In this episode, consultant obstetrician and gynaecologist Dr Fadi joins Laura for an open, practical conversation about pelvic floor health, incontinence, prolapse and the realities of modern obstetrics.

Dr Fadi explains how childbirth, ageing and menopause affect the pelvic floor, and why so many women end up living with stress incontinence, prolapse and faecal incontinence in silence. He walks through the full range of treatment options — from physiotherapy and pessaries to urethral bulking, Botox, sacral neuromodulation, robotic surgery, and the mesh procedures paused in Ireland since 2018.

The conversation also takes in interstitial cystitis, vaginal oestrogen, the impact of long inductions on older mothers, and the trade-offs women now weigh up between a vaginal delivery and a caesarean section. Dr Fadi closes with a reflection on his time working with Syrian refugees, where he met 13-year-old mothers and a 26-year-old grandmother.

1. Pelvic floor problems are common and treatable — Stress incontinence, prolapse and faecal incontinence are usually linked to childbirth, not an inevitable part of being a woman.

2. Mesh for incontinence has been paused in Ireland since 2018 — Ireland is the only country in the world where this procedure is currently unavailable, and patients are being sent to Spain to access it.

3. There is no single fix for incontinence — Treatment depends on the type, from physiotherapy and urethral bulking to mesh slings, Botox into the bladder wall, and sacral neuromodulators.

4. Prolapse is not just the womb — Bladder, womb and rectum can all prolapse, each with their own grade and treatment pathway.

5. Pessaries give women back some control — Different types of pessary can hold a prolapse in place, and many women can learn to manage their own at home.

6. Faecal incontinence is more common than women admit — Third and fourth degree tears at delivery can damage the anal sphincter, and primary repair at the time of birth gives the best outcome.

7. Vaginal oestrogen is a low-risk, high-impact tool — It can ease overactive bladder, recurrent UTIs, dryness, and slow the progression of prolapse after menopause.

8. Older mothers face different trade-offs — Long inductions, instrumental deliveries and unplanned caesareans are more common, which is why some women are now actively asking for a planned section.

Love Your Vulva — Laura Dowling

fabÜ Hello Healing

Continence Foundation of Ireland

01:46 — Introducing Dr Fadi and urogynaecology

02:49 — Why pelvic floor problems happen

04:14 — Assessing pelvis and baby size before delivery

05:09 — Robotic surgery and vault prolapse

06:34 — Stress incontinence and mesh as the gold standard

09:01 — Why mesh has been paused in Ireland

12:31 — Sending Irish patients to Spain for mesh

14:25 — Botox for overactive bladder and Interstim

15:43 — Faecal incontinence and tears at delivery

19:17 — Interstitial cystitis and hyaluronic acid

21:21 — Types and grades of prolapse

24:25 — How a pessary works

28:01 — Surgery for prolapse

34:18 — Vaginal oestrogen and pelvic floor

36:08 — Epidurals and instrumental delivery

37:25 — Why more women are asking for caesareans

45:00 — Working with Syrian refugees

48:32 — Advice for young people and the meaning of life

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, GP Dr Sarah Carty explains why ADHD looks so different in girls and women — and why so many only recognise it years, sometimes decades, after it first showed up.

She tells Laura how the "quiet" presentation — daydreaming, internal restlessness, working twice as hard to look fine — slowly turns into anxiety, perfectionism, and a quiet erosion of confidence. It's a clip that gives language to something a lot of women have silently carried for years.

• Why girls are diagnosed much later than boys — and what gets missed
• Masking, and how it shows up as perfectionism, daydreaming, or "just being quiet"
• The link between unrecognised ADHD and anxiety, panic and exhaustion
• How girls end up labelling themselves as "stupid", "lazy" or "not academic" — and why that's so far from the truth
• Why the right diagnosis can change a person's whole self-story

🎧 Listen to the full episode here.

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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What does proper midlife care actually look like, and who keeps getting left out of it?

In this episode, Laura sits down with Dr Caoimhe Hartley - founder of Menopause Health in Dalkey, clinical lead of the Complex Menopause Clinic in the Rotunda, and clinical lead for women's medicine at the new BlackRock Health Women's Health Centre.

They talk about the women being told no - those over 60 who feel they have missed the boat on HRT, and those who have come through breast cancer and are still struggling with symptoms. Caoimhe explains where the evidence actually sits on bones, blood vessels and brain, why so much of what gets repeated still comes from the Women's Health Initiative, and how modern HRT differs from the older oral preparations.

The conversation moves through midlife weight gain and changing body shape, the rise in adult ADHD diagnoses, and the link between oestrogen and dopamine. They also dig into osteoporosis screening in Ireland, why there is no national DEXA programme, dietary calcium, and the histamine flare some women notice on HRT.

Throughout, Caoimhe keeps coming back to the same point - care should be personal, joined up and built around the woman in front of you.

Guidelines are broad, not personal

They are starting points, not prescriptions, and individual risk-benefit has to lead the conversation.

Women over 60 are not automatically locked out of HRT

There is no longer evidence that starting later raises heart attack risk, and bone benefit is available at any age.

The WHI still shapes the conversation

A flawed 1990s study using Premarin and older progestins is still behind fears that do not map onto modern HRT.

The brain adapts after menopause

Hot flushes, night sweats and brain fog are not designed to last forever, and most women in their 70s and 80s are not symptomatic.

Breast cancer survivors deserve a real menopause conversation

Vaginal oestrogen is generally safe, complex menopause clinics exist for a reason, and non-hormonal options matter.

Body shape change is real and largely hormonal

Central weight gain is one of the top three things women raise, and no specific HRT fixes it, though better sleep and mood help.

ADHD is being unmasked in midlife

As oestrogen falls, dopamine regulation shifts and previously well-managed traits can come to the surface.

Ireland has no national DEXA screening

Despite international guidance over 65, screening here is opportunistic and goes through your GP.

80% of bone density is genetic

Peak bone density is in your 30s, with the remaining fifth shaped by vitamin D, calcium, weight-bearing exercise and not smoking.

Menopause Health Clinic, Dalkey

BlackRock Health Women's Health Centre

Women's Health Initiative (WHI)

Danish Osteoporosis Prevention Study (DOPS)

International Osteoporosis Foundation calcium calculator

British Menopause Society

National BreastCheck

00:00 — Why joined-up midlife care matters

03:20 — Women over 60 and HRT

05:10 — Bones, brain and the limits of the 60 cut-off

07:50 — Why the WHI still shapes the conversation

13:00 — The brain adapts after menopause

16:00 — Breast cancer and complex menopause care

20:30 — Cardiovascular health and nitric oxide

23:00 — Body shape change and central weight gain

27:00 — Ozempic and oral progesterone

28:30 — ADHD, oestrogen and dopamine

33:00 — Osteoporosis and DEXA screening in Ireland

41:00 — Histamine, HRT and hay fever

43:00 — Later motherhood and perimenopause overlap

54:30 — Advice for younger women

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, menopause specialist Dr Deirdre Lundy walks Laura through how decisions about HRT and family history of breast cancer actually get made in clinic — and why a blanket "no" rarely tells the full story. If you've ever been handed that flat refusal, this is for you.

She unpacks the difference between "a family history" and a strong family history, why outdated fears around HRT and breast cancer have cost women years of their lives, and why surviving cancer shouldn't mean accepting a wrecked quality of life with no support.

• What "strong family history" really means — and why it isn't a blanket no
• How specialists balance risk versus quality of life in real clinic conversations
• Why so many women have been wrongly told HRT is off the table
• The wider point: survivorship deserves more than "you should be grateful"
• What to ask for if you've been refused HRT and want a second look

🎧 Listen to the full episode here.

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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Pamela Deasy was in her early 40s, working full time and volunteering with the RNLI, when fatigue started dragging her back into bed in the middle of the day. Her bloods were clear. She was told it was perimenopause, then depression. Months passed before a kinesiologist, of all people, pointed at her pancreas — and within days she was in a Cork hospital being told she had a tumour.

In this episode, Pamela sits down with Laura to walk through what happened next: the chemotherapy that made her legs turn to jelly, the five and a half weeks of daily radiotherapy that put her on her back in hospital, and the Whipple surgery that took out the head of her pancreas, part of her stomach, part of her intestine, her gallbladder and her spleen. Then the slower, quieter battle that came after — the seven and a half stone she lost, the survivor guilt nobody warned her about, the Survive and Thrive programme that helped her step back into the world, and the small camping toilet she now keeps in her car because that is the honest reality of life after Whipple surgery.

Pamela also shares why she co-founded Pancreatic Cancer Ireland, what the signs of pancreatic cancer actually look like, and why "listen to your gut and keep going back" might be the most important sentence you hear this week.

• Why fatigue was Pamela's only consistent symptom — and how easy it was to put down to a busy life, perimenopause and then depression
• The signs of pancreatic cancer worth knowing: persistent tiredness, pain in the tummy that radiates to the back, floaty stools, dark urine, jaundice, an itch with no rash, new pre-diabetes
• What Whipple surgery actually involves, and why it is described as life-saving but life-altering
• The realities of life after a rewired digestive system, from packing a change of clothes to always knowing where the toilet is
• The chemotherapy side effects that have lingered for years — neuropathy, Raynaud's, cold intolerance
• Survivor guilt, the drop-off in support after the "all clear", and finding her way back through the Survive and Thrive programme
• Why pancreatic cancer is projected to be the second leading cause of cancer-related death by 2030
• Pamela's everyday philosophy: advocate for yourself, listen to your gut, and treasure the ordinary days

Pancreatic Cancer Ireland

Survive and Thrive

00:00 — Welcome

00:27 — Blackrock Health Women's Health Centre

01:34 — Introducing Pamela and trusting your gut

02:13 — 2018: fatigue, busy work and the RNLI

03:04 — Going back to the GP again and again

05:01 — A kidney scan and "the good news is there's no cancer"

06:00 — Being told she might be depressed

06:16 — A kinesiologist who pointed at her pancreas

07:17 — Jaundice and the alarm bell

08:51 — Friday 7th December: into hospital in Cork

09:22 — "You have a tumour in your pancreas"

12:02 — What Whipple surgery actually is

13:00 — Six rounds of chemotherapy

13:30 — Side effects: falling, neuropathy, Raynaud's

17:48 — Radiotherapy, gemcitabine and six weeks in hospital

21:51 — Whipple surgery on 15 August 2019

23:20 — What was removed during Whipple

24:17 — Losing seven and a half stone and severe cachexia

26:14 — Ascites and the slow road back

29:48 — From patient to survivor

30:23 — Survivor guilt and finding therapy

31:11 — The Survive and Thrive programme

31:38 — Life after a rewired digestive system

34:55 — Pancreatic cancer statistics in Ireland

36:00 — The signs and symptoms worth knowing

42:00 — Setting up Pancreatic Cancer Ireland

47:58 — Where to find Pamela

49:25 — Advice for younger people, and the meaning of life

51:38 — Blackrock Health Women's Health Centre

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, endocrinologist Dr Mary Ryan opens up about losing her husband unexpectedly while raising three small children, and what grief actually looked like for her in the years that followed.

She tells Laura about the shock, the anger, and the long fog of those first two years — and the small, practical things that helped: leaning into bonding routines with her kids, accepting help from family, friends and even her own patients, and letting people in when every part of her wanted to push them away.

• Why grief, in her experience, takes around two years — and why the second Christmas is often the hardest
• The "dark hole" she fell into, and what slowly pulled her out
• How she kept life moving day-to-day for three young children
• The quiet role of family, friends and patients in keeping her going
• A gentle, honest take on how you don't really "get over" loss — you come through it

🎧 Listen to the full episode here.

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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Anxiety author Caroline Foran joins Laura for a deeply personal conversation about parenting a young son recently diagnosed as autistic with a PDA profile, alongside her own long history with anxiety.

Caroline talks openly about the years before the diagnosis, the blame she turned inward, and everything she has had to unlearn about parenting. She explains what PDA — Pervasive Drive for Autonomy — actually looks like day to day, why traditional approaches can make things worse, and the social pressure of being seen to "manage" a child whose nervous system is set on high alert.

She also shares her own anxiety story, from a frightening breakdown at sixteen in Italy through to the severe physical anxiety that took over her twenties. Caroline talks about medication, CBT, and the years of work behind her new book Everything I Wish I'd Known About Anxiety, and why so much of recovery came from showing her body safety rather than trying to outthink her own mind.

Discovering a PDA profile — Caroline explains Pervasive Drive for Autonomy and what it means for her son's nervous system day to day.

Why traditional parenting backfires — Holding firm boundaries can push a PDA child straight into fight or flight, even at five.

Lowering the demands — A low-demand, declarative-language approach has reshaped everyday life at home.

Performative parenting — The urge to respond to her son for the benefit of onlookers, even with close friends.

The years before the diagnosis — A bumpy COVID start, severe separation anxiety and two preschool attempts that left him distressed.

Caroline's anxiety story — A breakdown at sixteen in Italy and a severe physical episode at twenty-five.

Medication, CBT and self-compassion — Prozac, behavioural therapy and learning to respond to anxiety with kindness rather than self-attack.

Showing the body safety — Why walking, rhythm and bottom-up regulation worked better than trying to master her thoughts.

The cost of constant stimulation — Social media, the pleasure–pain balance and collective anxiety since COVID.

Everything I Wish I'd Known About Anxiety

Owning It

PDA Society

Casey Ehrlich (Peace Parents)

Dr Anna Lembke — Dopamine Nation

02:00 — "Is he non-verbal?" introducing her son

02:30 — Autism with a PDA profile

03:00 — What PDA stands for

04:30 — Nervous system disability and perceived demand

06:00 — Why traditional parenting can backfire

08:00 — Performative parenting in public

10:00 — A pillow on the grass and what dysregulation looks like

13:00 — Blaming herself before the diagnosis

17:00 — Sensory overwhelm and rethinking exposure

20:00 — Preschool, school and what comes next

30:00 — Family life, marriage and never a date night

33:30 — Caroline's anxiety story begins in Italy

39:00 — A severe breakdown at twenty-five

45:00 — Starting medication and what Prozac actually did

51:00 — CBT, behavioural experiments and getting her life back

56:00 — Showing the body safety

59:00 — Social media and the pleasure–pain balance

01:04:00 — Caroline's new book

01:05:30 — Advice and the meaning of life

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, comedian Kyla Cobbler shares an honest, no-frills account of how her drinking quietly turned into dependency — while she was still training, working, and gigging five nights a week.

She tells Laura how being a regular performer in Barcelona blurred the lines between socialising and self-medicating, and how Dry January cracked the whole thing open. What started as a simple challenge ended in withdrawal, therapy, AA, and a completely new relationship with fear, nerves, and joy on stage.

• How "high-functioning" drinking can hide a much bigger problem
• The cycle of running, gigging, free drinks — and waking up groggy every single morning
• What withdrawal actually felt like by day two of Dry January
• Why it was never about the red wine — it was about wanting to feel different
• Performing sober for the first time, and learning to feel everything instead of numbing it

🎧 Listen to the full episode here.

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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Barbara Scully sits down with Laura for a wide-ranging conversation that starts with her own recent run-in with the medical system and opens out into what it actually means to age as a woman in Ireland today.

Barbara talks about months of hip pain, a string of MRIs, a suspected stroke that turned out to be nothing, and the moment she decided to step off the treadmill of tests, hand back the prescription and rebuild her strength in the gym. She also shares her type 2 diabetes diagnosis in her mid-50s and the two years of remission she achieved through diet and exercise before her mother died and life became harder again.

The conversation moves into menopause, brain fog, mood swings and the language used about older women. Barbara reframes brain fog as an information retrieval slowdown, makes the case that women's anger after menopause is real and warranted, and argues that being underestimated as you get older is closer to a superpower than to invisibility.

There is also room for the story behind it all. Growing up tall in a male-dominated house. Becoming an unmarried mother in 1987 and listening to politicians and clergy describe women like her as a scourge on the radio. The close, unconventional friendship she had with her mother, who set up her own business teaching women word processing in the late 1980s. And the comedy career she fell into in her 60s, now touring with her one-woman show Older Bolder Wiser. Her best-selling book ‘Wise Up’ is available now in Irish bookstores nationwide & on Amazon.ie 📚

Trusting your gut with healthcare

After months of MRIs and a hip replacement referral, Barbara declined the surgery and rebuilt her strength through physio and the gym.

A diabetes diagnosis as a wake-up call

A type 2 diagnosis in her mid-50s pushed her into healthier habits and into remission for two years.

Brain fog reframed

Women in their 60s have decades more information stored than younger people; what is labelled brain fog is information retrieval slowdown.

Anger after menopause is real

As life pressures lift, you have the headspace to notice ongoing inequalities, and that anger is not a hormonal mood swing.

Underestimated, not invisible

Being overlooked as an older woman gives you the element of surprise and the freedom to take risks without caring what people think.

The cost of conformity

A senior CEO told Barbara she would love to let her hair go grey but feared not being taken seriously at work.

Becoming an unmarried mother in 1987

Barbara remembers her father going upstairs to be sick, three weeks of silence, then a quiet "we'll stand by you" on a snowy morning.

A friendship with her mother

Her mother bought her her first baby cham at 12, set up her own business in her 50s and was a collaborator throughout Barbara's life.

Wise Up — Barbara Scully

Memoir reflecting on the years after menopause.

Older Bolder Wiser

Barbara's one-woman comedy show currently touring Irish theatres.

Funny Women Ireland

Set up by Orla Doherty and Val Troy to promote women in comedy.

00:00 — Hip pain and the MRI run-around

03:00 — Stepping off the treadmill of tests

07:30 — Type 2 diabetes and remission

09:30 — Why brain fog is not what we are told

11:00 — Anger after menopause is real

13:00 — Underestimated rather than invisible

17:00 — Letting the hair go grey

22:00 — The freedom of getting older

28:00 — A first smear test in the 80s

36:00 — Growing up tall and the slow set

44:00 — Giving up red wine and finding gin

48:00 — Her mother as collaborator

56:00 — Losing her mother in 2022

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, GP and menopause specialist Dr Sarah Callaghan explains why perimenopause so rarely arrives with a bang — and why so many women spend years "muddling through" before they realise what's actually going on.

She tells Laura about the slow, sneaky creep of symptoms, the patterns she sees most often in clinic, and the women who mistake their perimenopause for postnatal anxiety, burnout, grief, or "just life". It's a powerful reframe: if something feels off, you deserve more than "just cope".

• Why perimenopause symptoms rarely arrive all at once — and why that matters
• The fluctuating, "good week / bad week" pattern that makes women doubt themselves
• Common mislabels: postnatal anxiety, stress, grief, COVID, burnout
• The "I just don't feel like myself" phrase she hears in clinic over and over
• Why you don't need to be in crisis to ask for help — even a 20–30% drop in functioning is worth investigating

🎧 Listen to the full episode here.

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

Hosted on Acast. See acast.com/privacy for more information.