons and marathon plans I'd love to put 5ks and 10ks and but then the whole book there's so many plans in there already the whole book would have just been plans um but anyway yes hopefully they're going to be helpful but
UKRunChat: Yeah.
UKRunChat: Yeah.
Juliet McGrattan: they're They're tried and tested with many many, many, many, many women. So ah yeah, I wanted something in there that, as I say, you can just moan and you can give solutions, but and actually something practical that you can go and try.
UKRunChat: Yeah, yeah, it's brilliant. I love the section on nutrition as well. You've asked Renie McGregor, haven't you, to to input into that a little bit? And she's really good at what she does. Yeah.
Juliet McGrattan: Yeah, I just wanted someone to to to to um read what I'd written and and I respect her so much. So a sort of a technical edit to to make sure that what i've what I've put was correct and also her input actually in her in her own words as well.
UKRunChat: Yeah. yeah
Juliet McGrattan: So, yeah, I'm so grateful to them all. There's a couple of others who helped Dr. Kath Munro read through all the HRT section because I don't prescribe anymore. And she's a British menopause specialist.
Juliet McGrattan: And Emma Brockwell, amazing physio mom, read through all the pelvic health stuff. So yeah, I just wanted to make sure that it's such a responsibility writing a book and writing a book like this when there isn't really another book out there exactly like this.
UKRunChat: Yeah.
Juliet McGrattan: I just felt such a ah big responsibility to get it right. And because there's because it's lacking in evidence generally it it's it's harder to be absolutely certain about the rights and wrongs and I've tried to sort of reflect that as well so yeah it was a challenge i don't think I realized how hard it was going to be ah
UKRunChat: yeah It's a really good book, Juliet. I think you've done really well with it. it's I've read so many books on menopause, honestly, and but there's nothing there that's focused specifically on on women who run.
UKRunChat: So, yeah, it's it's really good to read. Yeah. No.
Juliet McGrattan: Yeah, when I approached the publisher, the first thing they said was, do you not want to write exercise and menopause? And I just thought, no, I really don't. Because for runners, i I am a runner.
UKRunChat: No.
Juliet McGrattan: I understand it. I don't understand open water swimming or the other things that I would have to write about if I was doing general exercise. And and running, yeah, I know it.
Juliet McGrattan: I understand it. I have the people, the community to tell me what they struggle with. And there was just so much to say about running. I couldn't possibly have included everything else as well.
UKRunChat: So you mentioned HRT there. Can we touch on that? Because and i think our kind of society's view of HRT is changing, isn't it? And it is. We went through a while where people were a bit scared of it. And and now we seem to be coming out the other side.
UKRunChat: and just Just explain to us a little bit about the options for HRT and how that might help.
Juliet McGrattan: Yeah, so I think it's, like you say, times have changed. When I very first started prescribing, when I was a new GP, everybody was taking it. And then there was lots of scares and everybody came off it.
UKRunChat: Yeah.
Juliet McGrattan: And now we're swinging back sort of in the other way. I think, and I've tried to to sort of stick with the British Menopause Society views and guidelines with with with this book. um I think the the main...
Juliet McGrattan: thing to know is that you don't have to be absolutely on your knees before you start taking it it's not that you failed and you've had to resort to hrt and actually we should also realize that a lot of the the talk now is about mht menopause hormone therapy rather than hormone replacement therapy but i left it as hrt because it's still in in the yeah uk which is where most of my think my most of my readers will be is we really still use hrt more commonly but anyway um
UKRunChat: yeah
Juliet McGrattan: So it doesn't have to be a last resort. It's very effective people helping to reduce symptoms and particularly symptoms which are to do with your vasomotor symptoms. So things like hot flushes, night sweats, but also mood changes of menopause as well. So rather than reaching for antidepressants first line, if the depressive symptoms are coming from menopause symptoms, then HRT will still be first line.
Juliet McGrattan: um So, and for some women, if their menopause symptoms are really severe, they can they can stop them being able to run.
Juliet McGrattan: So therefore, by using HRT to improve your symptoms, for some women, that actually then makes them able to run. So as well as getting the benefits of the HRT, you're then getting the benefits of the exercise too, which are so big, it's hard to it's hard to measure them.
Juliet McGrattan: So I wanted to make it clear really that it does definitely... have a role and for the majority of women it is safe um what i didn't want to say and i didn't because there's still a lack of definite evidence to say it can prevent this it can prevent that it can prevent dementia it can this that you know because we we're still it's a little bit of an on an unknown but what i do want to say is that we know that even if hrt can help to protect those things we're
UKRunChat: Yeah.
Juliet McGrattan: exercise definitely does help to protect those things so it's part of the jigsaw puzzle for lots of women many women don't want to take it many women can't take it um so it's really important to know that there are different options different alternatives but for those that can it can be really useful and it can really help you to be able to continue running if your menopause symptoms are stopping you from doing so
UKRunChat: Yeah.
UKRunChat: Yeah. and and how how do you know when it's time to speak to a GP about it? Like what like how how like what do you do? what what What would you say to a GP if you're just thinking about it and you're not even sure if it's perimenopause? Like, where do you start?
Juliet McGrattan: Yeah, that's a good question. I think if you're noticing changes in your body which are new for you and are affecting your ability to live your everyday life in the way that you want to, and that includes your hobbies, affecting your sleep, affecting your work, etc., then that is that is a time to to wonder what's going on.
UKRunChat: Yeah.
Juliet McGrattan: Because again, we shouldn't assume that everything is down to the menopause. So there might be other symptoms that you're having, which are indicative of something else. Now, if you think it's just it's menopause, you don't necessarily need to see a doctor.
Juliet McGrattan: But if you're struggling with the symptoms, and they're they're persistent, and they're affecting your everyday life, then just go and have ah go and have a ah chat, because it is very much about being informed.
Juliet McGrattan: It's very much about if you want to take it, understanding what any risks or benefits for you might be, and they're very different for every for every woman, and just starting the the conversation and finding out more so that you can really feel that you make an informed choice.
UKRunChat: yeah Yeah, I think that's important, isn't it? It's just kind of an information gathering exercise so that you can decide what's right for you.
Juliet McGrattan: Yeah. And reading as much as you can before you go, getting, getting, you know, getting information from reputable places and just, just not being afraid to have to ask and have a conversation.
UKRunChat: Yeah.
Juliet McGrattan: It's really not a taboo topic anymore, which is it here anyway, which is, which is wonderful. um it still is in lots of different places um around the world, but also in, in, in the UK and different communities, et cetera.
Juliet McGrattan: So just having those conversations and talking about how you feel and, what the effect it's having on you is is really important.
UKRunChat: Yeah, yeah, its it helps, doesn't it? and So what advice would you give to somebody who's feeling frustrated because running suddenly feels harder for them if they're at this stage of life?
Juliet McGrattan: I'd go, oh let's have a cup of tea and I'll tell you how it's affecting me.
UKRunChat: Thank you.
Juliet McGrattan: Because I'm struggling a little bit too at times. and I think I would say, remember, it's not your fault. it's not because you're weak or you're not doing things right. It is the hormonal changes going on in your body. So it is not your fault. Also remember that it doesn't go on forever. um There is, there is a light at the end of the menopause tunnel and you will, you will get through this. And um I, what I do in that,
Juliet McGrattan: frame is to fill my social media feeds of women in post-menopause who are just absolutely smashing their running and and enjoying life. and it makes me feel sort of more positive about it. um I would say as well, don't, don't, don't minimize your, the effect it's having on you. if it If it is, if you are struggling with it, speak to other women, speak to your doctor, get help and be, be really, be proactive.
Juliet McGrattan: um The more you, the more you can find out, the more you things you can try and just i think at menopause you can sort of feel like you're you're not in control your body's changing shape everything's sort of happening to you and whatever you normally used to do to manage things doesn't seem to work anymore so you can feel really out of control so i think just taking some some ownership and and finding out and and learning and educating yourself and trial and error and is really important but but just know that yeah it's not your fault and you will get through you will get through it and if you have a good day enjoy the good day it's a bad day you just have to manage the best the best way you can but get a bit get help
UKRunChat: Yeah, yeah. And I think, as you said earlier, it doesn't last forever, does it? That we do come out the other side of it. So what what happens on the other side of menopause then for those listening who are approaching the menopause?
Juliet McGrattan: Well, early post-menopause, your hormones don't suddenly, the the day you reach menopause after that 12 months without a period, it doesn't suddenly, everything's perfect. It doesn't really, unfortunately, it doesn't go like that.
Juliet McGrattan: There's still a lot of years um where you may have some symptoms and over time they will diminish and your hormones will reduce to a lower level and be in a steady state.
UKRunChat: Yeah.
Juliet McGrattan: There are other sources of estrogen and progesterone and testosterone in your body that will kick in. um and will will so you won't have none of those hormones but you so you lose those fluctuations and that up and down you get some fluctuation in your hormones during the menstrual cycle obviously you lose that when you don't have the periods but you lose this kind of roller coaster of hormones everything just is much more steady and friends i've got in post-menopause to say they just kind of wake up knowing how they're going to feel.
Juliet McGrattan: um And they they're not so day to day. Is it a good day to run? Is it not a good day to run? What's my mood going to be? They just feel more stable, which is definitely something to look forward to.
UKRunChat: Yeah, definitely.
Juliet McGrattan: Yeah.
UKRunChat: ah well, thank you, Juliette. That's been really eye-opening and the book is brilliant. and It's out on the 26th of March, isn't it? It's called The Runner's Guide to Menopause. So if you if you are listening and think it might be helpful, then do do check it out. What i really love about it is that it doesn't tell women to stop running or lower our expectations. It just tells us we might need to adapt a little bit for a short time, and but it's brilliant. So thank you very much for joining us.
Juliet McGrattan: Thank you.
UKRunChat: and
Juliet McGrattan: Thank you so much for letting me talk about it. And I really genuinely hope that it is helpful. um And there is an audio book too. So maybe I can run with you while you're listening.
UKRunChat: Oh, well, there we go. Yes.
Juliet McGrattan: I'd love that.
UKRunChat: ah Yeah, but let us know if you're listening to Juliet narrating her her latest book. So if today's conversation resonated with you, please do share it with your friends. And as always, if you enjoyed this episode, then do let us know. Conversations like this, we hope, help make running more supportive and a more informed space for everybody. Thank you for listening. It's been the UK Run Chat podcast, and I'll see you on the next episode.
