In this episode, Vicky Eldridge and Anna Dobbie sit down with the brilliant and refreshingly honest Dr Ginni Mansberg to explore the evolving conversation around women’s health, particularly menopause, and the intersection of evidence-based skincare and aesthetic medicine.
Dr Mansberg, author of The M Word and founder of Evidence Skincare (ESK), brings her medical insight, media savvy, and no-nonsense attitude to a discussion that aims to cut through the confusion, hype, and misinformation currently surrounding menopause.
Vicky Eldridge: OK, so welcome to the Aesthetics Business Cast with Hamilton Fraser. I'm Vicky Eldridge, and today I'm excited to host an episode about women's health and menopause. Menopause is a topic close to Hamilton Fraser's heart. They've recently launched their own menopause policy extension to support a set of practitioners working in this space.
It covers menopause advice and consultations, prescriptions and services provided by qualified doctors and nurses. So our episode today is being produced in partnership with women in aesthetic medicine, and our guest is the amazing GP, author and women’s health advocate, Doctor Ginni Mansberg. Before we catch up with Ginni, I'm delighted to introduce Anna Dobbie, she's editor of Aesthetic Medicine and founder of Women in Aesthetic Medicine. She's gonna be my co-host for today's show. Anna, great to have you here.
Anna Dobbie: Thank you so much, Vicky. Always a pleasure to be with you.
Vicky Eldridge: Absolutely. So before we get started, can you tell us a little bit about Women in Aesthetic Medicine and why Aesthetic Medicine started it? What is the ethos behind it?
Anna Dobbie: Yeah, of course. I came from a previous role where we also had a women's group and I think that when I came into this sector, I realised that the disparity between men and women can be even greater and one of the main things I noticed was the lack of female speakers on a lot of the agendas.
And then I was talking to one of our board members, Sabika Karim, about it. And she said that when she's been introduced on stage there'll be a panel and they'll go through the men and say, and this man has gone to this university, he's done this amazing thing. He's cured cancer. His solved world hunger. And then we have Doctor Speaker Karim. And isn't she pretty?
And I thought that was so frustrating that you could be on the same level as someone to the extent where you're on a panel, but you're still getting described in a sector that's, you know, there is an interest in looks, but to kind of it's very reductive and it makes people feel a bit like a patient as opposed to a colleague sometimes.
And then I think through the conversations we've had since then, it's been a year and a half. There's just so many different aspects in which and a lot of them aren't just to aesthetic medicine specifically. But you know, there is a lot of inequality in general for women.
You know, even more so potentially at the moment with some of the things that are coming in about transgender rights. So we've kind of just opened up the conversation we've been having lots of columns and we did some podcasts about it. And, you know, I think everybody has a different take on it.
Vicky Eldridge: Amazing now coming on to our guest now, someone who is a huge advocate for women is Doctor Ginni Mansberg, and she is going to be joining us now. Anna is gonna give a bit more of an introduction to Ginni before we start chatting.
Anna Dobbie: So I met Doctor Ginni about two years ago. She's a GP in Sydney and one of Australia's foremost experts in women's health and hormonal conditions, including permi menopause. She's also the co founder and medical director of science based cosmeceutical skin care brand, evidence, skincare, or ESK as we know it as well as the author of the bestseller of ‘The M word - how to thrive in menopause’.
And Ginni Mannenberg is a GP, a TV presenter, podcaster, author and columnist, and just an overall awesome person.
Vicky Eldridge: Yeah. Hi Ginni.
Ginni Mansberg: Hello what an introduction. I love it.
Vicky Eldridge: Thank you so much for joining us. Now you've been talking about women's health, menopause long before it became like the latest buzzword. And then we're all talking about it now. But what drew you into the women's health space as the doctor and how has that journey evolved for you over the years?
Ginni Mansberg: I think being a GP you tend to have a patient base that reflects yourself. So when I was a young mum in general practice I tended to have a lot of young women who were young mums and going through pregnancy and I dealt a lot with antenatal care and a lot of, you know, paediatrics, a lot of little babies - loved that and as I got to a certain age, I looked around and worked out that all of my patients looked a lot like me and the thing that really struck me at that time because I'm 56 now, turning 57 soon, and I found that when I was really noticing that a lot of my patients were in peri menopause, literally what I knew about that phase of life. You could put it on a postage stamp. It was literally nothing. I had learned zero in general practice training zero during medical school, which I think is very common to doctors, but I look back now with horror at some of the advice that I was giving to women. And that is really outdated and was outdated then and it probably reflected the times where I think, Anna, you spoke about a little bit of misogyny around women that I feel like menopause is where misogyny and ageism just sort of come together and combine and have a baby and there's just so much in there. And combined with a particular study that came out in 2002, that threw the entire menopause world under a bus. I’m sure we'll talk about it, it just became a taboo subject and to try and find information to help my patients that didn't consist of. No, you can't have HRT. It will give you cancer was really, really hard and I needed to go on a journey and part of that when I went on that journey and you just get sucked down that rabbit hole, right. Because there's just so much there. That's so exciting.
I needed to write a book about it because I felt like I needed to share this unbelievable information that had been really being gate kept from patients by doctors and had really thrown a lot of women into harm's way. They felt gaslit they felt like they weren't being heard by their doctors, and there was such an important story to tell there. In 2019, when I wrote the M word, I called it the M word because no one spoke about it. Now I should talk about, you know, renaming it to out and proud menopausal and literally every man and his dog is is, you know, claiming to be a menopause. And we gotta go. Wow, Tonto, not everything is about menopause, but I feel like I've just got whiplash watching this journey go on before me.
Anna Dobbie: It has to go one way before it can go, the other doesn't it? Sometimes. And what do you think? Are some of the biggest myths and misconceptions that you still regularly see people aside from the HRT thing you mentioned?
Ginni Mansberg: So I think so. I think obviously the really big one is still, does HRT cause cancer? And I think we can't get away from that and we maybe might unpack that a little bit, but I think the other thing is we now have so many influencers and tik tokers and people on Instagram who share their lived experience of menopause. Often driven by the fact that they've had an awful experience. And so if you look at women in the UK right now in their 30s, their greatest health fears are depression, breast cancer. And menopause, which is ridiculous because a lot of women do not have a bad experience. I can tell you that I've had close to zero symptoms. I mean, I can't say that I've had nothing. My skin has been really dry, but other than that, it's been a pretty easy run for me and I think the more we tell women that you are heading into a chasm of doom, it's gonna fill women with fear.And is also going to tell women that the answer to everything is hormonal and that is not true and it's over promising, and it's inevitably going to under deliver and leave women feeling even more ghastly and even more misunderstood. And the reality is the biggest killer of women in the UK right now is heart disease and dementia.
And those sorts of the risk factors for those will also cause the most common cancers and the most common cause of cancer death in the UK amongst women are lung cancer and bowel cancer. And those things are all lifestyle related and we are not talking enough about the things that we can do right now to have a better future instead of just focusing on this very narrow remit of hormonal health, which I think there are is a subset of women who will have an awful experience and we need to make sure that we are delivering adequate information and adequate treatment options for those women where they can choose their own journey, choose from the buffet of options that we have.
Alongside being very, very careful to ensure that women have very good information about their future health and the things that they can do in mid life to actually ensure that that's a better journey.
Vicky Eldridge: That's really interesting what you touched on there. You know, there have been this huge surge in awareness, which is a, you know, a great thing. But at the same time, it has created a lot of noise hasn’t it it out there and you touched on, you know people that are sharing their negative experience, do you do you think that this is making women really confused about what to expect because obviously you're told one take these supplements, do this do this. There's a lot of information, isn't there? Is it too much noise?
Ginni Mansberg: Look, I think into any chasm of information and doctors need to own that because we've been the ones gaslighting women, and we've been the ones who've been gatekeeping information in a way that is really unfortunate and has led to this space where women feel unheard, unvalidated, and where there are no options for them to get through this position into that you will have a flow of some information that is good, some that is bad, but you'll also have commercial operators who will seek to exploit that chasm of information and chasm of good options and to provide options that really don't have any evidence, and I think are quite exploitative of women. There are a lot of supplements out there that claim to be all sorts of things for women in menopause, and the reality is I'm not saying they don't work, but we certainly have no evidence that any of them work. Not one of them has been proven with evidence to work for women in menopause, now we do need more studies and there might be amongst all of the commercial offerings that are flooding your local boot store at the moment there might be actually some things in there that have a shred of evidence but it hasn’t been proven yet. And that is exploitative again of women in the same way that promising that the answer to all your ills is HRT. And that's not true. The reality is that menopause happens to a group of women who are in the sandwich generation. They're often caring for teenage children. It's the highest risk time for divorce. It's often a time where they’re managing at work, they're often responsible for a lot of their co workers’ mental health, they take it onto their own shoulders. They're looking after elderly and ageing parents often who are in different parts of the UK and they feel guilty they might be back in Ireland. They might be in Scotland, it can be very difficult if you're the only daughter and you can't make HRT fix that. It's just not going to it. It's going to help a large number of women but it’s certainly not a panacea, and we need to make sure that we're not going to lead women down a path of even further disempowerment, which I think is exactly where we were in the first place.
Vicky Eldridge: Yes, a great point.
Anna Dobbie: Yeah. And on the subject of supplements, though, I have to say I have just enjoyed some of these earlier, which were from the MiA event and whatever they're doing, they taste really good. That Arella Pause one. So a big thumbs up on them. I've had them every day for two months. So if you have one thing that you wish that every woman knew about menopause, like one bullet point. Are you able to summarise it in one?
Ginni Mansberg: Oh, I do think that is hard. I am going to say something that's going to sound really hard and preachy, and I'm going to have to say it in a way that communicates my love and worship of women of my age because I think they're goddesses, but there's a great movement at the moment of body positivity and of being healthy at any weight. And the reality is that of all of the biggest killers of women, but also the contributors to a poor quality of life in women, everything from poor mental health to poor joint health to poor sleep to cardiovascular risk to bone health risk. Everything that cancer risk, being overweight with a lack of skeletal muscle and a very high volume of particularly perivisceral fat. So that's the fat that sits around your middle, not the fat that's sitting under your tuckshop lady arms. That's fine, doesn't do anything bad to you. You might not love the look of it, but it's fine. It's not going harm you, but getting an apple shape and leaning into that unfortunately does more than make you not look great in a bikini. I think you look great in bikini. I don't care what like, honestly, I think you're all beautiful, but we do need to find a way to have a conversation that makes options around healthy lifestyle more accessible to women at this time.
We know that being overweight increases the number of symptoms that you have during your period and menopause journey and it decreases the effectiveness of your hormone therapy. So unfortunately apart from contributing to your risk of all the chronic diseases that will shorten your life and reduce its quality. We are also going to have a worse menopause journey and as a profession my profession needs to find a way that is supportive and kind. But evidence based when we have that conversation and I think evidence suggests that doctors just don't have the conversation at all. If you think menopause is hard to talk about, doctors are terrible at having conversations about weight because it can feel so judgmental and so like I'm calling you, ugly.
I don't see weight in terms of beauty, it's not. I think you're all beautiful, but I think we do need to find a way to have this conversation in a better in a more helpful way.
Vicky Eldridge: So true, isn't it? I feel like there's a lack of sort of advice on how to actually do that. So for many women, they do struggle, don't they, with weight gain or with the type of exercise they previously did, not working. And there's a bit of confusion around, so how do I need to shift and pivot? And one thing I hear so much is that one of the key things that you can do is to build muscle and to do that resistance training and things like that which you know is it's something that a lot of women perhaps don't want to – like I don't want to get too muscly. Is that something you've experienced, Ginni, like with a bit of like, confusion about that and what that means?
Ginni Mansberg: Yeah, I mean, I really think that the women that I tend to see who are, you know, struggling with their spare tyre are really not at risk of turning into Miss Universe like they, you know, Mrs Universe like that's just not your high risk here, what we're trying, what we now know that we didn't know as little as five years ago is that your fat is active and producing over 400 identified hormones that we have identified so far, most of which are pro inflammatory across your body and that your muscles so they're called adipokines. They're the they're the hormones produced by your fat that are really dangerous for your body. We also know that the myokines that are produced by skeletal muscles specifically, we also know that the myokines that are produced specifically by your skeletal muscle are anti-inflammatory and these things are amazing. Again, mostly, most of the research is still being done in rats and mice, but over 400 have been identified and most of which have been found in humans as well. And what we know is these myokines directly communicate with your immune system with your guts to help your gut health. You know so many women have horrible gut symptoms as they transition through menopause.
It's an awful time and we know that building skeletal muscle can help your gut health. It also directly helps communicate with your balance centre, so we've always wondered, like, why do women who get osteoporosis or sarcopenia? So osteoporosis is thinning of the bone. Sarcopenia is muscle loss. Why do they have more faults like it doesn't make any sense. It's because they are losing the myokines that speak to the brain that actually help them build the balance centres in their brains. It communicates with your metabolism, so the more muscle you have, it literally reduces the amount of fat that you will have, particularly perivisceral fat. So we know that building muscle is a really good way to go. The problem is is eating protein because evidence suggests now that you need maybe more than one gramme per kilogramme of body weight per day to actually maintain your skin, your hair, your muscles. And that is really hard and not only that there is a ceiling on how much protein you can absorb in any given meal, so you might have a juicy steak and go, you know, I'll just have two steaks for dinner. Well, that's a steak is great. 35 grammes of protein. Fantastic. Two steaks is 70 grammes. You can't absorb that. You need to be having protein in your breakfast. You need to be having protein in your lunch as well, because otherwise you're just not going to be able to get to that volume of protein that you need.
And the problem is having a high protein breakfast can be really, really difficult without something very processed, like a protein powder or a collagen powder or a protein bar. Those processed foods are the sorts of things that increase your perivascular fat, so it it is difficult for women, and I think what we need to be doing is having conversations like this that say, hey, women, why don't you share? What do you guys have for breakfast? What's your favourite high protein breakfast? Cause in there, someone's gonna have something that someone's gonna go. Ohh. I could do that. I like that. That's cool. That wouldn't that take me too long and I could actually do that.
Vicky Eldridge: Yeah, makes a lot of sense.
Anna Dobbie: I recently had a like a hormone analysis done from a blood work and I used to always have two eggs for breakfast every day and I was told to stop doing that because of the cholesterol implications. But I so I think there's an issue that not only is it's not one-size-fits-all as well, right for people.
Ginni Mansberg: That information is quite old school, so we have very good data of egg consumption in people with pre-existing heart disease and with people with diabetes. And it has not been shown to increase what we call MACE - major adverse cardiac events. So in fact, eggs are a very good and very cheap source of protein.
Vicky Eldridge: Yeah.
Anna Dobbie: They’re my favourite thing ever and it’s been really hard not having them for breakfast!
Ginni Mansberg: 2 a day. There's really no evidence.The thing that increases your cholesterol is going through menopause or going through perimenopause I almost thin it’s a better biomarker to me than hormone levels because hormone levels particularly in Peri will go up and down like a yoyo. And I can do a hormone level on you on Monday morning and then do the same blood test here on Tuesday afternoon. They'll be completely different. So which one is real? The reality is you are your hormones are doing a triple somersault with a half pike every single day and those hormone levels are not good. But what is a great biomarker is your cholesterol.Which goes up and what we know from the College of GPs in in the UK is that we put that into an algorithm looking at your cardio overall, cardiovascular risk that takes into account everything from your post code. So your socioeconomic status determines your cardiovascular risk to whether or not you have diabetes, to whether or not you are a smoker. And we put all of those things together into an algorithm, and you don't necessarily need to freak out about your cholesterol going up to 6.5. Especially if you've got good levels of good cholesterol, that's often totally fine. What I'd much rather you do is actually to prevent heart disease is build up your skeletal muscle in order to reduce your perivisceral fat in order to get your body mass index into a normal healthy weight range. That is the best thing that you can do for your cardiovascular risk.
And if that involves eggs all power to you. My problem with eggs is that one egg has 6 grammes of protein, so if you have two eggs for breakfast, that's 12 grammes, which is not bad. But if you're sitting at 80 kilos and we've got to get 80 grammes of protein into you over a day, it's just gonna be a bit of a struggle, unless you're having steak for lunch and steak for dinner, which I do not recommend if we’re going to avoid bowel cancer.
Vicky Eldridge: it's such a... I think I'm gonna circle back to your book a little bit now because we can see from chatting to you here that you're really good at making the science accessible to people and.
Anna Dobbie: Yeah. And I'm just looking at my exercise bike and it's winking at me. Covered in clothes at the moment.
Vicky Eldridge: Covered in and clothes.
Ginni Mansberg: Yes, isn't it a great place to dry your clothes? And that's where everybody I know has either a treadmill or an exercise or a Peleton bike that they bought during the pandemic. In a peak of like intention. And it is just a great place to dry clothes.
Anna Dobbie: Really useful.
Vicky Eldridge: So let's talk a bit more about the book. I know you. You talked a little bit earlier about the inspiration for it, but tell us a little bit more about what you break down for people in the book and how you make these sort of topics that can be confusing for people a bit more accessible.
Ginni Mansberg: I think because I work in breakfast television and we don't get edits in breakfast television, it's live and a segment is 2 1/2 minutes and if you don't get to the meat of a topic within the 1st 10 seconds, your audience won't stay with you.
So the art of communication, I guess was bashed into me by doing live television and podcasting. It's made me have to think about what makes the average person sitting at home watching breakfast television, understand science and a way that is exciting and gives them passion because I want people to be as passionate about this as I am.
So right through the book case studies, anecdotal evidence from my own stories, and my own experiences. But I go through every sort of major part of menopause, everything from hot flushes to joint pains to bowel issues to brain, brain fog, depression, depression is very different around perimenopause it's very interesting. A generalised depression often has what we call anhedonia, where you're just quite miserable and sad. We don't tend to see that as much. Actually, in perimenopausal women, when it is hormonal, what we tend to see more is extreme anxiety, close to panic, often in people who've never had that before.
Or can be quite paranoid, so really taking things the wrong way often blow up the entire family. By combining that paranoia, taking things the wrong way with the rage and just having explosive dysregulation of their emotions, which is terrible. And it is peak time for divorce, but a lot of my patients have blown up their best friendships. It's just terrible.
And if you take that behaviour into the workplace, well, you're not going to last too long there either. And we do see 10% of women exit out of the workplace, which is contributing to financial disadvantage. They are going to retire with far fewer savings at a time where they should be inspiring the next generation of leaders, nurturing the next generation of leaders and stepping up into C-suite roles. Why are women not in C suites? People say it's all to do with childbirth. I think it's a lot to do with menopause as well, but you know, there's a lot of that sort of information. I've got a lot about sex and the vagina because that is just not talked about. I do have a section called ‘give this to your partner’ because I think there's just a lot of particularly male partners, who just don't get it.
And then I have a whole section about beauty because I feel like the menopause professors want to write off hair and skin as being frivolous. And to me, I just watch women's confidence, just literally dive off a cliff and their confidence just hits such a low ebb. They feel unsexy. It's not just about the lack of sex and the low libido is not just about having a dry vagina. They feel very unattractive. They feel stupid. The brain fog is often really exaggerated in their head. Studies have actually shown that other people don't notice your brain for nearly as much as you do.
But if you feel that your skin that you've aged overnight that your hair is falling out, that your neck is now, really creepy. They're things that you will see far more than anyone else, but why shouldn't you?
So I mean what we know, I mean oestrogen is such a fabulous hormon. Oh my God. Like I could have an altar table and light incense for oestrogen every single day. It's such a great thing so we know that it's anti-inflammatory in the body but it's anti-inflammatory in the skin as well and it prevents UV damage. And.apart from that, it helps build the skin barrier. It actually helps your skin barrier make ceramides and hyaluronic acid - the natural parts of the mortar in a brick and mortar structure that help the skin have its integrity. It keeps the pH of the skin low, but really importantly, it stimulates your fibroblasts, the cells that make collagen to do its thing to do their thing and make collagen. And oestrogen inhibits, switches off an enzyme called matrix metalloproteinase 1. Which actually breaks down collagen in the skin. Now I don't know why Mother Nature decided to put MMP1 into a woman's skin. I don't think it has any role there, but it is kept on a leash by oestrogen. Lose your oestrogen and you’re turbocharging your collagen loss because you're not only losing your ability to make collagen, because fibroblasts are no longer being stimulated. And on top of that, you're breaking it down at a rate of knots, and what we do see is that women will lose 30% of their collagen in the first five years after menopause and still continue to lose more than two per cent of their collagen every year after that.
You will see women coming into clinics just going, I don't know what happened. Like I had great skin and all of a sudden it is itchy. It's dry. I can't tolerate any of my skin care that I used to love, I'm now burning at the drop of a hat and I look old. My skin looks. I've got these huge pores. My skin is saggy. And creepy and I've got all these lines and that at a time when a woman is at her lowest ebb, maybe emotionally, maybe her confidence has gone down. I feel that to not take her concern seriously is cruel and I don't want to be any part of that. I want to be - I always see my role in medicine as to not to tell you what to do, but to show you the way to the buffet and give you the recipes at each buffet station so that you really can make informed choices because there's never one way to skin a cat, particularly in menopause, and I really think that you could treat blood pressure via ChatGPT, there's an algorithm and pretty much everyone's the same. You do this. If that doesn't work out that you do, everybody has the same diet. You cut out your salt. You know, it's really, really easy.
But menopause is very different for different women and we need to be able to work with our patients and stand next to them at the buffet table and go here are your options. What do you think? And let her make that decision for herself because she should be driving the bus and I'm the copilot.
Vicky Eldridge: That's so true. What role does skin care play - so I know obviously you're the founder of the ESK and why is evidence based skin care so important and how can we, you know, use products to support skin during this hormone hormonal transition?
Ginni Mansberg: So there's nothing particular about menopause that tells you you need a specific menopause range, and there's really no evidence for that. But we know what the loss of oestrogen does to the skin. It you do get an impaired skin barrier function. So 70% of women, according to one Dutch study did report sensitivity and that reflects what most of the clinicians I know say they see in their practice, so they see sensitivity. They see dryness because of that impaired skin barrier. Often the pH drifts a little bit higher as well. So the pH of your skin care really matters. On top of that, it's that collagen loss. So we know what can repair a skin barrier and we know what can address collagen loss.
The thing is, unlike addressing a woman in her early 40s who maybe hasn't started losing oestrogen as part of her peri journey because in the beginning of the journey your oestrogen is up quite high, as your ovaries are trying to like spurt out those last eggs because they're designed to get you pregnant, right? So they're just like, you can do this. You can do this. And then often what they're doing is actually overproducing oestrogen in their attempt to get you another baby thanks. Don't want that.
But as you start to lose the oestrogen, we know what we're going to see. But what we need to take into account as well is that the sorts of things that you could have used before, things like maybe a retinol, which is a bit old school, and retinol needs to be converted in the skin to retinel and then from there to retinoic acid. We know that retinol can be very irritating, but more so in a menopausal women, we also know that things like vitamin C, which are fabulous for skin, really good for helping grow collagen, helping their anti-inflammatory. It acts as a scavenger for some of the reactive oxygen species that cause some of the damage in the skin. But sometimes women in menopause can't tolerate that. Alpha hydroxy acid serums. Beautiful for exfoliating, amazing for deep hydration, but they'll be often irritating. So what we always think of in ESK is having active without the reactive. So we have active skin care ingredients. What we have done is we've formulated our range. We have left off any excipients. So excipients are stuffing your skin care. That is not the active. So it might be a bulking agent. It might be the scent, it might be the preservative, it might be a buffer to sort of change the pH. We make sure that we use excipients that are non irritating.
And they are more expensive and I get why companies don't do that. But for us, we are very against cutting corners because I just have to look people in the eye and I can't do it if I'm using garbage, but So what we do is we use I guess the best evidence based ingredients.
We will always provide links to studies in why we will use things that we use. We know that if ESK was to send, there are pay to study labs out there and your results will be positive and you can even get them published in a pay to publish journal. So just because something's in a journal, it doesn't mean that we've got really good evidence.
What I would do is to say, what is this journal? Has somebody had to pay to get their results in there? Who has sponsored the trial that should be at the bottom? It's called a declaration. So when I look at the study, I scroll to the bottom and look at the declarations. If somebody’s paid for it, we know that there's a 90% chance it's gonna be positive. That doesn't mean that it's truly reflective of what's going on. So we tend to base more of our formulations on independent peer review journal that is non sponsored and we want I guess the higher quality of evidence going into our cosmeceutical skin care. But making sure that it doesn't burn and sizzle because nobody wants that.
Vicky Eldridge; Nope, you definitely don't, and you're nothing worse than that red, dry thing that you get round here. I used to get a lot of, like, sort of acne around here, and I love, you know, like you say, those products can be great, but when you get irritation and you get that sort of dry flakiness around there, when you’re already perhaps getting dry skin, it's it's not the best.
Ginni Mansberg: Yeah, totally.
Anna Dobbie: In all of this, where do you think aesthetics clinics fit in the wider conversation of menopause care?
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Ginni Mansberg: I actually think aesthetic clinics are in some ways at the cutting edge, because there will be women who have gone to their GP, been told no, you're not in menopause because you still had a period six months ago so you’re not in menopause and you can't have anything. It's too early or they'll be told no. That's not menopause. You're only 42. Or whatever it is. So they found answer with their GP.
And to feel better about themselves, because life has become so difficult, the one thing they can control is to go to an aesthetician. And there are clues. There are bread crumbs being dropped all over the consultation, and the aesthetician is actually in a position to not just be somebody who provides laser treatments or active treatments to somebody that they're seeing that actually be that trusted advisor who validates what they're feeling and going, you know what? I get it. I actually think you are in menopause. I tell you why - this is happening… This is happening. This is happening so just that sense of validation can be all that a woman needs to feel better about it, and it's not. Not every woman is gonna need HRT. 75% of women will get what we call vasomotor.symptoms so hot flushes. I do want to just quickly say that a lot of women think they're not having them because they've watched a Hollywood movie where a woman turns beat red and needs to jump into a swimming pool. I don’t know if you've seen that recent TikTok with the woman who had steam coming off her head? You think that that is what having a hot flush does? It's often just that you run hotter and that your partner who used to have to cuddle you because you were always cold at night is now the one going. Oh get away from me. You're too hot. It doesn't need to be the Hollywood version of a hot flush for it to be a vasomotor symptom. But for some women, if you're getting that happening once a day, do you want to go on a medication for something that's happening once a day? If you're not getting any other symptoms? I mean in four out of five women, they will disappear. Those hot flushes, they hit their peak two years post menopause. For one in five women, they will continue to have hot flushes into their 60s and 70s, and for one in 20 they’re super flushes. Severe, nasty hot flushes forever into their 80s nineties as long as they live, and that is linked by the way to a high risk of heart disease and dementia. So we do want to take it seriously, but I think the aesthetician can be that first port of call to really hear her and validate her and say you know what, maybe just say this to your doctor or give her some information and that relationship of trust is so important and women need somebody to be on their team.
Vicky Eldridge: Yeah, we're seeing a lot of aesthetic clinics now obviously, run by medical professionals who are branching into these areas, mentioned lifestyle earlier and all their training and they're providing hormonal services but actually to support women going through menopause, you don't have to go that that far, do you, do you think all aesthetic professionals should educate themselves a bit more about menopause because they will be seeing women in that age group coming through their doors, and if even if you don't want to start providing menopause specific related services, I guess you are in a way because you're treating skin.
Ginni Mansberg: That’s actually a really interesting question. I'd be interested in your opinion on that. I mean, Anna back to what you were saying right in the beginning about women in aesthetic medicine.
I'm not sure how comfortable a lot of women would be to talk to a male at practitioner about this because especially if they're having vaginal symptoms, low libido, those sorts of things often stay really inside the bubble, I think we know certainly from studies that have been done in workplaces that women really want to talk to each other and women who they see its peers. And similarly if you are starting out in the aesthetics industry, I think to know a bit about it is really important. But I don't know that a woman in her 40s is going to feel that comfortable to talk about this to a 23 year old woman. I think it's just going to feel a bit awkward, we women like to talk to our peers and talk to each other. So I would say that if you are a woman practitioner from your late 30s into your 70s, I think knowing this is really essential cause the chances are your patients are gonna open up to you and talk to you about it.
I think for everybody else I think you need to know about that as much as you need to know about the high blood pressure. Like you know somebody goes. I've got high blood pressure. You probably need to know about that. But you don't need to be an expert on it. I wouldn't have thought, and particularly if you feel uncomfortable talking about it, I don't want to make anybody uncomfortable.
Anna Dobbie: I mean, do you think though that the conversations around menopause can actually help to empower and support women and raise them up?
Ginni Mansberg: Yes, especially from people. So aestheticians tend to be quite scientifically minded and they have that way of cutting through the BS and it can be really, I mean it breaks my heart to think of 35 year old girls being terrified of menopause. I mean, honestly, I'm living my best life. I've and I see lots of patients who come to see me going well. Should I be on HRT just for my general health? I feel fine and the answer by the way at this point is still no even though we’re going to change that, I think, the studies are just really mounting for the benefits of HRT and preventing heart disease. But we can really get rid of some of the fear and some of the panic around this stage of life because there are answers for absolutely everything. It's just a matter of connecting with the right doctor or the right nurse practitioner. And there are a lot in our community, in the aesthetics community who are brilliant and who can do both things for you both treat your face or treat your neck and treat your menopause, and I think those you know, those people need to be put on a pedestal cause they're incredible. But I I think that the empowerment piece will come when women get access to really good, sensible information that is neither hysterical nor gas lighting that treads that fine line that says I'm so sorry for what you're going through. Now. Let's get you out of this. This is not your forever destiny or not even your next 10 years destiny. Let's just get you back.
Vicky Eldridge: Yeah. Amazing. Finally, coming to the end of our conversation. What's one thing then off the back of all of that, every aesthetic practitioner could start doing today and I guess it would be different like you just touched on for, depending on their own interests, their stage of life. But if you could give one bit of advice for aesthetic practitioners to support women, what would it be?
Ginni Mansberg: These are my buzz words for 2025, compassion and curiosity. Ask the questions. How are you going? How's life been? How have things been for you? Open up the conversation and be open to hearing whatever comes next and have compassion for the human being that is sitting in front of you and you don't know where that will lead.
And you can be really honest if you don't have all the answers, but you can say, Gee, that sucks and I'm really sorry. How can I help? But I think if you have compassion and curiosity, that will always make you a better practitioner. It will always allow you to connect better with your patients. It will allow you to establish that trust and it will allow you to be in a position where you can genuinely help. And what a privilege. Everybody wants to do a job where they genuinely help people and you can do that and compassion and curiosity are things that are in all of us. You just need to tap into those things to be the best version of yourself.
Vicky Eldridge: Well, couldn't end on a better note than that, Ginni, thank you so much. It's always great to talk to you. And Anna it’s been great co hosting with you today. Thanks for Anna and WiAM for supporting us in this episode.
Anna Dobbie: Thank you for having me
Ginni Mansberg: Thanks so much for having.me
