Podcast Episode 19: Menopause and the community with engagement advocate, Anita Powell
This week, fellow podcast host Anita Powell joins Lauren Redfern to discuss her work as a community engagement advocate and menopause campaigner. Lauren and Anita discuss the importance of facilitating opportunities in which harder to reach communities may gain access to vital support and information related to their perimenopausal and menopausal symptoms. They broach the topics of diversity, equality, and inclusion in health-related outreach, and spend time thinking about the importance of community-based spaces as a vital resource. In particular, Anita discusses her experience of both attending and facilitating support groups. She highlights how support groups can prove beneficial in helping to ensure each individual’s unique experience is recognised and held in a supportive space.
Anita Powell has a wealth of experience working within communities and regularly helps to facilitate menopause related events. Her podcast black menopause and beyond, explores Anita’s lived experience of the menopause and midlife through conversations with her peers. You can listen to the podcast and find out more about Anita and her work here.
Lauren Redfern [00:00:06] Welcome to the podcast for the Newson Health Menopause Society, a multidisciplinary collective of interested professionals passionate about improving hormone health across the world. The society exists to educate and inspire others to raise the standard of menopause care and access to treatment, to facilitate research collaborations across specialties and countries, and to provide expert advice and guidance to our associates. The ultimate aim of the Newson Health Menopause Society is to improve the lives and future health of women and all who experience the perimenopause and menopause. I’m Lauren Redfern. I’m a medical anthropologist and I’ve been exploring the experiences of those using testosterone as part of their HRT treatment. In this podcast series, I’m going to be talking to guests from a variety of different disciplines in order to share knowledge and ultimately improve our understanding of the perimenopause and menopause.
Lauren Redfern [00:01:05] When we think about the professionals involved in supporting those navigating the perimenopause and menopause, it can be easy enough to forget the essential and important work of the community-based advocate, support worker, and campaigner that gives voice every day to people’s lived experiences of the perimenopause and menopause. The person that signposts, guides and ultimately supports. Though we may fundamentally acknowledge that declining hormone levels do not discriminate based on race, class or professional standing, access to resources and treatment arguably do. With many experiencing a misdiagnosis of symptoms and the need to make multiple visits to their GP before the perimenopause or menopause is identified, it’s never been more essential to have well-informed advocates working within communities to accessibly raise awareness. Joining me today on the podcast to discuss her work as a menopause campaigner and community engagement worker is Anita Powell. Anita is the co-founder of Safe Space Black Women in Menopause and the creator and host of the podcast Black Menopause and Beyond. Hi Anita, welcome and thank you so much for joining me today on the podcast. I wondered if we might just start with you introducing yourself to those listening and telling us a little bit more about the work that you do.
Anita Powell [00:02:22] Hi. Yeah, I am, as you say, a menopause – I call myself an activist, which seems a bit kind of radical really, but actually I’m just a woman that moans to be honest with you. And I’m passionate as a person about equality and about giving people a voice and about people being allowed to have a voice. So one of my passions with regards to engagement is the menopause. And because I’m actually a community worker, so within my community work, I do face to face and podcasts, and online events and activities to engage in a conversation on menopause. But also as a community worker, I engage with people of all kinds of different scenarios and I need to be on top of the menopause conversation because it has a major impact on women’s outcomes full stop, with regards to employment, their health, their relationships, even, you know, their ability to make sure that their children are looked after, they’re paying their bills. They need to keep on top of their health. So for me, the conversation on the menopause is about really helping people be the best that they can be.
Lauren Redfern [00:03:39] Well, it’s interesting because in talking to you prior to the podcast and in just that little bit that you said, it seems like you kind of have many full time jobs outside of your actual full time job. In like the conversation we had I just thought, God, that so much to keep on top of. And you know, you mentioned being a community engagement worker, and I wondered if you could just tell us a bit more about what that involves and really, I guess how perimenopause and menopause has come to feature as an element of your work.
Anita Powell [00:04:05] Yes. So as community worker, I’m paid – yes, I’m paid, thank goodness – I’m paid on certain projects to engage with communities who traditionally are seen as harder to reach. So it could be – I mean, currently at the moment, we’re doing a project to men’s mental health and suicide within men because it’s dramatically increased. So my job is about engaging with people who traditionally don’t respond to adverts or if you don’t, you know, if a doctor says, ‘Oh, dial this number’, blah, blah, blah, well ‘stop eating this and skip every day’, and they don’t necessarily respond. So my job is about finding people who are hard to find and also trying to translate the dialogue into a manner that they will absorb in a more natural way.
Lauren Redfern [00:05:00] Yeah. And it’s interesting there because you mentioned like visual representations and I think it was something that we talked about prior to recording actually is how the menopause is notoriously kind of lacking diverse representation in images and I guess all outreach material really. And I wondered what you think the consequences of that really are, I suppose, and how that features or you know, you were saying it becomes difficult for people to respond to that. And I just wondered if you wanted to talk a bit more about that.
Anita Powell [00:05:27] Yes. I mean, when I first started off doing menopause work, in fact, I missed a bit in relation to your last question that I included menopause discussion as part of my community work, because I found that when I was working with older women, menopause was part of the discussion. Menopause was a prohibitive factor sometimes in women seeking work, you know, and also it is a prohibiting factor in women and their relationships. And older women say, for instance, who is experiencing homelessness. It might be connected to a break up in a relationship and therefore I realised actually, the menopause could be having an influencing factor in their decision making. And so that’s why I now incorporate menopause as part of my community engagement, because older women and also older men, because women don’t live in a world of isolation. So older women, older men and children, they could be impacted by menopause being in that home. And with regards to representation, it’s key because first of all, it’s a taboo, it’s a historical taboo and it’s a worldwide taboo. It’s not just isolated in certain communities, worldwide. In some communities, it’s more taboo than others. And to break the taboo, you have to add a face that people can relate to. Because I know sometimes people moan about adverts these days it’s very kind of, you know, there’s a higher rate of ethnic minorities in adverts and people have – some people have an issue with it. But actually when it comes to menopause, it’s about understanding that it affects all women and having a diverse representation helps break that taboo, which is stopping people from engaging. And I’ll give you an example, I was trying to work with a woman who – and this is a few years ago – who supported African women experiencing domestic violence. And the woman, she’s also African, and she said to me, ‘well, I grew up in Africa, we never talked about the menopause. The menopause is not an issue’. So she’s my gatekeeper to women who I need to access. And maybe with her, if she heard more voices that could resonate with her, if she saw more faces that could resonate with her – but even though she hasn’t experienced the conversation of menopause because it’s a taboo, maybe she would be more open for me to have dialogue with her group.
Lauren Redfern [00:08:03] Yeah, absolutely. And I think, you know, it’s important to touch on that as well, that it’s… you can be the leader of that conversation. But I did a podcast recently and we were talking similarly around how after you do that engagement work, that actually women then go on to talk to other people who go on to talk to other people. And it’s that kind of spreading awareness and being able to have those conversations within communities, I guess, which is at the heart of what it is that you’ve undertaken and do professionally. I know that you co-founded Safe Space Black Women in Menopause, and I wondered if you could explain a bit more about what moved you to do so and what you feel is important about really having such a space available and why it’s important.
Anita Powell [00:08:44] Well originally, which I still do now, I run a menopause group within my town. So I run one anyway called Menopause Lines. And I found that even though my town is a diverse town, it has over 30% of the town comes from ethnic minority group and I’m a woman of colour. I found that even when I was organising menopause groups and sessions and face to face, that 95% of the people who attended were Caucasian and I don’t have a problem with that. But I clearly could see that even though the group is run by a woman of colour, the town they’re living has one third of ethnic minorities of brown, white and Black but they were not in the room. And also it’s a peer led group. I’m not a medical professional. And even though I’ve screamed and shouted the word menopause, I don’t know stuff about it. I’ve learnt as part of my noise making stuff about the menopause. So I also needed a group which reflected my story and looked like me and sounded like me. And ideally, I wanted a space where you could dip in and out. But realistically, if no one else looks like me in my group, yeah, I can’t talk about things which relate to me in my group and there’s loads of things that I can talk about within the group which are applicable for every single woman, and I love my group in relation to that. But certain things I need to be tailored and not things like… food, you know, things like hair, the impact, I mean women and their hair is a major issue. But when it happens to Afro hair, the treatment of the hair’s different. And you can’t have that conversation in the room of women who don’t have hair like you. And how do you deal with thinning hair, which is one of my issues, you know. And very often some of the dietary preferences they talk about in relation to the menopause, if you eat cultural food and the cultural food does not include traditional Western foods, which they suggest for menopause, then it’s a bit alien to you. It’s harder for you to engage in and change your diet if they don’t talk about foods which are within your cultural palate. So I realised that creating a space for women of colour, all groups, because I encourage people from disabilities, other ethnicities, all groups, to find a space where they can optimise on their own personal healthcare. Because I realise that if you don’t optimise your own personal healthcare, then it will have an impact on your health outcomes. And then another example as well, I’m dark, I’m a black woman and I’m dark skinned. Now, only since COVID, did I discover that I need more vitamin D. Before that I didn’t know. And I discovered that loads of women and men and, you know, children, whatever, of my colour walking around England with vitamin D deficiencies because they weren’t aware that the darker your skin, the higher amount dosage you need and on vitamin D bottles, the recommended dosage does not apply to you. It’s inaccurate. So you can’t even just go by the guidelines. You have to kind of engage in your own conversation to optimise your healthcare. And that’s the reason. So it’s not about racism – because some people do feel it’s a racist act to create a group of black women talking about the menopause – it’s about actually tailoring the conversation so that the women can turn up and understand about menopause, women that look and sound like them and have a similar story.
Lauren Redfern [00:12:15] Well, I think also and the thing that you’re touching on is that a lot of the issues that we want to talk about at this period of time are very sensitive, you know, and I think it’s interesting you mentioned hair loss, because I know we don’t really tend to talk about that and we haven’t talked about it on the podcast as a symptom of actually perimenopause and menopause. But it’s very common. I mean, it’s interesting, right, because our hair is such an important part of our identity and that sense of if you’re losing it, it can make you feel naked, it can make you feel exposed. And you want to be able to be in a space where you feel safe and comfortable to be able to talk about those things and not necessarily feel like you’re struggling with that alone.
Anita Powell [00:12:48] Definitely. Definitely.
Lauren Redfern [00:12:49] Something you’ve talked about and we talked about before we started the podcast recording is the importance of accessibility and inclusivity, but also to include a conversation within that about class. And we talked a bit about that and how that in a way can almost extend a bit more beyond the parameters of these markers like race and sexual identity even. It’s this importance of actually talking about how we need to make these conversations accessible and that that does have some relevance to how information is being targeted and who it’s being targeted towards.
Anita Powell [00:13:22] I mean I’m – I suppose not everyone will agree with me – but I’m really passionate about the conversation of class. I don’t fully understand why, I’m not a historian, but the conversation around class in the UK today is often not spoken about. But in my opinion it’s always in the room. And you generally find that the decision makers, with regards to all things important, are middle class or upper. That’s the reality. The majority of the population are not. They’re working class. So to me, money and power and class influences outcomes. Now, one of the things that I find with regards to the diversity conversation is very often that the people who are being spoken about with regards to engagement and issues and concerns are people who are ethnic minorities and working class. But the working class element is very often not bought into it. And I find that sometimes not all people who are white ethnic minority, brown ethnic minority, black, ethnic minority are disadvantaged. Some of them live in really big houses and drive really nice cars. And if you actually look at their background, they reflect privilege. So sometimes I think that class has to be brought to the table because it influences the outcomes and there shouldn’t be a presumption that it’s all about colour or all about this or all about that. Sometimes the obstacle in the room – and it’s a dominant obstacle – is class because there are women who are black and brown or white ethnic minority who get really good menopause healthcare, because they can afford it. I mean, I’ve met some who can afford to go to a £500 menopause doctor. I can’t I have to rely on the National Health Service. So if I’m relying on a National Health Service which are not fully engaged in the conversation of the menopause, then I’m not going to get the same optimum level of healthcare as a woman who’s also my colour sitting next to me, who can afford a £500 a session menopause doctor.
Lauren Redfern [00:15:29] And I think there’s something also within that about really thinking about the dynamics of the patient-doctor interaction too, because I think we very rarely think about how – I mean, I talk about this quite often – about how if one of your main symptoms is brain fog, getting your thoughts clear anyway can be difficult to walk into a doctor’s office and say, ‘I’ve got these 13 symptoms, I’m going to list them out really articulately about everything that it is’. But if you then add into that a hierarchy or a dynamic in which you feel like it’s not necessarily comfortable to challenge your doctor or challenge that person that’s in kind of that position of authority, it can be really difficult to advocate for what you need and also feel equipped that you’ve been able to access resources that allow you to, you know, accessibly explain what’s going on for you. And we don’t always pitch that so it can be accessed and used by all people. And I think that that’s a real problem.
Anita Powell [00:16:26] I think it’s a major problem to be honest with you. The reason why I think it’s a major problem, especially in the menopause space, is because where we are now with the conversation of menopause has been created by women not being happy with the level of healthcare. So it hasn’t been driven by the health sector, it’s been driven by the client or the, you know patient. So I’m presuming that a lot of highly qualified, experienced, knowledgeable doctors have been put in a situation where women have walked in, waving books and…
Lauren Redfern [00:17:02] I love walking into spaces waving books!
Anita Powell [00:17:05] ‘I know what’s wrong with me, you know nothing. This is what I want’. Blah, blah, blah, blah, blah. And some of the information may contradict their knowledge because they’re not up to speed with the menopause conversation. And my gut feeling is that some medical professionals might respond in a not very patient-friendly manner of somebody coming in telling them how to do their job. So if you get little Sally-Ann who works at Tesco’s part time, who’s struggling with her menopause, walks in and says, ‘I don’t feel good, but my friend Anne says I need to talk to you about the menopause’. Some GPs, I would imagine, would not respond positively to them.
Lauren Redfern [00:17:49] Well, absolutely. And I think that’s also part of what we’re, I guess, getting to is that women are needing to become their own advocates and their own support workers because they’re not necessarily finding that support in the places which, you know, they should and that should be keyed up and up to date on what it is that they need in their spaces. In the work that you do, I wondered if you could identify any major barriers that you find are kind of consistently there when it comes to people accessing treatment, care and support, something that we need to really think more about addressing.
Anita Powell [00:18:28] I mean, I think I engage in the conversation of menopause as part of the work I do with everyone. I spoke to so many men about it it’s unbelievable. I talk to everyone, Tesco, Sainsbury’s, well all supermarkets – you name it I talk! I mean where I live, people come up to me and call me the Menopause Queen because I talk it at every opportunity.
Lauren Redfern [00:18:47] Lets get you a T-shirt.
Anita Powell [00:18:50] But the reality is most people in positions of signposting don’t. And I feel that that is a major obstacle because I would say I’m quite informed about things but I actually only learnt about the menopause say about four or five years ago. And I feel quite informed about most stuff because I’m quite nosey. Most people are not as nosey as me, and even though we talk about it more, I feel that more places need to talk about it just to do even casual signposting, you know. So if a woman’s hair is thinning, you go into a pharmacist and say, ‘Oh, my hairs thinning’ and whatever then, you know, maybe someone should say, ‘Well, go to your doctor, see what your doctor says, it might be connected to, you know, your age or whatever or the menopause’. You know, just casual signposting, I think is really important. But at the same time, I also feel that we live in a society where for some reason, some people have gone beyond signposting. And I feel that this is an obstacle as well, where people who create books, reading books are great, but sometimes you… to understand the menopause fully, you have to be a medical person. And even though I’m an activist, I truly respect and value the knowledge gained from the medical field with regards to menopause. So I would never, ever, ever recommend someone who has serious side effects to go to a non-medical person. But we do have loads of coaches or experts who have never gained any medical experience and some people who have no money but can’t afford a medical doctor, private medical doctor, their GP is not helping them, but somebody’s offered them some menopause guidance for £50 an hour. So they then go down that route and I feel that that’s dangerous and that has a negative impact sometimes, in my opinion, because they are not being correctly advised by someone who’s fully informed on menopause. What’s the other barrier? From my perspective, because I’m not a medical person, it’s about talking, it’s about having ears willing to listen because very often, which is less now, but very often you say menopause and people literally just cringe. I mean, five years ago, I’m sure I’ve made loads of men run down the street screaming, just by saying the word menopause in public.
Lauren Redfern [00:21:22] I mean same, the amount of people I’ve harped on to about dry vaginas, I don’t know if I’ll ever be forgiven for.
Anita Powell [00:21:30] The same thing has happened to me.
Lauren Redfern [00:21:31] I think we can say dry vaginas, yeah, we’ll go with it.
Anita Powell [00:21:36] But we need to talk about it, don’t we? And the thing is that those like for instance, I mentioned before about some women their obstacle with regards to my work. They’re struggling either with their relationships, with finance, all kinds of things. And sometimes there’s a connection to the relationship that they’re in. And it could be actually that they are suffering from very dry vagina and it’s affecting their relationship with their partner to the point where the relationship’s breaking and because the relationship’s breaking, other issues are kicking into place, money problems, housing problems, children playing up. And it could actually be that greater understanding on that woman’s healthcare can alleviate the things which are creating this kind of whirlwind negative impact in all aspects of her life.
Lauren Redfern [00:22:25] Well, I think… and actually I’m really glad that you brought that topic up, you know, we live in an information age where we can’t always necessarily distinguish between what information is kind of viable and real and what information is kind of exploitative. And I think we see it all the time, even with the private clinics that offer bioidentical hormones, it’s kind of like a cocktail of ‘personalised hormones that are going to get you back to feeling you’. But I think it’s really interesting that I suppose what you’re identifying in that is that we’re kind of seeing almost professional advocates that are actually exploiting people that are really desperate, can’t afford private healthcare, but equally aren’t having their needs met on the NHS and are just feeling desperate of where to go for information and help and support. It’s really vital that we have people like yourselves producing information, holding support groups, being able to facilitate those space where women can go to feel supported during this period of time.
Anita Powell [00:23:23] I mean, I don’t produce any information. What I do is I think is create a space where people could have access to professionals, but they traditionally would never get access to them. Or I signpost to professionals and if they have struggle to access those professionals, my gob kicks in and I help them access by being a support worker. So that’s what I do because I’ve seen so many women suffer because of the menopause that I know that I’m not equipped to give them medical advice. And I see women who two years ago didn’t know what the menopause is about. And now all of a sudden, they’re an expert and a guru and they organise retreats and they have brands, really strong brands with ‘cures’ on and then mango juice and stuff like that that can ‘cure the menopause’. And I think for people who traditionally have…like say for instance, I saw a masseuse whose, you know, just massages and whatever and they, all of a sudden, for menopause massage charge £30 more. And I think why are you charging more for a massage? What additional stuff are you providing? So I see that as exploitative. I don’t see that as a woman lifting women. I see that that’s one of the barriers to women’s experiencing positive health outcomes.
Lauren Redfern [00:24:43] Yeah. And also where we’re seeing that line between something that’s a real vital unmet need that we need to have more policy and medical professionals addressing that unmet need. What we’re actually seeing is the opposite, which is a capitalist opportunity, right, for people to, you know, profit off that. For those listening to the podcast today who are interested in becoming more active and engaged advocates, what advice would you give? Because, you know, I’ve loved hearing you talking about how you actually didn’t know that much about the menopause until four or five years ago. And then now, you know, you’re running these amazing opportunities for people to come into contact with professionals they wouldn’t usually get to and disseminating really important information. Yeah. And I wondered what your advice would really be for anyone that’s listening and thinking they’d like to be more active and engaged.
Anita Powell [00:25:33] So I’m not creeping up to you at all. But Louise Newson’s stuff is good.
Lauren Redfern [00:25:41] But we’re a bit biased but yeah!
Anita Powell [00:25:43] So you know, no one has paid me to say that, but I would say the resources that are provided from Louise Newson and The Menopause Charity and the balance app, because that’s what I signpost people to, to be honest with you. I also do things like the British Menopause Society and things like that, and it’s good to engage with menopause influencers so for instance, Davina McCall and things like that. So for some people they need an influence. I don’t need an influencer. I want to see something produced by a medical professional. So I wouldn’t necessarily go to another peer experience, but I realised that some people respond really well to somebody who influences them going through that journey, people who I generally would avoid are people who have no medical experience but give out actual medical guidance and advice, which should be medical. So I’m not saying if somebody says, ‘Oh, go and get a massage, that will help your aches and pains’ because some people it will help their aches and pains, there’s nothing wrong with that. But if you have a hormonal imbalance, then you do need to explore it medically and also optimise on your lifestyle because the beneficial element of alternative or non-medical spaces is the fact that actually they do promote a better quality of life. So they encourage you to exercise, they encourage you to eat better, they encourage you to be more aware of things which influence your menopause outcomes. And very often that’s how they work. But sometimes you need to be in the space where a doctor understands hormonally what’s going on inside you.
Lauren Redfern [00:27:38] Yeah. So I guess, as you’re saying, is really accessing those resources, using the balance app things like that to kind of, you know, make sure that you’re staying on top of your own symptoms and being able to advocate for yourself and talk to a doctor and just looking out for that information to tell others about.
Anita Powell [00:27:55] Definitely.
Lauren Redfern [00:27:55] That’s great. I think actually Anita that’s sadly all we’ve got time to talk about today. And I want to thank you so much for joining me. I like to end these podcasts by asking guests if they have any take home messages they’d like to share with those listening. So anything really about the topics that we’ve talked about to share with us?
Anita Powell [00:28:13] I’m going to say something really weird, enjoy your menopause!
Lauren Redfern [00:28:16] I love that.
Anita Powell [00:28:17] Just enjoy, I mean, there are obstacles. And they are just that, they’re obstacles. It’s not the end of the world. Realistically, if you’re going through the menopause, you probably have a few decades left of life. Enjoy it.
Lauren Redfern [00:28:28] Yes. It’s nowhere near the final chapter. Yeah, absolutely. Oh, that’s amazing. And for all of those listening, please remember that you can listen to Anita’s podcast, Black Menopause and Beyond. So go and check that out. We’ll put the links in the description. Thank you so much for joining me and speak to you again soon.
Lauren Redfern [00:28:46] We would love for you to join our collective of professionals passionate about the menopause visit NHMenopauseSociety.org to become an associate. You’ll receive regular webinars and advice from our experts as well as opportunities to network and connect with the latest research from around the world. You can follow us on Twitter @NHMenoSociety and don’t forget to tell your colleagues about the Newson Health Menopause Society.