What is Premature Ovarian Insufficiency?

Woman feeling anxious

POI can lead to menopause symptoms

Premature Ovarian Insufficiency (POI) can come as an unexpected and unpleasant shock, whatever age it occurs. It is the theme of this year’s World Menopause Day 2020 organised by the International Menopause Society to raise awareness of menopause issues.

POI and menopause before age 40 can give rise to feelings of loss and grief connected to loss of options to have children. As one woman, L, told me:

“My official diagnosis of menopause came on my 36th birthday. I’d had one child. To me, this was like ‘game over’. I don’t have the option to have children any more. I felt like I’d been hit by a train. That was the hardest thing to come to terms with.”

The Information

The average age of menopause is 52 in the UK but POI can happen at any age after menstruation starts up to age 40, plunging the woman into menopause. It has been estimated that the condition affects approximately 1% of the population but that incidence may vary between countries. There are various causes which include:

  • Genetic and chromosomal disorders
  • Autoimmune disorders
  • Chemotherapy and radiation therapy
  • Viral infections

Doctors are not sure why this happens and may be slow or reluctant to diagnose it. The symptoms are the same as menopause such as hot flushes, night sweats, brain fog, sleep problems, changes to menstrual periods and anxiety.

L said:

“I’d had my child at 34 and eighteen months later I was having hot flushes, constant headaches, lethargic, really tired all the time. Also, my periods were all over the place. I joked with my husband that I was going through the menopause and I was going to see the GP. She laughed at me when I said it too. She thought it might be thyroid. But she did all the tests and when I went in for the follow-up she said ‘Actually your hormones are indicating menopause’.”

Taking Action

If you are diagnosed with POI you are likely to be offered hormone therapy (HT or HRT) to aid the symptoms and specifically to support bone health. You may also be advised to take calcium and vitamin D supplements to prevent bone density loss. Changes to nutrition, exercise and lifestyle are also recommended to reduce symptoms and enhance physical and mental wellbeing.

“I worked with a trainer who uses kettlebells which is a form of weight resistant exercise. She said this would be excellent for my bone density. I was having a bone density scan every year but four years ago they told me my bone density was growing so I don’t have to go every year now. I do my exercise outside because I do get hot.

She also suggested changes to my diet. I had put on an awful lot of weight. As In the end I lost about two stone. I am happy now and fit and healthy and strong.”

Top Tips

If you are under age 40 and you are experiencing symptoms such as hot flushes, poor sleep, irregular periods or lethargy, don’t ignore it:

  • Visit your doctor and explain what you are experiencing
  • Ask for hormone tests if they are not suggested
  • Discuss your options for treatment.
  • Talk to your doctor about possible side effects and risks
  • Consider changes to your nutrition, exercise and lifestyle
  • If you were hoping to get pregnant you may want to talk to a fertility specialist or counselor to understand your options.

If you want more information or to talk about what you are experiencing contact me today.

For more information about Premature Ovarian Insufficiency, the IMS have released a White Paper: Premature ovarian insufficiency: an International Menopause Society White Paper


Taking Back Control After Lockdown

After three months in lockdown you may be greeting the gradual easing out of restrictions with joy and celebration as you take back control. You can’t wait to head down the pub and see your friends. Or you might be feeling anxious. Is it too much too soon? Do you feel safe?

Understanding Control
Illustrating what is inside and outside your control

Control During Lockdown

There is a Cognitive Hypnotherapy model I use with my clients called ‘Locus of Control’. Bear with the jargon because this can be very helpful. If you have an external locus of control (ELOC) you believe that control over situations lays outside of yourself.  That means that there is not much you can do to make any situation better. You feel powerless. It becomes very stressful.

If you have an internal locus of control (ILOC) you believe that there is always some action you can take in any situation. You understand what is within your control and what is outside and take action accordingly.

The first stage of lockdown was very ELOC. There were tight rules around what you could and couldn’t do. If you have an ILOC approach you understood the limits of your control. You could decide to stick to the rules, wash your hands regularly, stay indoors, keep your distance, exercise regularly and eat healthily. If you have an ELOC approach it might have felt like there was nothing you could do but worry and wait for things to get back to normal.

Moving towards ILOC

Now we are in a stage where individual control is being handed back to us. We are being asked to be more ILOC and make decisions about what we are prepared to do and not do. That may feel comfortable or very uncomfortable.

Illustrating what is inside and outside your control

Control Post-Lockdown

A risk management approach can help you to get worries about the future into perspective.  If you find yourself worrying about a future event, think about the benefits associated with the event and then the risks associated with it.  For example: meeting your friend at the pub.

Assess the likelihood of the risk you are worrying about happening. For example: Is the risk of you catching the virus by meeting your friend low, medium or high?

Assess the impact of the risk happening. For example: would the impact be low, medium or high?

If both your responses are in the medium to high range it’s time to assess the benefits of what you are considering. For example: Would you rate the benefits from meeting your friend low, medium or high?

If the benefits are medium or high and you want to go ahead, what can you do reduce the impact or likelihood of the risk occurring? For example: could you wear a face mask, sit at least 2 metres apart, sit in the pub garden, go at a time when it won’t be busy?

Finally, you can decide whether the benefits outweigh the remaining risks.

If you need more help taking back control and managing your risks, talk to me.

How to Maintain Good Mental Health

This week, 18 – 24 May, is National Mental Health Awareness Week, an opportunity to understand more about how to maintain good mental health.

The theme this year is Kindness because research has shown that kindness is connected mental health. When you are kind, your brain rewards you by releasing hormones into your system that make you feel good.

5 Top Tips for maintaining good mental health.

Mental Health Awareness Week

We are in the ninth week of lockdown and it can be very challenging. Most of us are spending more time online and on social media. That can be a dangerous place if you are feeling emotionally fragile. It is easy to become over-exposed to news bulletins that raise your levels of stress and anxiety.

#Tip 1 Limit your exposure to news programmes. Cancel your daily newspaper. Stop watching news bulletins after 6pm so that your system can be relaxed at bedtime.

Another problem with social media is that it can lead you to comparing yourself with other people and how they are living their lives. You might see friends who are coping really well with lockdown and even seem to be having a good time cooking and home-schooling their children. Or you might see people who are sharing how bad they feel.

It is important to recognise that what you are seeing is what others choose to share and it is just a glimpse of what they are experiencing. Don’t judge them or yourself. Your experience is unique to you and you need to acknowledge what you are feeling, positive or negative.

#Tip 2 Stop comparing yourself to other people. You and your experience are unique

If you are following the activities of friends and connections on line you may be thinking that there are things you ‘should’ be doing. You may be seeing people fundraising or making face masks or running online courses and feel bad that you are not doing something similar.

‘Should’ is a word that is loaded with guilt. There is nothing you should be doing if you don’t want to do it. Follow your bliss and do the things you enjoy doing. Maintaining your own good mental health is the best thing that you can do for other people.

#Tip 3 Let go of the ‘shoulds’.

Once you are aware of your feelings, don’t try to push them down or ignore them. Those feelings are sending you a signal that there is something in your life that needs attention. There is a saying that ‘what you resist persists’.  If you bury your emotions they will find another way to pop up.

#Tip 4 acknowledge your feelings.

If a negative feeling stays with you, find somebody to talk to about it. It’s not a sign of weakness. We all have times when we get tired or overwhelmed. Family and friends can be good, supportive listeners. You may need to find support outside your social circle such as from a counsellor or therapist.

# Tip 5 Seek help and support from people you trust.

I wrote this poem a couple of weeks ago to express how I was feeling that day and to encourage readers to recognise and admit to how they were feeling too.

Today is a day for crying

Today is a day for crying

I don’t know why

It just is.


The sun rose as usual

In a blue sky with fluffy white clouds.

Spring is progressing

The flowers are blooming to their inner schedule.

The trees are shedding their blossoms

and filling out their new bright green leaves


My home is still safe and comfortable

The village and fields a delight.

The cupboards are stocked,

the freezer is full

and the bathroom has toilet rolls.


My loved ones are well

I am healthy and fit

My heart and lungs are strong.

My friends are okay and staying indoors,

just getting older, one lock-down day at a time.


I’ve counted my blessings

Been grateful every day

I know that all will be well.

I’m finding the positives

I’ve meditated and journaled.

I’ve baked and gardened and painted

I’ve posted pictures of it all.


But today is a day for crying.

I don’t know why

It just is.

Some days are just like that

And it is alright if you feel that too.


There are more resources and suggestions available on the Mental Health Foundation website

If you would like to talk about what you are experiencing or need some support, you can contact me for a free 30 minute consultation.

Habit or Addiction?

I was recently asked to be part of a radio discussion about social media addiction. There has been so much in the news recently about social media, particularly Facebook, and people trying to decide whether to delete their accounts and whether they feel they can do without that contact. How easy is it to stop the habit of checking your Facebook account or is it an addiction?

Pat Duckworth, Royston Hypnotherapy, Addiction

Pat Duckworth with Chris Mann, BBC Radio Cambs


We use the word addiction a bit too freely. It is a serious medical condition that can ruin lives.  It’s often used in a way that demonises the behaviour of young people. When I was young, parents were worried that kids would be addicted to television. Now they are worried about social media.

So what does it mean to be addicted? You can become addicted to anything that affects the reward circuitry in the brain. It’s not about the substance or the behaviour, it’s about the way the brain responds through changing structure and releasing hormones such as dopamine and endorphin. A person experiencing an addiction carries on repeating the habit or behaviour regardless of the negative consequences.

Someone with a social media addiction would feel compelled to check their social media sites frequently and be unable to control the amount of time they spend online. This is likely to be accompanied by feelings of anxiety. The negative impacts could include:

  • Losing track of time
  • Procrastination
  • Stress
  • Need for instant gratification
  • Reduced self-esteem
  • Feelings of guilt
  • Being emotionally unavailable

Stopping the behaviour for a short period of time may be quite easy. The challenge is not going back to it or taking up a new addiction to replace it.

If you recognise any of this in yourself or someone you know, the first step to recovery is to admit that you have a problem and that you need help. Don’t let it ruin your life.

If you think you have just developed a habit that is wasting your time there are some steps you can take to break the habit:

  • Leave mobile devices outside the bedroom so they do not disturb your sleep.
  • Turn off message alerts
  • Limit your exposure. Decide how much time you are going to look at the website and stick to it
  • Delete sites from mobile devices so you don’t get tempted. Or make them password protected to make it harder for you to access the sites quickly

If you need help, don’t put it off, contact me now

What do you predict for 2018?

As I look back over 2017 I realise what an unpredictable year it was. Who could predict all the major events that happened in the world in the past twelve months?

And if I review my own year I know that I couldn’t have forecast half of what I have experienced back on 1 January 2017. I have been to so many different places this year, worked with amazing clients and met some wonderful people. There were bumps and obstacles along the way but they passed and life went on.

Also, if I had used my experience of 2016 to predict what would happen in 2017 I would have been way out. You can’t use your past to predict your future.

So my thought as we approach 2018 is that it is good to have a plan and a vision for the new year. It is good to set intentions and resolutions, and take action to achieve them. But build plenty of wriggle room into your plans for all the good stuff that is going to surprise you.

A final thought from Abraham Lincoln ‘The best way to predict the future is to create it.’ What do you want to create this year?

Contact me if I can help you with your resolutions or plans.

A very Happy and Peaceful 2018 to you and your loved ones.




Are you feeling anxious?

I am feeling anxious about you. So much has happened in the last 12 months that has raised levels of anxiety. First there were all the issues raised around the Brexit referendum. Then there was the American Presidential election.  Now we are in the process of another General Election which is stirring up fears around elderly care, the economy and immigration. All of that against a background of terrorist incidents and war in other parts of the world.

I wouldn’t be surprised if you were feeling a bit anxious but do you know what? It isn’t doing you any good and it’s not making the situation any better.

Our human brains formed when we were cave people and the environment around us was dangerous and life threatening. We had to forage and hunt every day just to stay alive. Add to that there were predator animals that wanted to kill us. Our brains became very sticky for bad news as a survival mechanism. That’s why your brain notices negative information far more than it notices positive good news.

When you watch scary stuff on the TV news or read it in newspapers, your brain imagines you having to deal with that scary situation. In response, your brain releases the hormones that prepare you for fight or flight or freeze. Those hormones inflame your system. That’s ok if you only get anxious in short bursts and not too often. Persistent levels of anxiety can lead to physical symptoms such as poor sleep, lack of concentration, weight change, headaches and raised blood pressure.

So what can you do about? Firstly, acknowledge bad stuff happens but it is not personal to you. It’s not the stuff that is happening that causes the anxiety, it is the thoughts that you have about it.

Secondly, stop reading news reports and listening to or watching the news, particularly in the evening and before you go to bed. There is nothing you can do to make those situations better so stop exposing your brain to them. Remind yourself of all the good things that are happening, the millions of people who will go to sleep safely tonight, the beautiful babies that have been born, the things of nature just outside your window.

Thirdly spend a few minutes each day calming your body and your mind by just focusing on your breathing. If you can, make your out breath longer than your in breath for even more relaxation. Even better, go for a walk and breathe deeply.

If you need more help, contact me today so I can find out more about what you are experiencing. You are welcome to book a free 30 minute consultation with no obligation.

Are you feeling SAD?

The clocks have gone back, the trees are turning colour and Christmas decorations are appearing in the shops. Autumn is here and for some people this is the season of SAD, Seasonal Affective Disorder.

Are you feeling SAD?

Are you feeling SAD?

Symptoms of SAD include:

  • Lack of energy and feeling sleepy during the day
  • Poor quality or interrupted sleep.
  • Loss of sex drive
  • Loss of pleasure or interest in normal activities
  • Anxiety
  • Mood swings, irritability and low mood
  • Cravings for carbohydrates leading to weight gain.

These symptoms are the result of lower light levels during the winter months which causes an increase in the production of melatonin (the hormone that makes us sleepy at night), and a reduction of serotonin (the Happiness hormone). These changes disrupt your internal body clock which regulates important bodily functions such as appetite, digestion, sleep quality and mood.

I have experienced mild symptoms of SAD since I was a teenager. Every year it creeps up on me and I wonder why I suddenly feel miserable and have no energy.

One way to boost your exposure to natural light and reduce the effect of SAD is to use a full spectrum light box.  These lights provide summertime levels of light and have been shown to be effective in up to 85% of diagnosed cases of SAD.  Light boxes are available from specialist retailers.

If you are experiencing mild symptoms there are other practical things you can do to improve your mood:

1 Take a 30 minute brisk walk outside around the middle of the day.  The exercise will make you feel better and you can get the best of the daylight.  Research has shown that a 15 minute walk can significantly reduce daytime snacking.

2 Boost your mood with healthy food. The food you eat can have a negative of positive effect of your mood and can increase or decrease mood swings. Some simple guidelines:

  • For an energy boost include lean proteins in your diet such as: cheese, milk, eggs, nuts, seeds, pulses, beans, fermented soya products (miso, tofu and tempeh), white poultry and seafood.
  • Avoid eating simple carbohydrates such as white rice, white bread and sugary foods. These foods will cause your blood sugars to spike and fall rapidly causing mood swings. Instead eat complex carbohydrates including vegetables and fruit.
  • Reduce your caffeine intake. Caffeine suppresses the production of serotonin and stresses your nervous system. Remember that caffeine is not just in coffee, it is also in black and green tea, chocolate and energy drinks.
  • Consider taking a vitamin supplement. At this time of year you may need to supplement your diet with vitaminB12 and D. Vitamin D is predominantly made by your body when it is exposed to natural sunlight which is in shorter supply during the winter months. Low levels of Vitamin B12 in the blood have been linked to depression, though the exact cause is still unknown. You can top up by eating fish, shell fish, fortified cereals, eggs, yoghurt, and milk.
  1. Maintain your social contact during the winter months. People with strong social contacts tend to stay happier and healthier and cope better with life’s challenges. Being on social media is not sufficient so contact your friends and arrange a regular get together. If your friends live at a distance, could you enroll for an evening class or get involved in a hobby group?
  2. Commit a random of act of kindness every day. Showing kindness and compassion to others is an excellent way of boosting your own feelings of well being and strengthening your emotional resilience.
  3. Do something that makes you smile or laugh for five minutes three times a day as this will help to boost your levels of serotonin and immunise you against stress. You could watch a funny video on YouTube or your favourite comedy on the television. But the best method is to have a laugh with a member of your family or a friend or colleague.

If you are experiencing prolonged or intense symptoms of SAD it is important to consult your medical practitioner.

For practical techniques to help with SAD contact me to find out how I can help you.

For more information on SAD see http://www.sad.org.uk/

Are you mindful when you eat?

When clients come to see me for weight loss, I ask them ‘How fast do you eat?’.  Most of them tell me that they eat quickly, often with the TV on.  I explain the importance of eating slowly and without distractions so that you can hear the messages that your body sends you when it has had sufficient to eat.

Last week I had an extraordinary experience.  I persuaded a friend to experience mindful eating with me.  I cut up some salad vegetables and feta cheese in bite sized portions and put them into two containers.  My friend agreed to put on a blindfold and then I gave him his food.  I did the same.  We agreed not to talk while we were eating.

It was hard not to talk but it became very meditative.  When we had finished we were both very calm and peaceful.  We had both really tasted and enjoyed the food.  The texture and sound of the food also became more apparent.  I stopped eating before the container was empty because I knew I had eaten enough.

I recommend eating with your eyes closed or blindfolded as an experience.  If you want to eat slowly and mindfully:

  • Eat at a table
  • No distractions – turn off the TV, put away the mobile phone or Tablet.
  • Put down your knife and fork between every mouthful
  • Keep the food in your mouth and chew slowly
  • Notice the ‘satisfied’ feeling and stop eating

This is a good start to losing unwanted weight.

The wonder of the placebo effect

The term placebo has often had negative connotations in the past.  It is almost as if something that helps the body heal itself naturally is somehow cheating or suspect.

The word placebo comes from the Latin for ‘I shall please’.  Most of us have experienced the placebo effect while taking traditional medicine.  If you have ever bought a branded medicine instead of a generic alternative, some part of your mind was convinced by the packaging or the extra cost that the branded medicine would work better.  If you believed it enough, it probably did work better.  That is the placebo effect and we all experience it.

In recent years there has been lots of research into the placebo effect in the area of pharmaceuticals.  It has shown that the size, colour, shape and the name of medications has an effect on their efficacy.  Even the smell has an effect.  Researchers found that if they wiped TCP antiseptic around the top of a bottle of tablets, the tablets were more effective!

The attitude of medical practitioners also has an impact on their patients.  The more the practitioner builds trust and rapport with their patient, the more the patient is likely to respond positively to treatment.

Bestselling author and speaker, Dr David Hamilton, has carried out a lot of research in the area of the placebo effect and you can read his thoughts at http://drdavidhamilton.com/?page_id=8

So, in my opinion,  we should be much more open to understanding and using the placebo effect to aid our natural healing processes.

Want to Lose Weight? Change Your Mind!

If you have resolved to lose weight this year, the chances are that you have been looking at diet books and weight loss clubs and wondering what will keep you motivated and whether you can keep weight off in the long term.  So many people lose weight on a diet only to put on more when they start to eat ‘normally’ again.

In a new book published this month*, Dr Deborah Cohen sets out two forces that are driving obesity in the modern world.  One is the availability of cheap food, large portion sizes and food advertising.   The second major force is our human nature, the fundamental limits to our self-control and the unconscious ways that we are hard-wired to eat.

Dr Cohen says, “Because our moods and desires change throughout the day, many people claim their weight problem is the result of emotional eating.  They say they eat when they are stressed, lonely or anxious  – whenever they are not at their best.  Yet others claim they eat too much when they are happy’.

When I work with clients who want to lose weight we talk about establishing a different relationship to food.  I always start by asking them to eat slowly so that they really notice what they are eating and can recognise the signal that their body has had sufficient and is satisfied.  I also help them to discover techniques for recognising emotional hunger and dealing with it.

If you really want to lose weight in the long term you need to change your mind first.  It is the only way to long-lasting change.

*’A Big Fat Crisis; The hidden forces behind the obesity epidemic and how we can end it. ‘ by Deborah A Cohen, MD., Nation Books,  Jan 2014