Talking hormones: Meet our expert who is here to answer your questions

expert

Finally someone who gets it.

Melbourne-based Dr Fatima Khan is highly skilled and experienced menopause specialist who genuinely cares about our hormonal health.

Many of us have been to our local GP for answers only to leave feeling more dejected than we arrived, but you feel like Dr Khan is actually listening.

She is passionate about creating awareness and empowering women to make informed choices about their health. Her integrative approach to balancing hormones helps optimise women’s physical, emotional and mental well-being.

We caught up with her to find out more, and to ask her to answer some of your most common questions.

Dr Khan
Melbourne-based menopause expert Dr Khan.

What made you so passionate about midlife hormonal issues?

I felt that there is so much information and support for young women in their 20s and 30s focusing on reproductive problems (menstrual, fertility etc). Even the school curriculum teaches about reproductive health and nothing about post-reproductive health. However, with life expectancy for women increasing globally, with an average age of 85 in Australia, women will spend at least 40-50% of their lifetime post menopause. The decline in oestrogen and combined with the ageing, predisposes women to chronic illnesses such as osteoporosis, dementia, heart disease and diabetes. Consequently, we are living longer but with poor quality of life and increasing nursing home indwelling. We need to be proactive in managing the short term symptoms of perimenopause but also prevention against the long term conditions so women can lead independent, active lives and age with dignity.

What is the biggest misconception about perimenopause/menopause?

That it affects old women! We need to change society’s perception of mid-life women to that of active, dynamic and vibrant members of society. The modern woman will not experience her mother’s menopause and therefore we must change the narrative by talking about this ‘taboo topic’ which will de-stigmatise this natural inevitable transition that every women will experience. We need more open and transparent we are, the less likelihood of women suffering in silence and ‘just putting up with it’. Mid-life women are experienced, confident and powerful members of society liberated from childcare duties and free re-create and re-invent themselves.

How has your hormonal journey been?

I was diagnosed with PCOS when I was 20 years-old. It took seven years to conceive my first child. The postnatal period was very challenging with an significant impact on my mental health. In 2013, I had a cancer scare (endometrial-womb) which made me explore the root cause of my hormonal fluctuations. I started learning about how hormones control every aspect of our life including our appetite, mood, sleep and disease risk. More importantly, our environment and lifestyle have crucial interplay with our hormones which impact our quality of life. Conventional medicine focuses on symptom control which is shortsighted when in comes to balancing hormones. After attending several conferences and reading scientific literature, I have come to formulating the ‘8 Pillars of Hormone Wellness’. (I am one of three sisters, one has endometriosis and the second had hypothyroidism and endometriosis. My mother had an hysterectomy and went through early surgical menopause. My aunt died of breast cancer at the age of 50 so my mother did not take HRT. As a results, she suffers from chronic illnesses which could have been prevented with HRT. My mother is one of three sisters, so I grew up with lots of women around me and witnessed the impact of hormonal imbalances and subsequent disease).

What do you love most about your job?

Making a difference to a women’s life-sounds cliche! I love coming at home at the end of the day having improved the quality of life for women. Their relationship with their partner/spouse, their children, their workplace and more importantly their relationship with themselves. (I see so many women who have been mis-diagnosed, told ‘its in your mind’, and when they know its not a mental illness but something more. Women are intuitive and we must listen to them). I also empower women to continue working and pursuing their career dreams. The perimenopause coincides when women are at the peak of their careers, unfortunately, several women take a back seat or give up work altogether due to the impact of menopause. This is partly why we have a Gender Leadership gap (50% women at managerial level but on 10% make it to Leadership level). This has direct and indirect impact on the economy.

When did you know this is what you wanted to do for a career?

I have always wanted to do women’s health and spent time training as a junior doctor in obstetrics and gynaecology and have undertaken further training in women’s health over the years whilst practicing as a GP. The advance menopause certification is a year long training at Kings College London which holds clinics for menopausal women with complex medical backgrounds. This required a lot of committment and investment on my behalf but something I was keen to learn to help so many women suffering in silence. GPs and gynaecologists in general do not get taught about the menopause as a core subject.

If you could give one piece of advice to a peri-menopausal women, what would it be?

Be proactive in managing your symptoms as you are young (Yes, 50 is young!) and have another 50 years to live! Focus on your short term symptoms control but also prevention against long term conditions so you can continue to be active, independent members of society and age with dignity. Don’t give up!

Common questions answered

Please help with the weight gain. There is so much conflicting advice out there

Weight around waistline is common during peri-menopause due to imbalance of hormones-cortisol, insulin, oestrogen and progesterone. Please see my ‘8 pillars of hormone wellness‘ to achieve balance and weight loss.

I have very bad pains/cramps prior and during my period, I am 49. They seem to be getting worse

This is due to lack of progesterone and oestrogen dominance which will also give painful breasts, mood swings, headaches etc. There are plenty of treatment options so don’t suffer.

Can I go on HRT if my mother had breast cancer?

You can have body-identical HRT after assessing your individual risks and benefits. BRCA gene is an exception.

What can help with night sweats?

Most effective treatment is body-identical HRT which will stop your nights sweats and improve sleep. It’s all about quality of life.

How can you tell if you are perimenopausal?

There are too many to list here but I have them on my IG account under ‘symptoms’.

Are fibroids part of menopause and can they lead to significant weight gain?

Fibroids can cause heavy painful periods which can make you anaemic (exhausted, dizzy, breathless). If large, can press onto bladder and cause you to urinate more frequently

Why is my anxiety so bad? Are there any supplements that can ease it and my mood swings?

Oestrogen directly effects your serotonin (happy) levels in your brain. Plant extracted oral progesterone stimulates your GABA receptors which has a calming effect like drinking alcohol or taking valium except its natural and balances hormones. Antidepressant and herbs will not replace the role of HRT.

What’s happened to my sex drive?

Low sex drive, uncomfortable sexual intercourse and vaginal dryness are all symptoms of low oestrogen. Vaginal oestrogens are safe and body identical. There are also good vaginal lubricants and moisturisers.

If you have a hormone question for Dr Khan, email us editor@50sowhat.com.au. We’ll do our best to have it answered (anonymously) and share it with our readers. You can also contact her direct by emailing inquiries@menopausespecialist.com.au.

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