Speaker 1: Hi, I'm Louise Aria, and welcome to season six of
Speaker 1: our New Zealand here on podcasts The Little Things.
Speaker 2: And I'm Francesca Rudkin. Good to have you with us.
Speaker 2: You might have noticed that we're releasing podcasts every two
Speaker 2: weeks this year. They're available at the same time on
Speaker 2: Saturday mornings throughout the year.
Speaker 1: And you will probably know by now. In this podcast,
Speaker 1: we talk to experts and we find out all the
Speaker 1: little things you need to know to improve different areas
Speaker 1: of your life. We can't throw all the confusion and
Speaker 1: the overload of information out there just to bring news
Speaker 1: to simplify your life.
Speaker 2: So good to have you with us now. In season four,
Speaker 2: we spoke to Ultra Troial marathon runner and trainer Kathy
Speaker 2: Duffy about not letting middle age stop us from setting goals.
Speaker 2: And Luise, you took that episode to heart. You decided
Speaker 2: to enter a trail marathon. Would you have just completed? Congratulations?
Speaker 1: Wow, he's completed is the right word for it. I
Speaker 1: don't blow anyone away. I did it. I did finish it.
Speaker 1: You know that was interesting.
Speaker 2: Was it what you thought it would be like?
Speaker 1: Yes, yes, it actually was. It was pretty much exactly
Speaker 1: as I thought it would be. Look, it was so
Speaker 1: much fun and I at the time I was saying
Speaker 1: never again, and but a few days later it's like,
Speaker 1: I want another crack at that. So yeah, like you
Speaker 1: and I we did the two we are in twenty fifteen,
Speaker 1: so that's even gosh, well, it's not was the end
Speaker 1: of twenty fifteen, wasn't it. And we've done plenty of
Speaker 1: other challenges, either together or a part in the interim.
Speaker 1: But I could not I guess that was the fundamental thing.
Speaker 1: I couldn't believe how much more the training took out
Speaker 1: of me as a decade later, and how much slower
Speaker 1: I am, and you would think less precious. Maybe the
Speaker 1: kids are older, I'm not running around as much.
Speaker 3: I don't know.
Speaker 1: It was the whole exercise of preparing and executing was
Speaker 1: was just harder. And maybe also because I was doing alone,
Speaker 1: not with your Francisca.
Speaker 2: Ah. I don't know if that would have made a difference,
Speaker 2: but it is. You do get a little bit of
Speaker 2: a fright. I noticed that suddenly I wasn't running as
Speaker 2: fast as I had been, or couldn't get to the
Speaker 2: top of a mountain or a hill as fast as
Speaker 2: I could a couple of years ago, and I was
Speaker 2: a bit taken back by that, and I just thought, oh,
Speaker 2: I'm just not as fit as I used to be,
Speaker 2: but you trained pretty hard.
Speaker 3: Yeah.
Speaker 1: I think there are differentely things. Having done this this time,
Speaker 1: almost like a newbie, there are things I would do differently,
Speaker 1: like really protecting myself in my space and my energy,
Speaker 1: not trying to just do to roll on in normal
Speaker 1: life and do that. I don't know how I would
Speaker 1: achieve that, but I'm sure there's something I found that
Speaker 1: I could either do strength work or speed work or
Speaker 1: endurance work.
Speaker 2: I just could not.
Speaker 1: Put the three, Oh that's interesting together in a week
Speaker 1: without feeling completely wiped out.
Speaker 2: Yeah.
Speaker 1: Yeah, So, I mean, you know, we're probably going to
Speaker 1: talk about that a little bit today as well. And
Speaker 1: one of the other things I noticed is that is
Speaker 1: that there weren't a lot of people who look like
Speaker 1: me in this event. I mean, I know it is
Speaker 1: one of those, you know, sort of elite events in Australia,
Speaker 1: but there were a lot of young athletes, but there
Speaker 1: just weren't a lot of women my age. And then
Speaker 1: when I so I did being researcher, I did a
Speaker 1: little bit of a look on the stats, and I
Speaker 1: saw that there were like eighty forty to forty nine
Speaker 1: year old orready four women who were forty to forty
Speaker 1: nine and only thirty nine who were fifty to fifty nine.
Speaker 1: Now that's half. You know, like we all know, there
Speaker 1: are hundreds of reasons you might not continue to do
Speaker 1: this stuff. But this is exactly what we were talking
Speaker 1: to Cathy about. Well, wasn't it. Why do we drop
Speaker 1: off in middle age?
Speaker 2: So on knees pack up?
Speaker 1: Well, there are a niece definitely came to mind.
Speaker 2: Well, I'm very proud of you because I can remember
Speaker 2: when you had completed your cancer treatment. You said to
Speaker 2: me your breast cancer treatment. You said, I don't ever
Speaker 2: think I'm going to be out in the bush running
Speaker 2: long distances ever again. And it's just a little reminder,
Speaker 2: never say never, no no.
Speaker 1: Siftly been in a different kind of summer. I was
Speaker 1: out in the Bosha Uni esterday, not running, just hanging
Speaker 1: out with my family and said, you know, I've been
Speaker 1: in this bush all summer. You've never even been to
Speaker 1: the beach. So yeah, that's the other thing. Maybe I
Speaker 1: do an event like in November and training through the
Speaker 1: winter and have my whole summer off. Anyway, live and learn,
Speaker 1: Francis Scarez, you know I need to learn from my
Speaker 1: own lived experience. Well, congratulations, thanks and thank you for
Speaker 1: all your support as well.
Speaker 2: That's all right. It's very easy to support from the sidelines,
Speaker 2: isn't it. Today on the podcast, we're delighted to have
Speaker 2: friend of the podcast speaker, author and menopause expert Nicki
Speaker 2: Beizant back with us. Nikki is the author of two books,
Speaker 2: This Changes Everything and The Everything Guide, both must have
Speaker 2: books for those heading into or in their midlife years.
Speaker 2: Nikki is also dedicated to helping women and workplaces navigate
Speaker 2: to the menopause journey and healthy aging.
Speaker 1: She Nicki really is an ally to the midlife woman,
Speaker 1: and she's just co authored the non medical section of
Speaker 1: the International Menopause Society's New Guidelines in Women's Midlife Health
Speaker 1: and Menopause Report, which is incredible, and she's here with
Speaker 1: us now to cover off some of the highlights and
Speaker 1: the key updates from the report. We're so lucky, Hei, Niki.
Speaker 2: Hi, thank you for coming in. I very much appreciate it.
Speaker 3: It's great to be here with you guys. Again.
Speaker 2: Firstly, can you just tell us a little bit about
Speaker 2: the International Menopause Society and the aim of this review
Speaker 2: that they've done.
Speaker 3: So, the International Menopause Society is one of the global
Speaker 3: bodies that is all about women's midlife health and minipause
Speaker 3: and about getting together experts in the field and medical
Speaker 3: practitioners and everyone involved in menopause care to study and
Speaker 3: help each other with all things menopause. I guess you
Speaker 3: could say it's one of the global bodies that makes
Speaker 3: recommendations about menopause care.
Speaker 2: So they're looking at all the latest research, they're looking at,
Speaker 2: you know, the experiences that you're having in different countries
Speaker 2: and things like that, and then they're putting together guidelines
Speaker 2: for your healthcare provider to be able to go off
Speaker 2: and say, look, this is the sort of the greatest
Speaker 2: information that we have.
Speaker 3: Yeah, it's aimed mainly at your healthcare provider. You so,
Speaker 3: and that's anyone who's providing menipause care. But actually these
Speaker 3: guidelines are available for anyone to read if we want
Speaker 3: to really dig into all of the info, which I
Speaker 3: have done.
Speaker 2: Very much appreciated the summary.
Speaker 3: It's a very large document, which you would expect for
Speaker 3: recommendations across the board on menopause because menipause is complicated.
Speaker 3: So yeah, it was one hundred and eighty page document
Speaker 3: called the Recommendations and Key Messages on Women's Midlife Health
Speaker 3: and Menopause.
Speaker 1: And I think so we're going to try and summarize
Speaker 1: the summary more an expect today so that maybe you
Speaker 1: know it obviously offers the resources to go and access
Speaker 1: this stuff too, because there may be some questions that
Speaker 1: you do want to bring to your provider. I guess
Speaker 1: something that comes to mind though, is how do we
Speaker 1: know our providers are accessing this information?
Speaker 3: Yeah, I mean you can't guarantee that, and it would
Speaker 3: be I would say that your average GP, for example,
Speaker 3: is not going to go and read this. It's a
Speaker 3: big commitment to sit down and read this, but they
Speaker 3: will be able to perhaps deep dive into specific areas
Speaker 3: if they come up. I think that's quite useful and
Speaker 3: for us as well. And there is a summary as
Speaker 3: you pointed out that it can be kind of useful
Speaker 3: with bullet points and stuff. But you would expect this
Speaker 3: kind of this kind of document to filter down into
Speaker 3: best practice recommendations through different countries because this is across
Speaker 3: the whole world. The IMS is the one minipause society
Speaker 3: that is really global. There's individual societies in different countries.
Speaker 3: It's one in the UK, there's one in America. You know,
Speaker 3: there's the Australasian Minopause Society, which is for our part
Speaker 3: of the world, and there's you know, every country just
Speaker 3: about has got its own, but this one is what
Speaker 3: The good thing that they do is that they take
Speaker 3: into consideration, you know, really global concerns.
Speaker 1: So if we can start with the one that sort
Speaker 1: of took me a little bit by surprise, I guess
Speaker 1: and made me think because I've been doing a little
Speaker 1: bit more exercise than usual lately. But can we start
Speaker 1: with the new section on cycopenia. Cycopenia if I'm saying
Speaker 1: that right, which is muscle loss in perian menopause. A.
Speaker 2: Yeah, this is.
Speaker 3: Really good that they've included this because we know that cycopenia,
Speaker 3: which is muscle loss, happens to all humans. It happens
Speaker 3: to us with aging, but there's a particular it is
Speaker 3: particularly common in women postmenopause or women because estrogen has
Speaker 3: a role in muscle and keeping on keeping hold of
Speaker 3: muscle and muscle building, So it's really good that they
Speaker 3: included this. And sycopenia is connected with osteopenia and ostroporosis,
Speaker 3: like bone loss and muscle loss are connected, so I think,
Speaker 3: and we need to all be across this because it
Speaker 3: gets worse as we age, So it was really good
Speaker 3: that they included this section. The interesting thing here is
Speaker 3: that there's really nothing that we can take to alleviate it.
Speaker 3: We have to do things. We have to our bodies.
Speaker 3: We have to exercise, and that is a combination of
Speaker 3: aerobic exercise they recommend, and strength training or strength exercise.
Speaker 3: So those two things together are going to be really
Speaker 3: really important for us to hang on to our muscle
Speaker 3: and that's going to have impacts for our for not
Speaker 3: only our you know, our metabolic health, but our bone
Speaker 3: health as well.
Speaker 2: We've been talking about that a lot, that whole idea
Speaker 2: of the white resistance as we age in things. Does
Speaker 2: it matter if you're already in your middle aged years
Speaker 2: and you don't do any does starting now still make
Speaker 2: a difference.
Speaker 3: Well it doesn't say this in this document, but I
Speaker 3: say editorializing absolutely, yes, you're never too old to start.
Speaker 3: And actually I just had a conversation with my mother
Speaker 3: at the weekend, and she's saying, you know what, I'm
Speaker 3: doing these these get ups. Now I'm practicing getting up
Speaker 3: off the floor and getting up doing she's getting doing
Speaker 3: sit to stand. You know, my mother's in her late seventies,
Speaker 3: you'll be eighty this year. She's doing sit to stand,
Speaker 3: which is just sitting standing up off a chair, and
Speaker 3: she's getting it. She's practicing getting up off the floor.
Speaker 3: And this is strengthening. This is strengthening exercises. So it
Speaker 3: actually doesn't matter what age we are. We can start
Speaker 3: doing things that will help with our musclim bone health,
Speaker 3: and I think that's super, super important. They recommend a
Speaker 3: few things in this document, including protein and tail, so
Speaker 3: that's an important one, which you guys are all across,
Speaker 3: I know. And then there are a couple of supplements creating,
Speaker 3: which again is coming into the consciousness now we're all
Speaker 3: learning about creating, and another one which was new to me,
Speaker 3: which is al citraline, which has got some quite interesting
Speaker 3: evidence around it for promoting muscle growth. But none of
Speaker 3: these things you can't just take those things and expect
Speaker 3: your muscles to grow. You'velementary to do the work, work
Speaker 3: those muscles. You can't just eat protein and expect, you know,
Speaker 3: to hang onto your muscle. You've got to eat the protein,
Speaker 3: maybe take the creatine, and also you've really got to
Speaker 3: work those muscles, challenge them.
Speaker 1: I mean, I know the creatine is a really well
Speaker 1: researched product, and I know that even people who will
Speaker 1: say don't need to take any something into the world,
Speaker 1: but creatine is a good is a good place to start.
Speaker 1: I certainly it certainly helped me over the years, and
Speaker 1: then then then I get a bit slack and I
Speaker 1: stop taking it. So it's about consistency too, isn't it.
Speaker 1: And we're not going to get away from the protein conversation,
Speaker 1: are we. No.
Speaker 2: I mean, I don't think you need to go crazy
Speaker 2: on the protein.
Speaker 3: I mean I'm not. I'm certainly I have pulled back
Speaker 3: from it a little bit myself. I'm not I'm not
Speaker 3: into a protein shake every day anymore. But I think
Speaker 3: it's pretty useful to just keep an eye on it
Speaker 3: and make sure that you're including it in every meal
Speaker 3: and that you're you're getting more than you perhaps would
Speaker 3: have in the past, and ideally from food I think
Speaker 3: is always going to be better.
Speaker 2: Can we blame menopause for midlife body changes because it
Speaker 2: is I think it's become quite convenient to do so.
Speaker 3: Yeah, I know, and we all can kind of relate
Speaker 3: to that, right, because I've had so many conversations with
Speaker 3: women over the years where they've gone, well, you know,
Speaker 3: I haven't changed anything, and look, I've just packed on
Speaker 3: the weight all of a sudden, all of a sudden.
Speaker 3: Is this constant refrain, I think? And this is it's
Speaker 3: a hard one. But the evidence, and this is what
Speaker 3: this recommendation also says, we can't blame menopause for weight
Speaker 3: gain as we age. There's just as an evidence tying
Speaker 3: those two things together. We can blame blame menopause for
Speaker 3: a redistribution of weight, so that is related to the
Speaker 3: loss of estrogen. We get that redistribution of weight through
Speaker 3: the middle of our bodies, and that happens even if
Speaker 3: you are a normal quote unquote normal weight or a
Speaker 3: smaller and a smaller body. And I've noticed that myself.
Speaker 3: I've always been in a relatively small, smaller body, and
Speaker 3: I have still seen that that bit of distribution where
Speaker 3: there's just a bit more weight going on around the middle,
Speaker 3: and that is that is estrogen related. But the body change,
Speaker 3: the weight gain is really more around aging, around getting
Speaker 3: older and the things that come along with that, which
Speaker 3: are lowered activity, lowered energy expenditure, and perhaps a little
Speaker 3: bit more energy intake, so eating a bit more.
Speaker 2: And you might think to yourself, Oh, I still do
Speaker 2: my daily walk or I still do this that, but
Speaker 2: maybe you're not walking as fast as you're used to
Speaker 2: or as far as you used to, or like I think,
Speaker 2: if we actually stopped and we're really honest about it,
Speaker 2: I mean, I know where my weight gain came from.
Speaker 2: It came from I've got no cartridge left of my knees.
Speaker 2: And my knees were so painful it's taking me a
Speaker 2: year to eighteen months really to rehab them. And I'm
Speaker 2: back on track now. Yeah, and now the weight is
Speaker 2: slowly coming off because I'm able to be consistent with
Speaker 2: my exercise again, which is great. But yeah, No, there
Speaker 2: was a little moment there where I was like, oh,
Speaker 2: this is so convenient just to blame this on but
Speaker 2: very metaphors and go, oh, well that's what it is.
Speaker 2: I actually, no, Francisco, if you stop and you're honest
Speaker 2: about yourself about what you eat, what you've been drinking,
Speaker 2: and how you've been exercising. It's kind of there on
Speaker 2: the paper.
Speaker 1: Eight to ten kilograms even on it. If you started
Speaker 1: from a smaller frame, then that just creates that lethargy,
Speaker 1: doesn't it. It just feels that much harder, particularly for some
Speaker 1: of those weight bearing exercises, like oh my god, I
Speaker 1: mean I think it's the one. What's the one where
Speaker 1: you get on the floor and then you jump up
Speaker 1: per burpie burpie. That's when you're like, whoa, everything's everything smooth?
Speaker 1: Sa same. I've been doing a lot of running, and
Speaker 1: you know, every couple of k's I lost made it
Speaker 1: just a little bit easier.
Speaker 2: Yeah.
Speaker 3: And I mean also if you think about menopause symptoms,
Speaker 3: so a lot of the things that happen in perimenopause
Speaker 3: and menopause hot flushes, sleep, you sleep, disturbance, you know,
Speaker 3: mental health issues. All of these things actually make us
Speaker 3: less likely to move.
Speaker 1: Super heavy periods. They would also make you.
Speaker 3: Get more tired, you get more, you get more you know, lethargic.
Speaker 3: You are exhausted, and you've got life or the life
Speaker 3: things that happen. You know, you can't get away from
Speaker 3: so all of those things can make us less inclined
Speaker 3: to move our bodies and make it more difficult, and
Speaker 3: so that then can lead to muscle loss. Muscle loss
Speaker 3: is related to weight gain because if our muscle is
Speaker 3: metabolically active, and that makes us if we have less muscle,
Speaker 3: we're more inclined to gain body fat. And so all
Speaker 3: of these things together, you know, can impact on weight.
Speaker 3: So and also you know, we can expect to gain
Speaker 3: a little bit of weight with age, which is not
Speaker 3: an unhealthy thing either.
Speaker 1: I thought it was a bit of a protective factors
Speaker 1: at some point.
Speaker 3: Well, your fat cells make estrogen their little estrogen factories,
Speaker 3: so we kind of need a little bit of body
Speaker 3: fat as we get older to help us with that.
Speaker 3: So all of these things together are impacting our body
Speaker 3: shape and size, and we probably need to have a
Speaker 3: it's not just one thing obviously, to solve those problems.
Speaker 3: We need to kind of look at everything.
Speaker 1: What I quite like is I do like a guideline,
Speaker 1: and so you know, if this does give us some
Speaker 1: guidelines about one hundred and fifty minutes of moderate intensity
Speaker 1: exercise per week with a couple of sessions in resistance exercise,
Speaker 1: which I'm sure for inchisc and I've probably talked people's
Speaker 1: ears off this list many episodes of The Little Things.
Speaker 1: But again, even us knowing all of that information, we've
Speaker 1: you know, we fall off the wagon too, and I
Speaker 1: quite like to just going back to basics. One hundred
Speaker 1: and fifty minutes that's what, Yeah, five thirty minute.
Speaker 2: Walks or yeah.
Speaker 3: And what's interesting about it one hundred and fifty minutes
Speaker 3: is that we know from the local research that fewer
Speaker 3: than half of women are actually doing that one hundred
Speaker 3: and fifty minutes, right, interesting, like forty forty six percent
Speaker 3: or something, less than half of us. So it is
Speaker 3: just as basic as that really is, getting up and
Speaker 3: moving whatever you can do is going to be useful. Yeah.
Speaker 2: And I also noticed that, you know, diet has spoken
Speaker 2: sort of throughout the document quite a bit, and the
Speaker 2: Mediterranean diet still seems to be the recommendation.
Speaker 3: Yeah, which is, if you think about it, a very
Speaker 3: sensible pattern of eating thing crazy whole foods, you know,
Speaker 3: healthy fats, lots of plants. You know, it's not rocket science,
Speaker 3: it is real basic stuff. But we do tend to
Speaker 3: latch onto the latest shiny thing that comes along or
Speaker 3: that we see on the socials that's got the promise
Speaker 3: of you know, blasting your minno belly fat, which is
Speaker 3: really not a thing.
Speaker 1: But I'm pretty resistant to those claims now. But again,
Speaker 1: still well, since we last spoke to, two of my
Speaker 1: children have left home, but I've still got one rugby
Speaker 1: player in the house, so, you know, just trying to
Speaker 1: balance that with my husband and I both wanting to
Speaker 1: drop some wait and feel healthier. Still working on getting
Speaker 1: that balance plus budget and everything else. Like it's all
Speaker 1: a bit crazy, isn't it. But it's good to know
Speaker 1: that there are just these simple things we could keep
Speaker 1: going back to.
Speaker 3: Yeah, and the interesting thing also was that they do
Speaker 3: note that hormone therapy is not really going to do
Speaker 3: much in terms of that body change. It's not going
Speaker 3: to melt off fat, and it's not going to really
Speaker 3: change that redistribution. It is useful for insulin resistance, like
Speaker 3: it can lower insulin resistance. That's useful, but it's not
Speaker 3: necessarily going to do anything in terms of our body
Speaker 3: shape and size.
Speaker 2: So don't jump on the ah TOI t not change
Speaker 2: anything else. And you know, a month later ago, oh
Speaker 2: you know, oh why aren't I drifting a bit away?
Speaker 2: Why are not losing a bit away? Yeah, okay, Can
Speaker 2: you tell us a little bit about primary ovarian insufficiency
Speaker 2: because there was a lot of that in the report
Speaker 2: as well, and I'm not usually familiar with what that
Speaker 2: is and how it compares to early menopause. Is it
Speaker 2: the same thing, It's sort of related. So it's premature
Speaker 2: ivarian insufficiency.
Speaker 3: So that is it is happening when younger women younger
Speaker 3: than forty are experiencing menopause. And the reasons are not
Speaker 3: really that no one, they don't really know why. It's
Speaker 3: pretty brutal, and it can happen in very young women.
Speaker 3: And actually I learn something from this, which is that
Speaker 3: it happens in three point five percent of women, which
Speaker 3: is quite high large.
Speaker 2: It's more than I thought it was.
Speaker 3: It is also interesting that if they say in this
Speaker 3: recommendation that if it's untreated, it leads to lower life expectancy.
Speaker 3: So it's pretty important that women are diagnosed if they
Speaker 3: do have this, if it does happen to them, And
Speaker 3: because because the treatment is actually hormone therapy, very important
Speaker 3: to have hormone therapy through until the natural age of menopause.
Speaker 3: So if you have, if you're going through premature menopause
Speaker 3: at say thirty five, you kind of need to be
Speaker 3: on that hormone therapy through until your early fifties at least.
Speaker 1: How would you know what would what would be the
Speaker 1: little red flags?
Speaker 3: Well, they've put some diagnostic criteria in this report, which
Speaker 3: I recommend you know that would be a good thing
Speaker 3: for your healthcare professional to be across. But there are
Speaker 3: some there are some key things that they look at.
Speaker 3: One of them as if sh levels, which is a
Speaker 3: hormone and disruption to your lucky periods stop basically and
Speaker 3: not come back. And so there's all kinds of there's
Speaker 3: various criteria, but that is something that if you've got
Speaker 3: disruption to your cycle and you are younger than forty,
Speaker 3: that's worth really talking to your doctor about.
Speaker 1: Well, it's a bit of a worry, isn't it, Because
Speaker 1: people are waiting a little bit longer to start their
Speaker 1: families too, So yeah, yeah.
Speaker 3: Child rearing or you know, trying to get pregnant. Even so,
Speaker 3: it's pretty interesting. It's also interesting that in that group
Speaker 3: of women, in that POI group, there is a real
Speaker 3: prevention role from hormone therapy from MHT, so can it
Speaker 3: can really help to prevent heart disease and cognitive decline
Speaker 3: and osteoporosis, all these things. It's it's really indicated for
Speaker 3: that which it's not necessarily for the rest of us,
Speaker 3: but for women with POI, it's really important to have
Speaker 3: that hormone therapy to sort of.
Speaker 2: Protect their health for the future. I'm sure there's a
Speaker 2: lot of women who is sort of thirty five forty
Speaker 2: who it's not the first thing that comes to mind
Speaker 2: if they have some of those symptoms. No, you know,
Speaker 2: you're not thinking to yourself, and it probably won't be.
Speaker 3: But it's really worth understanding and knowing that that's a
Speaker 3: possibility and getting it checked out because it's it does
Speaker 3: have some long term risks.
Speaker 1: So we we've used HIRT you and MHT, but they're
Speaker 1: the same thing, right, the same thing.
Speaker 3: MHT is just the new term that they prefer to
Speaker 3: use for hormone therapy. Hormone replacement therapy is not really
Speaker 3: an accurate acronym. I guess you could say it does
Speaker 3: not really replacing hormones back to your premenopausal level, So
Speaker 3: they sort of say menopause or hormone therapy to be
Speaker 3: a bit more accurate of what it's what it's about.
Speaker 3: But yeah, I just usually say hormone therapy because.
Speaker 1: Well that covers it doesn't it's covering.
Speaker 3: Yeah.
Speaker 1: So in terms of you know, the information, I thought
Speaker 1: it was interesting about the information around quality of life, psychosocial, psychological,
Speaker 1: cognitive health was interesting, particularly the cognitive health. But that's
Speaker 1: a bit I sometimes find slipping, like grasping for words
Speaker 1: and remembering things, which is brain fog.
Speaker 2: Yeah, all that stuff.
Speaker 1: So what do we what do we know about MHT
Speaker 1: or hormone therapy and cognition now that we've learned.
Speaker 3: Yeah, well what we've learned is that we still don't
Speaker 3: really know if it's going to if it's going to
Speaker 3: prevent dementia. It seems like no. Well at the moment,
Speaker 3: the evidence is no for women who go on to
Speaker 3: hormone therapy at the sort of normal age of menopause.
Speaker 3: But that again, like I said, with the POI, with
Speaker 3: the premature ovarian insufficiency, that is a different thing. There
Speaker 3: are known benefits of being on hormone therapy for those
Speaker 3: women because it's so much young, they're losing those that
Speaker 3: estrogen so much younger, so they can actually it can
Speaker 3: help them with their risk for alzheimers and dementia, but
Speaker 3: for most of us probably not. So you'll see people
Speaker 3: on the socials talking about how it can prevent dementia.
Speaker 3: That's not proven at this point. It may be in
Speaker 3: the future, we just don't know. At the moment, they
Speaker 3: can't say that. So they can't say, take hormone therapy
Speaker 3: for the prevention of dementia. They just can't say it.
Speaker 1: But in the moment, has it got some benefits for
Speaker 1: that cognitive function that that brain fog as we were
Speaker 1: talking about, does it?
Speaker 3: It can help. It can help indirectly with that, I
Speaker 3: think is the answer. So what happens is it helps
Speaker 3: you to sleep better, It helps you to have fewer
Speaker 3: hot flushes. Both of those things are going to make
Speaker 3: you feel more sharp. It can help you just with
Speaker 3: all of the general menopause symptoms, the moose stuff, the
Speaker 3: you know, all of the the pain stuff as well.
Speaker 3: Like you know, there's benefits potentially on joint pain from this, you.
Speaker 1: Can think or clearly when you're not soft, of those
Speaker 1: things help you to help you to be a bit sharper.
Speaker 3: And certainly the sleep thing, and that comes through quite
Speaker 3: strongly in here is that addressing sleep is a really
Speaker 3: really important part of everything else.
Speaker 2: You've got to be careful about anxiety, though, don't you,
Speaker 2: and not just expecting it to be the answer there.
Speaker 2: If you've got severe anxiety, then that might need to
Speaker 2: be addressed in other ways.
Speaker 3: They do make a distinction between anxiety and depression. Yeah,
Speaker 3: and I think the anxiety they've said, no, it's probably
Speaker 3: not going to help with that, but with some forms
Speaker 3: of depression it will help. And I think that's certainly
Speaker 3: the experience of many women as well.
Speaker 2: That when I went to see my GP about my
Speaker 2: mood swings which were turning sort of towards, you know,
Speaker 2: just being constantly angry at my whole family. You know,
Speaker 2: she talked to me quite a lot about anxiety and
Speaker 2: depression and those the mood and where it was because,
Speaker 2: as she said to me, actually maybe there is something
Speaker 2: else that we should be looking at, you know. As
Speaker 2: a result, in the end, she just thought, maybe I
Speaker 2: had a good night's sleep, i'd be fine. But it
Speaker 2: is worth you know, if the doctor does have that conversation,
Speaker 2: it is worth pursuing it and you know, and making
Speaker 2: sure you're getting.
Speaker 3: The right, Yeah, and it might help you. Combination of
Speaker 3: therapy is too, like an antidepressant plus some woman therapy
Speaker 3: that might be like amazing for your moods.
Speaker 1: And look, the exercise definitely helps as well.
Speaker 3: Exercise how with everything? Yeah, it truly does. It's the
Speaker 3: one consistent, kind of uncontroversial thing across all.
Speaker 1: Of this, and I think that's at any age, honestly, but.
Speaker 3: Yeah, yeah it is, and for all humans to be honest.
Speaker 1: Yeah, we're supposed to move right.
Speaker 2: Yeah, you're listening to the little things. And our guest
Speaker 2: today is author and menopause expert Nicki bizand covering off
Speaker 2: all the latest information on perimenopause and menopause. We'll be
Speaker 2: back after the break. Welcome back, Nicki. Many women don't
Speaker 2: want to take hormone therapy or hormone replacement therapy, or
Speaker 2: they can't, so we've got some good news for them.
Speaker 2: There's some other other options for them, maybe some non
Speaker 2: hormonal pharmacological therapies with good research backing them.
Speaker 3: Yeah. Well, I think the good news across the board
Speaker 3: here is that if you look at the recommendations throughout
Speaker 3: this document, there is always more than one thing in
Speaker 3: those recommendations. Not just take hormone therapy. It's always a
Speaker 3: whole range of things. And this is something that I've
Speaker 3: long been saying. It's a jigsaw puzzle and you've got
Speaker 3: to look at all the different pieces, and hormone therapy
Speaker 3: is just one piece of the puzzle. It's an important
Speaker 3: piece for some women. And then there's always people who
Speaker 3: just don't want to do that or who feel who
Speaker 3: can't do it for whatever reason, because there's risks and
Speaker 3: reasons why you might not be able to take it.
Speaker 3: So in here we've got an interesting section on complimentary therapies,
Speaker 3: which is everything non pharmaceutical if you like, including things
Speaker 3: like Chinese herble medicine. And I was quite interested to
Speaker 3: see that they have They have sort of cautiously recommended
Speaker 3: some of these things that are worth quite worth the
Speaker 3: try in a scientific way. They're saying, these are worth
Speaker 3: a try, and one of them is Chinese herble medicine.
Speaker 3: One of them is black cohosh which is out there.
Speaker 3: I think the soyosa flav ownes is another thing. These
Speaker 3: are all in supplements that you might see. But they
Speaker 3: also do say that the evidence is very low for
Speaker 3: a large number of herbs and nutrients that you also
Speaker 3: may see, So you kind of need to be a
Speaker 3: bit savvy in terms of just looking at what is
Speaker 3: promoted and marketed versus what there is evidence behind. But
Speaker 3: I also thought some of the interesting things that they
Speaker 3: mention are the kind of mindfulness things. Mindfulness yoga was
Speaker 3: one thing that they thought that they recommends potentially useful
Speaker 3: for some menopause symptoms. Tai Chi another nice. And these
Speaker 3: are all to me, those are all kind of like
Speaker 3: stress relieving things, aren't.
Speaker 2: There, Mum loves Loves are tai Chi? I've been into
Speaker 2: it for years. Yeah, yeah, so that's kind of interesting,
Speaker 2: I thought. And then the other thing in terms of
Speaker 2: other kinds of pharmaceuticals is that there's some new new
Speaker 2: things in the pipeline, and one of them is these
Speaker 2: this new class of drugs which are called neuerkin and
Speaker 2: three receptor antagonists.
Speaker 3: Yeah.
Speaker 2: Yeah, I'm glad you said that, because I was. I
Speaker 2: was trying to bring those up, but I wasn't sure.
Speaker 3: So the first one of these is out and it's
Speaker 3: called Featherlina tent and what it is is a drug
Speaker 3: which is acting on the temperature sensor and the brain
Speaker 3: which is the hypothalmus that is helping with hot flushes,
Speaker 3: and there's some really good trials showing that it really
Speaker 3: does help with hot flushes, and it's a non hormonal treatment,
Speaker 3: so it's a really good news woman, for example, who've
Speaker 3: had breast cancer or who can't take hormones for whatever reason.
Speaker 3: It's licensed around different countries around the world. It is
Speaker 3: not approved here, but it is available here, which is
Speaker 3: a kind of a tricky distinction. But you can get
Speaker 3: it through a kind of a backdoor under the Section
Speaker 3: twenty nine of the Medicines Act, which just means that
Speaker 3: you can get a prescription for it and you can
Speaker 3: access it. It's not funded and it's quite expensive, but
Speaker 3: I expect that that'll be something that's they'll be looking
Speaker 3: to get funded for the future. And there's more of
Speaker 3: these in the pipeline, these kinds.
Speaker 1: Of and they've had ICTs and yes, they.
Speaker 3: Wouldn't be able to license it in the States, for example,
Speaker 3: it's got FDA approval. It's approved in the States, yeah,
Speaker 3: and in the UK, I think too.
Speaker 2: And there's a whole lot of other.
Speaker 3: Kind of new new things coming down the line. There's
Speaker 3: another type of estrogen called estheterol, which is being and
Speaker 3: it's in development A slightly safer they say form of
Speaker 3: estrogen therapy we especially for breast tissue, has let less
Speaker 3: impact on breast tissue. So there's all these kinds of things.
Speaker 3: There's research going on, and there's more research going on
Speaker 3: into androgens, into testosterone and stuff as well, which is
Speaker 3: kind of interesting. I think.
Speaker 2: I was curious about how New Zealand is keeping up
Speaker 2: when it comes to accessing whether it's the drugs, and
Speaker 2: I think I was away with a group of ossies
Speaker 2: recently and we were discussing our various different hi t
Speaker 2: and what was available for them and their options. It
Speaker 2: seemed a lot more varied than what I can access
Speaker 2: if I want to go on hormone therapy in New Zealand.
Speaker 3: I think we doing okay here. I mean, we do
Speaker 3: have more options for estrogen then we had a few
Speaker 3: years ago. You know, we've got estrin gel now available
Speaker 3: and funded, which is a good thing. We've got different
Speaker 3: you know, we've got several brands of patches, which is
Speaker 3: also good that that's some of that is thanks to
Speaker 3: some pressure put on by women who were a bit
Speaker 3: angry about their options being taken away. One thing that's
Speaker 3: happened recently which is slightly disappointing, is that testosterone for women,
Speaker 3: that the one form of testosterone for women that is
Speaker 3: made for women, andropheme it's called that has not been
Speaker 3: approved by FIMAC for funding or it's been given low
Speaker 3: priority I should say, for funding. So that means that
Speaker 3: we're still having to pay quite a lot of money
Speaker 3: for that if we want that form of that form
Speaker 3: of testosterone, which is inequity, I think because men have
Speaker 3: got access to four or five different kinds of funded
Speaker 3: good point.
Speaker 1: Yeah, So did they have to give a rationale when
Speaker 1: they no?
Speaker 3: Right, as long as I know they don't have a
Speaker 3: ration now, the rationale would be that they're just trying
Speaker 3: to balance all the different kinds of things that they've
Speaker 3: got a fund. But this one, Yeah, is disappointing. And
Speaker 3: I think we can potentially make a bit of noise
Speaker 3: about this because it's not acceptable.
Speaker 1: Really well, it's a health issue. It's not a just
Speaker 1: a I want to feel better.
Speaker 3: Issue, and you know, just as specifically for sexual health
Speaker 3: is important and women's sexual health should not be less
Speaker 3: important than men's. I think I think we can all.
Speaker 2: Agree with that absolutely. Yeah, Sure, can we just talk
Speaker 2: a little bit about you know, we've debunked the myth
Speaker 2: over the years about hormone therapy when it comes to
Speaker 2: breast cancer in particular. Is there anything new there, Nikki?
Speaker 3: There is a good section in these recommendations on breast cancer,
Speaker 3: and I think there are a couple of things that
Speaker 3: stood out for me there. One. I mean, they do
Speaker 3: reiterate that the risk of breast cancer from hormone therapy
Speaker 3: is low, which we knew and has been gradually gaining traction.
Speaker 3: But we do know that the risk is low, and
Speaker 3: it's akin to the risk that we have of breast
Speaker 3: cancer from lifestyle things, so from inactivity that's a big
Speaker 3: risk factor for breast cancer, and alcohol is as well,
Speaker 3: so it's about the same as that the risk from
Speaker 3: breast cancer. And if we're going on to hormones at
Speaker 3: the time of menopause or just before, the risk is low.
Speaker 3: The risk increases slightly with duration of treatment, but it
Speaker 3: goes away once you stop treatment. A thing that I
Speaker 3: was interested to see and hear, and something I've only
Speaker 3: become aware of in the last year or two is
Speaker 3: this issue of breast density.
Speaker 1: Feel very much.
Speaker 2: Said yeah, because my boob's got denser, and I, you know,
Speaker 2: a mamogram wouldn't do the trick in the end, I
Speaker 2: was having to have ultras and things.
Speaker 3: So breast density increases can increase with hormone therapy, but
Speaker 3: also having dense breasts actually increase is your risk of
Speaker 3: breast cancer as well. So those things you're not necessarily
Speaker 3: you're not necessarily gonna know if you've got dense breasts
Speaker 3: from your regular mamogram because they don't tell you. And
Speaker 3: the recommendation in here is that is that if you're
Speaker 3: on hormone therapy, that you should have more monitoring of
Speaker 3: your breast tissue. So that is something that I think
Speaker 3: we need to just be really aware of.
Speaker 1: I don't know if my breast well, they'll tell you
Speaker 1: that ye if you ask right, no, no, if you've had
Speaker 1: breast cancer. So we didn't see it because you have
Speaker 1: such That was you know, that was why their argument
Speaker 1: that they didn't pick mine up and the previous mamogram
Speaker 1: was that my breast tissue was dense. And I was like, well,
Speaker 1: if my breast tissue tissue was dense, should we have
Speaker 1: had a different should we be looking for different diagnostics?
Speaker 1: Sort of you know, so screen.
Speaker 2: Or they get you back. So I had a couple
Speaker 2: of sists and they couldn't see them properly, and they
Speaker 2: just said to me, look, your breath, your breast is
Speaker 2: quite dense, so we need to get you back to
Speaker 2: just to have another lock. I actually misheard the woman,
Speaker 2: and I didn't think I thought it was purely that
Speaker 2: I didn't catch that they'd court NEThing is he going,
Speaker 2: and they're all so lovely and they're so nice to
Speaker 2: you when they go through the whole process, and then
Speaker 2: someone sits you down and says just you know, it's
Speaker 2: all kind of like, yeah, I thought it was all okay.
Speaker 2: I had no idea you weren't worried. Oh, I hadn't
Speaker 2: really thought. I didn't think I had the information to
Speaker 2: be worried yet. So that was quite bundy.
Speaker 1: But it's super important because it also was a funding issue.
Speaker 1: You know, if we are going to need more callbacks
Speaker 1: or people are making judgment.
Speaker 2: Of course, it's substantially more investigation was being doance right.
Speaker 3: Yeah, yeah, but it's something that I mean, there are
Speaker 3: there is some potential here for AI to help us
Speaker 3: with this one, because it should just be an easy
Speaker 3: thing to say to you when you've had your mamogram, Oh,
Speaker 3: your your brist tissue is dense. Just we need to
Speaker 3: just be aware of that. It's not uncommon. It's something
Speaker 3: like forty percent of women have got some level of
Speaker 3: density in their breast. So it's pretty pretty interesting that
Speaker 3: that's something that's been noted here. I kind of want
Speaker 3: to go and get another mamogram now and China.
Speaker 1: It's a good piece of health advice for anybody out
Speaker 1: there because most of ours, as I would dare say,
Speaker 1: are having fairly regular mammograms. So maybe if you haven't
Speaker 1: asked the question, asked the question.
Speaker 2: You know, you're always looking for a bit of a
Speaker 2: conversation starter while your boob has been squashed into a machine.
Speaker 1: So so they will.
Speaker 3: Tell you if you ask them at the time doing
Speaker 3: a mamogram. So that's something just to be aware of.
Speaker 3: And I also just on the breast cancer I thought
Speaker 3: it was it shocked me, but didn't shock me. But
Speaker 3: they do note in here that there is a lack
Speaker 3: of evidence at this stage about hormone therapy for breast
Speaker 3: cancer survivors, which I think is you know, is not
Speaker 3: good enough. We need more research across the board actually,
Speaker 3: but that was the thing that really stood out.
Speaker 1: A lot of breast cancer survivors will be on something
Speaker 1: like to moxaphin anyway for five years post their breast cancer.
Speaker 1: And I guess it depends at what stage of life
Speaker 1: you were. But mine was triple negative and I I
Speaker 1: can't see reason why potentially, you know, that would exclude
Speaker 1: me from MHT, but I have excluded my self just
Speaker 1: because don't have the research. Don't have the research.
Speaker 3: Yeah, and these are the conversations that are going on
Speaker 3: all the time, right with breast cancer survivors. You really
Speaker 3: have to make and make a call yourself on risk
Speaker 3: versus benefits, That's right, And it's very difficult without that.
Speaker 1: But I just pull all the other levers.
Speaker 3: Yeah, and which again is you have to be doing
Speaker 3: anyway we all have to be doing, That's right. Yeah.
Speaker 3: I think we do put we do tend to put
Speaker 3: a little bit too much faith and hormone therapy to
Speaker 3: to all the heavy lifting for us.
Speaker 2: No, absolutely, what about other cancers hormone therapy and its
Speaker 2: relationship to other cancers? Was there anything that sort of
Speaker 2: stood out for you there? Nikki? It seemed most depending
Speaker 2: on your health and whatever underlying health issues you may
Speaker 2: have didn't seem to be any sort of anything startling there.
Speaker 3: No, it's pretty like if we're worried about even ovarian cancer,
Speaker 3: there doesn't seem to be a huge amount of need
Speaker 3: to worry about that. The main one is really breast cancer,
Speaker 3: and as I said, again, the risk is low if
Speaker 3: you have a If you have you know, family history
Speaker 3: or other risk factors for some of these other cancers
Speaker 3: like colorectal cancer or lung cancer, those are more worth
Speaker 3: worrying about than the risk from hormone therapy.
Speaker 1: If you have those risk factors, you usually on a
Speaker 1: fairly good well you'd hope that you're on a fairly
Speaker 1: good screening plan anyway.
Speaker 3: Yeah.
Speaker 1: Absolutely, But if you're not, maybe there's something to get
Speaker 1: And they.
Speaker 3: Don't rule out, you know, they don't say you can't
Speaker 3: be on hormone therapy if you have those either for
Speaker 3: these cancers. So yeah, that's good news, I think.
Speaker 1: So, I mean we're in the space intermittently, you're in
Speaker 1: the space all the time. You know, what are what
Speaker 1: are our biggest misconceptions still around around menopause And.
Speaker 3: I think we still tend to think that menopause is
Speaker 3: just about our reproductive function, you know. And actually, as
Speaker 3: comes through loud and clear in this and across everything
Speaker 3: that you might see about menopause, it's a systemic change.
Speaker 3: It's a systemic transition. So it's our whole body and
Speaker 3: brain that is changing because of this major hormonal change
Speaker 3: that we're going through, and so we need to think
Speaker 3: about the whole body and the whole person, not just
Speaker 3: you know, the ovarias and the reproductive hormones.
Speaker 2: That's interesting you say that, because when I read, to
Speaker 2: be fair the summary of the report, my overall impression
Speaker 2: is the importance of our life style choices still plays
Speaker 2: a really big role in how we're able to manage
Speaker 2: perimenopause again, because absolutely does.
Speaker 3: And thinking beyond menopause toos is it. My big thing
Speaker 3: now is that actually, menopause is just this one stage
Speaker 3: of life and it's not forever. It's a transition that
Speaker 3: we go through and then beyond that we're going to live,
Speaker 3: you know, a long time hopefully, and so we need
Speaker 3: to think about how we want to be for that
Speaker 3: part of our life, and all of the changes that
Speaker 3: we make in midlife can really help us to be
Speaker 3: healthy long term, and that means looking beyond hormones, that
Speaker 3: is actually looking, as you say, at all all of
Speaker 3: the things that we can do, all the pieces of
Speaker 3: the puzzle.
Speaker 2: I should probably know the answer to this question by now,
Speaker 2: but a friend of mine made a comment to me
Speaker 2: a couple of weeks ago. We had very muggy nights
Speaker 2: in Auckland and she woke up in some hot sweets
Speaker 2: and she sort of said, Ah, do you think it
Speaker 2: was just the weather or do you think I've got
Speaker 2: a new symptom? And it did make me think. We
Speaker 2: talk about, you know, how perimenopause can be a ten
Speaker 2: year kind of journey. Do we kind of stop and
Speaker 2: start symptoms as we go through.
Speaker 3: I think things can change. Things can definitely change across that,
Speaker 3: across that transition. And I've experienced this myself. You know,
Speaker 3: things things happen. Things that were happening to me and
Speaker 3: perimenopause early periament pals aren't happening to me now. I'm
Speaker 3: kind of post early post menopause now. And your symptoms
Speaker 3: do change, and you know, it can be that you
Speaker 3: need to tweak your treatment as well. You know, if
Speaker 3: you're having more flushes all of a sudden maybe you
Speaker 3: need to look at your dose, or maybe it is
Speaker 3: just hot, like I've had that same but myself.
Speaker 2: As I just said, yeah, they were hot nights, they
Speaker 2: were all.
Speaker 3: So it's all the things, and all the things can change.
Speaker 3: It's a movable feast. It's very very different in individual
Speaker 3: for everyone. But things do do change and flow, and
Speaker 3: also other things in your life have an impact. So
Speaker 3: stress has an impact, sleep has an impact. You know,
Speaker 3: how much you're moving, how much you're what you're eating.
Speaker 3: All the things have an impact, and all of those
Speaker 3: other things can be affecting how we feel.
Speaker 1: Yeah, yeah, I would say we've had sort of something happen.
Speaker 1: It's been a stressful four to five weeks, I guess,
Speaker 1: and you know, you think you've kind of got on
Speaker 1: top of things, but then when another event happens, you're like, oh, man,
Speaker 1: I'm back in the back in the I want to
Speaker 1: know pain lock or hurt lock or whatever you call it.
Speaker 1: And then that just has knock on effects on the sleep,
Speaker 1: and then that has the knock on effects of what
Speaker 1: I get up for that run, and then you've really
Speaker 1: it's the mind of a man aspect is quite huge.
Speaker 3: I think oh, absolutely, yeah. And you know, stress is
Speaker 3: a huge factor in everything. It makes everything worseopause symptom
Speaker 3: or perimenopause symptom or anything else. It's huge. And so
Speaker 3: is sleep. So you know the quality and duration of
Speaker 3: our sleep can really affect everything from our mood to
Speaker 3: to our pain levels.
Speaker 1: I think we owe ourselves a huge amount of self
Speaker 1: compassion as well.
Speaker 3: Absolutely, yeah, we need to be much easier on ourselves.
Speaker 3: We tend to feel like our bodies are letting us
Speaker 3: down or we're failing in some way.
Speaker 1: That we've got some reason to get on top of
Speaker 1: this menopause mountain.
Speaker 3: Yeah, I do think that because of now there's so
Speaker 3: much more information out there, right, and the social media.
Speaker 3: I don't know if you, I mean, I'm immersed in
Speaker 3: menopause Instagram. I'm just like bombarded with it all the time.
Speaker 3: But even I can feel like, oh my god, I'm
Speaker 3: not doing menopause, right, You're not.
Speaker 2: Doing It's not like, oh, we've acknowledged perimeniples exists and
Speaker 2: I have know a bit about it. Tech done. Yeah,
Speaker 2: it's yeah.
Speaker 3: It's I've got to be doing all these things. I've
Speaker 3: got to be taking this and doing that and moving
Speaker 3: this way and buying this thing, and you know, doing
Speaker 3: all the things. And if you're not, you're not you're
Speaker 3: somehow failing at menopause. I think that that's that's not
Speaker 3: right either. Everyone's journey is different, and actually it's okay
Speaker 3: to give yourself a bit of a break. We are
Speaker 3: getting older, we are getting older as well.
Speaker 1: Yeah, yeah, exactly.
Speaker 2: I think that's a lovely note to end it on.
Speaker 2: And if Nikki, there was someone out there who was
Speaker 2: kind of interested to flick through the to flick through
Speaker 2: this review or take a look at the summary, where
Speaker 2: can they find it or do they just pretty much Google? Yeah,
Speaker 2: you should just be an International Menopause.
Speaker 3: Society Society and you and they'll have that. They have
Speaker 3: the recommendations there on their website.
Speaker 2: Look for the guidelines in Women's midlife Health and Minopause.
Speaker 1: Yeah, settle in, get a nice botee.
Speaker 2: Do what I to, get your heartlighter out, and off
Speaker 2: you go. Brilliant. Thank you so much, Nikki, really really
Speaker 2: appreciate you popping in and giving us a bit of
Speaker 2: an update.
Speaker 3: Pleasure.
Speaker 2: So lovely to have Nick back in on the podcast.
Speaker 2: She is just a wealth of information, isn't she when
Speaker 2: it comes to the perimenopause and the.
Speaker 1: Menopause, Yeah, it was. It was an excellent refresher actually,
Speaker 1: because I think, like I say, I do think that
Speaker 1: I'm pulling all the levers, and then I talk to
Speaker 1: someone and go, actually, I'm not sleeping that well, and actually,
Speaker 1: you know, I could be doing this better, you know,
Speaker 1: not trying to get an a in menopause, but just
Speaker 1: for myself.
Speaker 2: When she was mentioning yoga, I was thinking of the
Speaker 2: subscription to some yoga app that I got a year
Speaker 2: ago used oh sorry, snorting again, And I was like, yeah,
Speaker 2: do you know what I do use it for? I
Speaker 2: use their meditation recordings. That's nice, that's but that's like
Speaker 2: nine minutes of my life or five minutes of my life,
Speaker 2: you know. And I was thinking the same thing. I'd
Speaker 2: put things in place, or I'd tried to kind of
Speaker 2: find a few other sort of complimentary tools to use
Speaker 2: to how me through it. But we don't do it.
Speaker 2: But then, as NICKI was saying, as well, you just
Speaker 2: have to kind of you can't do it all, and
Speaker 2: you can't do it, you know, there is no expectation
Speaker 2: that we do. But I think reading through this report
Speaker 2: was a real reminder to me that actually, as much
Speaker 2: as the hormone therapy has helped me a lot, that
Speaker 2: you don't just go You don't just slap a patch
Speaker 2: on and think you've ticked all the boxes. There is
Speaker 2: a lot that we can do. And I still think
Speaker 2: of Niki. The main voice I have of Nicki in
Speaker 2: my head as her telling me that alcohol is not
Speaker 2: my friend, and you know she's right, so those alcohol
Speaker 2: free days suddenly become a lot more attractive and important.
Speaker 1: I still remember her in the episode the first episode
Speaker 1: when it was her saying I didn't need to eat
Speaker 1: as much as my son as I tucked into my pasta.
Speaker 2: Oh, you don't need to eat as much as you
Speaker 2: are right, I.
Speaker 1: Don't need it as much as my son, and I
Speaker 1: had a bowl of kabinara. That's the other thing about
Speaker 1: doing an event. You can you eat quite a lot
Speaker 1: while you're try doing all that training, and then you know,
Speaker 1: I might have to sign up to another event just
Speaker 1: so I can keep eating in the volumes that I've
Speaker 1: been eating. She's fantastic and it's a really important thing
Speaker 1: to keep to off in mind. You do not have
Speaker 1: to just dig your fingers in and grip on for
Speaker 1: dear life through menopause. You don't have to, but you
Speaker 1: also don't have to take on everything, which we always say.
Speaker 1: Everything we say, just pick a couple of things that
Speaker 1: you think. And also she had some really good practical
Speaker 1: advice about the dense breasts. I didn't know that wasn't
Speaker 1: in mainstream because that was something discussed with me ten
Speaker 1: years ago when I went through it. It's really interesting
Speaker 1: to me that that's only just being kind of commonly
Speaker 1: talked about in the last couple of years.
Speaker 2: Muscle loss and bone density as well, I found really
Speaker 2: interesting and I think we're going to hear a lot
Speaker 2: more about that going forward. Nikki has two fantastic books.
Speaker 2: If you don't already have them, you should pick them up.
Speaker 2: This Changes Everything and Everything guide both fabulous guides to
Speaker 2: perimenopause menopause and how to live our best lives? Our
Speaker 2: best mid lives?
Speaker 1: Should we say yeah, anything but met?
Speaker 2: Thanks Thanks Low, and thank you for joining us on
Speaker 2: our new Zealand Herald podcast series, Little Things. We hope
Speaker 2: you share this podcast with the women in your lives.
Speaker 2: We're all living our best midlives.
Speaker 1: You can follow this podcast on iHeartRadio or wherever you
Speaker 1: get your podcasts. And for more episodes from us on
Speaker 1: other topics, head to enzid Herald dot co dot nz.
Speaker 2: We'll catch you next time on the Little Things