EP 92: How hormones affect neurodiversity with Dina Siman, founder of Menopause Pilates

Please excuse any errors in this auto-generated transcript


Speaker Names

Dr Olivia KesselHost

00:06

Welcome to the Send Parenting Podcast. I'm your neurodiverse host, dr Olivia Kessel, and, more importantly, I'm mother to my wonderfully neurodivergent daughter, alexandra, who really inspired this podcast. As a veteran in navigating the world of neurodiversity in a UK education system, I've uncovered a wealth of misinformation, alongside many answers and solutions that were never taught to me in medical school or in any of the parenting handbooks. Each week on this podcast, I will be bringing the experts to your ears to empower you on your parenting crusade. In today's episode, we're going to be speaking with Dina Siman, founder of Menopause Pilates. We're going to explore the interplay of hormones and neurodiversity, alongside the connection of neurodiversity with other conditions such as hypermobility, inflammatory bowel disease, migraines and asthma. Dina will share with us insights on self-care and movement for both mothers and children, and really stressing the importance of just keep moving. She is a super fascinating person and this podcast is well worth a listen.

01:26

Welcome, Dina. It is a pleasure to have you today on the SEND Parenting Podcast. I am really interested in getting your insights in terms of neurodiversity and its interaction with hormones, both during puberty and in menopause, and then also how neurodiversity can be related to or alongside other health conditions like hypermobility, anxiety, gut issues, asthma, migraines. It's fascinating to me, so I'm super, super, super excited to have you on the show and I guess if we could start with just you telling us a little bit about your background and your specialism, Thank you.

Dinah SimanGuest

Thank you very much for inviting me, olivia. I really appreciate this opportunity because it is a fascinating area, for sure, in terms of understanding. So I'm Diana Siman and I've been teaching Pilates for about 26 years, I think. I also teach other movement methods like yoga and something called gyrotonic. I'm a meditation teacher. So my style of teaching has evolved over those years and my understanding of how different people experience movement and can understand movement and how the movements which we're teaching can be translated in a way that enables different people with different bodies and different needs to actually access the movements, has changed and developed over the years.

03:02

Because, of course, like most teaching modalities, you get, you have a basic map that you learn when you're teaching movement. There are certain things and certain, particularly with pilates, you know there's a sort of syllabus, a repertoire, if you like, of movements and knowing excuse me over the years as you teach, that what you're teaching doesn't necessarily make sense to some people, or they they don't understand the movement or they don't remember the movement, and trying to figure out why that is the case can be quite an interesting journey. And there's been more and more research into different bodily conditions, like hypermobility, which is something that really interests me, especially as it's such a spectrum. And then, of course, so I've done a lot of work, mostly with women. Definitely I've taught some men, but most of my experience is teaching women, and they've been varying ages.

03:58

So some young women all the way through, obviously, postnatally and then on to menopause. All the way through, obviously, postnatally and then on to menopause, so a wide demographic really. But I've specialized more in the menopause demographic as I've got older as well and also because so many women over the past 26 years whom I've taught have been in that demographic. Although I've taught the wide range, I'd say that most of them have been more, a little bit older. So there's always stuff to learn, constantly learning, and I think in terms of neurodivergence, there's masses which isn't yet being addressed in the movement sphere. It's beginning to be, I think.

Dr Olivia KesselHost

04:40

I think because you know and I know we're going to get into this in more detail on the connection between neurodiversity and hypermobility and movements and proprioception, but you know, in terms of it helping things actually or being able to support individuals, that movement, which we'll get to as well, it is important, but it is it's kind of a it's still a very small niche research kind of area. I listened to Dr Eccles, actually a couple of podcasts and some of the research she's done and she's like it's a very, it's a very it's a very niche niche research area, but but it's but it's getting more and more interesting, I think, as they discover more things.

Dinah SimanGuest

05:18

Yes, I think more and more is being highlighted, which is a good thing, and I, you know, when I look back to my early years of teaching, nobody mentioned neurodiversity and hypermobility. Nobody talked about that either. So you know it's been as you. If you continue in your profession as a teacher and you, most of the Pilates teachers I know are self-employed and they are fascinated by movement. They're movement junkies, if you like. They love the feeling of movement and so they're always upskilling and learning more.

05:51

And there is a sort of historical connection for Pilates with dance. Many ex-ballet dancers became Pilates teachers and Pilates has been used a lot in ballet schools and gyrotonic also is having that impact too. So you quite often would find that hypermobile dancers become pilates teachers. So obviously that influences what people start to talk about and what they're looking for and why they're doing, things that the people who actually come into the profession, for sure, but definitely these, you know, subjects which seem normal now or things we want to learn about that just were not mentioned previously. And you know, I would kind of figure it's trying to think well, why is it that this person I'm teaching doesn't understand how I'm explaining it? I need to find another way, why? What is going on?

Dr Olivia KesselHost

06:46

And then you know, I mean, I had no idea either. I'm neurodiverse, so is my daughter, and we're both hypermobile. You know, I can bend my hands all the way backwards. You know All of that going on, I mean people think I'm really good at yoga.

Dinah SimanGuest

07:02

But I'm not, I'm just hypermobile. This is the irony about hypermobility. There's this notion that it means you're super flexed, super bendy. You know you can turn things inside out, back to front. Some people might be, so there are some people who are, you know. And also, if you look, you know what it's like. Now, if you go on social media, you see all these videos of young people doing the most bizarre movements which sort of turn themselves inside out and back to front.

07:28

And of course you've got to have incredible flexibility and mobility in your ligaments, tendons, muscles, all of it. The connective tissue has to be able to give. So that does show a lot of flexibility. But likewise, if you're hypermobile, you can be incredibly stiff in your muscles, really stiff because you can be hanging off those muscles, because you've got too much laxity in your connective tissue, such as your ligaments and tendons. So it's very variable and it changes according to hormones, according to the kind of movement practice you do or don't do, according to your stress levels. So you know where if you've got, if you're on that extreme end in hypermobility of Erla Danlos syndrome you're, you know you've got that really tricky condition Maybe explain that, because some of my listeners won't know what that is.

08:24

Go ahead. No, you can.

Dr Olivia KesselHost

08:25

You're the professional I thought you were going to explain.

Dinah SimanGuest

08:28

So Erlen-Danlos syndrome is, if you look at hypermobility, it's a spectrum. You can have people who are, they have a degree of hypermobility. It might be only in certain areas, might be in the spine between vertebrae, or it might be in the knees knees, so they lock the knees out or in the elbows, but it's something which isn't too troublesome because it doesn't impact their ability to move and live and function. And then there's a continuing spectrum from that all the way through to conditions where you are in so much pain you can can't walk, you can't stand, you might have other issues going on in the heart or different parts of the body and you may have co-morbidities and things which are going on as well.

09:15

So it can be, you know, there can be a lot of issues with. You know, going from standing to sitting, all of those changes, and it can make life very painful and very difficult. And what is in common for these people is they have this hypermobile tissue, this tissue which doesn't seem to give a structure or a containment for their body, and they have to learn how to manage that so they don't have subluxations. You know, the joints don't come out of place and very often the starting place is actually tiny movements, working with breath, trying to calm the nervous system down, because if you're in pain constantly then it's just a vicious circle. You have to try to find the way in to support the body and the system.

Dr Olivia KesselHost

10:06

You're almost in that fight oror-flight response totally, totally, because you're similar to a lot of neurodiverse kids and adults as well.

Dinah SimanGuest

10:11

They're also in that fight-or-flight response yeah, because how do you keep going? Yeah, you literally have to keep going. Um, and early down loss syndrome is something which eds is something which I didn't hear a lot about in my early years of teaching Didn't hear about hypermobility. What was very obvious to me was that the clients I taught who had ME or fibromyalgia, they were all hypermobile. They all had this tissue which couldn't give them sufficient support and we needed to work a lot with resistance to try to build them up. But they weren't being sort of looked at in that respect.

10:54

And what then became more and more clear to me over the years as I learned about early Danlos syndrome and other connective tissue issues, is that they are all joined in this fact that connective tissue is relevant to them.

11:08

So they may have symptoms which you know the pain or the change of um of being able to accommodate getting up from the ground without getting dizzy or whatever these things, or fatigue, all these things in which are symptomatic. But actually what they all had in common was this hypermobile tissue and that's throughout the body, so it's in the gut as well as what you're feeling in your body, and it makes life in terms of hypermobility. You have less receptors in your tissue to respond to things, so it makes it difficult to work out where you are in space. So very often you can feel clumsy and people who have hypermobile tissue very often have other things going on, like eczema, asthma, migraine, irritable bowel digestive issues, asthma, migraine, irritable bowel digestive issues. So there are a lot of connections. You can make different things which people experience, but the common factor is this type of tissue, which is just the balance of collagen and elastin, is different and so maintaining muscle tone and strength is more challenging, but it's so needed.

Dr Olivia KesselHost

12:25

And then it's interesting with the connective tissue irregularities and then also looking at the link between neurodiversity and neurodivergence and the difference within the brain structures, the amygdala and other areas of the brain. You know and this is still research is coming out that the links behind that, or the higher propensity to see individuals with with both conditions, but not not necessarily I mean you can definitely have hypermobility and not be neurodiverse, and you can also be neurodiverse and not be hypermobile.

Dinah SimanGuest

12:55

Exactly, absolutely, yeah. And again, with you know, you can have hypermobility and not have Ehlers-Danlos syndrome. It's, it's, yeah, absolutely, and it's complicated, but I think that now more of the medical profession are looking at it and recognizing it, because for a long time none of this was recognized, because it well, is there other stuff going?

Dr Olivia KesselHost

13:18

on. It connects kind of the dots sometimes, and then also it can help in terms of what then you can do with individuals you know, some of whom might identify as just being hypermobile, others who identify as only being neurodiverse, but actually their dyspraxia is, you know, part of the whole package.

Dinah SimanGuest

• 13:45

So it's super interesting it is. It's really interesting and I think movement has a big part to play in helping, and I know in terms of the work I do with my clients who are hypermobile. For a lot of them it is really hard to retain the information in the body because when we do a movement, it's, it's a feeling in the body. So you know, you feel the movement. You can describe it with words, but you feel it in your body. And when you practice movement you build up that memory of the movement, the feeling, so you know that it feels, if you like, feels right, it feels okay, it feels like it's, it's a helpful, beneficial movement. You enjoy it.

14:33

But if your tissue struggles to retain that memory, it's very difficult. It's like you relearn it every time. It's like groundhog day, yeah, yeah, and that can happen in varying degrees, you know, because it's really an interesting area to work in when you know. I can think of one client I've had, I've taught over the years, who's a lovely mover, beautiful mover, that really struggles to remember what her body actually likes and will benefit from the most and to retain the adjustments which really support her. And it's not that she's not trying to, she just struggles with it. It's like needing a constant reminder, really.

Dr Olivia KesselHost

15:18

And how do you overcome those kind of challenges with the clients that you work with?

Dinah SimanGuest

15:21

Well, we do a lot of talking and moving with the clients that you work with. Well, we do a lot of talking and moving. It's why touch is so important, because if you get that feedback from touch and I always encourage my clients to self-cue and self-touch as well, because you need to feel where something is in space, you need to feel what it's like and how movement can influence it so we also talk about what it is. We might I might talk and remind the client what we did and how many you know and what and how it helped and how we adjusted things. Particularly, if there's one thing we're trying to work on, I try and keep it simple.

15:57

So we it's like reminding her what felt good and also sometimes I find that it's actually trusting that you do know what feels good because you have to trust your body and if it, that can be difficult for anybody trusting the body, particularly if you have pain. You don't trust your body, you know, and it becomes scary and fear immediately increases that fight and flight feeling. So trying to calm the system down and go okay, what helped me, what felt good? And I keep it simple really, because if you're still, if you're learning, you just need simple tools to find what will settle your body, what feels good and what makes you start to feel a bit stronger, a bit bit more connected. Because, as we know, if the body works well, the mind works well, everything works. We are an integrated human being, we're not bits in my experience, which oftentimes medicine forgets.

Dr Olivia KesselHost

16:59

I think it's because you're broken down into a cardiologist, a respiratory doctor, a gut doctor. You know a gut doctor.

Dinah SimanGuest

17:05

High load.

Dr Olivia KesselHost

17:06

And nobody talks to each other. You know, and then you know let's just ignore nutrition and sleep and everything else that's so important. And exercise is, you know, and building up your strength is so important. And your core stability, I mean, it's been a game changer for me actually, with back pain and joint pain doing Pilates actually and keeping that core stable. But really interesting, do you use mirrors and do you do videos? Does that help or is it really just touch and being hands on.

Dinah SimanGuest

17:36

I think videos are helpful. I often will film somebody to show them so they can remember what they've done as well. Because when you're a movement teacher, movement is a language. You speak the language all the time, but if you only come once or twice a week, then you may not speak movement. So therefore, to be able to see yourself doing it is helpful. Or, you know, I think, have things online people can do. I don't have mirrors. My very first studio I did have mirrors. They're very controversial. Some people love them, some people hate them.

Dr Olivia KesselHost

18:09

I'm not a huge fan of looking at myself in the mirror.

Dinah SimanGuest

18:11

No, and you know, my first studio was in a very old building so the walls weren't straight, so the mirrors were a bit distorted as well. So, as a teacher, I like mirrors because I can see things happening and I can see the back of people and I find them very beneficial. But I totally get that as you're in there doing it, you might not want that at all. There was something I was going to say and it's completely gone out of my head. Oh no, that's what I was going to say.

18:38

You were talking about doctors and recognizing the different needs that we have. This is one of the things I love about working with menopause specialist doctors, because they are more and more talking about the need for a holistic approach for nutrition, for stress management, for exercise, for those pillars of health which we need throughout our lives. But it is so good to actually hear them talking about it and endorsing it and actually doing it themselves and showing that they too have this stuff they need to do. I do think that that's one of the lovely things in the menopause sphere seeing professionals, experts, because we all think, oh, the doctor knows best, which very often they do. But actually when you see them saying, well, I have this issue and I have that issue and they go to somebody else for that health and support. It's actually very empowering, I think.

Dr Olivia KesselHost

19:36

Yeah, I think for me, like at the level of a GP, like when you know if I have autoimmune as well and you have joint pain and whatever, and the automatic response is well, let's give you more pain medication. Well, that's not going to help. Let's look at the diet, let's see if an autoimmune diet will work and it did really well and then there's a time and place for medication. Pardon me, I'm on HRT and it changed my life and in my household, my daughter's going through puberty and I'm slowly leaving it and so and the two of us live together and we're both neurodiverse, so it's, it's a fun time, and there's no hormones you can give your child, so I can understand where she's going through.

20:18

You know, at least I can give myself hormones. We can both, you know, do the nutrition and the exercise and that stuff, which is tantamount to keeping it on an even kind of keel to a degree. But you know what is your experience in terms of hormones and neurodiversity and how? I mean? You know, I think we discussed that some people even get diagnosed as they're going through menopause with neurodiversity. Yeah, but is there also I don't know if you have clientele that are also at the younger age, who are going through puberty. Do you see it at both ends?

Dinah SimanGuest

20:51

Yeah, I don't have younger clients currently, but definitely with my older clients, my clients going through the menopause transition. Absolutely, there are more of them being diagnosed with ADHD, for example. So, recognizing neurodiversity, because the change, the shift in hormones affects everything, and it may well be that they've just been able to manage their neurodiversity, even though they haven't really understood why things happen as they do. And then you have this dramatic change with the loss of estrogen, testosterone, these fluctuations and then depletion that really show this up. And there is more and more information. There are some great studies, leaflets and information leaflets and, um, there's some uh, what do you call it? The word is gone anyway.

21:47

It basically resources, um, online maybe resources yeah, yeah, so on some of the menopause websites because people are now talking about it, but even when I was researching for my book um three, four years ago, it wasn't being talked about. So this is very recent that people are actually really discussing it. And I have a number of clients who have um recently been diagnosed as neurodivergent, and it's come about because they have been to have to get help for their menopause symptoms and they've started hrt. But and they've looked at things you have you take responsibility. It's a time when you really have to, which is a good thing. You know. Looked at their diet, they've looked at their exercise, they maybe have taken some talk therapy and then they've recognized there's something else which isn't right here and gone on to seek more expert help and discovered that, yes, indeed, they are neurodivergent and actually that then explains a great deal of things for them in their life.

Dr Olivia KesselHost

22:46

Yeah, it can be quite liberating actually to understand, you know, looking back, as to where some of the challenges of life and where some of the you know, as my daughter calls them superpowers. Some people like that, some people don't, but she does, and I agree with it too. Some people like that some people don't, but she does, and I agree with it too of being neurodivergent, but kind of it's affirming, I think, as you get older, when you know to, for some people to get that diagnosis and it's kind of like the penny drops.

Dinah SimanGuest

23:12

Yes, yes, yeah, and it's a tricky one, isn't it? Because I know for one of my clients in particular who has had that diagnosis. She discovered that one of her children was neurodiverse and then she decided to investigate for herself because she thought, well, we have similarities. But also, it's very often, isn't it, for women actually having the time, the opportunity, the resources to actually look at themselves and say, ok, I can now do this. And it's not, it's not necessarily an option for everybody, and I think this is the thing with the menopause transition. I love the fact that there is so much available to help and support women, but a lot of it requires time and space, which many women still don't have at this time in their lives.

Dr Olivia KesselHost

24:04

Especially with women having children later as well, and I would say a lot of parents I mean. It's a struggle to get your child diagnosed. Nowadays it's something you have to usually self-fund or be on a waiting list for a really long time. So you go through a huge battle and a huge financial burden to get your child diagnosed and then you look and you think, well, that sounds quite familiar to me too, but can I actually like?

24:28

For me, I would say I probably have a lot of ADHD characteristics, but can I get a diagnosis? No, because I don't want to waste that money on it. I'd rather, you know, spend that on my daughter, you know, and therapy for her and what she needs, you know. So, and and you've gotten to this grand old age and you've managed, you know. So, yeah, it is tricky and I wish there's one clinic I spoke to which is thinking about doing like package deals for for parents and children, which I think is a great out of the box kind of idea of get your whole family kind of, because a lot of families the husband and wife will be neurodiverse, where we're attracted to each other because you know, like likes, like, and so it's not unusual to have both parents or one parent and several children with neurodiversity, and then if you want to go get those all privately tested, that could cost you, you know, 10, tens of thousands of pounds.

Dinah SimanGuest

25:19

Exactly, exactly so I think it's. You know it's not easy, but the more information that we can have and listen to other people's stories and you know, the more and that kind of is something which resonates with the menopause field's health it's so important that we actually do have an openness to share because we can help each other.

Dr Olivia KesselHost

25:51

so much and I mean I've, I've, you know, I was, you know, did a lot of research, listened to a lot of podcasts when I went on to HRT and went down that route. But a lot of women who are suffering, who I speak to even today, oh, you know, I just need to suffer through it, I'll get over it, I'll be okay and I'm like, but have you actually thought about the long-term health consequences of not having the right hormone balance in terms of your cardiovascular risk, in terms of dementia? You know it's preventative care and I don't think people quite make that. You know it's just like taking a statin after you've had a heart attack. It's too late. You should take a statin, you know, when you're feeling fine and you have no symptoms.

26:31

You know, it's preventative medicine is so much better than medicine delivered too late. And there is this still kind of stigma that we can just tough it out. You know, not sleeping and having night sweats and having, you know, emotional dysregulation beyond dysregulation. It's, you know, it's okay, you, you, you're a woman, get through it.

Dinah SimanGuest

26:53

Why do I do this? I completely agree with you, and I mean I was guilty in my early perimenopause of thinking, oh, it's okay, it's not too bad, I can keep going. You know, especially with the perimenopause, you get this. You may have a few months where you've got burning skin, or you've got burning tongue and dry eyes and you think, okay, well, I'll just give it a bit longer before I do anything about it, and then it suddenly stops. You think, oh, okay, and then before you know it, you've got hot flushes or heart palpitations.

27:26

So we go through this process of seemingly random symptoms which are all connected because of the hormone depletion and fluctuations, but they manifest in so many different places we don't necessarily link them together and we it's like we've done with that one, okay, now we have a new one, okay, so I'll work on accommodating that one. I'll work on managing that one, okay. Okay, now I'll try managing this one, because we're so good at managing and accommodating and sorting and and pushing on through. You know, um, no pain, no gain type scenario, which is like, for goodness sake, why do we do this? Um, because it is suffering, and I know that for many women it's because they're frightened of hormone replacement therapy. There's still a massive fear about it and also because there just seems to be this thing about do it naturally, you can get through it. I don't need help.

Dr Olivia KesselHost

28:19

You don't need help and that you're looked down upon. If you do, you need you actually need that help.

Dinah SimanGuest

28:25

You failed in some way, um, and I I just really hope and trust that this attitude is going to disappear. I remember when I told my daughter that I was starting hrt so she would have been 15 at the time and we were sitting in the car car We'd just rolled up to Aldi or somewhere supermarket and for me this was like quite a big deal. I was sharing with her that I started HRT and she sat there and I explained to her and she said well, why wouldn't you? I was like, okay. She was like well, why wouldn't you? Of course you can do that, because you're going to feel better. So you're going to feel better, so why wouldn't you do it? It's your hormones and I just hope that we get to a balanced position where women don't think they are failing by seeking help in this way.

29:15

And, as you said, hormone replacement therapy is a preventative care. And also for me, regardless of whether you use hormone therapy or not, you have to do everything else. You still have to exercise, you still have to sleep, you still have to hormone therapy or not. You have to do everything else. You still have to exercise, you still have to sleep, you still have to look at your nutrition. You still have to look at your stress, so you have to do that life audit and that will then support the hormone replacement therapy. And I don't know what you're you can't do it in a vacuum.

Dr Olivia KesselHost

29:36

No, it all comes together, but it's one key part in.

Dinah SimanGuest

29:43

Yeah, and it can be a bridge to enable you to do these things, because if you're just constantly firefighting and trying to manage different problems, then you can't focus on what you need to do.

Dr Olivia KesselHost

29:57

I couldn't even sleep.

Dinah SimanGuest

29:59

If you can't sleep, nothing else happens. It doesn't make me a very nice person. Oh, I'm with you completely. It's just horrendous For me. If sleep goes, everything goes.

Dr Olivia KesselHost

30:09

The research and the fear of breast cancer, which was something in my mother's generation, which was a study in the 90s, is not. It was skewed, you know what I mean. It was a population, yeah, and that's not known. It's reminiscent of people who are afraid to vaccinate their children because of a fraudulent doctor. You know what I mean. It's flawed and I always encourage people to read the research and actually educate yourself, because when you look at the research and you understand it, you realize that there isn't a risk. But even the pharmacist said to me do you have any history of breast cancer in your family, I know, to which I said no, even though my mother had stage two breast cancer because I knew they wouldn't give it to me. Even though they're uneducated about the research.

Dinah SimanGuest

30:52

Absolutely. I know it has done. I was teaching about this yesterday, training teachers, and it has done so much damage. That report which came out out in 2002. It has put women's health back by so many years. The research hasn't been there and the just the the by osmosis, this fear factor, because breast cancer is a hugely emotional subject. We know this um, my mother had breast cancer and you just immediately, well that's, it can't go near this HRT stuff, even though we know estrogen isn't a carcinogen. You know, and they start doing mammograms once you've lost your estrogen in your 50s. That's the idea You've lost it, so we need to check that you're not getting any. You know, increased risk of.

Dr Olivia KesselHost

31:35

And actually drinking a glass of wine, just one a night, increases your risk. Yeah, exactly.

Dinah SimanGuest

31:51

And it's that's scientifically proven, exactly. It's on the breast cancer website, you know exactly. And the women in that study were mostly the average age was 63 and I think something like 70% of them were obese. I mean, there were smokers and they were, and there was obesity and of course those are risk factors for breast cancer. Plus, that wasn't a research paper, a research study for breast cancer, it was for cardiovascular health. So you can't skew, you can't take out information about breast cancer when you're actually looking at cardiovascular health. So it messed up so much and I think-.

Dr Olivia KesselHost

32:16

And then it's become the holy grail of what everyone refers to, even today.

Dinah SimanGuest

32:20

Well, it's still the biggest research trial ever done on HRT and they are getting some interesting facts out of it, which is good, but I think what it really did destroy was choice, women's choice, and you know, for me, you choose HRT, you don't choose HRT, absolutely fine, but be able to have the choice, and it took that away from women and I think that is really, really important to recognize because it disempowered us again.

Dr Olivia KesselHost

32:51

Yeah, absolutely, and it's just it's knowledge is power, you know, and and and, as you say, it's absolutely your choice, but make sure you make an educated choice and that you've got all your facts right and that you've gone and listened to everything and that then you make your own decision. And that's what I've actually done with some of my friends who've been very against it. I've sent them some podcasts, I've sent them some research articles and I've said you know, this particular friend I'm talking about is a scientist, so, you know, has that kind of mindset. And eventually she's like you know what? I'm going to go on it. And after she's like oh my gosh, Olivia, why didn't I listen to you earlier? She's like this is my husband thanks you, my daughter thanks you, my mother thanks me. She goes, they saw a side of me that I didn't even know existed within me. Yeah, exactly.

Dinah SimanGuest

33:35

You know Exactly. I mean you can feel you are and your family don't know who you are, and I'm sure many relationships suffer massively, whether that's parent, child, um, or you know, between two people. It's. It's so impactful and it can creep in, it can just creep in. So, no, I, I completely hear you on that and I think, um, one of the things which the menopause specialist doctors I work with, who are all gps originally, they say to me this is the safest medication we prescribe. You know doesn't have the side effects. That because you're replacing your own hormones, so our bodies are accustomed to that. Yes, of course you have to figure out what dosage and you have to find the thing which suits you. But I've found, with my clients who you know, the ones who have decided to use it, it does mean that they can maintain certain movement more easily because they're not in pain, because it acts as an anti-inflammatory, that they can start to get on top of migraine issues and I know oh, it's life changing for me of migraine issues.

Dr Olivia KesselHost

34:43

And I know oh, it's life-changing for me with migraines. Oh my goodness.

Dinah SimanGuest

34:45

Exactly exactly, and I also know for my clients who are neurodivergent that HRT has helped them manage things, because you have this sudden shift in hormones and, as we know, one hormone doesn't work in isolation, they all work together. So the drop in dopamine which can happen once you're losing your estrogen and testosterone, that's going to influence so much. So it's it's it's not a straightforward picture and it's tricky because we're very accustomed in our society to taking a pill to feel better, to be fixed. But this is not like that. This is a yeah, this is an interaction between you and a hormone which is replacing your own hormone, and it's about how you, how you work with that, and really that should be the same with any medication, but it seems to be more obvious with hormone replacement therapy. Um, so that's a. I think that has a good side and a difficult side.

Dr Olivia KesselHost

35:45

Yeah, and then it's as we've said, it's also incorporating then the exercise, the movement, the nutrition that goes alongside it, because you know your body changes. You know, regardless of the therapy, your body's not going to stay the same. You know you put on more weight, you become less mobile, so you have to put more effort in as you get to this age, just like an old car, you know, and it's important. So tell us a little bit about some of the insights that, in terms of self-care and movement, you know, from a hormonal and from a neurodiverse perspective of like what you advise your clients in terms of how they can maximize.

Dinah SimanGuest

36:25

Well, I think, children and moms, if you, if you could, Well, yeah, I mean, I think that it doesn't matter what age you are, you need to move, I mean, unless, obviously, you have a condition which makes it very difficult to move or you need physiotherapy.

Dr Olivia KesselHost

36:39

But even then, like my daughter is, that has got cerebral palsy and you know what it makes it more important. Like my physio says Olivia, at school they they'll excuse them from PE classes. No, they should be getting double PE classes, but just modified to what they can do.

Dinah SimanGuest

36:54

Exactly. So, yeah, what I was going to say, exactly that is that if you have a condition which makes it very difficult, then you need support to be able to move and I think it's key, you know, first, first one, first we breathe, then we move. You know we have otherwise as we don't survive. Movement is is key and it's finding what you like and can do. And I think, if I just look at the menopause demographic, what can happen is because, with the depletion of estrogen, testosterone, the progesterone fluctuations and so forth, you can experience things which start to make you not to want to move. So, as we said, lack of sleep, you're knackered, you don't want to move, you hurt, and that could be joints, that could be muscles, that could be tendons. It can be, you know, people say joint and muscle pain, but it can be very vague pain, it can just be all over aching pain. It can be, you know, people say joint and muscle pain, but it can be very vague pain, it can just be all over aching pain. It can be site-specific pain. So you might have pain, you might be gaining weight, as you said, and then you start to feel your own body image is poor, you don't want to be seen exercising. You don't want to go to a gym, you know, or you hurt yourself every time you move, or you have an injury which gets worse because you haven't got the anti inflammatory effects of your hormones. So there are many things which stack up to make you not want to move. No, and obviously we've all been through the pandemic which, for some people encouraged them to move and other people they move less.

38:26

Working from home changed many things. So I think, fundamentally it's recognizing that you have to find a way that you are content to move. And I have clients. I have one absolutely adorable client who has severe EDS, terrible migraine, and she hates moving. That's why she comes to class with me because she's not going to do it on her own at home. So she comes to do it with me. And she's also like many hypermobile people. She has a big personality. There's all sorts going on there, so she needs to be able to talk about it and express it at the same time. And that's lovely. And I know that if I'm not doing this with her and trying to slow her down, because a lot of hypermobile people do things very fast and actually they need to slow right down because the system is not going to take on board with it as you're doing. So if we say you're hypermobile and you're in the menopause transition, you're going to have issues with muscle strength and stability. So you have to try to find something that you enjoy which is going to have issues with muscle strength and stability. So you have to try to find something that you enjoy which is going to be beneficial.

39:36

Now, it could be Pilates, it might be swimming, it might be some form of resistive movement which gives you something to work against. Maybe you start with going for a walk, cold swimming. Lots of people love cold swimming not my thing, but lots of people love it. Swimming not my thing, but lots of people love it. Fantastic. Some people prefer yoga. Some people do go to the gym, but you have to find what works for you and I think now there's so much online as well that you can do from home that just trying to figure out, even if you know you need to go to a class, but just putting your tipping your toe in the in the water just to see, could I do this? Would this interest me? So if you don't like it, you are not going to do it and you really need to like it, so it might be cycling. Whatever it is, you need to find something you like, and maybe you need to do it with a friend you know and you know it.

Dr Olivia KesselHost

40:25

It's same with our children, because you know our children, who are neurodiverse, get a lot of comfort, become hyper-focused on their devices. It's really hard to pull them away. They don't want to get up off the screen. That's their comfort place. And with my daughter I just keep trying to find things that she enjoys doing. So we're biking, we're canoeing this summer. She can't quite get the left side but we're working on it, but she enjoys it. She likes to go out there and do it and it's finding swimming.

40:54

You know, comes and goes in favor, but um, you know, playing, playing in the in in the pool with me is one thing, going to a swimming class is quite another.

Dinah SimanGuest

41:01

Um, but yeah it's.

Dr Olivia KesselHost

41:02

it's finding those things that you actually enjoy and want to do and that might change as you get older. Like, I love running because I think it helps my ADHD actually doing something powerful but then I injured myself and then what do you do? You know then you. So now I've had to do something or bring on biking and bring on some other stuff. So sometimes it's good to have a little arsenal of things that you can do and can do at different times, you know.

Dinah SimanGuest

41:27

Definitely. I completely agree with you and I think it's interesting no-transcript in school the football and cricket and so on he just couldn't do so. He could never get on a team and he had this masses of energy. So I tried lots of different things to find something that he might like and could do, and the first success we had was when I took him to learn how to play pigeon shoot and that was largely yeah, it was interesting. That was largely because the man running it was, um, very good at he.

42:19

He was an NLP practitioner as well. Okay, he really helped my son understand that, you know. Okay, you missed that one, right, you just leave it behind. That was in that circle, move to this circle and we're on and having that one-on-one attention with somebody who taught it to him differently and got him to not focus on failing. But what he could do was really helpful. And then after that, the next thing that we tried was kayaking and I had reached the point.

42:46

I was a single mom at this point with two boys and I'd reached the point where I was thinking, if he doesn't keep doing this, I don't know what we're going to do, because you know, there's only so much money and time to put into this, but I want him to really know he needs to find a movement he can do because he's got so much energy. And he was, we were going, we were, he was. He was saying to me I don't want to keep going, I don't want to keep going. And I was taking him.

43:10

Anyway, he was doing it at school eventually. And I went into his school one day and one of the teachers said oh, by the way, you know your son, he could be good at this. And I looked at this teacher and I said well, would you tell him? There's no point in me telling him, would you tell him? So he did, and he then won a race and then, from that point on, he began to get better coordinated. Yes, he still struggled, he'd still fall down the stairs, just walking down the stairs, but things began to improve and that cross patterning work, which really helped him.

43:47

Plus, succeeding in the races meant that when he came to do his GCSEs he actually got through them and he credits the kayaking with that happening. So you know, finding a movement practice which will support your teenager I know it's not easy and trying different things, because very often what they do in school- doesn't work, no, and also it's like team based.

Dr Olivia KesselHost

44:12

My daughter daughter always develops some sort of illness on PE day. It's like a weekly thing and the schools had to now do a separate PE class for the kids that find more challenging, which is something that they can achieve, because it's really embarrassing, frustrating, when you can't participate in the way that. She loves watching the Paralympics, she loves watching the Olympics. She loves watching sports Actually, I hate watching sports and she gets so excited. But then when she tries to do it, her, her ability is not there, but that whole like brain gym crossing over. We've only done the canoeing and I want to get her to kayak. She's a bit nervous but we will get there because that that's what happened to the bike. Her left and right side are not together but the right side teaches the left side, so it puts your body in equilibrium when you're doing same with swimming.

Dinah SimanGuest

44:57

Yeah, it's a great thing and the need to learn the balance in the actual kayak on the water is incredible. So, absolutely, and you're right, brain gym that was another thing I did with my son, so I found a local practitioner and that was that. That did help for sure. But you're right, I mean I, I remember I hated PE and sport at school. I was useless.

Dr Olivia KesselHost

45:18

I used to forge letters from my mother saying that I was ill and couldn't possibly.

Dinah SimanGuest

45:24

I totally relate. I mean, my one of my sisters used to be hired behind the tree in the front garden, wait till my mother had gone to work, then go and let herself back in the house. She didn't want to go and do it. But you know it's. I love moving, but I could not do sport because I wasn't. I was a very heavy child and it just didn't. I couldn't do it Whereas I love dancing I wasn't any good at it but I love doing it. So I found a movement expression and I think that's the thing If encouraging. And if you're as a parent, if you're not a mover, it's not necessarily the first thing you think of, but if you can start to understand how helpful movement is to our mind, body development and connection, you know everything works better if we move. Our system is meant to move, you know, to walking, and it decreases that fight or flight response, do you?

Dr Olivia KesselHost

46:15

know, I mean it puts our nervous system, yeah, it calms it?

Dinah SimanGuest

46:18

yeah, absolutely so, finding your movement that you can do and, as you said, it can change. So I had a period throughout my 40s I trained as a yoga teacher and I taught a lot of yoga and then I'd done too much because I am hypermobile and it actually I wasn't really. I was loving it, but with my hormonal shifts it was really causing me problems and I injured myself a lot. And that's one of the things to look out for that. If you are in this perimenopausal stage, you can injure and you might.

46:56

You know, there are some things which are flags in terms of, say, frozen shoulder that is viewed as a menopause symptom by menopause specialist. Carpal tunnel syndrome that's another one that can happen when you're losing your hormones Achilles, tendonitis, plantar fasciitis or connective tissue issues and there are certain vulnerable places in the body that we can suffer in. So these are real red flags and if you say you are a runner and you've not, you've not experienced any injuries and suddenly you start to get injured, then that is a sure sign. Okay, I need to think about one, how am I training? And two, what's going on with my hormones? And we don't necessarily think what's going on in my hormones. But for me now it's like this is key. I need to know what's happening in the soup, in the background, to know what we're dealing with, because that impacts what we do. We have to be sensitive to the stage that we're at.

Dr Olivia KesselHost

47:48

Yeah, and then when you do diversify and you find something else you enjoy, then it's, you know you, you know. So, for me, running now is it's a treat. I do it once or twice a week and then you know I do the other stuff. But I've you know, swimming is actually fantastic for you. It's, it's, you know, my physio is like this is the best thing you can do, because there's not many exercises where you're, where you're vertical, like that, and your body's vertical yeah, absolutely. And also the breathing and the fact that you are sometimes hypoxic is also very beneficial.

Dinah SimanGuest

48:16

It can really release a lot in the body. I think one of the things that always flags for me is that if the only thing you do is swimming, you need to make sure you've got some load-bearing going on as well, because, as we know, once we do it, that's what I'm guilty of.

Dr Olivia KesselHost

48:30

Well, I do the running, but, like the gym and the weights which are so good for us at this time of life, I really don't like it, and I know that's not an excuse, but yeah, the road to hell is paved with good intentions.

Dinah SimanGuest

48:42

Well, I know. But even your own body weight, you know if you can do body weight exercises, that's all good, and simple things like stomping if you stomp and say you're just in the kitchen holding two saucepans and stomp around, you are really helping your bones. Okay, you know something as simple as that. Or heel drops so you're standing and you just lift your heels and drop and drop and drop because, again, it's so, it's never I know it's never straightforward. So you know you need to keep your bones strong and that with the drop of estrogen, bone density drops. So we need to work on that. But if you've got pelvic floor issues which lots of us do have, particularly once we lose the hormones, and you don't want to do any impact because your pelvic floor can't take it, so it's finding out how do you strengthen your structure in a positive way, because you don't want to reinforce a pattern which isn't good. So you learn how to organize your structure, which is what Pilates is so great at teaching before you load it.

Dr Olivia KesselHost

49:41

Yeah, I totally agree and I would recommend anyone going and taking a Pilates class. You know, it's fundamentally. It saved my back, actually, in all honesty, and it's just a fabulous way to strengthen your core muscles. And there's simple things that you can do at home that can take you 10 minutes in the morning to do, that you can learn, and I'll include your website on the podcast notes so people can click and find the resources there as well, because, as you say, there's a lot of stuff you can do online. But it's also really good to go to a class and get that. Especially if you do have are neurodiverse and you have difficulties with knowing where you are in space, it's really good to have that instructor kind of show you what you're doing, where you are and what you're doing, and repeat it a few times actually so that you can get it right.

Dinah SimanGuest

50:30

And that's why, also because there are different types of Pilates. But working in a studio environment with the large equipment, which is spring based, is so good for that hypermobility, because you get the feedback. So it's like an external scaffolding, really excuse me, which is also like stretchy bands. They're also like that. They give you that feedback, which is so important, absolutely Well.

Dr Olivia KesselHost

50:54

Thank you so much. It has been an absolutely fantastic discussion today and, um, you've inspired me to do some stuff as well and to to to do more stuff with my daughter. I'm going to get her into a kayak, but I always end my podcast and I, I know I just gave you this warning just in time, but, um, I love to give my listeners three top tips from you to take away from them after listening to this podcast.

Dinah SimanGuest

51:16

OK. So three top tips I would say if you think you are into the perimenopause transition, do a bit of research, find out about it, be prepared if you can and I know it's hard because it's not talked about and lots of people haven't even heard of the phrase perimenopause, which is that lead up to the actual menopause. If things are changing, check into it. Don't be scared of HRT. It doesn't mean say you have to use it, but do not be scared of it. It is a really helpful form of very safe medicine.

51:56

You know people talk about the medicalization of menopause, but actually this is very simple. This isn't a complicated thing and it can solve and help so many things. Plus, remember, if you try it, you don't have to stay on it and you can stay on it for as long as you want. So it's it's it's got a lot to offer. And then I would definitely say, well, actually, so many things I would suggest. But you know, keep the conversation going and, um, ask for help and keep moving. Please keep moving. So look at your health and wellbeing. It's really important.

Dr Olivia KesselHost

52:27

I think those are great tips and words to live by. You know, because we all deserve to feel good and you know the best that we can equip ourselves to feel good, have our and teach those, teach that to our children as well. You know, if you're moving, you get your child moving. You both start to learn the benefit of it and you know it's it just it makes life a lot better, a lot better, totally.

Dinah SimanGuest

52:48

You teach by example, and if you're doing it, they see it and they think okay, this is good.

Dr Olivia KesselHost

52:57

Yeah, they won't listen to you ever, but they will. They do, they do. Are very good at copying you.

Dinah SimanGuest

53:00

You'd be surprised what they're taking on. Well, thank you so much. Oh no, Thank you for asking me. It's been a real pleasure. Thank you so much.

Dr Olivia KesselHost

53:06

Thank you for listening to Send Parenting Tribe. I hope you have enjoyed this podcast as much as I have today, especially if you're a woman of a certain age and understanding how important hormones are and how important movement is. But it's also important for our kids and it's interesting to learn about all the links between neurodiversities and other health conditions. If you've enjoyed the podcast, please follow us and also please rate us. It really helps us get more recognized by the algorithms. Wishing you and your family a week full of movement Till next week.