In this episode, Sue Moxley welcomes Emma Louise Soos from the Women’s Health Clinic to discuss vaginal health and CO2 laser treatments for women experiencing menopausal symptoms. Emma shares the inspiring story of how she started the clinic in 2015 with just a small room in Leicester, and how it has grown to 11 UK clinics and one in Spain. With her background as a nurse since 1998 and expertise in medical aesthetics and laser training, Emma revolutionized the approach to women’s health by ensuring all treatments are delivered by women’s health nurses—midwives, sexual health specialists, and gynaecological nurses—making treatments more accessible and affordable.
The conversation delves into how CO2 lasers work to address common menopausal issues like stress incontinence, vaginal atrophy, and sexual dysfunction. Emma explains that lasers signal the body to begin a collagen-building process by creating controlled micro-injuries, stimulating the body’s natural healing response. Rather than a “designer vagina” procedure, the treatment focuses on restoring function and confidence through tissue rejuvenation. She outlines the recommended protocol: three treatments spaced 6-12 weeks apart within the first year, followed by annual maintenance, as research shows no additional benefit beyond three treatments.
Emma addresses both internal and external vaginal health, discussing how menopause causes natural thinning of vaginal tissue, loss of volume, and reduced nerve endings—all contributing to urinary incontinence and decreased sexual sensation. Sue, who has personally experienced the treatment, shares how transformative it has been. The discussion emphasizes the importance of women taking ownership of their health, understanding their bodies, and recognizing that menopausal symptoms affecting daily life and intimacy are treatable.
Main Topics
The Women's Health Clinic was founded in 2015 and has grown from a single room in Leicester to 11 UK clinics plus one in Spain, with a unique business model employing only women's health nurses
CO2 lasers work by reacting with water in vaginal tissue to create controlled micro-injuries that trigger the body's natural collagen-building process over 6 months
The recommended treatment protocol is three laser sessions spaced 6-12 weeks apart within the first year, followed by annual maintenance, as research shows no additional benefit beyond three treatments
Common menopausal symptoms treated include stress incontinence, vaginal atrophy, loss of sensation, sexual dysfunction, and loss of volume—all caused by declining estrogen and collagen
The treatment focuses on restoring function and confidence rather than aesthetic redesign, with subtle external changes that improve sensation and reduce discomfort
Emma's nursing background in urology, gynaecology, and medical aesthetics, combined with 20+ years of laser expertise, informs the clinic's comprehensive, evidence-based approach
The clinic makes treatments more affordable than competitors by using a specialized nursing team model rather than solely aesthetic practitioners
Full TranscriptHi, I'm Sue Moxley. This is Women's Radio Station. This is The Menopause Show. Catch us on our socials, which is Women's...▼
Hi, I'm Sue Moxley. This is Women's Radio Station. This is The Menopause Show. Catch us on our socials, which is Women's Radio Station abbreviated, on Facebook and also on Instagram. And my guest today is a lady called Emma Louise Sous, better known as Emma Louise, and and she's from the Women's Health Clinic. Hi, Emma. Hi, Sue. Hello, lovely to talk to you. We had a chat the other day and we got on really well, and if you could like maybe tell the listeners a little bit about your clinic and why you started it up and what it actually does, and that would be great. Okay, so the Women's Health Clinic started back in 2015, and it was just basically little old me in a, in a clinic in Leicester just getting started. And then it sort of snowballed. So I was introduced to quite a few people with other women's health experience. So my background is medical aesthetics and particularly laser and training, but also my career history. I've been qualified for quite a while now, was urology, surgical, renal, that sort of thing. And it's sort of— nurse, a nurse. Yeah, I've been a nurse since 1998 in the Midlands, um, and it sort of— it was one of those things that happened a little bit by accident, but, um, I was given the opportunity to set up in a friend's clinic in a little room to sort of, you know, feather my own nest and help as many people as I could. And my interest in lasers has been going on for 20-odd years. I've been a trainer for a long while as well as a teacher, and I came across a laser at an exhibition in Italy that was quite fascinating and just shelved the idea for a few years. You know, kids and life just moves on a bit. And then I got talking to my colleague and I sort of got this idea. Um, I'm doing my medical aesthetics, it's doing really well, helping lots of patients, um, with a variety of conditions. And I just mentioned to him that I thought this could be useful because it already was in the UK, but it was very much so— CO2 laser for vaginal rejuvenation was sort of aimed really at the worst term ever, design a vagina. I hate that too. I hate that, don't you? But it is. So this lovely friend of mine said, look, I'll help you get started. Let's get the laser in and let's get— let's see how we go. So I didn't reinvent the wheel, but I sort of invented a service that aimed to help women. So there's a little bit of another background to which we'll cover later, I'm sure. And it sort of snowballed from there. And we started treating lots of ladies. With the, with the NuVe laser, which was our own brand. And the only thing that we did differently to the companies out there is that our business model, we decided that we would use only women's health nurses. Then I had a really lovely opportunity to sort of cuckoo into another clinic, sort of have a sort of a joint venture with them, and then started sort of launching that all over the country. So we've gone from within a year just having little old me and another colleague to then opening in Canary Wharf. Then we looked at Harley Street and then Birmingham. So all these opportunities were coming up. And of course, I was, I was on the road, like, up and down the country doing these treatments. And then we got the coverage on ITV's This Morning program, which a lot of people will have seen. And one of our patients very bravely talked about why she came. They called it a vagina facelift, which made my skin crawl even more. But again, Yeah, I know. Yeah, we couldn't get on ITV this morning for a while because their sponsors were the Tenor Company, so thinking of different ways to treat incontinence. And then it sort of snowballed from there. So we started meeting nurses all over the country that, you know, had different women's health experience. So we've got midwives, sexual health, gyne, and then we were able to offer that service to a lot more women at a much more reasonable price. Than some of our, in inverted commas, competitors because of the way that the business was structured. So, so now currently we've got 11 UK clinics, 6 nurses, and we've got one in Spain as well. So yeah. So could you explain to everyone what the actual laser does? I mean, I know myself, I've actually had it done, not, not with your brand, but, you know, someone else a while ago. And I found it absolutely amazing. It changed my life. Could you explain what it is that it does? Essentially, one of the sort of things that really appeals is that lasers work in so many different ways, and they work in conjunction with your body. So they're actually a signaler. And what happens is, as we get older, as you know, being a woman, you know, our estrogen declines over the years, as does our collagen. And estrogen and collagen, as we've talked about before, are bedfellows, which is why when we go through the aging process, it's very different to the chaps. And collagen, as you know from being in the beauty industry, is in our skin predominantly. But it's also joints, blood vessels, nerve endings. And this is why when we go through menopause, we have so many issues. And if you look at a picture of yourself sort of 10 years ago and now, you can see we're not built to last. We're degrading, thankfully quite slowly, but that accelerates as we get older. And if you think in terms of sort of the vagina particularly, you know, many of us choose to have children, and that comes with its own issues. Um, none of us can opt out of menopause. You know, that has its own issues, and we show patients pictures. So what we're trying to do is to say to the vaginal tissue that we want something to happen. We're not happy with this. So symptoms that patients would present with would be stress incontinence, lack of sensation, you know, similar to your sort of case that you wrote about, you know, vaginal atrophy, sexual dysfunction, lack of confidence, loss of volume, all of these horrible terms, you know, that people come to us which affects their day-to-day life and so on and so forth. And what the laser does— this particular laser, the NuVe, is a carbon dioxide laser. And for anybody who doesn't know anything about lasers, all lasers react to something. So hair removal is with the pigmentation in hair, certain ones react with blood vessels, this one reacts with water. So it's incredibly superficial, and what it does is it creates an atmosphere that the body sees as an injury. Now there's two ways to stimulate collagen. One is to apply heat. So when you cause heat, so things like HIFU or laser, radio frequency, you get a contraction in tissue which the body releases certain proteins as a result of which stimulate collagen building. The other method is to fracture the surface, so things like needling, chemical peels, exfoliation, microderm, all those sort of things. And you know, if you've ever been in the shower and you cut your leg shaving, it will hurt more tomorrow. You cut yourself when you in the bed, because what the body's done is it's gone, holy smokes, something going on here, we need to come to action. Yeah, so the way that I simplify it with patients is to say that, think if you were going to build a house, you would start with the foundations, you would then bring the builder, the tiler, the electrician, all these different ingredients that go towards building a house. And that's what the body does, lots of different growth factors, platelets, plasma, so on and so forth. And what happens is over a period of weeks and months, so you You don't go out of the clinic with your singing, all new singing, dancing vagina. This is chapter 1, part 1. You start a build process, which for most people will go on for about 6 months. Most healthy people. At the end of that 6 months, that build project has finished and you go back to your normal aging. You don't go back to day dot, thank goodness. So in theory, you would come every 6 months for this treatment. Yeah. What we know about collagen is when it's done that foundation, so done the footing, so to speak, and you start laying the bricks. If you go in and stimulate that new collagen, you can actually send the message to it to ask it to go on for longer. Now you might think, wow, that's amazing, my vagina is awful, I'll have 50 of these. It doesn't quite work that way because the mold needs— what they've discovered in lots of research that's been going on for 20, 30, nearly 40 years is that when you look under the microscope and you ask patients with a variety of different reasons for presenting, that beyond 3 treatments there's no more benefit. So you having that 5th date, there's waste of money after the 3rd. But 3 treatments seems to give about a year to 18 months of collagen production. Brilliant. So that's where the protocols come from. So you would come along, 3 treatments spaced 6 to 12 weeks apart, so 2 to 3 months, paydays, periods, holidays, whatever, and then have the next one, do that again. So 3 within a year and then from the third one just have an annual top-up, because we're not getting any younger, unfortunately. No, but yeah, the thing is, okay, so we're talking here more about the internal vagina, aren't we? Not what it really looks like, um, which is what people say with the Designer Vagina, that kind of thing, and a vaginal facelift. We're not talking about that so much. We're talking about function, aren't we? We're talking about, you know, that the internal organs, so that the collagen thickens the walls a bit, which helps with— not the collagen, the laser— which helps with, you know, urinary— you, you say it— urinary issues. Yeah, it's one of those words I can't say. And it helps with that. I mean, I know you can treat the outside as well, can't you? But it's not that you're really looking to do like a facelift with this product. Product, is it? No, definitely not. I mean, if you take stress incontinence, for example, you know, we lose— so if you had babies, then that can affect some of the walls, so the support for the urethra, the wee tube, can be altered. As we go through menopause, there's a natural thinning of the vaginal lining, so instead of being round and tight like a doughnut, it's sort of a bit of a sort of cherry shape. So the coughing, the sneezing can cause problem, you know, leakage and so on. We're also looking at pelvic floor because as nurses that's one thing that we can help with, whereas sort of in the aesthetic industry it's just a case of pop a laser in and you won't do any harm, but it's pretty much one size fits all. But also for a lot of women in terms of sexual function, there's not many nerve endings in the vaginal lining, which makes intercourse a very different ball game for women than it is for chaps. So a lot of women will find that the sensation is not as good as it was. The blood supply has reduced because the nerve endings are not getting getting fired as well. But also, if you look externally— and we always say to patients, you really should, you know— how— one of my questions is, how often do you look down here? Or don't, you know. There's still this, this taboo that we shouldn't. But we lose volume, so the fat pad around there gets reduced. It's the one bit of fat we don't want to lose in our life. Um, tissue becomes a bit more frilly, a bit more redundant. So the actual— for a lot of women, stimulation needs to happen externally to get things going before things like penetration. But women are finding that because of loss of volume, as it's more of a tissue-moving than a button-pushing exercise, if that makes sense. So they find that they're not getting the quality of the climax or that intimacy feeling. So when we do treat around there, and I describe it to patients, what will happen, you know, your partner's not going to come in and go, oh my goodness, what have you done? It's not sort of very, very noticeable, but it just makes things feel a bit more refreshed. It makes things feel a bit plumper, increases confidence, because, you know, if you're worried about smelling of wee, and that's slowing down and getting better, that helps. So yeah, it's a combination of it all, and it's no skin off our nose to do that little bit at the end, you know, the procedure is very, very short. Okay, so with me, you know, you said the nerve endings kind of die off. With me, my pain was caused because of nerve endings and the skin being so thin. So there is that angle as well, isn't there? Definitely. There's a condition, so atrophy, so atrophic changes. People think that everything's gone south. For a lot of ladies, it's classified as thin tissue, you know, around the entrance. If you look at that piece between your thumb and your forefinger and stretch it out, you can get a band that feels like that. So some ladies will find that having intercourse is like being sawn in half. Yeah, they may talk about feeling that, you know, I can get my partner past the entrance, but then it's like being shredded inside, or I can't get my partner in because things are so stiff, but then once we get going, it's fine. Other ladies will find, we're okay with intercourse, but I'm sore for days and days and days after. And when we're doing our examination of patients, we're looking at you as a person, but also looking at other things that we as nurses could recommend, you know, like, you know, things like vaginal oestrogen, the, the good quality lubricants and vaginal moisturisers that are suited to the menopausal condition. Because if you and I go in a shop with a 20-something and buy whatever strawberry-flavored boot thing that's going on, because our pH changes as we get older, that product is actually going to be counterproductive. You know, I still get patients using KY jelly and it doesn't, it doesn't help. No, I mean, that can, it can even dry out more, can't it? Yeah, it's handy if I'm trying to put something in or get something out of you, but you know, just like a, you know, digital examination or whatever, but it doesn't last the distance. But it's probably one of the better known, and, you know, sort of older, the older generation. But, you know, things have moved along quite a lot since then, and there's some good quality clinical-based products that are more suitable. Yeah, I, you know, it's so sad that we have to go through all this, isn't it? It's really sad. I'm not coming back as a girl in my next life. I always say God must have been a man, really, because he's like, you know, I'm not, you know, I'm I'm sorry, anyone out there that's religious, but he was definitely a man. And yeah, but, you know, it's sad because we don't feel any different to when we was 20 or what. We might feel a bit different, but our feelings haven't changed since we were, you know, 20 or 30. But our bodies have changed so much. We don't feel any different, but our body doesn't kind of, you know, stay up with it. And it's so sad. So I'm really I think it's really amazing that you've opened these clinics, and I'm a big fan because I did actually have it myself and it really, really helped me and changed things for me. So yeah, do you plan on getting more clinics out there and conquering the world? Well, we are hoping to go overseas. Well, we've already got a clinic in— it's an English nurse over in Spain. And obviously each country's got its own different ways of doing things, but generally that is the same template as here. You know, everything is the same, laser's the same. Morocco, Marrakech, UAE, you know, the, you know, women, you know, are all over the world and they've all got the same issues. And I would certainly say to patients that, you know, 100 years ago we didn't live beyond— we didn't have the issues with menopause because we didn't live that type of life, whereas, you know, 60 is definitely the new 40. And the newsflash, you know, if I always say to my patients, you know, if I go to my GP and say I'm in my 40s, I've had a couple of deliveries, one traumatic, sex life's gone off the boil, there's a bit of pain, they sort of look at you as if to say, well, what's wrong? And the newsflash is, women, you know, 100 years ago, you didn't have the care that we have, we didn't have contraception that we have, You know, we were having children left, right, and centre, and if you complained about your women's issues, you usually had a hysterectomy whether you needed it or not. And, you know, the newsflash is that lots of women want meaningful— it's not about sex, which is helpful for some people, it's all about intimacy and having a safe space to talk. And I think that's where we sort of differ, and certainly we're finding women coming to us because they want that help. So So yeah, and because they feel, they feel relaxed with you as well, I imagine, because you're nurses and they, they feel very relaxed because they know that you've kind of, you know, been there, done it, and seen it all kind of thing. Same issues. Yeah, exactly. So yeah, I think, I think it's a really good thing. So what, there was some like controversy about late vaginal laser treatments recently. What do you say about that? How long you got? I mean, because I'm really interested as well, and I know that everyone will be, because I think that it's a real shame that they've put that out there, because personally I'm such a huge fan of it that, you know, and it done me— I'm not making this up, you know, I've got nothing gain from it. I'm just saying what a positive experience I had, and, you know, I don't think people should be put off. So I just wondered what you make of it, or if you can explain it to us. Well, at the end of the day, a laser is a messenger, and what we say is, as long as the laser's made properly, so it ticks all the right boxes— CE, medical, it's made with all exactly what it's supposed to— and there's not an idiot either side of it. So that sounds a bit blunt, but, you know, the patient is following instructions that they're given and the nurses or the practitioner follows the protocol appropriately, there's very little that can go wrong. You know, it's a bit like baking— you can always add but you can't take away. Now I'm going to go back a little bit in time because my background, like I say, I've been a teacher for nearly— well, got nearly 30 years now. And back in 2008, there was an announcement that lasers were going to be deregulated for aesthetic reasons.. So the rationale for that was that they're pretty set. You used to have to be CQC registered and you had to have a doctor on the premises or at least on call. And what they were thinking was the CQC are like, goodness me, we've got so much work, do we need to be policing tattoo removal, hair removal, skin rejuvenation? Because it's pretty safe. So that was the idea of wisdom. Now people that were at the top of the game in terms of laser safety and all of that were like, oh my goodness, are you not thinking straight? What are you going to put in place? And they were like, well, Well, it'd be fine, I'm sure it'd be fine. So everybody knows around about— see what that is, that, that regulated— Care Quality Commission. So they're the people that regulate hospitals, dentists, care homes, and so on. So in 2010 that came in, which meant you don't have to have a special qualification to do what we do or buy a laser of any sort. And people are buying them from good quality places, getting good training, and some people weren't. You know, we could go on about the aesthetics market forever. And then sort of around about 2012, we had the sort of the Keogh Report into the PIP breast implant scandal to say, look, aesthetic medicine isn't regulated. So there are issues. So we've certainly seen our insurance go up over the years because, you know, people are setting up doing Botox and filler parties in their front room. And some people are very good at, you know, level 4 trained. Some people are just doing a course that's half a day. Never learned any of my nursing skills. So yeah, we were on the committee in 2011. I was running an academy then as well as a clinic, and they were saying, you know, with the government, what should we do here? And we're saying it's just insane. You should have an entry-level qualification so that the patient that comes to you, or client, knows what skills you've got. You know, basic infection control. You should have basic level of what happens if something goes wrong. What do you do if there's an eye injury? Simple thing like how do you set your room up so you don't trip over? They're all these silly things that they— so they came to the conclusion that you should have different levels, and the regulation is changing hopefully soon, that you should have a baseline, what's called the core of knowledge, which was written by the Medicines and Health Regulatory Authority. So, but it's, it's not enforceable at this moment. So basically, if I brought you into my clinic and said, so look, here's a patient, stick that in there and wiggle it around, that's fine. 9 times out of 10, not a problem. You see things like HIFU, which is a slightly different version, being done in beauty salons by therapists, which is, which is absolutely fine. But without some of that, they don't have to have that anatomy. So anyway, we were going— we've got me on my soapbox now. We were setting up our clinics to do things that required Care Quality Commission registration, so all of our clinics are registered. And there was a big hoo-ha about the NuVeY, and they were saying, it's laser, you have to be registered, you have to be regulated for it. And we said no, because I've been on this committee, I know that, you know, aesthetic lasers don't need that. CO2 can be used on your face. And they— this went backwards and forwards for 2 or 3 years, and they would not be drilled down as to why we should do that. Now, eventually we managed to get an email, and I'll show anybody who wants to see— I might frame it and put it on the wall. So the conclusion they came to this is the regulator that keeps people safe from harm. Yeah. Was that a therapist falls under that radar of, yep, you're right, it's an aesthetic laser, they can put it in the vagina, that's fine, probably not going to cause any harm. But because we were using nursing skills related specifically to women's health, so I've got urology, sexual health, gynaecology, we've got cancer specialists, all of these, is that you are regulated because of that. No, that's absolutely great because that means that I can legitimately say— so the category it falls under is the treatment of disease and injury, which means I can say that this is a medical procedure because of the processes we go through. Now, if you come to the clinic, in our clinic, you don't have— there's no salespeople. You speak to a nurse. We do a health screen before you come because you don't want to waste your time coming and finding you're not suitable. You then have 45 minutes with that nurse in that appointment where we are looking at your medical history, gynaecology history, what's going on in the bedroom, what's going on in the bathroom, what's going on at work, what's going on with the kids, what's going on with your relationship, all of that. 45 minutes, bearing in mind you've already had 20 before you come, is a long time to explore a lot of things. And then if we feel that the patient is suitable, we can do that treatment but precede that with a full pelvic floor examination within our skill set. We're not physios, but we know what we're looking for and what we're hoping to achieve, and then you can have the treatment on the day. So we feel that gives a bit more of a safety aspect, but also a more personal aspect to this type of treatment than is already out there. Yeah. Oh no, I, I, I definitely get that. I mean, funnily enough, I'm on the other side of the fence in a way. I think I told you that in my email, is that I'm not a nurse and I do have an aesthetics clinic, but I'm very highly qualified and trained, you know, as much as you can be without being a nurse. And it's like difficult for me as well because I know people that, that come in and they, they have been on a 2-hour course or something and start sticking Botox in people's faces. But there is like, so you've got the nurse, you've got me, that's, you know, I don't feel I've got as good a reputation as you because you're a nurse, and then you've got me, and then you've got the people that really shouldn't be doing it. But what I mean, what do you think about— you did actually say earlier on when we was talking, some people are Level 4 trained and you're okay with that. Yeah, well, I personally, in my clinic, I've got therapists that work with us. So everybody— so we've got our own training academy as well because like I said, I'm a qualified teacher as well as, um, as well as this, is that all of our nurses are trained to, you know, you don't need to have a core of knowledge course, but you don't get in front of a laser because the core of knowledge is— oh my goodness, it's my partner just as well, not again, a business partner, right? She's like, here we go. Yeah, you're talking about what is a laser, which is a big topic, what are the risks, what are the current government guidelines What is a safety procedure? So we have lots of things in place— laser protection advisors, daily checklists, regular servicing. All of that is, is done to within an inch of its life because I don't want anybody to touch me or my family or my patients or my colleagues without having that baseline of knowledge. Because you have to know what's going on to be able to work out when things may not be quite right, you know. And, you know, we have had patients where it's not suitable for them, and you need to know why so that you can signpost them appropriately, which we sometimes have to. But yeah, it's a difficult one without the regulation, but we have to do it the best that we can, and everything we do is transparent. If you want to see a certificate, you can see it, it's there, you know, it's that extra level. Okay, well, so, um, Emma, how did you— because you said you had a bad, uh, experience really, and you're a nurse, so that says it all. Do you mind sharing that with us? Yeah, definitely. I'm not going to go into the gruesome, awesome detail. You had all that the other day, bless you. I'm surprised you slept. But it's all women on this channel. We think. So we— I had baby number 1 with a C-section. I was adamant I was going to have baby number 2 not. Quite a difficult— it was only 19 months between the kids. Had quite a junior midwife. I was classed as high risk. This went on for a while, lots of problems struggling to get baby out. Got put in stirrups, one of them snapped, got put in stirrups again. Sorry, funny, but you just— the way you said it. I was very happy sitting on a birthing chair, stood up to stretch my back. No, don't sit down. 'Well, we've taken it away, somebody else needs it.' Oh goodness me, more labour than me, great. Then the junior midwife was like, 'Oh my God, you're one of the preceptors at the hospital here, aren't you? What about this?' Like, really, this is not the time. This is really not the time to have this conversation. What, they were asking you questions? Oh yeah, 'Well, you work here, don't you?' Please just leave me alone. You know, you just want to be left alone. Anyway, it progressed. I was getting absolutely exhausted. 'Oh, if you don't do it, we're going to cut the I'm gonna cut you again and we're gonna do this. And in the end, when I pushed— he's nearly 18 now, bless him— there was quite a severe tear, let's put it that way. And then they called— the junior midwife called the arrest button, at which point quite a lot of my colleagues came running in. So I really don't want to be seen looking bow on some stirrups. Gynaecology— the obstetrician had to come in and he was stitching for about an hour, bless him. All very horrible, very difficult. Two kids under two, you know, all of this malarkey. And I started having issues with sort of bathroom activities, and I had pain. There was a very specific pain. The guy did the work, did brilliant job, but, you know, in the circumstances, you know, it's— it was an emergency. You don't have time to stop and think and, you know, have a break and come back. And so I sort of said, I've got these problems Some of it related to going to the bathroom, either for a pee or a poo. Some of it related to pain either during intercourse or just at rest. You know, it was just difficult, very difficult. This went on for about a year, and I sort of asked for help. The stress incontinence was getting worse. I was going when I had to, not when I wanted to. And you know, you can't— when you've got 2 kids under 2 running around at a playgroup, you can't just I was going to quickly nip to the bathroom and it was just horrible. And the thing, it caused problems with relationships as well. And I sort of went back to the GP and they went, okay, we'll refer you to the hospital. So back to work I go, go to see the gynae. Gynae says, this problem— so it's a bit of tissue on the inside and something going on on the outside. This is not gynae, I think it needs to go to the bowel surgeons. Okay, so go over to the bowel surgeon, they go, No, it's urology. So bear in mind, I was still working there. So back to the urology and there's like no urogynaec. So this went on for about— so pants off, legs up, pants off, legs up. Oh, let's get the medical students in. I'm thinking, I'm— this is just not nice. Very little support. You can't go and tell your friends what's going on, whatever. So anyway, this culminated and I went to get another appointment and these are all 6 to 12 weeks apart. Yeah, sorting the kids out, all of that, trying to work, keep my head above water. And I just, I flipped. I absolutely just broke down one day. I said, just somebody, somebody do something. I cannot keep doing this. I'm going round in many circles. And, uh, okay, so we're going to refer you. We'll get you another different referral. So I get this referral and it's for a psychosexual counsellor. Oh God. So I'm getting there and she's flicking— I'm doing it here now— flicking through the notes and she says, look, I'm just having a look through your notes. Oh, I see you were a bit aggressive at your last appointment. Oh, aggressive? I said, that's called assertive. I said, I am not going to say the words, but I'm cross, really cross. And she went— and she asked some really, really stupid questions about functionality. My ex-husband now was there, so I couldn't, you know, we want you to bring your partner, so I couldn't talk about what was going on because you don't want to talk in front of your partner about bathroom stuff particularly. And in the end she said, well, what did the physio say? She was getting really with me. And I said, what physio? And she went, oh, this bone. Yeah, youngest is 3 at this point. So I went in to the physio and poured my heart out. I was there for an hour and a half, snot bubbles, the lot, you name it. And she just said to me, right, tell me where it is, just show me where it is. And I showed her and she went, okay. So we did a program of physio which helped, but I was still getting this ongoing pain around front and back and whatnot. And this— So, excuse me for interrupting, but did you need to urinate a lot then? Often? Was that part of the— Yeah. Oh, you had— Yeah. But it was— you needed to use the loo a lot? Yeah. Well, yeah, I mean, I've got pelvic organ prolapse, which wasn't helping. And it, you know, potentially, you know, what had happened was there was a problem with you having a tear from front to back, is it can give you some— what's called a rectocele. Which is where the bowel sort of pushes, the rectum pushes into the vaginal wall. So you get a bulge, so you have problems with constipation, urgency, all these sorts of, you know, pressure in that area. But then also similarly, I've got what's called a cystocele. So the bladder had dropped. So I was— I got it all going on. So the physio, to be fair, and touching wood, worked really, really well to a level, but I've still got this ongoing pain. And in the end she said, I'm going to get you in front of all three. I don't know how she did it. All three of these doctors, bear in mind I'm working at this hospital and my mum's best friend is in theaters. I'm going to get you to have an EUA, an examination under anesthetic, so that I can show them what you keep trying to explain. So I went for that procedure and I was under for— well, I was in and out of recovery within 10 minutes. 'Yeah, so how did it go?' She went, 'Well, you were under for 7.' She said, 'The first 2 minutes was me putting the speculum in and saying, that bit there, that, that's what she's telling you.' Oh, so the next 5 minutes was them arguing about who owned the problem. And she said, 'I had to remind them that it was you that owned that problem.' And the 3 of them were like— and by the way, still, she's still under anesthetic. Yeah, legs akimbo. So it was just a small sort of a short procedure that needed— I'm not going to go into too much graphic detail, but it was a very short thing that needed to happen, like a, you know, 5, 2-minute-long sort of thing. And each one of these chaps was like, "No, I don't want to do it." "I'll do it." "All right, I'll do it then." Yeah, they were like, "Done." And that sort of came out, and the relief instantly was immense. And I sort of took that— You had it done there and then? Yeah, yeah, it was just, it just needed a small, I don't know if I'm being squeamish, but it just was a piece, a band of tissue that was pulling everything completely out of alignment. Yeah. Is that right? Yeah. Okay. So you actually had it done like within those 7 minutes that you was under? Yeah. And it was like, I'll do it then. And then from that experience, and this is, this is when, this is 2009. Yeah, I hadn't set this business up then, I was still working in the hospital, but I took away from that experience that my ethos is that if I can't find a way to help, if it's not in my remit, I'll always do my very, very best to try and get you that help, be that advocate for you. So if I go back to that lady that says, I've had a couple of kids, 'But stress incontinence, sex has gone off the boil,' and the GP goes, 'And?' I will write that in a letter for that patient saying, 'Mrs. X presented with— this is the vagina, this is the da da da da da.' So I'm asking the same questions in a different way and then giving them what I want to happen so that that patient has got an advocate. So if I can't— we have it with vaginal estrogen at the minute, you can't have Ovestin and, um, Vagifem at the same time. Yes, you can, because if your problem's on the outside, bloody fends on the inside, or vesting's on the outside, you know what I mean? You can do that. So yeah, and that's sort of the ethos, you know, of what we do. And, you know, you've seen from some of the feedback we've had, and, you know, people like Sarah Carson, that we have done that over these years and we continue to do it. That was good fun, that was different, but yeah, I came back. Why did you come back? Did you emigrate there? Yeah, the kids were quite small and we wanted a bit of a change, but it's just I've got— because I inherited stepkids who are now adults, and it's just too far away. And there's a little bit of a glass ceiling when it comes to English nurses. It's very— at the end of the day, Sue, there's 4 million people on the same landmass as the UK, so it's very different. So But yeah, it was all right, I had good fun, worked in a surgical unit over there, got some great friends and great experiences out of it. But yeah, home sometimes calls you, doesn't it? Yeah, definitely. I don't think I could emigrate. I speak to a lot of people that have and they eventually come back. One said, well, there's only so much beach and sunshine you can take. That's what they said. Because you could get bored with that. Well, I don't do it anyway because as we all know, skin is— sun is not good for the skin. And you've got the— the what's it hole? Oh, there you go, here comes brain fog. Crater? The ozone hole. It's over there, so much more active than the sun over there. Yeah, okay. So So what do you think about HRT? You're a fan of it. I think you must be because you supply it. But so many people have so many different, you know, you shouldn't use HRT because it can do this, it can give you cancer, it can do this, it can do that, which I'm a total fan of HRT. But what's your, what's your, you know, ideas on it? I think it's personal preference. I mean, I'm not the menopause expert, you know, Karen Arner is. And it's again, you know, in terms— we talked about this the other day— in terms of education, it is a lot better in the last few years. A lot more, um, sort of, you know, things like the TV programs and whatnot is that women are getting more educated. You know, we've got a shortage of HRT. No, we've got more people wanting it. So that's because they're more educated. Women are, you know, never say go on Google for your diagnosis, but women are learning a lot more. And I actually was at a conference British Menopause Conference, and I actually met the chap that was on the— remember the big scary one where you take HRT, we're all going to die, the one that they pulled the plug on? And he was explaining some of the politics behind that and how it's probably done more women more harm to it in those years to have not had it. Now we've understood safe zones of starting it and monitoring and so on. And also in this country, until very recently, you had to pay for both types of hormones separately, and you were paying for them a lot, and that's changed now. So it's making it more accessible financially for women. Um, say one prescription, you know, a few months, and then you would have your— you can buy up to 3 months or a year, whatever. But I think again, when it comes to menopause, I mean, I, I don't sell laser as the, the golden chalice. I'm looking at all the other things that you might use, and some of my patients go away and try that, um, and then maybe come back. But with our menopause service, you've got 45 minutes to an hour with a nurse doing all the things that we do in our clinic where you're going through everything so that then you can say, these are all the options. What, what do you think is best for you? As opposed to, right, 7 minutes, one symptom. You know, it's a lot of education about menopause, understanding what's happening to your body, why it's happening, and giving women the option to say, 'Actually, I think I might try that,' and if it doesn't work, although they're not feeling good on that, then we can change that. You know, some, some GPs really, really up to upskilled massively. We've got a lot of stuff going on there. Some not so much, you know, it's a bit of a lottery. But, you know, patients have to have all of the information to be able to make the right decision for them. You know, it's not about targets or, you know, let's sell how much of this or whatever. But yeah, It's personal preference, and I know certainly I'm not going to say no to it. No, I mean, I think I'll be on it forever, to be honest, because that's the other, that's the other kind of misconception is that, you know, one day we're going to, we're going to have our menopause, but we're going to get over it and it's going to go away. But for some people, it just carries on forever, doesn't it? I mean, it's, it's, I mean, the NICE guidelines are there for a reason. We don't do bloods underneath the NHS guidelines, because in the figures, about 60% of women, depending on what method they choose to manage their menopause, are okay. They're happy with it, whether it's HRT or not, or supplements, whatever. And generally, there's no point in me doing bloods on everybody because that'll be going up, that'll be going down, that for everybody. It's just when there is that— I always say to patients, it's a bit like a tightrope. So, so for some ladies, their menopause tightrope in terms of symptom management is as wide as a plank, and for others it's as thin as a spider's web. So you try this and it works, and then you tip over the edge again. And I think it's having that ability to work out what needs to happen. And we do— sometimes we do bloods just so that we can monitor, see how people are going on. And obviously you can't do that on the video calls, but it's, yeah, it's a challenge. But, you know, women Women are in a lot more control now than they ever have been, I think. And medics, you know, there's some fantastic courses helping them to be able to support women better as well. Yeah, yeah. No, I think it's definitely getting better and women are getting more information and there's so much more support out there because menopause recently has become a hot topic, hasn't it? But I still meet women that will say to me things like, 'Oh, I can't take HRT,' although they're really, really suffering because their grandma had breast cancer. And it's not always the case, is it, that you can't, you can't take HRT because, because of that, you know, it might be, but it's not always the case. And I think there's still a lot of women out there that do think they can't take it. And that's quite sad, really. But also, I mean, there's— I've worked with patients that have had breast cancer who are, you know, more risk of, you know, if they have estrogen, there is more risk of that cancer possibly coming back. Yeah. And they are certainly— I've certainly seen a trend probably in the last year or so where women are basically— they're having their trauma of the breast surgery, chemo, radiotherapy, all of those. And for some of those ladies who weren't menopausal when that happened, they— it's instant. You know, they're— they plunged into it. You know, Sarah Carson on our website has been there and back in a handcart and been really good about sharing her experiences. So they find that the sexual function is so debilitating— oh great, I've got— I'm alive, but I can never connect with my partner again— which can be really soul-destroying. So I've probably had 3 patients in the last 6 months who have jointly with their breast surgeon said, look, I know the risk of me vagina and estrogen means I'm at 10% more risk of this coming back because of the sensitivity, but it's a chance I'm willing to take. Yeah. And they're getting that opportunity to make that decision for themselves because 25 years extra life without ever connecting with your partner again is soul-destroying on so many levels for both partners. Yeah, we sort of— me and my husband talk about that, you know, um, he likes a drink and I like sugar. It's not— neither of those things are good for us. But, um, you know, we say, well, we could live maybe another 5 or 10 years if we completely cut out the sugar and the alcohol, but it won't be that much fun, will it? Do you know, it's responsible for yourself, isn't it? Take it, you know, rather than being told you cannot have this or you must not have that. Well, I want it. Yeah, and the risks, you know, we had this with all the, the stopping the mesh sort of thing is One of the issues with the mesh is that some— in some cases it was being, well, if you don't have that, then there's nothing else to help you with. So people were having it for the wrong reasons rather than making a clinical decision for themselves that worked for them. And, and, you know, at the end of the day, we've got to include partners in this, because if your partner doesn't understand, if you don't understand what's going on with your body during menopause or atrophy or all of that, then how on earth are you expected for your partner to be able to support you? Because partners It's not all about sex. It just isn't. It's all about, you know, partners don't just love women because they've got a vagina and breasts. They love that person. They want to be intimate. They want to have— because if you thought you were hurting your partner, it would be awful. And I've had women in the clinic saying, I've told my husband he ought to leave because, you know, we want intercourse and we can do everything except penetration. And I've just told him to go. And It hurts men just as much as it does women with this, and that's why we have to really do what we do in the consultation to see how we can help everybody and educate. Safe marriages. Yeah. Relationships. Yeah. Yeah. So, um, oh, so you end up being a bit of a counselor as well, Emma, I expect. We do. And, you know, our feedback shows that. I mean, all of our feedback, you know, can check it all. It's all genuine. You know, when you get people, when you get patients coming to you and say, I feel so much better, or I feel like a weight's been lifted, or, you know, I just, I didn't know, I just didn't know this was available. Or, you know, they've been put off with the, I mean, ITV vagina facelift, when Lindsay was brave enough to go on there. She's just come back actually, the patient that was on there after baby number 6. And then they call it that. Yeah. And then the doctor sits— because I was like, I'm quite happy to come and advise you because I'm up to— I'm on the ball when it comes to all the research. You know, everything we do is evidence-based, as it should be. Yeah. And I said, I'm happy to come along, not go on the telly. I don't want to go on the telly. I'm happy to share all of that with you. And then the doctor sits there and says, there's not much research in this. I'm screaming, absolutely screaming. And anybody that knows me would never dream of calling it a vaginal facelift or designer vagina because it's not. We're not about vanity. I mean, there are designer vagina things going on, aren't there? There are, there are treatments that can just be for aesthetic reasons, but, but not this. This is a whole different ballgame. This is about your health and your, you know, your your way of life. It isn't about what it looks like, basically. It's to make it work better and be more comfortable. So yeah, I get really annoyed about that as well. Procedures aren't the be-all and end-all. They come sometimes come with their own problems. Which is— what's that, sorry? So people having surgical procedures can actually cause more problems than it solves. That's why a consultant— so when I had my issues, I was in my early 30s they didn't want to operate. And, you know, to be fair, I'm touching wood because the Nuvi is going to be 18 in May. The Nuvi has managed problems that will need at some point, because it's mechanical changes, will need a surgical intervention. I'm touching wood because I'm holding off on that. But I've managed to maintain what I've got and make it usable and, you know, help, you know, manage all those problems my own way. Yeah, because I tell you that it kind of— are you saying that, you know, it does help long term, but maybe one day you might have to have, you know, some surgery, but in the meantime you're keeping it all under control? Oh yeah, menopause is going to cause its own problems as well. I mean, it's a case of if I operate on somebody in their 30s, then chances are in about 10 to 15 years, because the age process, menopause and all that, is that those problems will maybe come back because, you know, loss of volume, reduction of blood supply, scar tissue and all of that. And then if you do need that procedure redoing again, so another prolapse repair, let's say, or another rectocele repair, then you're 10 to 15 years older, you're a bigger anaesthetic risk, you've got a longer anaesthetic, and we're working with scar tissue. So they will sensibly, which, you know, that's the NICE guidelines, if you try everything non-surgical until you have no other option, and that's sensible. But also, our treatment can also maintain. So I've got patients that have had the transvaginal tape, patients that have had the mesh, they're fit and healthy, no problem. What's a transvaginal tape? Can you tell me what that is? Basically, it's a simple day-case procedure, but it's sort of fallen out of favor with the whole mesh side of things because it's a foreign, you know, a foreign body, the body can reject it. And that's what they think, in a nutshell, is the issue there. You could have a reaction to a hip replacement, a heart valve replacement, even a contact lens. But basically, it's a strong mesh-type procedure that lifts the top wall, the anterior wall, so it lifts the urethral opening, the wee tube opening, so that it makes— just, it just shores things up, basically, in a nutshell. But it's not used as much now because of the you know, the guidelines changing and whatnot. But it has been very useful as a simple, you know, a vaginoplasty or an anterior posterior repair, you're out of action for 6 weeks, whereas the TVT, transvaginal tape, you've got, you know, a day case procedure and you're sort of back to work within 7 to 10 days sort of thing. But it's the Nuvi can actually help maintain the results of that procedure because it's stimulating the collagen, which is the thing that changes which makes your symptoms come back. Yeah, in most cases. Yeah, well, you know, I mean, this— have you heard of fibroblast skin tightening? Yeah, yeah. So I actually have that device here, and I do do it on people, and it is quite a painful procedure. And I don't know if people understand it, it's plasma, plasma arc that is created by the the water on your face and the device being put near to it. So just— this is the truth, right? I do do it under my own eyes occasionally. And last week— or no, about 3 weeks ago now— I just did under one eye, and then I literally brought it across the cheek because I was starting to get quite a few lines. I didn't do the other eye because I couldn't cope with it both at the same time. And do you know what? It's bloody amazing that one side of my face is now, I would say, 80% less wrinkles than the other. And that's exactly the same kind of thing where you damage the skin and then the collagen kicks in and, and starts to work. So these things really, really do work, don't they, if they're done in the right hands and that you, you have the right equipment. You know, I mean, one of the other challenges that we've got, and we sort of touched on it, is if on our— so on our womenshealth.clinic website and silvery.blue, which is our medical aesthetic arm, so we— part of our advertising is for Google Ads. So we do PRP, platelet-rich plasma treatments, which you can do vaginally as well with hyaluronic acid for dryness for those ladies that can't have estrogen. Is Google every now and then change the rules a little bit. So they'll review things in line with, I don't know, the FDA, for example, or, you know, different guidelines, research, and they'll pick out words that they will not— no, they will no longer push. So last year it was PRP, platelet-rich plasma. Oh, that was, that was, that was off of it, was it? That was off the Google. Yeah. What they're saying is, I mean, the thing with PRP there's so many different ways you can do it. There's no wrong way, but there's also no right way in research. So that was their argument. So if you— even if I paid them, say, £500 a month, they— because I've got PRP on my website, that sort of grays out, so you won't find it so easily. Yeah. This year they have thrown an absolute curveball, and I find this quite offensive because I think this is, this is preventing women getting good quality access to the information that they need that will help them. Back on my soapbox again, and that the words that they've chosen are intimate, vaginal, sexual, incontinence, urine. Now, those words— so they'll still take that £500 or whatever it is we pay a month, but you won't find us as easily. And people don't always find us easily anyway because they don't know what they're looking for. Yeah. So again, it's another way of stopping women from, you know, menopause are probably the next one. And how do you know that? I'm really curious about that. We'll have to get my business partner on for that one. So we work really closely with them at quite a high level. And he's gone, you know, he's gone all the way up to— he's gone to America, not physically, but he's gone as high as he can within Google to say why Facebook did it. They want that— it's rude to talk about vaginas. No, it's not. Every woman's got one. Is penis on the banned list? Of work? No, probably not. No, no, just— I'll send you the screenshot of it. You'll make your blood boil. But I just see that— I didn't know that they did things like that. Yeah, yeah, definitely. So we've now, you know, we— PRP treatments are so amazing. You're using what your body's got. We're putting it where it needs it, and it's very, very safe. You know, I've done Botox and filler training. It wasn't for me. Yeah, my heart just wasn't in it. And I thought, there's no— you know, I could make money hand over fist like some people do, and you know, fine, but it just doesn't float my boat. Whereas lasers, chemical peels, needling, radio frequency, they're all working with your body, and then we can supplement that. Yeah, so it's just— well, I've got my soapbox again. That's all right, Emma, you can like— you You can get on your soapbox. I totally get it. I just didn't know that Google did that with words. Yeah. Do they kind of like change it again the following year? Will they decide that it's okay to have the word vagina? Or maybe, maybe not. But, you know, PRP is definitely not on there. So we had to change it to some ridiculous name which makes no blinking sense. You can do things on your YouTube channel where you're talking about, you know, we've got Instagram, we've got Facebook, we've got our YouTube channel where we show these treatments and obviously we can name them. But, you know, you can't then go and put PRP on our website because you can't find it because it's got a different, completely different name. It's just so frustrating because it stops us helping. Yeah. And stops people learning. Oh, now I told you, I told you. Yeah, it's a— God was a man. There you go. Well, one of the things, and we sort of touched on it as well, is that if you're an existing patient, so let's say after today when this goes out, somebody thinks, I'm really interested in that. So with our protocol, just going back up in terms of the pricing, so the recommend— so you would come to clinic, and I know you're going to say this next bit, you come to the clinic, so you speak to a nurse for 20 minutes before, which you can book online, WhatsApp, whatever. You would then come to the clinic, we take a small deposit, you come in, you're gonna laugh now, we don't say, right, Sue, come on in, get your pants off, get your legs up, let's crack on. We do that 45-minute consultation, and then if you think it's suitable for you, you can have it there and then, and you'll get that £25 back. If you take our advice and you go away, pelvic floor, whatever, fine. But what some ladies will do is they'll pay for that program of 3 straight up and tell me if I'm doing this wrong. So they'll pay for the triple pack or they'll pay for the first one. And then when they come back 6 to 12 weeks later, pay the difference. And everybody loves number 3 because it feels like it's free. But let's say you go and speak to your friend and you say, I really like this treatment. And she rings up and says, Sue Moxley came to your clinic and she said this, this might help for me. Then what we would do, we wouldn't tell you that Jane Smith came in because that's private and confidentiality laws and whatever, but you would both get a £25 voucher. So you will just see those, you know, coming up. So the more people that share this and, and talk about their experiences means that you're helping us to help others. Does that make a bit of sense? Yeah, of course. That's why I've got this radio show, you know, to get it out there and with people like you and help to spread the word. So yeah, yeah, no, okay. Well, well, Emma, it's been really, really lovely to have you on the show, and thanks for being really open and honest about everything and discussing vaginas with me today. That's all I ever do is talk about vaginas. It's better than When I was on the urology ward, because it was 50/50 boys and girls. It's all girls now. It was quite funny when you said it's not a great legacy to leave my children and the vagina, but I think it is a brilliant legacy. And so again, the name, the name of your clinic and also all your clinics and also your web address and how they can get in touch with you on your social media, etc., etc.? Yep, so we've got— so the womenshealth.clinic is the website, all one long word, .clinic. Yeah, there's different ways to get in touch. So you see at the top of the website there's the 0800 free phone number, so you can ring there. So we're all nurses at the end of the phone. If the nurses are busy, it will default to the all-female call centre, so they'll take a message. The other thing you've got is if you look at the bottom of of the page, you've got the work WhatsApp number. So you can— we're all nurses on there. There's about 5 or 6 of us that are on the telephone team there, so you can always send a message. The other way you can do it is if you click the book button at the top of the website, you can actually see the diary for the nurses. So they're almost like a clinic in themselves. This is for the telephone nurses for menopause and Nuvi and the aesthetics that we do. So you can actually book yourself in there and register. And are you on social media? We are. So if you click on the top of the— so we've got the YouTube channels, which is the Women's Health Clinic, and you'll see there's other women's health clinics in America, and I could probably send you the links actually. It's got the logo that you'll see on our website, nice blue picture. And then we've got— we don't use Twitter so much because we've got too many strange people, let's say, asking rude questions to try and catch us out. But we're also on Facebook. Facebook, so you'll find us, the Women's Health Clinic, on there as well. And again, just check out for the logo on that, but you can actually access them from the website. So if you click on them, and then on the Instagram, again, it's just the Women's Health Clinic. Okay, well, that's great, Emma, and thank you so much for coming on. And, um, hopefully we'll, we'll, uh, we'll talk again in the future, but keep doing your good work and Yeah, so really nice to talk to you. Okay. And you, darling. Thank you for having me. Okay, we'll speak soon. Okay. So, well, that was a really nice conversation I had with Emma about vaginas today. And yeah, she's a very, very informed lady and a nurse, and the women's health clinic sounds like a wonderful place. And I'm hoping to go there myself for an appointment. And yeah, so everyone, thanks for listening in. This is The Menopause Show, and this— and I'm Sue Moxley, women's radio station. Follow us on Instagram and Facebook and YouTube, and speak to you all soon. Thank you very much.
