Episode 102: Breast Cancer, Menopause & Sex

Hi, this is Suzanne Noble, and you're listening to Sex Advice for Seniors. And today I'm with a woman who's probably got the best name of the 99 episodes that we've done of this program. Honestly, she— it's, it's a name of a porn star in my mind. But yeah, definitely, Darlene Honey. I mean, I was like, honestly, is this your real name?

Yeah, yeah, it's my real name. Such a great name.

She's a sexual health nurse and we've been having a rant. We're probably just going to continue ranting from what we were saying before, working in a sexual health clinic in Slough, based in Kingston, and obviously dealing with lots of people who I suspect come and see you because they might be concerned that either they've caught something or they're experiencing some problems in their sex life. Welcome to Sex Advice for Seniors.

Thank you.

So yeah, we were talking about the fact that basically most of the people that you see are young people, and why do you think that is?

Um, I'm not really sure, but I think that we're not— probably not very welcoming. Our clinic is welcoming, but I think there's some clinics aren't very welcoming to older people. As you previously said when we were talking, that the website of the clinic you were talking about, said 18 to 55, and I don't know if they just assumed that older people aren't having sex, but in my experience in the clinic, older people are having sex, and why not? They're coming in because they may feel like they've got an infection, when actually it isn't, it's related to their genital symptoms of lack of oestrogen, or erectile dysfunction. So yeah, we are getting older people, they come out of relationships, they come into the clinic sometimes for advice, and just to work out what's best way forward.

Yeah. And I mean, I know that, you know, it used to be the case when we were younger that sometimes when you got into a new relationship, the first thing that you would do, because you knew that you'd both been sexually active, you had previous partners, is you'd go and you'd have a little test. You'd have all your screens done, right? And then you turn up with your little piece of paper and say, we're good to go. Everything's good to go, right? But I suspect that older people don't even think about doing stuff like that. When they get together.

No, I don't think they do. And we're seeing a lot more HIV in older people because they come out of relationships, they're not used to wearing condoms or protection, they haven't been checked, um, and the internet is just available for everybody to go out and, and do as they please. So I don't think it's thought of anymore. Before, where you might have met somebody in a bar, you might have had a conversation or a party, but these days people are hooking up online, which is great, but there's this whole thing missing now around, oh, should I get some condoms, or should I get a check, or— yeah, so it can be a bit difficult.

And we were saying that, you know, my experience and what I'm hearing from a lot of people that comment on posts that I, that I put up and everything is that when they go and see the doctor and they talk about their sex life, and perhaps they're experiencing some pain, or like you said, they might have ED, erectile dysfunction, or, you know, things aren't functioning like they used to, sometimes the reaction they get is, well, you're an older person. I mean, that's the way it goes, you know. What, what were you expecting? Like, you're not making babies anyway, so, you know. And you were saying that you've heard some pretty horrific stuff.

Yeah, yeah, I did hear somebody say that people under, under 50 shouldn't be in the sexual health clinic, but, um, I think that— I don't know why people think that people stop having sex. I mean, the sex may be different because they're, uh, they're not so agile or fit or young. There may be erectile dysfunctions, but it's— it differs from person to person. We're not all kind of decrepit. And, and, you know, you're younger much longer these days. I mean, 60s, the new 50, and, and everything else. So there's no reason why you can't keep going, apart from the fact that your estrogen stops a little bit. And Other things happen for guys too. But even when those things happen, there's still ways to be intimate. There's lots of different ways to have sex. It's not just about penetrative sex. You can have sex in so many different ways. And, and so we need to be kind of thinking about that a little bit more. Um, generally the women that are older tend to go to the menopause clinic for this kind of advice, but, um, maybe not the right place. Maybe we should be encouraging more more people over 50 in the doors, especially to get tested before they embark on a new career of, um, sexual activity.

Yeah, for sure. I mean, my experience in the last time I tried to get tested was that they wouldn't see me in a clinic, and they pretty much demanded that they sent me a self-testing kit which had a bunch of things to take swabs and stuff. Then it had this little blue thing that I had to prick my finger with and then fill an entire vial with my blood, which I was completely unsuccessful at doing. Completely unsuccessful. I tried like 3 times. I'm phobic about needles anyway, so that was not the easiest thing for me to do. And squeezing my little finger to try and get these drops of blood out to fill a whole vial was just, frankly, it was just impossible. So I ended up demanding to see a clinic and then waited 2 hours in the waiting room. But it's not easy. It's not easy. Like, they're not making any of this easy for us.—

or I'm so sorry that that was your experience. I can just give— on the side, I can give you a tip, is to put your hands in some warm water and then drape them upside down so that you squeeze the blood down to the bottom of your fingertips, because that's what I would be doing if you came in clinic. But that problem is so, so common. The tests are great for people that can't come in because you can get it delivered to your house, and it's a great idea. But for people that would like to be seen, I mean, our clinic does offer that, so you can come in anyway. But, um, for that, you, you do to be helpful. And blood letting, or blood— getting blood from yourself, so many people are needle-phobic, so many people. And you see the biggest guys with the most tattoos, and they're kind of sitting there thinking, oh my God, oh my God, and can I lay down? And, and so it's really, really common, and I'm not quite sure it's been thought about that much, because sometimes it, it just needs to have a person there to reassure you when they're taking your blood.

Well, and also the other thing, of course, that we spoke about just before this was the fact that if you're an older person, maybe you've never been to a sexual health clinic, right? I mean, I was very sexually active in my 40s, so I was a frequent visitor there to the point where at one point they asked if I was working, which I thought meant, did I have— was I fully employed? And I said yes. And they said— I said, yes, I have a job. And they said, no, no, you know, like 'Are you a sex worker?' And I said, 'No, no, I'm just a person who, you know, is quite active, and I'm— and I, and I also want to make sure that I'm not passing on any nasty things to people, so, you know, I'm just taking proper precautions here.' But back then it was kind of quite easy. I just, I just wander in. It was all really friendly. Everybody was really nice. But the other thing, of course, about seeing somebody with that degree of frequency, or seeing somebody at all, is is that they ask you other questions, right? So you have your little self-testing kit and you do your thing and you send it off. Nobody's asking you anything about your life 'cause you're not meeting a human being, right? But when you meet a human being, they ask you like all sorts of questions. When was the last time you had sex? Was it protected sex? Was it unprotected sex? You know, how many partners have you had? Like you get asked this whole series of questions the testing kit doesn't ask you any of those questions. So they don't know anything about your lifestyle. They don't know that maybe you need that testing kit with more frequency, or you're just doing things that frankly are bloody stupid, right?

Yeah, and you do see a lot of it. Our testing kit has got certain safeguarding measures in it, which is great, but they're not at length. So when you've got somebody sat in front of you, you've got more chance to be able to ask some questions about behaviours, drinking, all sorts of things, drugs. And, you know, sometimes people do actually really want help, but the cuts that have been really brutal to the sexual health services across England have just been awful because it's, it's cut right back. So you don't get the appointments because there's not the staff there. They are really well organised, but then you've got a limited time for appointments. You get the self-test kit, which is great for people who are working, they can't get into a clinic, but It's not suitable for everybody, and digital isn't suitable for everybody because it's difficult for some people.

Yeah, yeah. And it's— and when you— if you are an older person and you suspect you might have something wrong with you and you've never experienced any sexually transmitted disease in your life because maybe you've been married for 40 years or whatever, yeah, and suddenly you're seeing something that's not familiar to you anymore down there, right?

Like, suddenly you start itching and, and, and this is quite common for, for older people. As you lose your estrogen and your vaginal walls get thinner and they atrophy, it is quite common to, to get an imbalance in your flora because your estrogen supports your epithelial cells, and that supports the flora and the lactobacilli that's in there. And that needs to be a balance for you to be able to, to keep going there. And then if it's not the balance, it creates problem, um, and then you end up with BV, which is itchy and horrible and, and nasty, and you're walking around with this and not knowing what to do. And then you go into sexual health clinic and it's relatively simple for us to look and say, well, this is what this is, because we looked under a microscope and we've decided what that is, and here's the problem that you can treat it with. But it's, it's difficult because lubes and stuff like that shouldn't have any colors, tastes, things like that. They should be as free as possible, and that really irritates and upsets the internal vagina. And I'm going to tell you one, um, I'm going to tell you one thing is that a lot of women suffer from UTIs when they're older. Yeah, yeah. And most UTIs are actually E. coli, which quite often is really rather prevalent in your bowel. So don't fart in your car. That is the biggest piece of advice I would say, because it rolls forward and it pops right by your vagina.

Well, I'd never do that, darling. That's so funny. But you know, the other thing I was going to say was, of course, I was told by somebody that 50% of all women over 50 have vaginal atrophy, right? Like, it's an unbelievable statistic. That's apparently the, the the statistic, you know, and so the tearing and the dryness and everything are, they're really super prevalent, right? And I know that before I went on vaginal estrogen, I was getting BV all the time, like all the time, to the point where I was just constantly on antibiotics and I was getting really fed up with the whole thing, right? I was thinking maybe I just, I'm going to have to stop doing this because like this is getting ridiculous now.

And I think you're not alone there.

You know, so, um, and, and it— and what I recognized was a couple of things. One was obviously not being lubricated enough, but as you said, and Sam Evans, I don't know if you know her, she runs—

oh, I love Sam, she's fantastic, right?

So she's a friend of mine. So Sam is like, she is the, the massive ranter when it comes to what's in lube, right?

Yeah.

And most lube is shit. Most lube is shit, right? And And of course, I even had yesterday I was doing some, some work and I got in touch with a guy who has a massive Substack following and he writes for Psychology Today. He's an American. I think he's a doctor. Anyway, he was talking about giving women orgasms and you don't give women orgasms and everything. But he started talking about the importance of lube, especially in older people, right? Older women. And he mentioned vegetable oil. I have to say, I was absolutely horrified. I was like, yeah, this is like the leading, the leading writer of sex education in America. He's got 2 million followers, right? And the guy is writing about vegetable oil. And I thought, and I had to write to him and go, look, what I put in my vagina. It's very, it's very important. And there's no vegetable oil that's going in there. None. But you know, I've been told coconut oil is okay.

But yeah, coconut will be okay. But there are lots of lube. There's a company that even make one for menopausal women. It's extra thick and it just clings in there longer. And then you can use a more water-based from the outside to make it more greasy or slippery. But the inside bit is the bit that's the problem. It needs moisture, it needs to be moisturized. Your vagina should be moisturized like your bloody face, you know. You should think face, fanny, and put it on both because it's really, really important to, to look after it. And I don't think we're giving enough, um, shout about that.

No, definitely not. And I think, you know, like I said before, doctors are— there's, you know, the fact that somebody with that kind of following can give such poor advice, for me, is an indication of where we have got to with this, right? Here we are in 2024 and some man is telling me to put vegetable oil in my vagina. No, I'm not going to do that. But if he's saying that, then what's the doctor, like the normal GP that you just go to, what's that person saying?

Because I don't know, but they've just got so much to do. I'm sorry for them. That's why we need the GUM clinics because we need for people to be able to come to a specialized service. To get help and get advice. Because when you're at— when your vagina atrophies and you're more likely to tear and bleed, you're much more likely to be able to get a blood-borne virus, um, HIV, um, hepatitis, you know, all those things. Because the blood-semen content is where this is passing. And older people are now much more, um, you know, they're not using condoms because they come out of relationships, they go straight into another relationship. The internet sends them off all over the place having great time. But you need to be thinking about these things. You need to be at least checking regularly, because if you don't want to wear a condom, you need to check and have a little bit of faith with somebody that you're, that you're sleeping with to make sure, because there's quite a rise in older people with HIV now, and I think that's one of the reasons why.

Um, yeah, yeah. I mean, I hadn't heard about the rise in HIV. I'd heard about the rise just generally in STIs, you know, and about the fact that gonorrhea is huge, syphilis is huge.

Syphilis is the highest it's ever been since the Second World War. It's huge.

Really? Wow. Yeah, I'm not surprised. I'm not surprised. But you know, I, I, I have to say that in the past few years I haven't encountered too many people who have given me the old, oh, I can't wear condoms because I lose my erection nonsense.

And if I had a quid for every time somebody had told me that in clinic, I would be a rich person. 'Oh no, he can't wear a condom, he's allergic,' or 'He doesn't like it,' or 'It won't work,' or—

but also, you know, in line with that, and this, and then, and it goes with the same thing about lube, it's like not all condoms are the same, right?

It's like, no, there are so many different—

men are different, but also there's some chemicals on these condoms, and I do know men, for instance, who come out with rashes. They put, um, like spermicides or whatever they are on these condoms, and they just don't you know, they irritate them. So, you know, the one that I— is it— I want to say it's, it's Silk. Is it Silk?

Silk.

Silk is, is the one that everybody I know really likes more than any of the other ones. I don't think it's made— it seems to be like the most natural one. But even, you know, when we use the word, even using the word natural, like latex. Okay, some people, that's, that's considered natural, I guess, right? But it can have all sorts of other crap that it's—

yeah, it depends how it's made, doesn't it? And what it's got in it. Um, I, I probably would go for, yes, organic or, or Sutil, because Sutil make the menopause one, um, which is thicker.

And yeah, yeah, but then you have those condoms that come in the brown pack. They're the ones that every— the guys like, and they're like non-latex, um, oh God, I can't remember the name of them. I'll have to remember the name of them, but they're, you know, everybody I know prefers that particular brand over Durex, for example, which—

yeah, I'm not sure. I mean, they're very different makes now, but I think Durex were the brand leader for a really long time because they were said to be reliable. But there are different makes out there now that, that— and people say, oh, this split, this split, and I have to say, how long did you have it on for? And they say, oh, about an hour and a half. And we'll stop, stop, change over at half an hour, you know, because these things, they're not built for that, but they're very strong. They really are strong. I can put my foot in one, you know, they are strong, but they're not strong like that much. No, 2 hours worth. Change over, just give yourself a break and this poor woman, whoever she is.

Can you imagine? 2 hours. Bloody hell. Well, yeah, but still. Yeah. I mean, I just think there's just such a massive, there's just such a massive lack of education and whether it's like, well, it's all of it. And I mean, how do you, you know, how do the issue is if you, if those people are not coming into your clinic, right. And you're not there and you're not asking them the right questions, they're not getting sent— they're, you know, they're getting sent these kits, so they're not talking to anybody. For me, it's got to be the opposite way around. Like, I want to go to my GP when I'm having my checkup and asking them about my general overall health, or they're asking me about my general overall health, and I want them to tell me— they want to ask me what's happening with my sex life, because otherwise I'm not going to tell them. Like, it, you know, it's, it feels like either they're going to include it as part of the conversation and acknowledge that we have sex or we may be having sex. It's fine if someone says, oh, I don't have sex anymore. That's fine. But at least if they say that, they could say, oh, why is that? Is that because it's painful for you? Is that because you're struggling with getting an erection? Because otherwise, how are we going to educate these guys?

People won't— they won't talk about sex. There's still a huge stigma attached to coming into a gyn clinic. It doesn't matter what you call it. We do all sorts of things. It's not just infections, it's contraception. It's just all sorts of stuff we do in there, you know. And it's— there's still so much stigma. And even the young people say, it's taken me 3 weeks to build up the courage to come in. And I say, oh, that's so sad. We're not judgmental. We just want you to come in so we can help you out. We love doing what we do. We love our job. Yeah, yeah. Um, so yeah, just, just come in and, you know, get help. There's help out there. We can do it.

Yeah, yeah. But well, you, you can do it because you, you have got a clinic still that's open.

Yeah, that's true. That's true. It's really sad that these clinics are closed. And do you do walk-ins or We stopped doing walk-ins in COVID just because we needed to know what we were doing, and we needed people to be in and out very quickly. So we needed them to come in for their appointment time, go out like fairly quickly. It, um, it's continued that way because it worked that way better, and people weren't complaining that they were sitting for hours in, in a stuffy waiting room full of people coughing. So we've continued that, but we've also got a backup plan for those emergency situations when people need to see people like— so if they may have been exposed to HIV, they can come in for PEP. And PEP's another thing that nobody knows about, you know. If you've had an encounter with somebody that you don't know, or unfortunate enough to be sexually assaulted, you can get this medication that can stop that. Nobody knows this. I say this to every single person that comes in, and hardly anybody knows about this. We need more campaigning, really, to get sex open a little bit more so younger, younger people don't feel afraid to discuss it, but older people feel welcome to attend clinics and come in and just say, right, okay, this is what I think I need, or can you help me with this?

And just if, let's say, some, other than just actually handing out medicine or, you know, taking blood and doing all the stuff that you do, do you, is there an opportunity to actually talk with people about lifestyle changes that they might need to make to help to support their sexual health? Like, for instance, erectile dysfunction. It can be a manifestation of a, of a bigger problem, cardiovascular problem, right?

Yeah.

And that can sometimes be sorted by changing one's diet and taking up exercise. So is there an opportunity to actually have those conversations, or is it simply, I've— I'm not able to achieve an erection, here's a blue pill, go away, see how you get on?

So all of our clinicians are trained to do the initial part of that. If somebody's talking about that as a problem, if they feel it's a problem that's been going on for too long, we have a psychosexual counselor, right? So we can refer into her, and she can then get back to them and, um, see. But there's a criteria that they have to meet as well, which is, you know, it's quite strict. And so, um, there's kind of barriers in most places for this kind of thing, because there's just not the funding, I don't think. We've got funding for one, which is great, and she is busy, and it is helpful. Most of us are managing to talk to people about things. I'm always happy to go to the floor and talk about lifestyle changes or things that people can do, because there's a bigger, a bigger sexual scene going on now, with swinging and meeting up couples. It's not just parties and sex parties. There's all sorts of stuff going on out there. And I think we need a bigger service, not a smaller one, so that we can accommodate more people to have sex safely and with fun and, you know, and more comfortably. So for people maybe with breast cancer who don't have estrogen because they've got estrogen blockers, there's a huge problem with having sex again after, you know, you've had all that done to your body. Intimacy is a real problem, and we're not really covering that either because it's kind of all in the same area. There's lots of things it could be improved.

So when you've got breast cancer, as an example, and you're on estrogen blockers, does that mean that you're not allowed to use vaginal estrogen, for instance?

Well, it depends what you're taking. So if you're postmenopausal, which we're talking about now, or older, um, aromatase inhibitors are generally— not always, but generally— what you get for hormone-positive breast cancer, which blocks your estrogen, which is great. But then you go freefall into menopause. And for the younger women that have this as well, I really feel for them because they've not even got to a point where they've finished swinging the cat round. So you get to the point where you think, you know, for older women it's bad enough. You can't use the estrogen gels for certain types of breast cancer. They don't recommend it, although a lot of people will prescribe it. And a lot of people will take it because your quality of life is really important. So, it's still on the fence, and there are a lot of people that say, "Oh no, it's fine," and then there's a lot of people that say, "Oh no, it's not." So, I think that with aromatase inhibitors, I don't think they really like to.

Oh, right. This is the situation a friend of mine's in. She's been going through breast cancer, and she's come out the other end now, and, um, But of course she slammed straight into the menopause now, so.

Yeah, oh God. Don't, it's like falling off a cliff.

Yeah, she said that. She said it's like, wow, you know, just incredible, but.

Yeah, it really does change the whole thing and you think, what's happened? What the hell has happened here? And then, and then what they don't tell you is that not only does your vagina atrophy, is that your clitoris shrinks back like male penises do, and you can lose bits of your architecture, they call it, but your labia. No. Yeah, they shrink back. It kind of shrinks back like it's— so you need to use it before you lose it to keep it, you know, just to keep everything going. So you need estrogen for those things. And I think that the person that develops something that isn't so strong. You don't need an awful lot, you need a tiny little amount. And it's, you know, what they give you in those pessaries and those things is a minuscule amount. Yeah, yeah. And so I think I'd like to hope that somebody can actually come out and say, well, actually, yes, all of you can have it, rather than some of you can, some of you can't. Because that's like my crack cocaine, that would be, you know, just be hunting the streets for people to let me have estrogen because my GP won't prescribe it. No.

Well, mine was, I was really lucky. Sam was the one who told me about vaginal estrogen because I didn't know anything about anything. And you know, I was having some pain and then she told me about it and I went and I just phoned my doctor and I went, right, this is what's going on. Can I have some vaginal estrogen please? And she just went, yeah, yeah, sure. I'll just write you a prescription. Just go and pick up the chemist. No problem. And I did that. And then I told somebody recently, a German woman that I know who's out in Spain when I was visiting, and she was a younger woman complaining about all this stuff. And I said, oh, go and get some vaginal estrogen, showed her what I had. She just wrote to me like a few days ago and she's like, honestly, I don't even know where to start thanking you. Like this stuff has transformed my life. She's like, I've got the vagina of a 25-year-old again. I just think this This is amazing. But she said, if it hadn't been for you— this is like Chinese whispers, this stuff. I mean, it's ridiculous.

Yeah, why is this a secret amongst certain people? I mean, I think, I think Sam should actually be put up in her own clinic, really, because her website, Joe Divine, is absolutely full of amazing stuff. It is. But also, it's crazy that you have to go underground to find this stuff.

It's nuts. And the thing is that, you know, Sam did it to start with because she recognized that she was getting these calls from people wanting to buy sex toys, not knowing where to start. And some of them were older. So she starts, you know, kind of basically counseling them over the phone.

Yeah.

And since then, she's become, you know, such a massive advocate for women using vaginal estrogen, sex toys, etc. But honestly, all of us, I just think, what is going on here? This is— frankly, this is ridiculous. Like, she's a nurse, so she's got some Obviously she's got lots of training. You're a nurse, so you got training. I'm just a woman who likes it.

I'm actually not a nurse.

Oh, you're not a nurse?

No, I'm psychology-based with counseling.

So, but you know, you're trained, right? You're trained.

Oh yeah, yeah. No, we have to train to do the job. Yeah.

But you know, I look at the number of people out there who are sharing this information and it really does feel like this little underground club where We're all going, get some estrogen.

Yeah, go and talk to Sam.

Because nobody, like the medical profession, is just not sharing this information. It's like, I don't know why. Are the pharmaceutical companies not paying them enough? Do we need to, do we need to go to them?

It's really hard because your day in the NHS is so damn busy that you, you don't have those set aside moments to keep up to date on research. You don't have it. You can do it in your own time, which is great, because obviously I'm interested. I go to a lot of different conferences, especially with the breast cancer side of things, just to see where the latest research is. But you still meet differing opinions on whether you should get this or not. Some people are all for it, and some people aren't, because of that. And I think maybe if you were worried about ovarian cancer, or you had that in your family, then maybe a reason that you might not want to use it so much, but it's a game changer. It's such a game changer. Totally. And it's such a tiny amount that's in the cream.

Well, I use the little pills, you know, there's only, it's only 10 milligrams. It's like nothing, right? Absolutely nothing. Twice a week, absolutely nothing, but completely transformative, like unbelievably transformative. I feel, feel like Evangelica when I talk about it.

Yeah. And you can sit down without wiggling because you're uncomfortable and Yeah, it's so uncomfortable, this stuff.

It is, you know. And the— and like you said, my, my friend's mother recently had a very, very serious UTI. I had a UTI for a while where eventually I didn't know what was going on. I just thought— again, I just thought, oh, you know, this was before I started taking the estrogen. I thought, oh, oh, this looks like maybe it's BV again, or maybe if it's 'Let me just see if it clears up on its own.' And eventually it turned into quite a significant STI, which meant I had to go on really hardcore antibiotics and stuff. But, you know, again, and much older people, as you say, it's very, very prevalent, but nobody's talking about it. So all of these people are walking around and it's getting really serious.

And UTI is really painful. Oh, it was horrible, really painful. It can be really uncomfortable and really annoying, and then it can go further, and then you start to get really not well.

Yeah, I mean, the only reason I eventually put all of it together was because I started getting feverish, and I thought I was getting like a flu or something else going on, and I was getting quite delirious with the whole thing. And then I, and then I, I got tested and they said, no, you've got a really serious UTI. So it had reached that stage where it was going into other parts of my body.

And yeah, no, that's not good at all.

No, it was terrible. But, but yeah, I mean, I think, look, the message is that A, the NHS needs to fund more gum clinics. Definitely.

They do need to give us more money, but they also need to have a few public campaigns about certain things. We need to encourage people, don't, please don't be embarrassed to come. We love our jobs. We love helping people. We just love to be able to give you the help that you need. It's, it's not embarrassing for us because we do it all day. We love talking about it. Yeah.

And I, and I've always, I've never encountered anything but lovely, friendly people every time.

Yeah. No, some clinicians are great.

I've never ever gone to a clinic and had a poor experience ever. I find the people are so lovely. So if you're out there and you're thinking about this and you're wondering, oh, should I, should I get tested? Go, go and see somebody, get tested, check yourself out, make sure that you're healthy and, and demand that you get the kind of treatment that you deserve.

Absolutely. And don't be embarrassed. And the reason we ask lots of questions is because we just like to make sure that we've covered all areas for you. And really, there's nothing we haven't heard.

I can totally believe that. I don't even want to go into what you've heard.

No, no, probably not.

Anyway, it's been so lovely to chat to you. Thank you so much.

And it's my pleasure.

Yeah, put all your details and everything. And yeah, let's just keep fighting the good fight.

Yeah, let's have older people in our clinics.