The Menopause Show With Sue Moxley – Sally Ann Turner, Director Of Bodyline Clinics

Hi, this is Sue Moxley. This is women's radio station. This is The Menopause Show, and today my guest is Sally Ann Turner. And hi Sally, are you there? Yes, I'm here. Hi, hi Sue. Hi, nice to speak to you. What's that accent that I can hear? Where are you? Well, I live in Blossop in Derbyshire, which is not far from Manchester. Ah, is that beautiful? It sounds like it's beautiful. Yes, it is. It's in the Peak District. Lovely. Yeah, lovely. Bit rainy today though. Yeah, it's very rainy here. I think winter's definitely on its way, isn't it? Yeah. So tell me about your company, Bodyline. So I am founder and MD of a medical wellness company and that we started to build about 17 years ago. And we specialize in a couple of areas of treatment, mainly for women. And the first one being menopause and HRT treatments, and the second one is supportive medical weight loss programs. And the majority of our patients, as you can imagine, probably 95% of those are women, and we treat about 500 women a week through our clinics, both either in clinic or through our remote healthcare platform. Wow, amazing. So how did this come about? You know, how did you decide to do this? So the menopause specifically, Because of the amount of women that we saw to do with helping them manage their weight loss and weight health journey, we, we, we see a lot of women who are in perimenopause or menopause, and one of those symptoms or conditions with menopause is that women see weight gain. So we, you know, we constantly see that and help women through that journey. But of course, we looked at how can we better manage that journey for these women. And of course, it's looking at the balance of the hormones and those stages of menopause. So we started to do our homework of look at how internationally people were treating it, how we were treating it in the UK. And a lot of women were coming to us with these menopausal stories that they'd been through the NHS, that they'd still not resolved, you know, how, you know, their menopause journey would be treated. And so we started to have a look at, could, could, can we do that a little bit better, especially for those women who haven't had success within the NHS? And so, you know, we've been doing that for a number of years now, and we do uh, where people can come directly to us in the clinic, but we also specialize in providing, uh, services for large organizations, um, whether that be, uh, occupational health providers putting it on their platforms for employers. So there's a lot of movement now within the area of corporates actually adding this to their employee benefits. Wow, so, so that's a step forward, isn't it? It is a step forward because I think that if you get offered as a woman, um, an employee benefit that you could have a supported, uh, menopause journey with treatment options in there. And let's say, for example, if the NHS hasn't managed to get that journey quite right for you, that you've got that ability on your occupational health platform to actually access that, then I think that, you know, a lot of women would see that as a positive step forward. Yeah, so is there quite a few companies that have done that? Yeah, I've not heard of this. There's, there's, we're quite new into this because there's not a lot of scalable operators out there that can offer this on occupational health platforms, but we can. Our prescribing team, we've got 25 specialist nurses headed up by two clinical directors. So, you know, this is starting now to happen that we're working with occupational health providers who are saying we want treatment options. There's a lot of education and awareness out there with— yeah, there's a lot of talking of all the changes that we could make physically, whether that be air conditioning, fans, you know, breakout things, things like that. But the reality is, is that if you're still waking up 10 times a night with hot flushes and you're not sleeping at all, then, you know, there will be certain women that only treatment, as in managing their hormone levels, will work for them. So it's that area that we specifically specialize in. So is it bioidentical, Sally? No, we don't do bioidentical as a first pass because we, uh, you know, obviously can only use licensed medications. Yes. Um, so, you know, as a healthcare provider and CQC registered, we use licensed medications. Bioidentical, um, hormones is not quite there yet from a licensing perspective. Yeah. And, you know, if you look at internationally, uh, it's quite big in America But we use only licensed preparations within Bodyline Medical. So why, why is yours different then from the, from the sort of like tests that you'd get at the NHS or something? So the first fundamental thing that we believe does make a big difference is we actually do a blood profile first. And there's a lot of debate of whether that will, you know, sort of like the accuracy. But what we've tried and tested, it gives us a really good benchmark. Patients like it because they, they understand where they are. And we don't just do the fundamental hormones. So what we do is we will test. So we will do obviously our testosterone, estrogen, progesterone, but we also look at your B12, vitamin D, the zinc and the magnesium, because all of those things together, it's about looking at the whole. So, you know, you know, your hormones could be, you know, within tolerance levels. But, you know, if you're, if you're really low in vitamin B12 and really low in vitamin D, you're going to have a problem. So, um, you know, and these, these manifest themselves then into certain type of conditions. So, you know, whether that be fatigue and all of those types of areas. So we look at the whole, and we do, um, we've developed our own, uh, menopause, uh, blood profiling kit which is called the M-Plan. And that gets sent out, and you can do this through Capillary. Then we look at your complete bank of results, and from that we can then develop your treatment option. So where we believe that we're very different and we can get good successful outcomes for patients is that we provide a whole supported journey and, and It's not a one-size-fits-all scenario. And this, we know this because we see the women say, you know, I know that this is my hormones and I just want to understand how I can do it. So, you know, what we might prescribe for you, Sue, and what we might prescribe for somebody else, those levels and those tolerances are very, very different and requires support for women to be confident. A, in— we educate them in how that might be. So if they come to us with a list of symptoms, we was— we will probably say, hmm, it might be that your estrus, you know, your estrogen level might be too high, or it might be that your progesterone level is not enough. But we have— we work it out, um, with the patient, and generally we find that the first 3 months of that journey, the You know, we work it out with them with those titrations. It might take some women up to 6 months to do that, and we work with you of understanding what we think they are. And, you know, when we have those monthly reviews, it's about, so tell us what's changed on your symptoms, and it's about having that discussion and working it out with the patient of effectively where that balance is right for them, the types of things that they're going to do, because it's not just about the medication, is it? It's about the whole holistic of lifestyle. And, you know, exercise is absolutely huge within that, but there's no point in saying to somebody, well, you know, go to the gym 3 times a week if they've got, you know, they haven't got the ability to do that. It's about working out with the patient of going, what works for them, whether they've got a dog, whether they've got to up going walking with the dog. It's about understanding the patient, what their needs are, and getting the best outcome for them. So what, so monthly then, do you retest them or do you just kind of like— No, we would suggest, so depending on what the first profile would show, okay, we go on the journey with the patient. As a minimum, we would say we would probably do it every 12 months. But let's say that we're 6 months down the journey and we've, you know, we've still not got the journey quite right. We would be going, right, let's retest and let's see where those levels are and where we've got to. So for example, you know, we see a lot of women. It's quite interesting, you know, we'll see a lot of women who have maybe using too much estrogen. Yeah. And their estrogen levels are right at the top end and they're getting symptoms of estrogen dominance. Yeah, which can be dangerous, can't it? Exactly that. And, you know, so it depends where people first show up, and then we will advise as clinicians as to how often that retesting— because the point of testing is that you get the benchmark and you go from there. Now, if we've got, you know, a patient who's having a re— you know, we've got them on the journey, they're getting a good result, we wouldn't really retest that until you know, uh, just to check that their intolerance levels, probably every 12 months. The other key thing is, is, um, around testosterone as well, because obviously some women will come to us. Now, testosterone is not, um, really prescribed on the NHS, but obviously you can get that from quite a few private clinics. But we like to test testosterone to see where they are on the scale before we prescribe that. You know, with, you know, so that we can make sure that our patients are kept within the right tolerance levels. Yes, because if you give them too much testosterone, there'll be all sorts of problems as well. All sorts of problems, especially for their husbands. And so, but what we do find interestingly, and I know that sort of like a lot of people link testosterone with libido and things like that, well, You know, we find that if you can get the balance right of the sort of like, you know, the estrogen and the progesterone, sometimes that can actually sort out those issues. Yeah. And, and it's something that we would then put in the prescription later on down the line if we need it. So, you know, it's, it's, it's working it all out together of, you know, what, what the combination of those hormones is right for that particular patient. The other thing that has effect of that, we— it's like a double whammy, isn't it, in menopause? Because, you know, with women, we have children growing up, so we have that issue to deal with. We have elderly parents. Yeah. And those types of life events to deal with. And we have careers. So all of those other environmental aspects also become part of that whole journey as well, because if you're stressed and you're drinking a bit more alcohol, that then has an impact on everything else. And yeah, so, so it's the, it's the whole really. Now, if we look at the NHS and what reasonably it can, can provide, you can see why that a lot of people drop off those treatment options because they don't quite get it right, because it's not a one-size-fits-all. So, um, you know, we believe that we've developed, um, you know, a service that, that gives really good patient outcomes because it is a journey and it's supported. Yeah, yeah, no, I totally agree because I, I've got an aesthetics clinic and I get many, um, ladies coming in and they try all sorts of of, you know, hormone treatments from the NHS, and then they either get bloated or heavy breasts and never quite seems to be quite right. And then they give up on that. So that's exactly what happens. People drop off and say, yeah, it didn't work for me. But the reality is, is that it wasn't right for you. That's what— well, and also, you know, the other thing is, is that if it's not worked and somebody's been given a patch, well, if you can imagine, a patch is almost like a one-size-fits-all scenario. Yeah, exactly. So if you find that, you know, it may well be that it will be better for them to have the gel or the cream, but start off in really lower doses. So what we do is we start off low and slow. Okay. And, you know, we then titrate up so that people can find— so very often we think that people start off on too high dose. Yeah. So, but unless we're explaining that and how that actually works, and, you know, with your GP, if— unless they're specially trained, which, which, um, not a lot of them are. I mean, they are through a training at Snarrow, but, you know, and nor do they have the time to actually educate of saying this, this is how we're going to do it and these are the reasons why, because we, we then get better outcomes. Yeah, I mean, I, I interviewed a lady the other day that is kind of campaigning for all doctors to have some menopause training, you know, because like you say that they— so many don't. And we're not just talking men here, we're talking lady doctors as well because I had an experience myself that really just wouldn't have believed it. But so basically what you're saying is you're— when people can't find a solution through the NHS, they come to you and you do a much deeper and, you know, service. And the other thing is, is that the NHS don't traditionally do blood profiling. No. So someone goes along and they don't have a blood test. And then they're just given patches or something and hope for the best. And hope for the best. So, and you know, it's not about— it's just what we offer is a personalized journey. And don't get me wrong, that journey works for some people within the NHS. You know, when there's a lot of successful, you know, patients who've had a really good result. However, it doesn't work for everybody. And so we offer what we would call a personalized tailored solutions, but even to corporates. So, you know, organizations can come to us and say, you know, can you run a clinical workshop? Can you, you know, and they will refer people, you know, there are, you can imagine in workplaces that there will be people in their occupational health systems that are suffering from menopause, but, you know, it's then about offering them a, you know, a personalized treatment journey so that we can actually get them operating at an optimum level again. Because women don't really want to take any time off and, you know, have that impact in their careers. They just want solutions and they want to use things that work. Yeah, because you hear about a lot of women that actually leave work around menopause age because they don't feel good, they can't cope the way they used to, and there's no reason to, to, to leave their job, is there, if they can get their treatment correct? Exactly that. So when we look at all of the symptoms that, um, you know, can be part of menopause, so, you know, if we looked at this sort of like the brain fog element and those types of aspects. I mean, there are very strong clinical links with lack of estrogen in those areas, and I believe there'll be a lot more research coming, coming out doing those significant links between the brain and estrogen and the fluctuations of estrogen. So that, you know, we look at that brain fog. If you, you look at, um, uh, women, uh, can suffer from anxiety. Well, You know, I've, you know, we treat a lot of women who said, look, I got given an option of antidepressants. I don't want to, I don't want to take antidepressants because I know I'm not depressed. I know it's my hormones. Yeah. So if they're perimenopausal, for example, and they won't get treated with, um, for menopause, um, at those early stages. No, because they say the NHS, that normally they would say you need to stopped your period for a year, is that right, before they'll start to give you— exactly, yeah, exactly that. So, so we do look at, and we're seeing more and more, a lot of younger women coming through the service who are suffering from perimenopause and they're just not getting those solutions. So, um, you know, we will look at that and, you know, we are seeing more and more that, that, you know, they're suffering those symptoms and in order to, you know, in a, to do their jobs and continue in their careers, you know, it's giving those women those treatment options that can make them feel good and back, back to where they were. Because fundamentally it is a fluctuation in our hormones and what, what our job is to do is to try and balance those back up to the point where you've got— you don't have those symptoms, or you've got reduced symptoms. Yeah. So, you know, it's easier to, uh, to manage. And so we know that, um, people wait, you know, hot flushes. I mean, that's a fundamental one, isn't it? That they're not waking up. The number one. Yeah, 5, 6 times a night, you know. Yeah, we see a lot of women who, um, you know, they'll be, you know, having, you know UTIs and those types of things. And, you know, some of those simple treatment options of having, you know, local estrogen, you know, pessaries. And, you know, generally, you know, that, that's a really, really good solution. But it's about talking through those things, understanding the symptoms. And my own journey into this space as well, apart from the fact that of meeting all of our a lot of our patients who have the weight issue as well was, I had UTI after UTI after UTI, went through a 12-month process in the NHS and, you know, ended up with the local estrogen pessaries, never had a UTI since or any incontinence or anything like that. And it absolutely magic for me, changed, changed everything. And it was a simple— so, but we didn't— why was it— why was you getting the UTIs then? If you can't— basically vaginal dryness. So, and, and what if you asked me that question, have I got vaginal dryness? The answer to that would be no, because I didn't feel that I did. What I did have is UTI after UTI after UTI. And, and is that because it's Is that because where the skin's dry, membrane, does it like get into the system easier? Yeah, so exactly. And it was, it was the membranes that were causing it, um, and causing a little bit of incontinence. I'm thinking, oh my God, went into blind panic of going, oh my God, I can't, you know, this can't be happening. And got to the urologist in the end, he said, you need to take these pessaries, local estrogen, and his view was, is every woman over 45 should be taking these. So, you know, but if you'd have asked me, you know, was it menopausal or whatever, I'd have said no. We didn't connect the dots. So it's about really having the education and connecting the dots for these women of going, okay, on this list, how many symptoms have you got? And we help them to work it out. Because, yeah, this process is education as well. Yeah, totally. Um, yeah, I mean, I had a really, really bad menopause, uh, and, and it was— that's kind of like what me got me into doing this, and I write for a menopause mag. Um, and I didn't really know what was wrong with me for 3 years, you know. Um, even though I went to many doctors, gynecologists, You know, even things like I was— someone said I had eczema and I didn't, and all of those things. And it turned out— so I had nerve pain around the vulva. Yeah, right. And I, I just couldn't understand how menopause— I mean, I'd heard about dryness and, and all those kind of things, but I'd never heard of someone like— it feels like an electric shock. If you touch it. Yeah, yeah. And it seemed like a lot of the doctors didn't know either, you know. And I went on all different types of things, and I've done allergy testing and different things. And eventually, I— it was someone on, on a Facebook group that said to me, have you heard of like the Mona Lisa Touch? I don't know if you, you know about that. The lasers that are inserted into the vaginal canal. Anyway, I Googled it and there were only about 3 in this country, and I went to one of them. Two of them were in Essex, actually, which is where I live, amazingly. And the gynecologist there, who became like my god, really, he, in about 3 sentences, he explained to me what was actually happening. And, and he said, where the skin is so thin and unhealthy, your nerve endings are almost exposed. Yeah, right. Now, he said that to me in one sentence, and it was like a light bulb moment because no one had said that to me in 3 years. They told me I had eczema, or I had this, or I had that. Oh my God. And you You know, and then I got that treated and now I'm okay. I have to continue to treat it, but I can imagine that so many women spend so much time trying to find the right thing and they never even get there in the end. Because it's different for everybody. Yeah. And that's the challenge. It's not, it's not one thing and one thing doesn't necessarily work for everybody. So it's a double whammy all the way around. And this is why it's a journey and a process. Yes, of all of those different things. And you talk about, you know, as you say, those types of specifics of having that education to say, actually, I think that, you know, we could try that. So it is, and the whole area of how we treat menopause is developing. And as new treatments come onto the market and new clinical evidence is there to say say this works, that works. So, you know, the whole landscape is changing. I mean, I'm just very proud that, you know, and all of my team at Bodiline, that we have an opportunity here to actually push these boundaries and give better treatment options to women of, you know, how we do treat it, and that the landscape as we go forward is going to be easier., you know, as new research is, you know, put onto the market and better treatment options are available. I mean, what happened to the women in the olden days? They got— because, you know, they didn't have any of this, did they? There was no knowledge, no help. It's incredible that women had gone— have gone through this for many, you know, hundreds of years. With no support really. I think that's why apparently the suicide rate many years ago around the age of 50 or whatever was really high, or in, you know, earlier than that you got burnt at the stake, you know, or you put— you got put in an asylum. Yeah, that's it, and never come out again. I mean, why are we laughing? It's not funny, is it? But you know, but the reality is, is mental health and anxiety and depression and all of those is that they're you know, really big factors in this. And, um, it— so when you look at where, where that has, you know, come from, you know, at least now we've got that education and awareness out there and we can, you know, we've got those treatment options available. Yeah. And I think it's more, you know, the great thing for me is that employers now are really looking in this space and you know, sort of like saying to themselves, look, if we've got women who were going through this stage of the life, you know, within our organisation, you know, we can help them. So it's, you know, in my view, it's no different to any other treatment options that you might have of, you know, if you've got any musculoskeletal and you go for physio, why would it be different for menopause? You know, we've got to have those treatment options in those wellness packages. Do you think it's because, um, really men never really believed that the menopause was a thing? Do you think that, that that's an option, but now they know that it is? I think it's education really, isn't it? I don't think it, it's necessarily didn't believe it. I think they've always known it because I think the impact of menopause on family life, marriage, relationships is huge. Yeah, so I think, I think that it's just education of understanding what it is. And I've done a couple of webinars to men, you know, where they're saying, we just need to understand it a little bit better. Yeah, we want to support, we want to support our partners, but how do we do that? Yeah, yeah, you're right. And what are those options? So I think that when organisations look at, especially if they're employing quite a lot of women, you know, looking at how they can better help women through this stage of life. And I, you know, I don't think it should be classed as— it's not a disability, it's just a period of life that we go through. And, you know, if we can have those, all of those different options available to us, whether that be holistically or whether it be a HRT treatment option, because HRT is not for everybody. Um, some women, you know, when it depends on the severity of women's symptoms, you know, some people, um, can do that through supplementation, exercise, change of lifestyle, um, you know, CBT, all of those things. It, it, they just, those options just need to be open for us and it's just better education as well. Um, the type of women that we see do need HRT because the other options traditionally have not worked for them. Yeah, yeah. And that's why we then come in on the clinical end. But they've not— these treatments haven't traditionally been available in occupational health before, or they, they generally had a, an appointment with a generic GP, well, that's not going to get you on a, on a supported HRT journey. So, you know, it's those, it's those types of things that we're bringing to cover and say, actually, and we're changing the landscape on, you know, putting those treatment options in. And, you know, the other side of that is employees are demanding those types of things in their packages and their employee benefit programs. So it's coming from both sides, really. Yeah, you're right, you're right. Did you see the, um, the— I think it was the Mail last weekend about the, the andropause? Did you see that? The front page? Yeah, they're now demanding the same kind of things as women in the workplace. Did you see that? Yeah, but I also do believe that that is an area that is going to develop because Yeah, and the reason— there is data, there's a lot of data out there, um, have been collected on body scans and those types of things of how dramatically men's muscle mass goes down after a certain age and all of those types of things. So obviously the factor for them is around testosterone. So as part of our treatment options, we do treat men with low testosterone. Again, it's another area that the NHS, you know, they're sort of, you know, it's quite a long process for men to go through from an NHS point of view. So I do believe there's a lot in that, Sue. I think that that evidence and data has not quite come to the market yet, but I do think that they have a point. And I think that there'll be a lot more evidence to come down that pathway. Yeah, I just wondered if you thought, you know, if you did agree with it or whether you thought it was the men lashing out saying, "How about us?" You know. No, I agree with it and we see a lot of clinical evidence through our patients of what we see to support it. So I think that there's a lot more to come on that. Okay, interesting. I'll watch. So what, um, so what, how did you like become interested or get into this in the first place? Um, I suppose, well, we came into it because we, we looked at the, um, uh, into the area of my first clinic was, was specifically just in, uh, supported weight loss programs where the area of healthcare and weight management wasn't regulated Yeah, so it was very much seen as, um, you know, the NHS didn't treat it particularly well. And, you know, in order to— that there weren't a lot of programs out there in, in, you know, there are behavioral programs, but there weren't a lot of treatment options. Um, so what I wanted to bring to the market was a safe treatment option for, uh, patients, which we did. And, you know, that, that's eventually grown now um, as I said, to 9 clinics, and we see 500 people a week, and, um, we're very successful in what we do. Um, but obviously the game-changing element of that now is the new medications on the market that naturally treat it. But we see a strong link between weight gain and menopause, so people can have treatment options with weight management, um, treatments in as well as their HRT. So, you know, it's, as you say, it's not a one-size-fits-all element. So we can bespoke and personalize the whole journey. Yeah. And what we try to do is balance the hormones from a menopausal point of view to see whether that's having an impact on the weight. Yeah. And if not, then we can add other medical interventions into that to get a better result on the weight. Yeah, okay. Yeah, it's such a problem, isn't it, like weight in the menopause for women, you know, it's another thing that really gets them down. Yes, it is, and it affects confidence and all of the rest of it, and, you know, consequently affects, you know, people's, women's careers. And, you know, I mean, the data out there of, you know, how it does affect women in work is huge. It's very, very compelling. And, you know, if we can balance that right and get them a result, it just affects all areas of the life, not just work. It's, you know, better for the relationship, but all of those different aspects. And also, we're in the prime of our lives, you know, we should be, you know, we want to be healthy and you want to be enjoying all of those things that, you know, when we get to that stage in life that we're healthy and that we can perform to the levels that we want to. I know it's quite hard being a woman, isn't it? Sometimes, you know, it is so, isn't it? I mean, because you have your periods and then you have pregnancies and then you have the perimenopause and then instead of having like, you know, a really good rest of your life, you have the menopause to deal with. I mean, what did we do to deserve that? I think how that landscape has changed now, because I think there's a lot of females such as myself in charge of a healthcare organisation. We actually have— we can make a difference. Yeah, I said to my team, I said, you know, guys, we can make a big difference here. We can do— we can get better outcomes for patients. How do we do that? And We sat down, we planned it, we went out and educated ourselves, and we worked it out. And I think there's a lot of women in our position who can actually make those changes. Fortunate that, you know, we've got women who are prepared to speak up. We've got women who are in medical research, you know, putting the new products on the market. Yes. The likes of myself looking at how we treat it, you know. So there's a whole— there's masses. You've got people like yourselves who are talking about it and educating. So we've got— there's a huge push of women going, actually, ourselves, we can make this better. It comes from all areas, doesn't it? You know, because it needs all of those different cogs in the wheel of different women's expertise to, to come together to actually make those differences, provide to say, have you looked at this? These treatment options need to be better because IASMI is about innovation, because we are bringing these new things that, that give better choice for women to be able to manage it. Yeah, exactly, because if, you know, it's okay to say complain about the menopause and not, and not feeling good. But if you've got no solutions, what's the point, you know? So we are getting more and more solutions now. Yes, we are. We are. And if we have also, if you have a look at the, you know, the products on the market and how we treat it, you know, if you have a look at that whole area, which I'm quite interested in, of they call it femtech. So, you know, all of the new products coming onto the market, all of the new different ways, there's some new devices, all of that type of thing. There's a lot, there's a lot of movement in that sector of, um, you know, you know, the whole movement of women's health and, you know, the development in that area. Yeah. Well, do you think that there are people that are kind of jumping on the bandwagon a bit though? Because like now I go into, say, a high street chemist and see all these different— because I'm a beauty expert really, and I see all these menopause skin creams and you sort of look at them and you think there's not really anything different in there from, you know, from an anti-aging cream. And do you think that maybe some people are jumping on the bandwagon at the moment? Moment though as well. I think you'll always get that, won't you, in a growth area. I think that, I think you'll always get a little bit of that, but I do think, and potentially from your perspective, you know that, you know, the skin changes with the fluctuations. It does definitely change, yeah, it does change. So I think that when we look at what actually happens to that, of people looking at um, you know, from a skincare point of view, what, what those things are needed through menopause. And we definitely know that, that's, you know, we can look at it from a getting the hormones right. And we, we absolutely know that estrogen is a key, is a key factor with skin because we know how it thins membranes. Yes. If it's low, so that translates into our biggest organ, doesn't it, which is the skin. Yeah, and all of those things. And we absolutely know that, you know, feedback from patients of when we've got their estrogen levels right, that they see a difference in their skin. Because one, some of those symptoms might be itchy skin. Yes, that's a big one, isn't it? Yeah, I hear that a lot. And I never, I never used to, you know, think, well, that, that could be a menopausal symptom. But yeah, all sorts of strange symptoms that people Exactly. And the reason for that is because we've got so many estrogen receptors. And as women, because we reproduce, we've got more estrogen receptors. So it goes within that, you know, if you follow that argument through, well, of course, if you're having fluctuations with all of those estrogen receptors, whether that be in your brain, whether that be in your skin, you know, and all of those areas, we are bound to have those types of symptoms. And for some women, you know, itchy skin is massive. Yeah. And psoriasis and all of those types of things. So it does follow. So I think back to your question with skincare, you know, if we understand that, you know, we can put additional products in there that actually help that, you know, process, then all to the better. And it would be good to put estrogen in skincare, but it's not really allowed. You'd have to have a doctor prescribe it. Great for you, wouldn't you? Yeah, and I think there's a big area in that skincare, and we've— we, you know, that's potentially something that we will add to our portfolio of treatments because, um, you know, but as you say, it needs to be, um, you know, uh, prescribed within that. And I think that, you know, that's something that, you know, I think for certain women, you know, who have those, um, you know, symptoms which can be quite severe, I think that they— those are options for them. Yeah, I just had a vision then of like a doctor, um, sitting in like, you know, Boots or Superdrug or something, and there's a big queue of women waiting to get their oestrogen face products prescribed by the doctor. Yeah, yeah. But I just think it's— it is an area that I think that will get more and more traction, um, of, you know, And, you know, also, you know, how those preparations are made. But, and I think for some women, you know, because the other thing is, the other areas are hair loss. Yes. And those areas. So it does, you know, these things are, and you'll have met some women who have that. I mean, that's, you know, those are areas I think that will span out as we develop on this, of those types of treatment options, of how we balance the hormones and get better results on women who've got hair loss and those type of elements. So in 50 years, I reckon this is all going to be kind of like sorted, don't you? Well, I certainly think that there will be all of the options out there for women to access, um, of, you know, of them being able to better control their navigation of this life event, that there will be options available for them out there to go, actually, you know, I can go and, you know, I've got a solution. It's about solutions, isn't it, that work for them. So yeah, I do think, and, you know, as I say, that it will open up into as these new things come onto the market, because if they don't work, and there will be a demand for them, and if they, you know, and they've got to work to be successful, haven't they? But I do think, you know, it's innovation, research, clinical evidence, and I do think that these, you know, these solutions will just get better and better as we— as time goes by. Yeah, no, yeah, yeah, I agree, totally agree. So tell me a little bit about you. So were you born in Derbyshire? Yes, I was. So, okay. Yeah, I was. I used to work for a large corporate in program management of delivering large-scale change in corporates, and then came into healthcare in context of delivering large-scale programs, and then decided actually I can make this myself. I can make a difference here. My background is regulation and, you know, looking at sort of like compliance, so, you know, which is very key in healthcare. And we've got a CQC rating of good across our organization, which we're very proud of. And so, you know, brought all of those things together and, you know, as I say, started 17 years ago with one clinic and And we've grown it from there. But, you know, it's not just about me. It's the absolutely amazing team that I've got behind me, you know, helping grow this business into what it is today. Do you think you'll open more clinics, or do you think that, you know, you would just do a lot more online? Both, really. I think, I think that Some women do want face-to-face, so we'll just see how that develops. The thing is with the remote is that it's very flexible, isn't it? And women increasingly, we want flexibility, don't we? So it's a bit of a balance of the two. But I think the thing is that if patients want to come and see us, they know where we are. So you've got the option. They've got the option and, you know, we're not just out there on the ether of a virtual clinic. Do you know what I mean? As a healthcare provider, we, you know, we're bricks and mortar, we're very real. And, you know, I think some, some women want that assurance that, you know, you're actually there and you're really there. Yeah, we're not floating around somewhere, you know. So I think when you're delivering healthcare, I think very important, you know, that people and patients feel very comfortable, that, you know, they've got somewhere to go if they've got a problem. Yeah. And, you know, but we do do, you know, we do, you know, as I say, a large percentage of our business is remote, but that works really well for us because people want that flexibility. And, you know, it's easy for us to deliver that over weekends and in the evenings that people want. Yeah, and to be honest, you know, if say you live far from a clinic, you know, and you have to spend a couple of hours getting there and then a couple of hours getting home or whatever, you'd much prefer to do it from your own front room, don't you really? Exactly. And make yourself a cup of tea. And I would, I do anyway, I would much, much rather do that. I can't get my head around but then why people wouldn't want to do that. But there are things you have to go to the clinic for, like you say, maybe blood tests or examinations can't really be done any other way. But, um, and obviously for big, um, organizations, we need to deliver that service remotely because it may be that they've got international, um, employees. Yeah, you know, they've got employees all over the UK, so really those programs fit very well with providing those services for large organizations. Okay, so yeah, so going back to you, the mystery lady, so have you got a family, have you got children? My children, yeah, so I've got two children, 23 and coming up to 25, boy and a girl, all grown up now. And yeah, so they're all grown up and they're doing both employed, you know, doing their, doing their own thing now. And I have a partner who lives in Nottingham, right? And we got engaged a few weeks ago. Oh, how lovely is that? Congratulations. I know. How nice is that? I know. So life is, um, it, it, you know, like some people, they get a bit older and they go, okay, well, my life's over now. But you know what? It isn't. It's like, oh my God, there's always something around the corner. Um, oh yeah, like, like my dream really for many years was, was to be a singer. And I actually became a singer with, you know, my husband when I was about 50. And it was, it was amazing, you know, because it's never too late to do, to do anything, really. Oh my God, no. And but I do think fundamentally, I mean, you know, I am an advocate of, of our own service in the sense that I have got my hormones balanced and life is a lot easier and a lot more fun. When you've got more sorted out. And, you know, it, it, it, it, you know, when, when you do find that solution, um, that you can, you know, you've got it controlled and, you know, you're feeling good and, you know, you don't have your hot flushes, things like that, it's, it's, it's life-changing. And you can move on, can't you, in life with, with all of those things that we should all be enjoying because Believe me, I think, you know, I love being this age because, you know, my children are growing up and it's time for me in a relationship that I want a relationship. And all of those things, when you balance almost, you can, you know, it's great. Yeah. So, you know, we, you know, sometimes just need other supportive treatments or whatever to make that happen. It depends on what, where on the scale of where you are, but you know, we should be enjoying what I would consider to be the prime of our lives, where we've built our careers, our children are grown up, and life's exciting. Yeah. And don't you think that it's easier to say no when you get older? Oh yeah. Oh yeah. Which, which, you know, you know, I do quite a lot. And I think that, you know, the, the element of being, uh, very much your own person. I think that what, what we do see when we treat people in menopause is their confidence grows and, yeah, and they become very much their own person. And very often women make big life-changing decisions, like leaving their husbands. Sorry, it just made me laugh. Yeah, but it's true. And because we go on the whole— now, well, it can go either way, can't it? You know, with that, people like me getting it. So it— but I think women become very much themselves, you know, because those big changes of your children growing up and things like that. And what does this next chapter actually, what do they want it to be? Yeah. You know, I think there's a lot of those changes that go on with women as well. So it's not just about, you know, treatment, clinical, it's about the whole life-changing experience. And I'm sure you've had lots of discussions with lots of people. You know, it can be quite significant for some women. Yeah, no, totally. I hear it all the time when you're a beauty therapist, you know, an aesthetician, it's a bit like being a hairdresser, really. Yeah. Everyone tells me I've got so many secrets, it's unbelievable. But maybe you should add like a dating agency. So after they've been through all the treatment and they feel really amazing and they've left their husbands, yeah, we can find them a new, a new boyfriend. Well, absolutely. I mean, we do see, you know, we do see, and we're a little bit the same because, you know, when people are on those journeys and, you know, it's supportive, we're the same, you know, it's the whole holistic of what's going on in totality of their lives of, you know, in those changes. But, you know, I think you're right. And I think, you know, I mean, you'll know I've got friends who are similar age you are, you know, in that dating scenario. And, you know, as, you know, women sort of, you know, look at what that next 20, 30 years looks like. And yeah, um, you know, I think that, you know, whether that be that they want to meet a partner or not, or, you know, or they're, you know, what they're doing in retirement and things like that. But, you know, it's not we're not old when we, when we're in our 50s, are we? You know, there's a whole— not at all. No, all the traps are there. And I think that, um, you know, women are empowered to, um, you know, make that— make, you know, whatever that chapter looks like. For me, I want to go and do some traveling, um, and sailing with my partner, um, and, you know, it's different for everybody, isn't it? Totally, totally. Oh God, no. I mean, that's why it's so important that, that you do get your health right when you get to that age, because, you know, a lot of women do retire and they've, they've worked all their lives and they want that part. They've been looking forward to that part of their life. Absolutely. For so long, you know, when they, when they can retire and they have got some money in the bank and, and it's sad if it's then marred by, you know, bad menopause symptoms when you should be having the best time of your life. Absolutely. I absolutely concur with that. So if you go back then to some simple analogies of where you can take that back, you know, a lot of women suffer joint pain. Yeah. As a symptom. And they think, you know, people going, oh my God, it's arthritis. You know, I'm getting old. And do you know, there's a huge link between that and the balance of hormones. And I know, you know, we will get hearing from patients all the time saying, do you know what, my joint pain's gone. Yeah, joint pain is gone. Don't get it in my hands anymore. I don't say it's those things from a health perspective, as you know, because it, there is a strong correlation between getting that balance right and those types of things like joint pain. Is the link between oestrogen and Alzheimer's. Yeah, yeah. And if we have a look at the international data on it, it's quite compelling, really. And I think that as we go down this journey, more and more evidence is going to come out between those links of, you know, having the right oestrogen levels and your reduced risk with Alzheimer's. How long do you think you can or should be on HRT? Well, I won't be coming off it. That's me neither. Me neither. Exactly, exactly. You know, I'm going to take it for the rest of my life, I think. Absolutely. So for me, why wouldn't you? Because, you know, just because, you know, this is what I don't understand when people say, oh, you know, you're going to go through the menopause and then you're going to come out the other side. I never came out the other side. No, and I don't think you'll have a continuation of, you know, the symptoms will slightly change and all of those elements, but I certainly won't be coming off estrogen especially, but given health benefits that I've seen from international studies and elements like that information coming out of the States, because of course they have evidence of a lot more people being on a longer period of time for HRT. Obviously, we went through that issue when, about the study, and a lot of women came off HRT, if you remember. Yeah. So SAIT's got a lot more evidence around this of, you know, women on HRT into their, into that older period. That they have got increased mobility, they've got less issues around Alzheimer's and dementia and all of those types of things. So I think that we'll see that evidence start to feed through. Yeah, and that's a good thing. So, well, Sally, it's been really lovely talking to you. So interesting. No, no, such a, you know, a wealth of information and Can you just tell us again your, your website or where people can get hold of you? Or if you have, do you have like social media as well? Yes, we do. So our website is bodylineclinic.com. Yeah. And, you know, just, just give us a call. We'll talk you through any treatment options. And if you're an organization out there looking to you know, add this as a service on your wellness platform, occupational health, then just give us a call and, you know, we can look at what we can do for you. Amazing. And how about, how about Facebook, Instagram? How do they find you? So, you know, they can find us on Facebook and they can find us through, you know, through the internet. You know, our number's there. We've got a fully trained customer service team. So don't really do Instagram, but we do definitely Facebook and, you know, our website, and they can get us, you know, we've got a fully, you know, our website's got a wellness hub on it, and we'll talk you through, you know, what our treatments look like. Okay, okay, Sally, well, it's been so nice to talk to you. Pleasure. So that was a really, really interesting conversation to today. Yes, she's a late Sally-Anne, very nice lady, wealth of information there. So if you're interested in her services, as she said, go to her website. And this is— that's all for today. This is The Menopause Show on Women's Radio Station, and I'm Sue Mockridge. And if you want to follow us on Facebook or Instagram, we are Women's Radio Station, abbreviated STN. And I will see you all— no, I won't see you, I'll speak to you all very soon on my next show. Bye everybody, thank you.