the top 4 things you need to do to manage · vaginal dryness, cystitis and incontinence and life...

Dr Sohère Roked Page | 2 © 2018

The Top 4 Things You Need To Do To Manage Your Menopause – NOW!

Copyright © Dr Sohère Roked 2018

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www.drsohereroked.co.uk


Hi There! I’m Dr Sohère Roked and I am a GP. I specialize in women’s health and in particular

menopause. I practice what is known as integrative medicine, which is looking at a

combination of the best of Western medicine, lifestyle interventions, supplements and

individualized care for the patients I see.

I’ve been a doctor for almost 15 years and in my time I have worked in A&E, assisted in hip

operations and bowel surgery, worked on elderly care wards working with patients with

dementia and strokes, delivered babies and been part of caesarian sections. I was a

psychiatrist for 3 years and sectioned patients, taken part in ECT treatment, worked with

people with learning disabilities, eating disorders and have been a therapist to children with

psychiatric problems. As a GP I’ve done baby checks, nursed patients with terminal cancer

and visited numerous nursing homes. However despite this I knew I wanted to make a

difference in another way. This lead me to discover and train in integrative medicine, then

study bioidentical hormones and age management medicine.

I have been seeing patients in London for several years and have helped thousands of

women successfully navigate through perimenopause and menopause. An article in The

Daily Mail called me ‘one of the UK’s leading holistic doctors’ and ‘at the vanguard of a new

movement in health; the science of anti-ageing’. I am a regular contributor to press such as

Top Santé magazine, Glamour magazine, Vogue and Marie Claire.

Although getting public praise is enjoyable, my real passion is to help empower women to

be the best they can be. In particular, I value helping women through their menopause. I

guess I’m a bit of a feminist. I feel it’s unfair that men are perceived to be better with age,

whilst women are seen as ‘past it’ over 50. Why should women be judged on their looks and

weight and not their strength, skills and wisdom?

Introduction


Perimenopause and menopause can cause a woman to feel lost, under-confident, tired and

old. It comes with not just physical but emotional changes. Hot flushes can cause

embarrassment and the lack of sleep, brain fog, low mood, headaches and joint aches can

affect a woman’s self-confidence and self-worth. Add in a lack of sex drive and troublesome

vaginal dryness, cystitis and incontinence and life can feel really unfair and affect

relationships. This can impact on work, marriages, not being able to cope with the kids and

not wanting to socialize anymore. The worst part is a lot of women don’t feel comfortable

talking about these symptoms with their partners or their girlfriends, their doctor isn’t

always able to help, and it can feel like a really lonely time.

I will never forget a powerful woman in her 50’s who works in the City of London in Finance

telling me about having to give a big presentation in front of her colleagues and feeling the

sweat drip down her face and going red as she had a flush, and seeing her male colleagues

in their 20’s sniggering at her. Hearing about this degrading and humiliating experience from

a brilliant and bright woman who is being judged by her age and hormonal state made me

vow to help as many strong, powerful, wise women as possible to not have similar

experiences.

In my clinic I prescribe bioidentical hormones to help women balance their hormones and

ease their symptoms, as well as offering bone protection, cardiovascular and neurological

health. This is based on an individualized assessment and monitoring. However there is so

much improvement that can be made by making lifestyle changes and addressing other

imbalances and adding in supplementation.

So this free e-book is to help women like you by giving you 4 easy tips to improve symptoms

and feel better. Let’s jump in!!


It can be really hard to adopt good nutrition when you feel tired and worn out, when mood

is low and your focus and concentration isn’t good. However this is one of the most

important things you can do to help your menopausal symptoms.

Here are some easy guidelines to follow:

Cut out sugar: sugar spikes can make flushes worse, as well as affecting energy, mood

and making brain fog worse. I would recommend cutting out as much processed sugar

as possible to ease some of your symptoms.

Protein with every meal: protein will make you feel fuller for longer and will

therefore help ease cravings.

Low carbohydrates: I’m not a big advocate of cutting out food groups completely,

but keeping carbohydrates low GI (glycaemic index) and slow release, such as sweet

potatoes, brown rice, whole wheat pasta, will prevent the sugar spikes and reduce

cravings.

Get enough good fats: We’ve been misled into believing fats in our diet are evil but

this isn’t the case. Good fats are fantastic for our bodies. This would involve cooking

with coconut oil, using olive oil, eating avocados, nuts and seeds. Don’t fear fat –

essential fatty acids are anti-inflammatory to our bodies and will help reduce symptoms

such as brain fog and hot flushes and night sweats.

Be kind to yourself: We will all fall off the wagon from time to time and eat a whole

bar of dairy milk (king sized!) or gorge on a packet of Jaffa cakes because we’re feeling

low or emotional or tired.

TIP #1: Eat Right for Hormone Balance


Or eat Nutella from the jar, with a spoon. It’s ok. We’re all a work in process. So don’t

feel too bad. Acknowledge what has happened and perhaps write down why, so you can

get to know your triggers. Think about what you could do instead (i.e. go for a walk

outside or call a friend when feeling low). Think about leaving tempting foods out of the

house. Look for slightly healthier options, like keeping 70% dark chocolate in the house

instead of milk chocolate, or make your own raw brownies or healthier flapjacks to

snack on. Whatever you do, remember everything’s not lost and tomorrow is another

day.


The health benefits of exercise are well-documented, and include weight loss, improved

mood, building muscle, improving heart health, increased lung capacity, improving focus,

memory and concentration. So why wouldn’t you exercise?! Well, it’s pretty darn hard to

get motivated when you are feeling exhausted, low in mood, have a busy job and family life

and feel generally fed up.

Regarding balancing hormones, exercise can increase testosterone production which will

help energy, motivation, focus and libido, and can also help mood, sleep and balance

oestrogens to reduce hot flushes.

Here’s my tips on how to build exercise in to everyday life:

Start at the beginning: If you haven’t exercised for a while you can’t expect to go out

and run for an hour. Start at where you are currently at. For example, if you have been

pretty inactive for a while, perhaps start with a 15-20 minute brisk walk. If you feel

conscious going to the gym maybe start with a workout DVD at home, or use YouTube.

Consider getting a personal trainer if financially viable. The one on one sessions will give

you confidence to keep exercising and a good trainer will listen to your particular needs

and concerns and build you a programme based around these.

Lift Weights: Women have traditionally shied away from lifting weights as they worry

about becoming ‘too big’ or feel they aren’t strong enough. But weight training is not

only incredibly empowering for women, but it also burns a lot of fat and can help you

change shape. Another bonus is that building muscle helps stimulate testosterone

production. I wouldn’t recommend doing this alone if you aren’t used to weight training.

A lot of women now take CrossFit classes which teaches you to lift weights. Other

alternatives are seeing a personal trainer to help you to do this, using the weight

TIP #2: Move Your Body


machines in the gym which are generally easier to navigate, or perhaps going with a

friend or your partner. It can sometimes be fun to do this with a friend or your partner

who will keep you motivated and encourage you to be your best.

Yoga: A range of exercise is always good and yoga is very important. It will help reduce

stress on the adrenal glands which can make your symptoms feel worse, and also

improve flexibility, and rest the mind through the movement and breathing exercises. It

may be good to start with gentler yoga such as hatha or restorative or vinyasa, as

sometimes hot or bikram yoga can make flushes worse!

Build exercise into everyday life: It can be hard to get everything done in a day, so

build exercise in to every day. We need to take 10 000 steps a day to stay healthy. You

can do this by getting off at an earlier tube or bus stop on your way to work, parking

further away in the supermarket car park, going for a walk at lunchtime or using the

stairs instead of the escalator or lift. The easier you can make things the better you feel

and the more likely you are to keep up the good work.


There are plenty of supplements that can help with the symptoms of menopause. Whilst I

always emphasize the importance of a good diet, we can’t always get all the nutrients we

need from a diet alone and I particularly believe in targeting supplementation to aid specific

symptoms. When I see patients I recommend particular supplements based on their specific

symptoms and also testing. But if this isn’t something you can do there are general

supplements I often recommend:

Vitamin D: Vitamin D is actually a hormone and we are often lacking in this due to the

lack of sunlight we get, especially in the UK in the winter! Vitamin D is an anti-

inflammatory hormone, which means that a good level in our systems can reduce

flushes, and also help mood and energy. It also has apoptotic effects which, in English,

means that it destroys diseased cells and has anti-cancer properties. The minimum dose

I would recommend is 1000iu a day, but I often use higher doses once I’ve checked

levels of my patients.

Magnesium: Magnesium is so important for women. It improves muscle aches, mood,

memory, and helps sleep and energy. Good food sources of magnesium include nuts,

seeds, dark leafy greens, bananas, yoghurt, dark chocolate. However it can also be

supplemented, when used at night in particular it can help sleep. Nutri Advanced and

solgar are both good supplement brands that produce good magnesium products. The

formulation ZMA can also help sleep.

B Vitamins: These are really important for mood and energy, concentration and focus.

Food sources include poultry, fish, dark leafy greens, eggs, soya beans, red meat. Taking

a good B complex can help symptoms.

TIP #3: Supplements


Omega 3 fish oils: Omega 3 is very anti-inflammatory for the body, and therefore can

help reduce flushes. We can have too much omega 6 in our diets from vegetable oils and

processed foods, and the imbalance between omega 3 and 6 causes inflammation in our

bodies. This is something I can test when I see my patients. It is can be helpful to take a

good quality omega 3 supplement. Food sources of omega 3 are oily fish, seafood and

flaxseed oil.

Superfood Supplement: New evidence shows that we now need not 5, but 10 a

day to stay healthy. 10 fruit and vegetables a day is a lot so this is why we may need

supplements. Nutri Advanced do a superfood supplement, as do Nature’s Gold. Some

people I know use Juice Plus. Green powders can provide a wealth of antioxidants for

the body.


The menopause can be a lonely or frightening time that challenges your sense of self-worth

and identity. There’s a lot of conflicting information out there – take HRT, don’t take HRT.

It’s important to do research and find sources of information you can trust.

For years, doctors have been reluctant to prescribe HRT due to the Women’s Health

Initiative study which showed increased risk in heart problems and breast cancer. However

it’s widely accepted now that the study flawed and the women who had the increased risks

were generally women who were started on HRT in their 70s and not at the point of

menopause. There are other studies that show taking HRT at the point of menopause

improves heart health, bone health and neurological health. In fact, a study published in the

BMJ 2012 which followed women for 16 years (Effect of hormone replacement therapy on

cardiovascular events in recently postmenopausal women: randomized trial BMJ 2012; 345)

showed that taking HRT reduced all-cause mortality by 40% compared to women not taking

HRT.

We also know that one of the biggest killers in women over 70 years old is not recovering

from a fracture, and HRT can help prevent fractures by improving bone density and reducing

osteoporosis.

Of course taking HRT is a personal choice but requires you to be well-informed and to do

some research. When I see my patients I’m happy to go through the studies and answer

their questions, as well as look at their individual medical history and family history.

I prefer to use bioidentical hormones and individualise treatment for the women I see.

Bioidentical hormones mean that the hormones used have the same chemical structure as

the hormones made by the body and therefore are metabolized by the same pathways. I

find these hormones produce the best outcomes for my patients.

TIP #4: Do Your Own Research


I also like the women I see to address diet and exercise if they aren’t already doing so, take

personalised supplementation for their symptoms and needs, and look at ways of managing

stress. I also encourage my patients to have regular breast screening, pelvic ultrasound

scans, smear tests and bone density scans.

I also encourage my patients to talk to their partners and families about what is happening

to them. It is important that there is more understanding around the symptoms of

menopause and how it affects women. It’s also good for men to understand what the

women in their lives are going through. The more that we can be open about menopause

the better it will be for everyone.


I hope that you have found this e-book helpful. Hormone balance is very important, and I’m

passionate about the difference that bioidentical hormones can make but there is so much

we can do by making lifestyle changes.

If you need more information or advice, you can contact me on

[email protected]

If you need to see me for a consultation, you can call my clinic Omniya on 0207 584 4777.

Wishing you the best in health and happiness.

Dr Sohère Roked

NHS GP and Integrative Medical Specialist

BMed MRCGP DFRSH DipSIM

Conclusion


FOR FURTHER INFORMATION OR 1-1 CONSULTATIONS

PLEASE CONTACT DR SOHÈRE ROKED ON:

0207 099 1752

[email protected]

www.drsohereroked.co.uk

FOR MORE DETAILS, THE TIREDNESS CURE BOOK IS

AVAILABLE HERE:

http://bit.ly/TheTirenessCure

the top 4 things you need to do to manage · vaginal dryness, cystitis and incontinence and life...

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