Dr. Nighat Arif

INSPIRATIONAL WOMEN

Dr. Nighat Arif is a portfolio NHS GP with a specialist interest in Women’s Health from Buckinghamshire. She is the resident doctor on BBC Breakfast, ITV This Morning, BBC Look East and presenter of the Sunday Breakfast show on BBC Three Counties Radio.

She has a passion for making evidence-based, accessible social media content around menopause, family planning and other health matters particularly targeting women from ethnic minority communities for whom English is not their first language. Some of her content is in Urdu/Punjabi to help break taboos, stop the stigma, increase understanding, and improve awareness of women‘s health conditions to tackle health inequalities. Her verified Tiktok platform has accumulated over 203K followers and over 31K followers on Instagram. She is the ambassador for the charity Wellbeing of Women. Her work around Women’s health and menopause has been covered in British Vogue, Good Housekeeping, Red and Hello! Magazine.

Working in the NHS must be very challenging and rewarding, as well as presenting your own radio show and appearing on TV as a healthcare specialist – tell us about a typical week for you? I work 3 days in the NHS and during the pandemic, this has been incredibly challenging. I have had to adapt to how I manage women’s health as a lot of my work is doing difficult cervical smears, inserting IUD/coils which are patient-facing procedures and so I struggled during the lockdowns to provide, what I felt was, gold standard care for my patients. On a Monday, I have a 6.30am ‘GP Slot’ on BBC Breakfast where I discuss any topical medical stories. Then I get my three sons ready for school and head off to work. Mondays I am the duty/ emergency doctor which means I see any acutely sick patients as well as my routinely booked patients. I usually work 16 hours and am exhausted. On a Tuesday or Wednesday I go to the ITV studio at Television Centre in London to cover any health topics for This Morning. I read the latest research and articles, discuss with colleagues in their specialist fields, write articles and record my social media content as part of my medical journalism role. On a Thursday and Friday, I am back in my NHS surgery, I see routine patients, hold an IUD/coil clinic and am in surgery. I try to catch up with all my clinical work and meet with my BBC Three Counties producer to plan my radio show and get an overview of the guests booked for Sunday. I research my guests and plan topics of conversation ahead of my 3hr show on Sunday, which is live from the studios from 7-10am. Sunday afternoon I prepare for the week ahead! What I love about my work is that it is varied and hence I am a portfolio GP. It’s hard work, I get exhausted by my clinical work, but keeping updated in an ever-evolving medical climate is what drives me, feeds my passions and I believe makes me a better clinician

As a British Pakistani Muslim woman, have you found that culture and language are obstacles for some women gaining access to menopause education? Yes, there is an incredible variation of access and obstacles for women from Black, ethnic minority communities and this is more so for women who don‘t have English as their first language. In some languages, there is not even a word for menopause. It took me ages to work out that ‘Banjee’ translated as ‘barren’ is the Urdu word for menopause. Women seldom know words for their gynaecological anatomy. Derogatory words are supplemented for vulva, vagina etc or English words are used. When women don‘t have the lexicon and confidence to discuss their health this perpetuates health inequalities and means a lack of access to adequate healthcare or access to early life-saving interventions. So, women from ethnic minority communities feel left out. There is an exclusion of conversations around menopause for women of colour and therefore they are less likely to participate in research that can shape inclusive care, and for the women themselves there is scant knowledge of how to manage menopausal symptoms therefore further perpetuating a cycle of silence and shame or ‘putting up with the symptoms’

If so, how do you try and engage women within your own community? It is simple - ASK THE WOMEN from Black, Asian ethnic minority communities. This is why I love women‘s health. If you ask a woman the most intimate gynaecological questions, the woman will share them with you and tell you what she wants. If women have knowledge they believe will help others, they will go around sprinkling their knowledge like confetti. I see this more so in my Pakistani community where there is high illiteracy among first-generation immigrant women, so they use stories and word of mouth to share knowledge. As researchers, doctors, and healthcare professionals we need to gain trust from women in ethnic minority communities. Currently, there is such a lack of research on Black, Asian women that they feel left out, and their symptoms are not taken seriously. Some still believe Black women feel less pain - and this means their pain is not taken seriously. This sort of misinformation leaves deep scars in a community and therefore outreach work, ambassadors from the community and working with established grass-roots organisations must be engaged with. Finally, we need allies. Sadly, institutionalised racism, medical misogyny and patriarchy exist, and we need men and women to be allies to stamp it out to make sure that health inequalities around women’s health and menopause does not exist. What advice would you give to women who think they may be experiencing symptoms of perimenopause?

Please never put up with your symptoms. Keep a diary to track your symptoms. Know your medical history, medication history if you are taking any and family history. Get your symptoms investigated and consider the diagnosis of perimenopause. If there is no underlying cause of your symptoms then understand how perimenopause can be managed through diet, exercise, yoga, acupuncture, and hormone replacement therapy (HRT)

HRT has moved on leaps and bounds and the data shows it has more benefits than risks. It has also shown to provide future health benefits in reducing osteoporosis, dementia, heart disease, depression, bowel cancer, diabetes, reducing weight, reducing fatigue, increasing libido, and stopping genitourinary syndrome of the menopause (GSM)

It’s important to understand that not all oestrogens are the same. Transdermal, topical systemic body identical HRT has a lower risk profile for VTE/Clot, breast cancer and heart disease compared to oral synthetic systemic HRT.

Topical localised vaginal oestrogen HRT only works locally in the bladder, vagina, and vulva. It is safe to use lifelong and does not increase your risk of breast cancer or recurrence of breast cancer. Using Vagifem for 1 year is equivalent to taking 1 tablet of oestrogen orally a day because it’s such a low dose, but will stop urinary tract infections (UTI) painful smears, painful sex, vaginal itching, vaginal dryness

Have a look at my social media channels for free evidence based medical information on treatments and care available on the NHS.

How did/does menopause affect you, or your mother

It was my mother and the aunties in the community that made me passionate about menopause. I realised we were passing on generational shame and women were expected to pray harder to relieve their symptoms or repent because their menopausal symptoms are a test from Allah/God. This means that women from my community didn’t understand that their quality of life could be improved. I would talk to highly intelligent, educated women at the mosque who had given up their jobs. This rendered women from my community more financially insecure or not taking up their places at the head of the table where decisions are being made.

What do you do to relax and find peace of mind?

I could talk about women‘s health all day! But when I am not immersed in medicine which is my first love - don’t tell my husband and 3 boys that- I love swimming. During the pandemic, I taught myself how to swim by watching YouTube videos. I also unwind by going to the gym with a group of friends. I love watching Bridgerton, the Crown and movies on Netflix. I have a huge sweet tooth, so if I am not eating out, I am baking and cooking at home. Even after a long busy day, I will still cook from scratch whilst bingewatching on boxsets.

What piece of advice would you give to your younger self? I have 3 bits of advice that I am still trying to adhere to currently. I am acutely aware I am the first hijab-wearing Pakistani doctor on mainstream TV and this has come with the good and bad. Growing up I never saw anyone that looked like me on my TV screen - so my advice to myself is... • Being different is your superpower. Do not try to blend in - as much as you feel you have to because it‘s easier for someone else.

•Fight the fear. On the other side of fear, there is a whole other thrilling world of happiness.

I struggle with imposter syndrome and will lose days working through it. I understand that my imposter syndrome is deeply rooted in my fear of my abilities, and I have in the past turned down projects, or not said anything because of fear of “what will people say?”- trying to work through cultural shackles takes time.

•Share what you have. If you have knowledge freely let others light their candles in it.

We love to champion inspirational women, who has inspired you the most and why? So many to count, I am blessed to be in touch with so many inspirational women who have helped me along the way in my life and career. Louise Minchin is a true champion of women and we connected through BBC Breakfast. She has inspired me and helped me to pursue a career in media and medical broadcasting. Finally, the most important woman of all is my mother. She has always supported my work and is always on hand for last-minute childminding, which is greatly appreciated!

What I love about my work is that it is varied and hence I am a portfolio GP “ “