Speaker 1: You're listening to another mere podcast.
Speaker 2: Hello, Unleashes mea Friedman in your ears. And one of
Speaker 2: the things I love most about podcasts and Unleashed in particular,
Speaker 2: is the way you get to see different sides of
Speaker 2: our co hosts on this show. They're all amazing and
Speaker 2: accomplished in their own fields, and some of them you
Speaker 2: were probably familiar with before you started listening to the show.
Speaker 2: Some of them were probably new to you. But what
Speaker 2: I love about this show is that you get to
Speaker 2: see different sides of them, and you also get to
Speaker 2: see that kind of friendship chemistry dynamic that's developing in
Speaker 2: real time. So they're kind of getting to know and
Speaker 2: falling in love with each other, and we're all getting
Speaker 2: to know and falling in love with them. So many
Speaker 2: of you have said, we actually want more, We want
Speaker 2: to know these women even better. So today I've brought
Speaker 2: you from the Art Chives one of my first chats
Speaker 2: with doctor Ginny Mannsberg. I think it was the first
Speaker 2: time I met Ginny. She has a fascinating story of
Speaker 2: her own, and she's the kind of doctor that every
Speaker 2: woman dreams of having. She's honest, she's got a sense
Speaker 2: of humor, no bullshit, And she's an absolute expert on
Speaker 2: what your hormones are up to, particularly in this midlife
Speaker 2: stage that I'm at, our hosts are at, and you're
Speaker 2: probably at two or will be at soon. So if
Speaker 2: you love the unfiltered no Bs conversations that you get
Speaker 2: here on Unleashed, you are gonna love this episode from
Speaker 2: the archives of No Filter. Here is my one on
Speaker 2: one conversation with doctor Ginny Mansburg.
Speaker 3: So, seventy five percent of women will get hot flushes
Speaker 3: and it's a lot.
Speaker 1: Well, I think it's seventy five percent is a lot.
Speaker 2: Yeah, and I thought you were going to say, oh,
Speaker 2: you know, it's only twenty percent.
Speaker 1: No, it's a lot most of us.
Speaker 3: Yeah, and a third of those men will find them unbearable.
Speaker 3: So that in my back of the envelope, Mask says
Speaker 3: that one in five women will hit menopause with unbearable
Speaker 3: hot flushes.
Speaker 1: That is a big group of us. Hello, and welcome
Speaker 1: to No Filter.
Speaker 2: I'm mea friedman and I'm possibly perimenopausal. Before you say
Speaker 2: to yourself, well that is too much information. I don't
Speaker 2: want to know about your periods. Thanks, Look, I guess
Speaker 2: that's fair enough. However, if you are a woman or
Speaker 2: a man who knows a woman, Perry menopause, which is
Speaker 2: the little sister to actual menopause, is coming into your
Speaker 2: life at some stage, and so you better be prepared
Speaker 2: for it, because you know what, It's not just about
Speaker 2: your period stopping.
Speaker 1: Oh no, Harry.
Speaker 2: Menopause can last as long as seven years, can start
Speaker 2: as early as your thirties, and can include everything from
Speaker 2: changes to your genitals to changes in your mood, big changes.
Speaker 2: Doctor Jenny Mansberg knows a lot about perimenopause, and because
Speaker 2: she's in her fifties now and she's going through it
Speaker 2: too as many of her patients, she's written a book
Speaker 2: called The m Wor that busts myths and offers plenty
Speaker 2: of advice. Ginny herself is pretty awesome. She's been a
Speaker 2: single mum, a political advisor, she has a skincare company
Speaker 2: as her side hustle. She's hosted TV shows, and she
Speaker 2: continues to work.
Speaker 1: In general practice. So if you have a vagina or
Speaker 1: know someone who does.
Speaker 2: You'll really want to hear this conversation.
Speaker 1: Here's Ginny.
Speaker 2: Tell me about your first date with your second husband.
Speaker 1: Have you heard about this? I've heard about this.
Speaker 2: It's the best story I've ever heard about a first day.
Speaker 3: So he had three children. I had three children. I
Speaker 3: had managed to get all three on a sleep out.
Speaker 3: The eldest was fifteen. I had wanted this first date
Speaker 3: for so long, and he was so rude. He rang
Speaker 3: me on a Thursday and said, are you busy on
Speaker 3: Saturday night? And I went, oh, no, rang the other
Speaker 3: blow canceled that date, spent the entire day getting ready.
Speaker 1: We went out to a restaurant.
Speaker 3: It was just going so well for about the first
Speaker 3: half hour.
Speaker 1: And known each other for a while.
Speaker 3: Oh yeah, we known each other for ages, but he
Speaker 3: just had never asked amount of day whatever anyway, So
Speaker 3: I basically the meals got put in front of us,
Speaker 3: and I got a phone call from my eldest son's friend,
Speaker 3: the other fifteen year old, to say, can you come
Speaker 3: and pick up Sam.
Speaker 1: He's not feeling very well Saturday night.
Speaker 3: Saturday night, it was his first experience of the Schmirnoff virus,
Speaker 3: which is basically he was legless, he couldn't talk. He
Speaker 3: was standing there sitting lying down in the guy's driveway
Speaker 3: in his jeans, covered him vomit. I said to Daniel listen,
Speaker 3: you don't need to come, just you know, drop me
Speaker 3: off at home.
Speaker 1: I'll do this. He's like, no, no, no, I'll come,
Speaker 1: I'll do this.
Speaker 3: So he arrives in his amazingly gorgeous car, not like my,
Speaker 3: you know, rubbish. So we're in his car. He picks
Speaker 3: up Sam. Now Daniel's now covered in vomit. He puts
Speaker 3: Sam on his back in his back seat, so Sam's
Speaker 3: head is on the baby seat and Sam.
Speaker 1: La, la la, and his vomit.
Speaker 3: Yeah, of course, I think he's spewed about four times
Speaker 3: on the way home. We get we get home, Daniel
Speaker 3: picks him up, carries him into the shower. Sam still
Speaker 3: hasn't opened his eyes at this point, and we put
Speaker 3: him in the fetal position, the left lateral position, you know,
Speaker 3: which is appropriate for vomiting, because he's continuing to vomit
Speaker 3: in the shower. And Daniel turns on the warm water,
Speaker 3: but it comes out cold, and Sam basically sat up,
Speaker 3: looked at him. First time he was conscious and yelled
Speaker 3: out a lot of expletives that I won't repeat here,
Speaker 3: and then passed out again. And I just said, Daniel,
Speaker 3: this is my son, Sam, who's a really.
Speaker 1: Nice kid, and he really is a lovely kid.
Speaker 3: And Daniel said, well, I think I'll go now, because
Speaker 3: he was now literally swimming and vomit. His car was
Speaker 3: covered in vomit, his baby seat, his baby seat was
Speaker 3: covered in vomit. And he said, I'll come back to
Speaker 3: help you get him into bed, because he was a
Speaker 3: big boy and I'm a small girl. And I was like,
Speaker 3: he's not coming back. You just ruined my first date.
Speaker 3: I'm going to kill you, kid. Anyway, I basically managed
Speaker 3: to drag Sam into his bed. I put it back
Speaker 3: next to his bed, and I said, if if you
Speaker 3: want to vomit, vomit in the bucket. I went and
Speaker 3: had a shower, took all my makeup off, I now
Speaker 3: had wet hair. I was in a tracksuit. And Daniel
Speaker 3: came back. What a man, What a man?
Speaker 2: And he hasn't left blended families? Is it like the
Speaker 2: Brady bunch? He had three? You had three?
Speaker 1: No alice. I'd like an alice. We all would like
Speaker 1: an alice.
Speaker 3: Yeah, if you'll find one lying around, give him my number.
Speaker 3: My husband would say, no Den.
Speaker 1: Oh yeah, the Den. And also Carol didn't have a
Speaker 1: lot to do. No Carol Carol quite leisurely.
Speaker 2: Work outside the home, and yet you did so when
Speaker 2: you guys got together, how do you blend a family?
Speaker 3: Well, we had all these crazy fantasies about how it
Speaker 3: was all going to work.
Speaker 1: And I remember the first time we got all the
Speaker 1: kids together.
Speaker 3: And we put on some Sunday night movie and I
Speaker 3: remember Tara, Daniel's littleis sat on David, my second eldest lap,
Speaker 3: and they're all watching together, and we just stood there
Speaker 3: looking at them, going, this is the way it's always
Speaker 3: going to be? Isn't it beautiful? Didn't we make a
Speaker 3: fabulous decision here? There's been a lot of ups and downs,
Speaker 3: a lot of kinks in the road. I think you
Speaker 3: just need to lean into it and just go with
Speaker 3: it and don't have too many preconceived ideas about how
Speaker 3: good it's going to be. You had two sets of
Speaker 3: kids at different life stages, didn't you. So Yours were
Speaker 3: kind of teens at the time and his were twains
Speaker 3: and even littler.
Speaker 1: How old were his when you got together?
Speaker 3: So I think they were like ten, eight and five
Speaker 3: something like that.
Speaker 1: Yeah, So how do you like?
Speaker 2: They're two very different worlds that you're in. How do
Speaker 2: you kind of blend those two different life stages.
Speaker 1: Well, it's just.
Speaker 3: Busy because you've got to be running to so many
Speaker 3: different sports on a weekend, there are six sets of
Speaker 3: sports to be running to. Someone's got to get dragged along.
Speaker 3: You can't really do that together anyway. If there's I mean,
Speaker 3: they's just that he has such gorgeous girls. I'm just
Speaker 3: very lucky that, you know, none of them were terrible, dreadful,
Speaker 3: you know.
Speaker 2: Kids, so they were very easy to let, didn't hate you, no.
Speaker 3: And what we're really lucky is that they've got a mom,
Speaker 3: and so I was able to be that benevolent auntie.
Speaker 3: And I really love his daughters the way I love
Speaker 3: my nieces and nephews, because you know, I adore them.
Speaker 3: But somebody else has got all the responsibility. That's a
Speaker 3: lovely position to be in, and I'm very grateful for that.
Speaker 2: I grew up in a blended family too. My brother
Speaker 2: had a different father, so how One of the things
Speaker 2: that can be hard to manage is, as you say,
Speaker 2: you know, your first husband was in your kid's life,
Speaker 2: and Daniel's first partner was in his kid's life. So
Speaker 2: that's one to three different households that you've got people
Speaker 2: coming and going from, well, I did manage that.
Speaker 3: So my kids did not have a lot of contact
Speaker 3: with their dad, so they've never slept over at his place. Interestingly,
Speaker 3: now as they're all adults, they're all really close. It's
Speaker 3: an amazingly close relationship, and the fact that he was
Speaker 3: unable to sort of be there in their childhood has
Speaker 3: not really made any difference to the way their relationship
Speaker 3: is now, which I think is amazing and very good
Speaker 3: news for any dat out there who's really worried about
Speaker 3: not getting enough access to his children.
Speaker 1: It doesn't matter. It can all work out really really well.
Speaker 3: But at the time, there were only there was only
Speaker 3: one household for my children, and that was so easy.
Speaker 3: And I could watch what was happening to my stepdaughters
Speaker 3: having to negotiate two sets of rules to households, two
Speaker 3: sets of toothbrushes, two sets of school uniforms. That was
Speaker 3: really tough compared to my kids, who just had a
Speaker 3: bedroom in a place that they did homework. That was
Speaker 3: much easier for them, I have to say. And in
Speaker 3: a way, we've ended up in this really good space
Speaker 3: where the kids absolutely are very close to their stepdad
Speaker 3: very close to their dad, and I never had to
Speaker 3: negotiate one set of rules, so that was really easy.
Speaker 3: On the other hand, I think my stepdaughter's benefited from
Speaker 3: two homes and four effective parents, which is really, I
Speaker 3: guess a good thing too.
Speaker 2: When your first marriage broke down, your three kids were
Speaker 2: pretty young, and you weren't working full time at that time,
Speaker 2: and you weren't particularly financially independent, were you.
Speaker 3: I was clueless. There's just no other word for it.
Speaker 3: I mean, I spent money and I didn't even think
Speaker 3: about how the credit cards got paid. At the end
Speaker 3: of the month I worked. My husband said, work. If
Speaker 3: you want to work, don't work. If you don't want
Speaker 3: to work, it's completely up to you. So it was wonderful.
Speaker 1: You're a doctor, you're working as a GP.
Speaker 3: But like two mornings away, let's be honest, that's not
Speaker 3: really going to cut it for most women.
Speaker 1: Know, more like a hobby. Yeah, it was a hobby.
Speaker 1: It was lovely. I enjoyed it.
Speaker 3: And if I couldn't go to work because I had
Speaker 3: a friend's lunch on, I'd just bring my boss and
Speaker 3: say I can't do that day.
Speaker 1: It was fine.
Speaker 3: Wow, did that all change? And it was literally overnight.
Speaker 3: I had the full carriage of the finances for myself
Speaker 3: and my three children on my own, and so I
Speaker 3: had to learn pretty quickly, and I had to work
Speaker 3: out how to use Excel and a spreadsheet. So my
Speaker 3: best girlfriend, who's really really financially savvy and works in
Speaker 3: the finance industry, was like, so, what do you need
Speaker 3: to live? And I was like, I have no idea.
Speaker 3: So she was sitting there with me, going, well, how
Speaker 3: much does insurance cost? Do they need braces? You know, yes,
Speaker 3: that all three needed braces at the same time. Yeah,
Speaker 3: that's fine. So you just need to work out what
Speaker 3: it is that you need to live, what do you
Speaker 3: need to earn pre tag to be able to support that,
Speaker 3: And if you want to save for something like a holiday,
Speaker 3: how much more do you need to earn? And my
Speaker 3: first holiday was about five years after I got divorced,
Speaker 3: and I was so excited.
Speaker 1: I took all the kids to Bali.
Speaker 3: And it's still the most emotional holiday of my life
Speaker 3: because I did that for them.
Speaker 2: Often when it comes to this idea of women working
Speaker 2: after they've had kids, it boils down, or some people
Speaker 2: think it boils down to this issue of feminism, and
Speaker 2: you know you should try to get the corner office
Speaker 2: and you should brah rah rah, and I but it's
Speaker 2: my choice.
Speaker 1: I want to stay home.
Speaker 2: And I'm always like, it's not about It's about being
Speaker 2: able to look after yourself if something happens, if your
Speaker 2: partner leaves, if your marriage breaks down, if your partner dies,
Speaker 2: like you just don't know what's going to happen.
Speaker 1: And if you don't have.
Speaker 2: Any ability, any skills, any job history to fall back on,
Speaker 2: you are very vulnerable.
Speaker 3: And it's interesting because it has that experiences of having
Speaker 3: to pick up full time work, be financially savvy, balance
Speaker 3: the books at home from zero has really impacted on
Speaker 3: the way I relate to my daughter and to my
Speaker 3: three step daughters, and in the way they approach school
Speaker 3: and university. So just I'm so desperate for them to
Speaker 3: be financially have the wherewithal to be financially independent, and
Speaker 3: not to assume that their ticket to success and happiness
Speaker 3: is through a man.
Speaker 1: Is not a financial plan. God, that's great. Love that.
Speaker 2: So, skipping forward, I want to ask about your experience
Speaker 2: with perimenopause and then menopause. How did you know you
Speaker 2: were something was up. I mean, you're a doctor, so
Speaker 2: presumably you're fairly alert to changes in your own body.
Speaker 1: Yeah, so I guess.
Speaker 3: So I'm now fifty one, which is plum menopause age.
Speaker 3: And I don't think home anywhere close to menopause yet
Speaker 3: it doesn't look like I'm at this late stage of perimenopause.
Speaker 3: But the first thing was just not being able to sleep.
Speaker 3: And I guess you know, I just went, well, you know,
Speaker 3: I'm forty six. I guess you know I'm plum perimenopause age.
Speaker 3: I've always been an Olympic level sleeper. I can yeah,
Speaker 3: we say, yeah, like eight hours on a plane, no drama.
Speaker 3: I don't need to sleeping pill. I can sleep sitting up,
Speaker 3: standing up. Probably that has never been an issue. And
Speaker 3: all of a sudden, I'm not great at that whole
Speaker 3: sleeping thing anymore. And I remember my parents complaining about sleeping,
Speaker 3: and I'd been like, oh, come on, guys, you know
Speaker 3: how hard can it be?
Speaker 2: Just shut your eyes, go to bed so you can't
Speaker 2: get to sleep, or you wake up through the night.
Speaker 3: Both get back more than waking up. I mean you're
Speaker 3: often so exhausted, often by you know, eight o'clock when
Speaker 3: you want some scintillating conversation with your partner and all
Speaker 3: you can do is just one word, monosyllable come out that.
Speaker 1: Yeah, that word is Netflix.
Speaker 3: Netflix is like, that's all I want to do right now.
Speaker 3: We swore, we swore we would never have a TV
Speaker 3: in the bedroom. We just didn't want that sleep.
Speaker 1: Howd that go for you? It's so there now.
Speaker 3: Because I can't dog and you know, and I'm falling asleep,
Speaker 3: like literally three minutes into whatever's on. But you know,
Speaker 3: come eleven o'clock, I'm up, and that has I have
Speaker 3: not been a good sleeper now for five years.
Speaker 2: So I'm going to try to not treat this as
Speaker 2: a consultation with you as my doctor, but possibly I
Speaker 2: will because I am going to describe some of my
Speaker 2: symptoms to you, and you tell me if they seem perimenopausal.
Speaker 2: I'm angry a lot, yep, I'm weepy a lot, yep.
Speaker 2: My skin is itchy. Yes, I've got a marina and
Speaker 2: which I had to have because my periods suddenly became
Speaker 2: very heavy after never having heavy periods. But and that's
Speaker 2: been great for the last few years, and it was
Speaker 2: making me very iron efficient. But I'm now even getting
Speaker 2: breakthrough periods through my marina.
Speaker 1: What else.
Speaker 2: I've got a hair coming out of my chin off,
Speaker 2: only one in one, very persistent one.
Speaker 1: I call it Erica.
Speaker 2: And it just appears overnight and it's like the length
Speaker 2: of a dog lead, just overnight, and the night before
Speaker 2: it wasn't there.
Speaker 1: Is it gray yet? It's not gray?
Speaker 2: But yes, there's gray issues happening in all sorts of places,
Speaker 2: including even the odd gray eyebrow that was fun.
Speaker 1: I've got to pluck those out of it.
Speaker 2: I've got wind caused and pimples and I haven't had
Speaker 2: pimples for ages.
Speaker 1: Amazing speak to me.
Speaker 3: Okay, So menopause happens when your ovaries basically stop working
Speaker 3: all together. So that's you know, it's fairly obvious, and
Speaker 3: you stop having any periods whatsoever. But in the lead
Speaker 3: up to menopause, your ovaries don't do very well what
Speaker 3: they're designed to do, which is basically to produce egg
Speaker 3: of the months to go off and meet the sperm
Speaker 3: of its dreams.
Speaker 1: That bit doesn't work that well.
Speaker 3: So normally we don't even know why One egg gets
Speaker 3: selected and it basically goes off, it grows in a
Speaker 3: little bubble, and then when that bubble gets big enough
Speaker 3: it bursts. It goes into the fallopian tube to do
Speaker 3: what it does, and that bubble then becomes a progesterone
Speaker 3: producing factory. It is maze balls. So basically the way
Speaker 3: it does it is it takes your male hormone, your
Speaker 3: androgens and spits them out as progesterone. Now, progesterone is
Speaker 3: awesome because it calms you down, it's sort of quite relaxing,
Speaker 3: it helps you sleep, and it's also good because it
Speaker 3: gets rid of your male hormone. If that system is
Speaker 3: not very efficient, which it really isn't for quite a
Speaker 3: few years, you get a couple of things happening. Number one,
Speaker 3: not enough progesterone, so you're not a good sleeper anymore,
Speaker 3: and you can get really angry, and you can get
Speaker 3: really weepy and teary because you don't have any calming
Speaker 3: hormones in your body. And on top of that, you're
Speaker 3: getting a build up of androgens male hormones, so chin hairs, pimples,
Speaker 3: fantastic oily skin, but also you've got really dry and
Speaker 3: itches thin. At the same time, it's all happening on
Speaker 3: the one.
Speaker 1: Face itching myself now a happy days. Yes, I call
Speaker 1: it hormone hell. It's just the absolute worst.
Speaker 2: And you talk in the book about how it's kind
Speaker 2: of there's not much points. I keept saying I'm going
Speaker 2: to go to my GP and get my blood my
Speaker 2: hormones tested, but you kind of say that there's no
Speaker 2: point in doing that.
Speaker 1: And why is that?
Speaker 3: Because hour to hour they're different, minute to minute, they're
Speaker 3: different day to.
Speaker 1: Day they're doing That's how it feels inside. You can
Speaker 1: almost tell.
Speaker 3: You can almost tell when your estrogen is surging, and
Speaker 3: there's no balancing progesterone. You can tell when that's happening.
Speaker 3: And so there's no point in getting a blood test
Speaker 3: because it might be different in three hours time, So
Speaker 3: there's no I often get asked for hormone tests, which
Speaker 3: I think a code for I'm really weepy and really
Speaker 3: teary and I'm just yelling at the kids and I'm
Speaker 3: yelling at my husband, and help me, I listen to
Speaker 3: the help me cry in that rather than sort of
Speaker 3: going down the blood test route, which is often unhelpful.
Speaker 1: I mean, we do need to look at.
Speaker 3: Your thyroid and your land, particularly if we're going through
Speaker 3: what you and I. I've also got the marina in
Speaker 3: at the moment, I'm getting a new one, I think
Speaker 3: next week, but it's you know, I'm also getting periods
Speaker 3: despite the marina.
Speaker 1: I went to my gynecologist and my.
Speaker 3: Six week check up after my daughter twenty three years
Speaker 3: ago and said, can you put this in? I never
Speaker 3: ever want to have a period again, And I didn't
Speaker 3: until I turned forty six. And now I've got periods.
Speaker 3: And now I'm fifty one, and I'm going to need
Speaker 3: to get another one because we're still fertile despite all
Speaker 3: of this. If we actually are ovulating, and it is
Speaker 3: a bit sporadic, you can ovulate twice during perimenopause, so
Speaker 3: you can get twins. Yeah, and if you do go
Speaker 3: on hormone therapy, it's not enough to stop that. It
Speaker 3: won't be a good contraception.
Speaker 2: How long does perimenopause last?
Speaker 1: On average? About seven years?
Speaker 3: Oh?
Speaker 1: Cool? Yeah, great, isn't it fantastic?
Speaker 2: And I hear a lot about hot flashes. You know,
Speaker 2: that's kind of like the I'd never even heard of perimenopause.
Speaker 2: I'd heard of menopause, but I always said that was
Speaker 2: something for old ladies and then this pary thing seems
Speaker 2: to when does it sort of to kick in for
Speaker 2: is it all women or just some women?
Speaker 3: Most women or women will have a perimenopause period and
Speaker 3: it can be look one in four of us get
Speaker 3: heavy periods, but and the others don't. Not everybody gets
Speaker 3: more aggressive, not everybody gets less sleep, not everybody gets
Speaker 3: skin changes, but everybody gets something that's absolutely for sure.
Speaker 3: When does it start around sort of seven to eight
Speaker 3: years before you go through menopause, so that can be
Speaker 3: in your late thirties for some women that can definitely
Speaker 3: hap Is.
Speaker 2: It good to ask your mum how old she was?
Speaker 2: Is that an indicator of when it might happen to you?
Speaker 3: We don't have really good study data on that, but anecdotally,
Speaker 3: all the menopause experts that I speak to you say
Speaker 3: absolutely yes, yes, you can almost date it to when
Speaker 3: your mum had menopause, which is not good news for
Speaker 3: me because my mum was almost sixty.
Speaker 2: Treatments of also changed a lot. Like when my mum
Speaker 2: was my age. I guess her perimion apausal symptoms were
Speaker 2: incredibly heavy periods that were so debilitating and the answer
Speaker 2: back then thirty years ago its heystroctomies which brought you
Speaker 2: into sudden onset menopause. It's not treated like that anymore though, now,
Speaker 2: is it like what are if someone comes to you
Speaker 2: presenting with perimenopausal symptoms, will you try to treat the
Speaker 2: individual symptoms or is there like a pill?
Speaker 3: So it depends on what the symptoms are, So we
Speaker 3: would really break them down because at the end of
Speaker 3: the day, something like mental health issues, we need.
Speaker 1: To take those seriously, regardless of the cause.
Speaker 3: I mean, it doesn't matter if it's happened because you've
Speaker 3: lost your job or because you're in perimenopause. If you
Speaker 3: are not coping, that is potentially a fatal illness because
Speaker 3: you know, we still do see suicide amongst menopausal perimenopausal women.
Speaker 3: So we need to take it quite seriously, and we
Speaker 3: might need to treat that in its own little bubble,
Speaker 3: quite separately to the chin heads, which we do have
Speaker 3: treatment for that as well. Tweezers I like those, but
Speaker 3: you could also get electrolysis, and you could also get laser,
Speaker 3: and you can also get a cream that actually slows
Speaker 3: down hair growth on your chin. We can talk about
Speaker 3: that later, but we can also treat your acne. We
Speaker 3: wouldn't treat your acne differently to the way we would
Speaker 3: treat let's say, acne when you're twenty. Seriously, we've got
Speaker 3: all the same sort of creams and even tablets available
Speaker 3: to you that we would just use short term. But
Speaker 3: if you can get away with hormone treatment that will
Speaker 3: scoop up all of it into one little bucket, how
Speaker 3: good would that be? I can't promise you, but it
Speaker 3: has reasonably good evidence for it.
Speaker 2: Let's talk about HRT hormone replacement therapy. I, like most
Speaker 2: women of my age, my only knowledge and understanding of
Speaker 2: menopause really is through half listening to my mother and
Speaker 2: half thinking, you know, conversations or things that she might
Speaker 2: have said, or conversations that we've had. And you tend
Speaker 2: to be pretty uncurious about what your parents are going
Speaker 2: through in their lives, and it feels like it's a
Speaker 2: long way away and it will never.
Speaker 1: Be relevant to me.
Speaker 2: But I do have in my head that HRT causes
Speaker 2: bread cancer and that it's a terrible thing and that
Speaker 2: no one must ever have it. And in fact, I
Speaker 2: said to my mum the other day, are you an
Speaker 2: HRT or not? Because like should I be worried, and
Speaker 2: she said that she had a really good gynecologist who
Speaker 2: had calmed her down during the big HRT scare of
Speaker 2: a number of years ago. Can you just talk a
Speaker 2: little bit about HRT and whether it's evil or a
Speaker 2: great thing?
Speaker 3: So I think it's a great thing. Basically all of
Speaker 3: the drama happened in two thousand and two. So in
Speaker 3: the nineteen eighties and nineteen nineties HRT was amongst the
Speaker 3: highest selling medication in the world, and drug companies were
Speaker 3: cleaning up from HRT. And one of the things that
Speaker 3: it did, apart from relieving hot flushes, and they said,
Speaker 3: keep you more youthful and make you look fabulous and
Speaker 3: keep your vagina healthy, which is all fantastic, it also
Speaker 3: seemed to prevent chronic diseases, particularly osteoporosis with fracture, which
Speaker 3: can be fatal. That's actually quite a nasty one.
Speaker 2: Because your bones lose density around it peratidly.
Speaker 1: First year it starts happening and it really unwinds quite quickly,
Speaker 1: which makes you more prone to breaks.
Speaker 3: Yes, which is if you just fracture your wrist, that's inconvenient,
Speaker 3: but if you fracture your hip you know, a third
Speaker 3: of people will die within a year, so it's a
Speaker 3: really nasty fracture.
Speaker 1: We want to prevent that if we can.
Speaker 3: But it also prevented heart disease to the point where
Speaker 3: the American Heart Association indoorsed HRT as a preventor of
Speaker 3: heart disease for women. And so there was a massive
Speaker 3: study that was undertaken called the Women's Health Initiative Study,
Speaker 3: designed to look at exactly that did HRT taken regardless
Speaker 3: of menopause symptoms, reduce heart disease. And so they recruited
Speaker 3: one hundred and sixty thousand women for what we call
Speaker 3: a prospective trial, and it was randomized and place Ebo control.
Speaker 3: Now doctors just go gaga over these trials because we
Speaker 3: weren't looking backwards and going hey, did you have HRT
Speaker 3: or not, because sometimes that data is unreliable. This was
Speaker 3: looking forward, and we literally put women into two groups,
Speaker 3: those who took HRT and those who didn't, and we
Speaker 3: followed them up designed to see, hey, can we prevent
Speaker 3: heart disease even if we're not trying to get rid
Speaker 3: of your hot flushes. So the average age of women
Speaker 3: who were recruited into this troll was sixty three, well
Speaker 3: past the age where most women are even getting hot
Speaker 3: flushes anymore. In fact, twenty percent were over seventy, so
Speaker 3: we had a very old cohort, and in fact most
Speaker 3: of them were overweight, so they were already at risk
Speaker 3: of heart disease. And guess what, five years into it,
Speaker 3: we found that there was a small but significant increase
Speaker 3: in the women who took HRT having breast cancer. So
Speaker 3: for every ten thousand women who took a place Ebo,
Speaker 3: we would expect thirty breast cancers, but thirty eight in
Speaker 3: the group who took the HRT. The HRT that they
Speaker 3: were taking is in a form that is basically not
Speaker 3: used today. It was an oral form of HIT. We
Speaker 3: don't tend to use a lot of tablets these days.
Speaker 3: And it was also an old school formulation that again
Speaker 3: we just don't use anymore. But they needed to stop
Speaker 3: the troll early and that had huge media attention and
Speaker 3: the headlines read HRT causes cancer. If you looked at
Speaker 3: the subset of women who were taking it between the
Speaker 3: ages of fifty and fifty nine starting it, they actually
Speaker 3: had no higher risk of breast cancer whatsoever. And if
Speaker 3: you look at the fact that the group that were
Speaker 3: taking the HRT were much older, they were much fatter,
Speaker 3: they were at higher risk for breast cancer. Anyway, when
Speaker 3: you look at the fact that even in that trial,
Speaker 3: taking HRT increased your risk of cancer about the same
Speaker 3: as having a glass of wine a day, or being
Speaker 3: overweight or not doing exercise, and less than having all
Speaker 3: of those three together, which is not an uncommon combination
Speaker 3: for women our age. So that bit was not in
Speaker 3: the headlines. And all we know is that eighty percent
Speaker 3: of women who were at that stage taking HIT chucked
Speaker 3: it in the bin and stopped. There were three hundred
Speaker 3: and thirty million dollars worth of lawsuits against various drug companies.
Speaker 3: It set one of them bankrupt. The biggest maker of
Speaker 3: HIT at that stage went bankrupt.
Speaker 1: Well, it got sold for a very low price to
Speaker 1: another drug company.
Speaker 3: A lot of drug company said we're not going to
Speaker 3: invest in the women's health space around menopause anymore. It's
Speaker 3: just too risky and there's too many lawsuits, and doctors
Speaker 3: wouldn't prescribe it because doctors were sued too, and so
Speaker 3: doctor said, we're not prescribing this anymore. It's too dangerous.
Speaker 3: Governments came in and insisted that HRT has black box warnings,
Speaker 3: so like cigarette, exactly like cigarette, saying this can give
Speaker 3: you breast cancer. And despite the fact that subsequent analysis
Speaker 3: of this study has said, no, it doesn't really increase
Speaker 3: the risk of breast cancer at all if you take it,
Speaker 3: even in those old formulations which we don't use anymore,
Speaker 3: if you took it at when menopause just started for
Speaker 3: the relief of hot flushes, it doesn't increase the risk
Speaker 3: of breast cancer. We still have this fear that is
Speaker 3: pervasive today that I see daily in my practice that
Speaker 3: women if I say, you know, we could try HRT, you.
Speaker 2: See, I would go, oh, no, I won't do that.
Speaker 2: I'll try lighting a candle instead.
Speaker 1: Yes, let me you know, I'll meditate, I'll have some macupuncture. Yeah.
Speaker 1: Do any of those things work? Some of them might work.
Speaker 3: The problem is with any trial that the more statistical
Speaker 3: power we have, the more we go that definitely works.
Speaker 3: So a trial, an unrandomized trial of thirteen people for
Speaker 3: three weeks, is never going to get any power behind it.
Speaker 3: So we have lots of these little trials that show
Speaker 3: lots of benefit for lots of different complementary and alternative therapies,
Speaker 3: but doctors can't really go, yeah, that's great evidence. It's
Speaker 3: not evidence the way a one hundred and sixty thousand people,
Speaker 3: you know, prospective randomized plus EBO controlled trial is. And
Speaker 3: we're never going to get those big trials because who's
Speaker 3: going to pay for them. I mean it's drug companies
Speaker 3: that will pay for that sort of stuff.
Speaker 2: On the whole, you talked about how in your book
Speaker 2: that because of what happened in two thousand and two,
Speaker 2: there's a whole generation of doctors who don't know anything
Speaker 2: about prescribing HRT because what I didn't realize is that
Speaker 2: it's not just a one pill. It's like a quite bespoke,
Speaker 2: isn't it, depending on what your symptoms are and what
Speaker 2: you're trying to cure.
Speaker 1: I think that's absolutely right.
Speaker 3: And a lot of the newer, more popular formulations amongst
Speaker 3: people who like prescribing for menopause have come on to
Speaker 3: the market since the WHI the Women's Health Initiative study
Speaker 3: back in two thousand and.
Speaker 1: Two has stopped.
Speaker 3: And therefore the doctors who said I'm not prescribing that
Speaker 3: never got familiar with these newer forms things like micronized
Speaker 3: progesterone or estrogen gels that you put on your skin.
Speaker 3: Those doctors never found out about it, and they're too
Speaker 3: scared to prescribe it anyway. But they really don't prescribe
Speaker 3: it very well if they will prescribe it, and so
Speaker 3: a lot of women will say, oh, I tried HIT
Speaker 3: and it didn't work for me, And in fact, they
Speaker 3: just didn't get the right formulation for them.
Speaker 2: You've mentioned hot flushes a couple of times. That's kind
Speaker 2: of the most commonly understood and recognized symptom of menopause.
Speaker 2: Can you explain what a hot flush is physiologically and
Speaker 2: the so, what does it feel like?
Speaker 1: Like? Do you have? Have you had them? I think so,
Speaker 1: but I'm not sure.
Speaker 3: I know that I'm very hot at night now and
Speaker 3: I drive my husband crazy, but it's never been a flush.
Speaker 3: So I think women do experience them differently. So some
Speaker 3: women go from zero to like fifty degrees break out.
Speaker 3: You've seen them, you know, they go bright red, they
Speaker 3: start sweating, they start fanning themselves. A lot of them
Speaker 3: just quickly stripping off their clothing and it's quite dramatic.
Speaker 3: There are other women who just run hot and they
Speaker 3: drive everybody mad at work because they want, you know,
Speaker 3: the temperature of the air conditioning sort of set to
Speaker 3: thirteen degrees and everybody else is in a ski parker
Speaker 3: and they're just sitting there going, oh goodness, it's just so.
Speaker 1: Hot in here.
Speaker 3: And there are some women who run hot at night,
Speaker 3: and it is different for everybody, and we still don't
Speaker 3: really understand the physiology of it.
Speaker 1: Does every woman get them?
Speaker 2: No?
Speaker 3: No, no, So seventy five percent of women will get
Speaker 3: hot flushes and it's.
Speaker 1: Still a lot.
Speaker 2: Well, it's I think it's seventy five percent is a lot. Yeah,
Speaker 2: and I thought you were going to say, oh, you know,
Speaker 2: only twenty percent.
Speaker 1: No, it's a lot most of us.
Speaker 3: Yeah, yeah, And a third of those men will find
Speaker 3: them unbearable. So that in my back of the envelope,
Speaker 3: MASK says that one in five women will hit menopause
Speaker 3: with unbearable hot flushes. That is a big group of us,
Speaker 3: a big group of our girlfriends that it's happening to.
Speaker 1: What are the treatments for hot flushes?
Speaker 3: Well, you could do some really simple lifestyle stuff like
Speaker 3: you know, carry a fan and dress in layers so
Speaker 3: that if it happens. You can get undressed really quickly
Speaker 3: and have cold water on your desk and always have
Speaker 3: you know, ice with you, and that's really helpful. It
Speaker 3: is definitely helpful. We know that women who smoke have
Speaker 3: worse hot flushes. We know that women who are overweight
Speaker 3: have worse hot flushes. So if your doctor tells you
Speaker 3: to lose weight, it's not entirely being patronizing. However, that
Speaker 3: will at best manage it, and it's probably less likely
Speaker 3: to take them from unbearable to bearable.
Speaker 1: It's probably just.
Speaker 3: Going to make the unbearable moments maybe from ten to
Speaker 3: nine and a half. I don't call that a treatment.
Speaker 3: I call that kind of okay. It's not bad advice.
Speaker 1: If you want to get rid of them.
Speaker 3: The one that has ninety six percent efficacy is hormone
Speaker 3: replacement therapy. So here we are back in this catch
Speaker 3: twenty two where there is a treatment that's available. It's
Speaker 3: incredibly effective, and yet it's very hard to access for
Speaker 3: most women.
Speaker 1: But why is HRT hard to access? It's not an
Speaker 1: illegal drug, no, but it's expensive.
Speaker 3: A lot of it is not funded through the Pharmaceutical
Speaker 3: Benefit Scheme, so a lot of it is super expensive,
Speaker 3: particularly the better newer forms of HRT like how expensive,
Speaker 3: Oh like it could be like seventy bucks a month,
Speaker 3: which is very expensive. Plus you still find it difficult
Speaker 3: to find doctors who go absolutely, let me get my
Speaker 3: scriptpad out.
Speaker 1: I know what I'm doing.
Speaker 3: My recommendation is we start with this and this, and
Speaker 3: I'll see you again another month and we'll kind of
Speaker 3: go from there. I mean, when it comes to testosterone
Speaker 3: for women, which is endorsed by the International Menopause Society
Speaker 3: for low libido in particular women, and it really can
Speaker 3: be quite amazing.
Speaker 1: Try and find doctors to prestis that for you? That
Speaker 1: is really really difficult.
Speaker 3: But I think times are changing as more doctors are women,
Speaker 3: and as more women doctors are reaching my age, so
Speaker 3: those of us in our fifties all of a sudden
Speaker 3: super super interested in this.
Speaker 1: Oh yeah yeah.
Speaker 3: And so weirdly enough, the ranks of the Australian Menopause
Speaker 3: Society are starting to swell. It has been slow, but
Speaker 3: we're getting there.
Speaker 2: What should you do if your symptoms are unbearable?
Speaker 1: Should you? I rang?
Speaker 2: I mean most GP practices now there's a bunch of
Speaker 2: people and you have to be comfortable with whoever you see.
Speaker 2: And I rang and said, is there anyone who specializes?
Speaker 1: Is that what you should do? You can, but there
Speaker 1: are so few.
Speaker 3: YEA, Since I wrote this book because I'm a member
Speaker 3: of the Australian Menopause Society, so I just thought, you know,
Speaker 3: you'd go and find your local Australian Menopause Society doctor
Speaker 3: and you'd go to them because we all really really
Speaker 3: interested in it, except for there's not a lot of us,
Speaker 3: and for example, there's nobody in the Northern Territory at all.
Speaker 3: So I've had lots of women reach out from the
Speaker 3: NT going well, okay, that's great advice, but there is
Speaker 3: no one in the entire territory.
Speaker 2: That is an expert in understanding HIT and the different
Speaker 2: you know, treatments and therapies.
Speaker 3: The number of doctors in New South Wales alone, which
Speaker 3: is my state, is really small, and there might be
Speaker 3: like there's one in Orange and there's one in Newcastle
Speaker 3: that there's just not a lot of us around.
Speaker 1: So then I guess you're going to need to go to.
Speaker 3: Hopefully your doctor can help you. But I think this
Speaker 3: is one of the reasons I wrote this book is
Speaker 3: because it is so hard to go to your doctor,
Speaker 3: and if your doctor says I'm not prescribing you this
Speaker 3: for you it's dangerous, or gives you a formulation that
Speaker 3: is I mean, I've heard of patients who've been for
Speaker 3: ten years on formulations I don't think are great. You know,
Speaker 3: they are not as safe as some of the other
Speaker 3: formulations we have today, or they might give you something
Speaker 3: that you know, because the guidelines were back then, start
Speaker 3: as lower dose as possible. I can tell you that
Speaker 3: if the lowest dose possible fixes your hot flush, as
Speaker 3: you probably didn't need it in the first place. It's
Speaker 3: one of those things where you need to need to
Speaker 3: give it a reasonable dose, so there's just kind of
Speaker 3: no point in taking it.
Speaker 1: So but if there are doctors who say, I.
Speaker 3: Won't give you anything more than the absolute lowest dose
Speaker 3: of ATEN, and it's not going to do that much
Speaker 3: for you. So one of my concerns is it's very
Speaker 3: hard to access good treatment and it's almost the only area.
Speaker 3: I mean, I would say gps in this country are
Speaker 3: excellent and practically everything. If you've got asthma, heart disease,
Speaker 3: a gastrobug, if you've even if you've got depression, if
Speaker 3: you've got acne. Doctors are all over this and they're
Speaker 3: really good treatment algorithms out there, but when it comes
Speaker 3: to treating the symptoms of menopause, it can be really,
Speaker 3: really tough.
Speaker 1: There's been a.
Speaker 2: Lot of sort of pop culture references to the Karen, Yes,
Speaker 2: the Karen true Karen, the Karen with the asymmetrical blonde haircut,
Speaker 2: who is always wanting to complain to the manager.
Speaker 1: Is Karen just hairy aphosal?
Speaker 3: I reckon, Karen could absolutely be in plum perimenopause and
Speaker 3: you just feel like going.
Speaker 1: You could go to the soccer coach, or you could
Speaker 1: go to the doctor and get some HRT, you know,
Speaker 1: go and complain to the teachers.
Speaker 2: Like because I feel very Karen at the moment. It
Speaker 2: feels like a bit like when I used to get
Speaker 2: PMT when I was younger, where it's like you're you
Speaker 2: just have no tolerance for anything, and so all the
Speaker 2: kind of the buffer that's usually between you and the
Speaker 2: world that's like, I'll let that slide, I'll let that slide.
Speaker 2: It suddenly feels in my life that I can't let
Speaker 2: anything slide in any area of my life, whether it's
Speaker 2: a conversation with my husband, or you know the coffee
Speaker 2: that I got served that's not right. Yeah, Is that
Speaker 2: symptomatic of perimenopause or have I just run out of
Speaker 2: shits to give?
Speaker 3: No, no, no, that's I mean, probably a combination of both,
Speaker 3: but it is definitely, I mean, that is almost you're
Speaker 3: describing the classic perimenopause kind of symptoms. And this is
Speaker 3: often happening to him, like you had PMS when you
Speaker 3: were younger, But this is often happening to women who
Speaker 3: have never had any mental health stuff go on in
Speaker 3: their life ever. And I've had patients come to me
Speaker 3: like who are losing it from anxiety and depression and
Speaker 3: just fighting with every It had been big bus stops
Speaker 3: at work, like was always the easy going one and
Speaker 3: then just like yelling her people at work, and then
Speaker 3: when you go into it, like that's what's really worrying them.
Speaker 3: They're coming to me thinking, oh, I need a bit
Speaker 3: of an antidepressant, which they might it's possible, but also
Speaker 3: at the same time, they've got aches and pains, and
Speaker 3: they've got sore legs, and they've got sore back, and
Speaker 3: then they're just not sleeping very well and they're getting
Speaker 3: some hot flushes and then they're just not wanting sex
Speaker 3: anymore at all. Like sex is just like, oh, please
Speaker 3: go away with your hot body, get.
Speaker 1: Away from me.
Speaker 3: And when you put all those things together, often the
Speaker 3: HRT will get rid of all the moon swings as well.
Speaker 3: So it's I can't promise, but in my experience as
Speaker 3: a doctor, it's a pretty good place to start because
Speaker 3: it wraps up.
Speaker 1: So much of the symptoms that you're having.
Speaker 2: Can we talk about sex and vaginas?
Speaker 1: Yes?
Speaker 2: Please please tell me what impact perimenopause has on your
Speaker 2: vagina enormous?
Speaker 3: So what powers the vaginal cells to there like a
Speaker 3: self cleaning oven. They are just amazing little cells, so
Speaker 3: they keep their cells are quite plump. They have a
Speaker 3: nice buffer between you know, the penis that's coming into it,
Speaker 3: or possibly the finger or the tampon, and you know
Speaker 3: the rest of the tissues deep inside the pelvis. They
Speaker 3: make a lot of lubricating fluid, They make yourself cleaning fluid,
Speaker 3: and that all just goes to hell basically when there's
Speaker 3: not enough estrogen going on. So in the second half
Speaker 3: of perimenopause, you don't only lose your progesterone, you start
Speaker 3: losing your estrogen as well, and that really has lots
Speaker 3: of women disproportionate effects on the vagina. So instead of
Speaker 3: sex being enjoyable, it really does feel like a sandpaper
Speaker 3: cupvered baton is being rammed into your vagina. It's not
Speaker 3: fun and sex and that doesn't do great things for
Speaker 3: your libido if it's uncomfortable, but then.
Speaker 2: Sign me up for that, please, Yes, more sound paper, Yes,
Speaker 2: love that.
Speaker 3: And then also it affects your bladder, so like you
Speaker 3: feel like you're needing to pee in the middle of
Speaker 3: the night all the time.
Speaker 2: Yes, I need to get up. I never used to
Speaker 2: get up to go to the bathroom in the middle
Speaker 2: of the night. What's that about.
Speaker 3: Yeah, So that is all to do with a combination
Speaker 3: of getting older and the tissues of the vagina and
Speaker 3: the urethra that comes out at the vulver. So the
Speaker 3: urethra is the little tube that takes wheed from the
Speaker 3: bladder into the vulver at the front, just in front
Speaker 3: of your actual vagina, And when those tissues start getting
Speaker 3: weaker and thinner, then your bladder just becomes a lot
Speaker 3: less able to sort of hold your WII and it
Speaker 3: just discharges and that's the other thing. The key in
Speaker 3: the door, you know where you just basically if you
Speaker 3: don't weigh right this second, you're going to wet yourself.
Speaker 3: That's another feature that happens. More urine retract infections. Like
Speaker 3: you feel like you're back to you know, when you're
Speaker 3: swinging from the chandeliers when you first started having sex.
Speaker 1: You're getting more.
Speaker 3: Urine infections all the time. You're like, come on, I'm
Speaker 3: not even having sex that often. What's going on with that?
Speaker 3: And all of that stuff? Like, you know, doing a
Speaker 3: gym class is just going to be very hot, very sweaty,
Speaker 3: and very similli in your underpants as well. So a
Speaker 3: lot of women stop doing as much exercise. It's just
Speaker 3: too hard and that doesn't help their mental health. So
Speaker 3: you just get this kind of big circular spiral of yuck.
Speaker 2: That makes so much sense because I was saying to
Speaker 2: someone the other day this thing happens seems to happen
Speaker 2: as you get older, where it's like your eyes you
Speaker 2: need to go to the toilet, and your eyes see
Speaker 2: the toilet and then your body just goes, oh, we're
Speaker 2: going to the toilet.
Speaker 1: And now I was like, no, not yet, can I
Speaker 1: just pull my pants down for sin, sit down. Your
Speaker 1: timing is off, give you a second. It's just totally
Speaker 1: what happens.
Speaker 3: And then you know that's your what we call the
Speaker 3: urging continents. And then stressing continence is when you jump
Speaker 3: up and down at an aerobic space, which is just
Speaker 3: not joyabul anymore. It's just potentially very embarrassing, where dark
Speaker 3: gym pants is my advice, but you know that kind
Speaker 3: of stuff happens as well, and then you've often got
Speaker 3: a combination of the.
Speaker 1: Two, which is just awesome.
Speaker 2: I watched an interview that you did on Sunrise with
Speaker 2: Koshi and Sam, and it was to talk about your book.
Speaker 2: And in the introduction, Sam, who is younger than us,
Speaker 2: she's I think maybe forty or in early forties, and
Speaker 2: she said, oh, we're going to be talking about menopause,
Speaker 2: you know, hang on to your hats Koshi, as if
Speaker 2: like Koshi was going to hate this, and then it
Speaker 2: was actually Koshi who was like leaning in and saying
Speaker 2: this is really bad and this is really hard.
Speaker 1: And can we talk about this?
Speaker 2: And I thought, ah, so interesting, Like you would expect
Speaker 2: the woman to be more sympathetic, but I can also
Speaker 2: relate to Sam, it's like, oh, menopause or crazy women
Speaker 2: stuff when you're not up to that stage yet. But
Speaker 2: Koshi's I've obviously been through it with his wife, and
Speaker 2: I thought that was really interesting his insight, because it
Speaker 2: really can impact on marriages and relationships.
Speaker 1: Come on so much.
Speaker 3: I mean, for a start, a lot of women don't
Speaker 3: want to have sex anymore, so that's a big thing.
Speaker 3: Number Two, if the woman's cranky and just yelling at
Speaker 3: him all the time and he doesn't know what he's done,
Speaker 3: and he personally because we all do see everything through
Speaker 3: our own lens instead of from the other person's lens,
Speaker 3: and then you know, sleep is interrupted because the doners on,
Speaker 3: the doners off, the doners on, the doners off. She
Speaker 3: wants the air conditioning on to twelve degrees and he's like,
Speaker 3: I need five sets of pajamas. It does impact on
Speaker 3: partners a lot, and they're expected just to shut up,
Speaker 3: and the women are expected to just shut up. And
Speaker 3: I don't think we I mean, I think there can
Speaker 3: be this stereotype of feminism that we've got to be
Speaker 3: allowed to bring all of our complaints out into the open,
Speaker 3: and everybody's got to be clucking around us and going, oh,
Speaker 3: you poor thing. I've never been somebody to wallow in
Speaker 3: self pity. We've got great treatment. But instead of taking
Speaker 3: treatment off the table and shaming women from seeking treatment,
Speaker 3: we've got to say you have a right to access
Speaker 3: every treatment that there is out there in an evidence
Speaker 3: based way, and not to be harmed with fear that
Speaker 3: is unnecessary that takes treatment off the table, which implies
Speaker 3: that you should just suck it up.
Speaker 1: Princess.
Speaker 2: Do you think a lot of marriages and relationships break
Speaker 2: down because women think that that's what's making them angry
Speaker 2: and weep?
Speaker 1: I wonder.
Speaker 2: I mean, that's a really interesting how you'd study, but
Speaker 2: like there's a real sense of midlife crisis about it,
Speaker 2: because just nothing in your life sort of seems right.
Speaker 2: And you mentioned also anxiety, depression. Just list some of
Speaker 2: the real off some of the symptoms of perimenopause and menopause.
Speaker 3: So we've already talked about the vagina, we've talked about
Speaker 3: the hot flushes, we've talked about the mental health stuff,
Speaker 3: but we haven't talked about the itching, the bloating, the
Speaker 3: weight gain, the aches and pains, which in some studies
Speaker 3: are actually more common symptoms than hot flushes, and that's
Speaker 3: particularly true of women who are Asian ethnically Asian, so
Speaker 3: they have a lot of back pain, leg pain, shoulder
Speaker 3: pains that often will get a lot better from HIT,
Speaker 3: which is really interesting. But I also have a lot
Speaker 3: of patients who come in to get relief from their
Speaker 3: hot flushes and then go, you know what, Actually, I
Speaker 3: had all this back pain before, and I don't have
Speaker 3: that anymore. That's really an interesting one. But you sort
Speaker 3: of wonder if a bloke is feeling like he can't
Speaker 3: do anything right, that his wife just yells at him
Speaker 3: all the time that she doesn't want sex with him
Speaker 3: absolutely ever, and then some other girl starts making eyes
Speaker 3: at him and making him feel like a really hot stallion,
Speaker 3: and that everything he says is hilariously funny and incredibly interesting.
Speaker 1: Is it any wonder.
Speaker 3: That there are quite a lot of affairs that happen
Speaker 3: with husbands at this age and they go for younger
Speaker 3: women who are not going through the same stage of life,
Speaker 3: And what a I mean, I think that's an issue
Speaker 3: in the relationship. I'm not sort of condoning that whatsoever,
Speaker 3: but it does make it a little bit more understandable
Speaker 3: if no one's talking about it.
Speaker 2: And getting context, because he's like, well, clearly she doesn't
Speaker 2: love me anymore.
Speaker 1: She's just shouting at me or crying.
Speaker 3: Yeah, and rejecting me and thinking that I'm horrible and
Speaker 3: ugly and terrible in bed and these other chick things
Speaker 3: that I'm awesome. I kind of I do understand. I
Speaker 3: think it's a shame because it's so avoidable, because there
Speaker 3: are such great treatments that we have for all of
Speaker 3: these stages, if only we would talk about it and
Speaker 3: get doctors more on board with it.
Speaker 2: I just want to end by asking you about self
Speaker 2: esteem around this time, because it's a time when we
Speaker 2: start to become invisible and a time when we're literally
Speaker 2: our body is saying you're not of use anymore. You
Speaker 2: can no longer make a baby, you know, and that
Speaker 2: can be quite confronting, Like once upon a time, women
Speaker 2: were only here to make babies and continue the species,
Speaker 2: and once we couldn't do that anymore, we tend to just.
Speaker 1: Die yeap because we were of no use.
Speaker 2: And even though, of course there are many many different
Speaker 2: ways to be a woman and a value and lots
Speaker 2: of different choices to be made, whether you have children
Speaker 2: or not, there's something about that part of your life
Speaker 2: being over, even if you decided to stop having children
Speaker 2: or ever have children many years previously. Yeah, that can
Speaker 2: be quite a confronting time, kn't it. Yeah, left rounds
Speaker 2: as women.
Speaker 3: And you just accept that no bloke in the street
Speaker 3: is going to stare at you and think you're, oh,
Speaker 3: she's hot, because there's like so many other much better
Speaker 3: looking girls out there.
Speaker 2: I thought that cat calling was no longer a thing
Speaker 2: in the street, and then I was walking along with
Speaker 2: a younger friend and a guy like, and I'm like,
Speaker 2: I didn't think that happened anymore, And then I went, oh,
Speaker 2: just doesn't happen to me, so because it's a weird
Speaker 2: thing because I don't like being cat called, But when
Speaker 2: it's not there, you're kind of like, right, I'm invisible now.
Speaker 3: Yeah, And that's crazy because you look twenty two. But
Speaker 3: I think that you know, it's menopauses where ageism and
Speaker 3: you know, misogyny kind of come together and in a
Speaker 3: hybrid that's really dreadful. And yet if you look at
Speaker 3: the purchasing power of the perimenopausal and menopausal woman, she
Speaker 3: spends more at Bunnings, she spends more at Toyota, she
Speaker 3: spends more at Woolords and at Priceline pharmacy, and.
Speaker 1: It's Sephora and Mecha. Correct. So I'm spending all my
Speaker 1: money because they Because.
Speaker 3: We finally actually have a bit of money which we
Speaker 3: didn't have before. We've got our kids out of the
Speaker 3: house often which is much cheaper.
Speaker 1: We actually have got some We've risen up the ranks
Speaker 1: in our jobs.
Speaker 3: Unlike our poor mums who encourage not to have a career,
Speaker 3: we have been able to have careers, and we're actually
Speaker 3: earning much better than we did in our twenties and thirties.
Speaker 3: We've often paid off the house at this stage, where
Speaker 3: our mortgages are quite negligible.
Speaker 1: At this stage. So it's actually a really good time.
Speaker 3: And certainly the big businesses out there, the consumer businesses,
Speaker 3: they know they want us and so they make us
Speaker 3: invisible at their peril. We actually are a really big force,
Speaker 3: and I think we've got to now. We want to
Speaker 3: have sex. We possibly we're quite happy to write off
Speaker 3: our sex lives at age fifty. You know, twenty years ago,
Speaker 3: we're not anymore. We want to look good now. We
Speaker 3: didn't really care before, we do want to now, and
Speaker 3: we're going to live close to half our lives on
Speaker 3: this side of menopause. So actually, we need to get
Speaker 3: this right. We need to get it right for every woman.
Speaker 3: And at least if we don't say that every woman
Speaker 3: should have HIT, and I certainly don't think every woman
Speaker 3: should have HI, but I think every woman should have
Speaker 3: access to the best treatments for her, regardless of what
Speaker 3: they are.
Speaker 2: I'm so glad we're going to end on that note,
Speaker 2: because if there's younger women listening to this thinking, oh,
Speaker 2: that sounds like a massive bummer. Like, I've never been
Speaker 2: happier than I am at forty eight. I've never been
Speaker 2: more self confident. I've never been more sure of who
Speaker 2: I am. I've never been less willing to take shit.
Speaker 2: I've never needed approval less than I do. Now I
Speaker 2: know who I am all of those things. I feel
Speaker 2: less guilty than I used to and more capable than
Speaker 2: I used to.
Speaker 1: So it's not all bad news, it's mostly good news.
Speaker 3: Yeah, why get make this period of your life terrible
Speaker 3: when it could be unbelievable.
Speaker 1: As you say, the best ever stage of your life.
Speaker 1: So let's talk about it.
Speaker 3: Let's get it out in the open, and let's get
Speaker 3: access to treatment.
Speaker 2: And let's start by reading the M word How to
Speaker 2: Thrive in Menopause, Doctor Ginny Mansberg, Thank you.
Speaker 1: This is bloody brilliant.
Speaker 2: And there's a chapter at the end which I love,
Speaker 2: which is for your partners, which I'm going to give
Speaker 2: my partner to look at as well. And if you think, oh,
Speaker 2: I'm not at menopause yet, well anytime from your late thirties.
Speaker 2: The thing with women is that we always want to
Speaker 2: know about the stage that's coming up in our life.
Speaker 2: So you know, if you're in anywhere from your late
Speaker 2: thirties or even your mid thirties, and you want a
Speaker 2: bit of a sneak peek as to what your forties
Speaker 2: might bring, just so that you can be alert to
Speaker 2: what those symptoms are and not just go God, it's
Speaker 2: weird that I'm itchy.
Speaker 1: All the time.
Speaker 2: I mean, until I read this book, I was like, God,
Speaker 2: I'm just itchy.
Speaker 1: What's wrong with me? I had no idea. I know
Speaker 1: that itch is a thing. Genny, thanks so much. Thanks Maa. Well,
Speaker 1: that was enlightening. Do you feel a little less scared?
Speaker 2: I do. Ginny Mansberg's book is called the M Word.
Speaker 2: I've been texting her a few times because there are
Speaker 2: things like itchy skin that I never knew were part
Speaker 2: of perimenopause. Ginny is also a host of Medicine or Myth,
Speaker 2: which you can find on SBS on Demand, and she's
Speaker 2: the host of Embarrassing Bodies Down On. But she's also
Speaker 2: a passionate anti aging skincare geek, and her skincare company
Speaker 2: is called eskcare dot Com.
Speaker 1: I'm Meya Friedman.
Speaker 2: This show was produced by Melanie Tate and I'll see
Speaker 2: you next week. That was doctor Ginny Mansburg on No Filter.
Speaker 2: Did you love it? I loved it. If you like
Speaker 2: that kind of vibe, go follow No Filter. It's hosted
Speaker 2: by Kate Langbrook now and god, she does a cracking job.
Speaker 2: I get to be a listener now. I don't have
Speaker 2: to do any of the work. I can just enjoy
Speaker 2: it as part of the audience. But if you love Ginny,
Speaker 2: Cath Sally, Mary Grace and Brunner as much as I do,
Speaker 2: as much as so many thousands of women do the
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