Speaker 1: Hi, I'm Louise Ari and I'm Francesca Brudkin, and this
Speaker 1: is season five of our New Zealand Hell podcast, The
Speaker 1: Little Things. It's good to have you with us.
Speaker 2: In this podcast, we talk to experts and we find
Speaker 2: out all the little things you need to know to
Speaker 2: improve all the years of your life and cut through
Speaker 2: the confusion and the overload of information out there.
Speaker 1: We've got such good topic today, have looyd Owiz. We're
Speaker 1: going to talk about midlife rage, midlife emotions. And I
Speaker 1: think at this point my family would quite like to
Speaker 1: take over and have their two cents we've maybe contribute
Speaker 1: to this conversation. I'll keep them a million miles away
Speaker 1: from this. As a child, I was quite explosive, not
Speaker 1: all the time, but I could. I was quite unpredictable
Speaker 1: and I could definitely let loosen and rage a little bit.
Speaker 1: And as an adult, and you've known me as an adult, Louise,
Speaker 1: I've worked really really hard to I suppose, calm things
Speaker 1: down and challenging moments and you know, I've you know,
Speaker 1: as immature, you learn lots of ways of dealing with things.
Speaker 1: If you know that your responsive, you know, i'd maybe
Speaker 1: just say to people. That's great, I'll have a think
Speaker 1: about it and come back to talk about things like.
Speaker 1: I just learned all these little ways of remaining calm,
Speaker 1: and actually to the point that when I got really angry,
Speaker 1: I got quite quiet, and then i'd slow down my
Speaker 1: talking to a patronizing kind of spit on the ski
Speaker 1: fields and I'd talk very slowly like this, And when
Speaker 1: that happens, my kids got, oh shit, she's really angry.
Speaker 1: Like like, I learned that. That was when I was
Speaker 1: really really angry. But then I hit my forties, probably
Speaker 1: my mid forties, and this explosiveness just came back, all
Speaker 1: this complete lack of patience for what was going on
Speaker 1: around me, and you'd never know what would set me off.
Speaker 1: I mean, still not the big stuff. I can still
Speaker 1: when all the big stuff happens, I'm still very calm
Speaker 1: and but but there'd be just little things that would
Speaker 1: happen and I finally could no longer cope, and I
Speaker 1: would just verbalize everything going through my head while at
Speaker 1: the same time going, you should really just be saying
Speaker 1: this in your head. You should not be letting this out.
Speaker 1: But I couldn't. I couldn't stop it. I'd be like
Speaker 1: I just been like, who is this person? Then discovered
Speaker 1: hit and thankfully we've kind of got a middle ground now.
Speaker 1: But I'm still I'm still slightly I'm actually slightly embarrassed
Speaker 1: about that behavior, and I'm also still slightly shocked at
Speaker 1: how it kind of crept up on me over again.
Speaker 2: I think you should not be too hard on yourself
Speaker 2: because because certainly not alone for starters. I mean, I'm
Speaker 2: impressed that you worked on your explosiveness throughout your life,
Speaker 2: and I do think as I got to know you more,
Speaker 2: I did put into practice some of your measured sort
Speaker 2: of responses to things. Not all the time, but sometimes
Speaker 2: I don't think I did it nearly so much, and
Speaker 2: I think I could be.
Speaker 3: I was quite a ragy mum.
Speaker 2: I think the kids would say, I mean, there's some stories,
Speaker 2: but I mean I even hurt them, But there were
Speaker 2: some same we're just thrown into baths. I guess they
Speaker 2: don't need them. I believe they got flashed out of
Speaker 2: the toilet. But but look, weirdly, my health, Cristi has changed.
Speaker 2: I feel deduced with the kids in the mouth of
Speaker 2: the time, and you were through the sandwichesn't meet them.
Speaker 1: Yes see, I would have stopped and going, I'm just
Speaker 1: going to clean that up. That'd be really annoying.
Speaker 2: Oh, I said they had to eat them, but they
Speaker 2: didn't obviously eat them. They got out of the fun the.
Speaker 3: Toilet and dully they ate them. So there you go.
Speaker 3: So that was that was I.
Speaker 1: Feel like my kids have missed out. Maybe maybe I
Speaker 1: shouldn't let loose a little bit more.
Speaker 2: It's probably the worst one, to be fair, And I
Speaker 2: mean we do laugh about it now anyway, but my
Speaker 2: health christis changed that that ragey little bit, because I mean,
Speaker 2: I don't know, maybe it was the universe talking to me,
Speaker 2: but I felt less irritated by every little thing because
Speaker 2: something big had happened. But they said, I can get
Speaker 2: set off. And and I want to know. I guess
Speaker 2: if it's whether you know that thing about getting to
Speaker 2: a certain age and not giving two shits anymore? Is
Speaker 2: it that or is it realizing life is too short?
Speaker 2: Or is it hormonal or is it a big old
Speaker 2: mixture of all of them.
Speaker 1: If you didn't give two shits anymore, or if you're
Speaker 1: realizing life's too short, then you probably wouldn't react at all,
Speaker 1: would you.
Speaker 3: Hmm? Good point.
Speaker 1: I mean, you'd probably go, why am I going to
Speaker 1: antagonize you one? Why am I going to put this
Speaker 1: out there? If you just roll your eyes and move on.
Speaker 2: Well, that's why I can't the keep all worry stuff
Speaker 2: gets to me because I can't understand why if you're
Speaker 2: that full of vitriol and hate.
Speaker 3: Yeah, yeah, what's up?
Speaker 1: Judgment and opinion and yeah all the rest of it,
Speaker 1: keep it to yourself. Well maybe it's good we let
Speaker 1: it out somewhere, but somehow more something more productive.
Speaker 2: Healthy, that's our healthy way. But maybe they're just all
Speaker 2: struggling with midlife rage.
Speaker 3: Who knows? They can't just think No.
Speaker 1: I think there's a lot of rage about everything, and
Speaker 1: you know, isn't there at the moment in the world.
Speaker 1: But look, we hear about women struggle with their mood
Speaker 1: and women dealing with mental health issues such as anxiety
Speaker 1: and depression, sometimes for the first time in their life
Speaker 1: as perimenopause sets, and if they even know about peri
Speaker 1: mortive menopause, it can be so destabilizing for your relationships,
Speaker 1: your marriage, your job. Does menopause make pre existing anxiety
Speaker 1: and depression relapse or intensify? And what can we do
Speaker 1: to help ourselves. Joining us today is doctor Caroline Gervich.
Speaker 1: Caroline is a clinical neuropsychologist. She is the Deputy director
Speaker 1: of her Center Australia, head of the Cognition and Hormones Group,
Speaker 1: and an associate professor at Monash University. She has a
Speaker 1: research interest in the neuropsychology of women's health and the
Speaker 1: role hormones play on cognition. Welcome Caroline, thanks so much
Speaker 1: for being with us.
Speaker 4: Hi Francesca, thank you for inviting me to talk to
Speaker 4: you today.
Speaker 1: Should we start, maybe at the beginning and talk about
Speaker 1: what hormones are the ones that are impacting our mood
Speaker 1: and our mental health.
Speaker 5: Yes, So during these life phases where our hormones change,
Speaker 5: like menopause, the key hormones we're talking about are estrogen
Speaker 5: and progesterone.
Speaker 4: So these are sex hormones and they're the hormones.
Speaker 5: That regulate our reproductive function, and that's often what we
Speaker 5: think about when we talk about estrogen and progesterone, but
Speaker 5: they actually do a whole lot more than just regulating
Speaker 5: our reproductive functions. So they can cross over our blood
Speaker 5: brain barrier and enter our brains and have quite potent
Speaker 5: effects on different brain areas and particularly brain areas that
Speaker 5: regulate our mood and regulate our thinking skills. So that's
Speaker 5: why these times of life where our hormones change, we
Speaker 5: can also experience changes in mood and thinking skills.
Speaker 1: As well, because we often think of them as the
Speaker 1: six hormones, but there's so much more to them than that.
Speaker 4: Yes, yes, so much more so. That's right.
Speaker 5: They are the sex hormones and as I said, regulate
Speaker 5: reproductive function. But these hormones, so we know probably a
Speaker 5: bit more about estrogen and how that works in the brain,
Speaker 5: and we've learned a lot about how estrogen works in
Speaker 5: the brain from animal research, and these studies show that
Speaker 5: these hormones actually are quite potent sex steroids in the brain,
Speaker 5: so that means that they have an impact.
Speaker 4: They actually change the thickness or density of.
Speaker 5: Our connections between our different neurons and the way different
Speaker 5: parts of our brains communicate.
Speaker 4: They also have an influence on neurotransmitter systems.
Speaker 5: So these are chemicals in the brain, and you will
Speaker 5: have probably heard of things like dopamine and serotonin, So
Speaker 5: these are chemicals in the brain or neurotransmitter systems in
Speaker 5: the brain that are really important for regulating our mood
Speaker 5: and regulating our thinking skills. So at times when our
Speaker 5: hormones either fluctuate or gradually decline, our brains react to this.
Speaker 5: And some people are sensitive to these hormone changes in
Speaker 5: terms of their mood and thinking skills, and.
Speaker 4: Some people aren't.
Speaker 5: So it's not a uniform conclusion that we draw that
Speaker 5: when your hormones change, your mood will change, because that's
Speaker 5: absolutely not the case. But for some people, they're just
Speaker 5: sensitive to hormone changes. But all this animal work that's
Speaker 5: been done has really laid that scientific basis for us
Speaker 5: to have a really good guess at why some people
Speaker 5: might be more sensitive to times of hormonal change.
Speaker 2: So throughout our reproductive lives, we go from puberty through
Speaker 2: pregnancy up to perimenopause. Is that the impact we're seeing
Speaker 2: is it? Are some of us more sensitive all the
Speaker 2: way through or can it vary?
Speaker 5: Yes, it's such a good question. I think there's both scenarios.
Speaker 5: So there's certainly some people who are sensitive to hormones always.
Speaker 4: So there's some people who during.
Speaker 5: Their reproductive years when they're experiencing a menstrual cycle for women,
Speaker 5: or people assigned female at birth, when they're experiencing a
Speaker 5: menstrual cycle. Each menstrual cycle has little fluctuations in estrogen
Speaker 5: and progesterone, and the time of the menstrual cycle that
Speaker 5: most people who are sensitive to hormone changes experience mood
Speaker 5: symptoms is in that pre menstrual so in the few
Speaker 5: days before someone gets their period, and at that time,
Speaker 5: in terms of our hormones, our progesterone levels are increasing
Speaker 5: and our estrogen levels are a bit lower than our
Speaker 5: progesterone levels at that point. So the thought is that
Speaker 5: it's the progesterone that is some people are sensitive to,
Speaker 5: and not even the progesterone itself, but the progesterone has metabolites,
Speaker 5: which is kind of when it breaks down and flow
Speaker 5: on effects from the progesterone, and so one of them
Speaker 5: is called alopregnant alone. But that is what the theory is,
Speaker 5: that some people are sensitive to an increase in this
Speaker 5: alopregnant alone, and when that increases, some people experience these
Speaker 5: mood symptoms. So some people experience that. Then there's some
Speaker 5: people who experience quite significant mood changes in the postnatal period,
Speaker 5: and there's lots of significant hormone changes that happen both
Speaker 5: during pregnancy and in the post natal period. I should
Speaker 5: also say that having a baby is a huge life
Speaker 5: change as well, so we can't just say, well, it's
Speaker 5: all hormones, because there's lots that happens when someone has
Speaker 5: a baby, but there's also quite significant hormone changes, and
Speaker 5: so it's thought that some people again are sensitive to
Speaker 5: those hormone changes.
Speaker 4: And then the next life.
Speaker 5: Phase for females that a lot of people are sensitive
Speaker 5: again to hormone changes is in that perimenopause, so the
Speaker 5: menopause transitioneers and early postmenopause. So sometimes we see someone
Speaker 5: in perimenopause and it's the same person who's been sensitive
Speaker 5: at different life phases to hormone changes.
Speaker 4: But then sometimes someone's had none of that. They've not
Speaker 4: had any kind.
Speaker 5: Of pre menstrual mood symptoms, they haven't had any postnatal
Speaker 5: depression or post natal anxiety, but during menopause they experience
Speaker 5: for the very first time a big change in their mood.
Speaker 4: So I think there's both types of people. Some people
Speaker 4: are just.
Speaker 5: Sensitive to hormone changes, and some people experience mood changes
Speaker 5: for the first time during menopause, and whether that's a
Speaker 5: hormone sensitivity or a number of other factors contributing to it.
Speaker 5: We're still kind of learning and understanding why those mood
Speaker 5: changes come about, but it seems to be related for
Speaker 5: a lot of people the hormone changes.
Speaker 1: And have we been able to work out why someone
Speaker 1: might be sensitive.
Speaker 5: No, that's a really good question. So there's probably a
Speaker 5: number of factors. So there's probably some genetic factors our
Speaker 5: genetic makeup. Some people might carry certain combination of genes
Speaker 5: that makes them a bit more sensitive to changes in hormones.
Speaker 5: There's also a theory that some people who have experienced
Speaker 5: trauma throughout their lives and have got a sensitive or
Speaker 5: a more sensitive endocrine access that governs our stress response,
Speaker 5: that person might also be more sensitive to changes.
Speaker 4: In our reproductive hormones.
Speaker 5: So there's a bit of a crossover between these different
Speaker 5: endocrine axes that govern different That are hormones that govern
Speaker 5: different responses, so stress response, reproductive hormones, or sex hormones.
Speaker 5: So there's also a theory that those who have experienced
Speaker 5: trauma of some sort, and trauma can be lots of
Speaker 5: different things. It's a really personal I mean, somethings are
Speaker 5: obviously trauma, and some things are not necessarily considered trauma,
Speaker 5: but for an individual that you know, poor attachment when
Speaker 5: they were younger, or peer bullying or things like that
Speaker 5: can constitute trauma for an individual. And so all sorts
Speaker 5: of things might make someone more sensitive to hormones. And
Speaker 5: then sometimes we're I mean, it could be a combination
Speaker 5: of genetics of trauma for some people, or yeah, I
Speaker 5: guess we just don't really know exactly why some people
Speaker 5: are more sensitive.
Speaker 2: It makes me very grateful I suppose that we're in
Speaker 2: a slightly more enlightened age where we're talking about these
Speaker 2: things before they happen. Because freendiscin I both confessed to
Speaker 2: not really having any clue about perimidopause for a long time,
Speaker 2: and it has sort of come into the social consciousness
Speaker 2: a little bit more, particularly for women obviously, and I
Speaker 2: just sometimes think about, you know, the jokes around what's
Speaker 2: the one before you get your period, premist tension, Yeah, yeah,
Speaker 2: foggy brain and in middle life rage and all of
Speaker 2: that sort of thing, and you know, we do, we
Speaker 2: do laugh things off because we don't understand them.
Speaker 1: M m.
Speaker 5: Yes, And sometimes that's fine, Like for some people the
Speaker 5: mood changes the brain fog.
Speaker 4: It's kind of mild and you can laugh it off.
Speaker 5: It's a coping mechanism, and it's absolutely fine to do that,
Speaker 5: and it can be.
Speaker 4: Pretty subtle and it's not a big deal.
Speaker 5: But then there are other people where it's it's not
Speaker 5: so subtle and it is more of a big deal
Speaker 5: and it's a bit more.
Speaker 4: They can't just laugh it off, you know, they're really struggling.
Speaker 5: So I think there's a whole spectrum of experiences that
Speaker 5: people have, and yeah, the different sort of coping mechanisms
Speaker 5: or help that people need can also be really varied.
Speaker 1: So, Caroline, during perimenopause, in menopause, how are our hormones
Speaker 1: impacting our brains and our mental health?
Speaker 5: So as we transition from our reproductive years into menopause,
Speaker 5: there's this timeframe, this transition timeframe called perimenopause, and that
Speaker 5: can span four to eight ten years for different people.
Speaker 5: And during that transition time, we move from having the
Speaker 5: reproductive regular menstrual cycle for people who aren't taking any
Speaker 5: kind of hormone or contraceptive, and then our sex hormones
Speaker 5: estrogen progesterone, instead of fluctuating in a regular cyclical pattern
Speaker 5: start to be a bit more erratic, and they can
Speaker 5: fluctuate quite rapidly, and at the same time, the estrogen
Speaker 5: and progesterone are also gradually declining, So that happens, as
Speaker 5: I said, over four to ten years. The things that
Speaker 5: we can notice during that time in terms of our
Speaker 5: menstrual cycle, that can become irregular, and that's often what
Speaker 5: the basis of diagnosis of perimenopause is that your mental
Speaker 5: cycle can be come irregular.
Speaker 4: But often just before that happens, people can start to
Speaker 4: notice changes to their mood and their thinking skills. So
Speaker 4: that's the brain fog of menopause or perimenopause that people
Speaker 4: talk about. And the mood changes, the rage, the irritability,
Speaker 4: paranoid thinking, anxiety, depression, a whole spectrum of different symptoms
Speaker 4: that fall under that umbrella of kind of a perimenopausal
Speaker 4: depression that can happen early on in that perimenopausal transition.
Speaker 4: They can be some of the first signs that happen,
Speaker 4: and it might be that our brains start to become
Speaker 4: a bit sensitive to the fluctuations in our estrogen levels
Speaker 4: and that gradual decline and progesterone. But if it's happening
Speaker 4: early in the perimenopause.
Speaker 5: It's probably our bodies and brains reacting to the fluctuations
Speaker 5: in estrogen and progesterone levels that happen during the early
Speaker 5: stages of that perimenopause and that transition phase.
Speaker 3: That's fascinating.
Speaker 2: Gosh, that's really making me think back to my late
Speaker 2: that is an early forties, to be honest, And so
Speaker 2: would you call it a common phenomenon for women and perimenopause.
Speaker 5: So in terms of the mood symptoms, it really varied
Speaker 5: depending what literature you look at. It's probably about a
Speaker 5: third of women will experience some depression and about two
Speaker 5: thirds of women will experience some degree of brain fog.
Speaker 4: But I think there can be kind of secondary depression
Speaker 4: secondary brain fog.
Speaker 5: So if people start to experience things like poor sleep,
Speaker 5: like anyone knows that if you're not sleeping well, it
Speaker 5: can impact your mood, it can impact.
Speaker 4: Your ability to think clearly, So that can happen as well.
Speaker 5: But people can also experience just the mood changes or
Speaker 5: just the brain fog on its own. And there's also
Speaker 5: a link potentially between the vasomotor symptoms of the hot
Speaker 5: flushes there's a theory that if you're experiencing hot flashes
Speaker 5: during the night, then that disrupts your sleep, then you
Speaker 5: have poor sleep.
Speaker 4: Then you have a flow and effect mood changes and
Speaker 4: to brain fog.
Speaker 5: But also, as I said, there's the people who don't
Speaker 5: experience any of that but just have the mood changes.
Speaker 5: It might be more directly related to the hormone changes
Speaker 5: in the brain.
Speaker 3: Can I just ask you a quick question.
Speaker 2: You're talking about contraception, and this is a thing that's
Speaker 2: been on my mind, but I haven't known who to
Speaker 2: ask and you may not be able to answer. So
Speaker 2: does contraception have any impact on perimenopausal symptoms?
Speaker 5: Yeah, so it can, absolutely so, because it flattens out
Speaker 5: the natural fluctuations in our hormones across menstrual cycles, but
Speaker 5: then adds in synthetic hormones that kind of replicate that.
Speaker 5: But if you don't take the sugar pills, so if
Speaker 5: you're just taking the active hormonal contraception, then it's kind
Speaker 5: of flattened out, and so you lose some of the
Speaker 5: effects of a menstrual cycle and you have less fluctuals.
Speaker 5: So I think the Australian menopause or Australasian Menopause Society,
Speaker 5: which extends to New Zealand, suggests that you can keep
Speaker 5: taking hormonal contraceptives in consultation with your doctor until about
Speaker 5: the age of fifty And yeah, so that can have
Speaker 5: a beneficial impact on mood for some people, but some
Speaker 5: people might also need to consider and talk to their
Speaker 5: healthcare professional about different options if it's if it's not enough.
Speaker 1: Yeah, and there are there are different options. But I
Speaker 1: found it really helpful just for when those when the
Speaker 1: metal cycle became really erratic and have to started having
Speaker 1: a little bit an impact on life. You know, it
Speaker 1: was one way to be able to It was just
Speaker 1: another tool to use to try and kind of stabilize
Speaker 1: things control. Yea, So how many women who have never
Speaker 1: you know, we talked about the sensitivity and things towards
Speaker 1: hormone fluctuations and things. I'm sure it must be quite
Speaker 1: a surprise for a lot of women to get to
Speaker 1: sort of middle age and all of a sudden be
Speaker 1: dealing maybe for the first time with anxiety or a
Speaker 1: panic attack or this irritability in things.
Speaker 6: Oh.
Speaker 5: Absolutely, And I think you say middle aged, but I
Speaker 5: think for some women it's sort of forty, like it's
Speaker 5: quite early that some women experience some of the mood
Speaker 5: changes because they can be some of.
Speaker 4: The earliest changes.
Speaker 5: So the median age of menopause is fifty one, but
Speaker 5: if perimenopause, that transition can go up to ten years,
Speaker 5: it can be sort of forty early forties. So some
Speaker 5: people don't even have menopause on their radar, so they
Speaker 5: don't necessarily know why they're starting to feel a bit anxious,
Speaker 5: a bit paranoid, irritable.
Speaker 4: So the connection might not be there.
Speaker 5: And it might come a bit out of the blue,
Speaker 5: and it can be really hard to deal with.
Speaker 4: And I think the timing of menopause is now with
Speaker 4: our lifestyles, is often at a time of life that
Speaker 4: people are really quite particularly women, are quite stretched and
Speaker 4: quite busy. So in the middle of your life, you're
Speaker 4: often at the prime of your career. You might have
Speaker 4: teenage children, perhaps elderly parents who might be managing house,
Speaker 4: the household, like you might be doing a whole lot
Speaker 4: of things, and so you're just really busy and stretched,
Speaker 4: and with that often comes stress, and so I think
Speaker 4: that's a huge factor that sometimes we forget to take
Speaker 4: into the into consideration. When we think about the impact
Speaker 4: of these hormonal changes, it can sometimes be like the
Speaker 4: tipping point. You can kind of cope and then you
Speaker 4: get to this point where you just can't cope with
Speaker 4: all of that pressure and stress anymore.
Speaker 5: And so it might be the hormones that are triggering things.
Speaker 5: But then if we look at the whole story and
Speaker 5: take a holistic approach, is often a lot going on
Speaker 5: for that person at the same time.
Speaker 3: Well, that's that's right.
Speaker 2: So that leads nicely into the you know, that rage
Speaker 2: and that irritability, that sort of almost breaking point. Then
Speaker 2: you kind of have little all out and then regroup.
Speaker 5: Yes, yes, and I think within that presentation of depression,
Speaker 5: we've done a bit of work at her Center, which
Speaker 5: is at Monish University where I work, led by Professor j. Shukulcanni,
Speaker 5: where we've looked at characterizing that perimenopausal depression, which is
Speaker 5: a bit different to a clinical depression at other life
Speaker 5: phases because.
Speaker 4: It's a bit more on. It can be for some
Speaker 4: women quite on off.
Speaker 5: So suddenly there's that rage or that paranoid thinking, that
Speaker 5: irritability kind of out of nowhere, and then you do
Speaker 5: bring yourself back together and feel like okay, So it's
Speaker 5: kind of got this on off flavor to it that's
Speaker 5: a little bit different to that potential, you know, ongoing
Speaker 5: sadness or helplessness that might be part of a clinical
Speaker 5: depression at other life phases, if.
Speaker 1: I hit an explosive moment at home, Caroline, half the time,
Speaker 1: I'd just be going off, saying whatever was going through
Speaker 1: my head, and at the same time I'd actually would
Speaker 1: have it was like I was looking at myself outside
Speaker 1: my body, going who are you? What are you doing what?
Speaker 1: It was really strange that two things could be happening
Speaker 1: at once. That I could be putting so much effort
Speaker 1: into yelling and you know, at my family about something
Speaker 1: ridiculous like the fact that no one can put dishes
Speaker 1: in the dishwasher, and at the same time I was
Speaker 1: sort of going, goodness me, Francesca, what on earth is
Speaker 1: going on with you? Who are you? You know?
Speaker 4: It was bizarre, Yeah, And that's not uncommon.
Speaker 5: That's that's a very common description of the feelings and
Speaker 5: the emotions and how they play out for a lot
Speaker 5: of people.
Speaker 2: And I think it is good to make that distinction that,
Speaker 2: like you say about the on off and you're not
Speaker 2: saying this is a rule. You're saying this is in general.
Speaker 2: But if you are feeling like, gosh, am I clinically
Speaker 2: I mean, obviously your first portocoll is your health professional,
Speaker 2: But am I clinically depressed?
Speaker 3: Or is can I?
Speaker 2: And this is why they often tell you to do
Speaker 2: a diary, don't they to kind of work out when
Speaker 2: how often that's happening, what time of the month it's happening,
Speaker 2: what time of the even the day it's happening.
Speaker 4: Yeah, exactly.
Speaker 5: And for that reason, we also developed this scale it's
Speaker 5: called the MENO D that people can access and it
Speaker 5: provides people are capacity to rate their perimenopausal depression to
Speaker 5: kind of get an objective score.
Speaker 4: To say where am I at? Is this really I
Speaker 4: need to.
Speaker 5: Follow up with a doctor or is this okay? So
Speaker 5: there's in the MENOD there's cutoff scores. But I think
Speaker 5: if anyone's concerned, intuitively within yourself, just go and speak.
Speaker 5: Don't hesitate. Always go and speak to a health care provider.
Speaker 5: Because there's so many different options out.
Speaker 4: There to support people.
Speaker 5: People shouldn't just have to bear, you know, put up
Speaker 5: with it and bear it and get through. I think
Speaker 5: that that thinking is something that's definitely changed that we
Speaker 5: now appreciate that it's quite common to experience changes to
Speaker 5: mood and to experience brain fog. But you shouldn't just
Speaker 5: have to suffer, because you know, four to ten years
Speaker 5: is quite a long.
Speaker 3: Quite a long time.
Speaker 1: Yeah, I've pulled up the questionnaire. It's quite extensive. It's good.
Speaker 1: It's about four pages, but it's going to cover everything,
Speaker 1: which is fantastic. Oh, thanks for pointing us in that direction, Caroline,
Speaker 1: that's awesome. Another thing that's almost the opposite of everything
Speaker 1: going on in your brain at once and exploding is nothing.
Speaker 1: Having moments of blankness and struggling to kind of get
Speaker 1: through the brain fog is something that a lot of
Speaker 1: people talk about as well.
Speaker 5: Yeah, that's something that's I think gained a lot of
Speaker 5: traction and discussion, particularly in the social media space over
Speaker 5: the past maybe decade. And it's weird because brain fog
Speaker 5: isn't a term like depression. It's not a term that
Speaker 5: has a clinical description. It's not a diagnostic or medical
Speaker 5: term or psychological term. It's just a term that's emerged
Speaker 5: from the community to describe their experiences. And we've asked
Speaker 5: them in about what it is for them. You know
Speaker 5: what is brain fog, And people talk about memory lapses,
Speaker 5: attention lapses, difficulty in making decisions, that word finding difficulty,
Speaker 5: you know that when you've got a word on the
Speaker 5: tip of your tongue and you just can't find the
Speaker 5: right word. So they're the main kind of symptoms that
Speaker 5: fall under that umbrella of brain fog for women, and
Speaker 5: our understanding of it is a bit similar to the depression,
Speaker 5: like we think that some women again when they're sensitive
Speaker 5: to the hormone fluctuations. There's estygen receptors in our brain
Speaker 5: in the front part of our brain, which is really
Speaker 5: important for our higher order executive functions like organizing our thoughts,
Speaker 5: as well as in a part of our brain called
Speaker 5: the hippocampus, which is really important for our memory. So,
Speaker 5: again going back to the science, it makes sense that
Speaker 5: when these hormones are fluctuating and declining and they're in
Speaker 5: brain areas that are really relevant for our thinking skills,
Speaker 5: that there might be a flow on impact to our
Speaker 5: thinking skills. And again there's all the other stuff that
Speaker 5: can impact life, stress, poor sleep, mood changes, So all
Speaker 5: of those things independently can impact your thinking skills. But
Speaker 5: then the hormones might have a direct impact for some
Speaker 5: people as well on their brains and on their thinking skills.
Speaker 5: But one thing I do like to always add is
Speaker 5: that while women experience this brain fog in daytay life,
Speaker 5: it's very real.
Speaker 4: It happens in about two thirds of women.
Speaker 5: For some people's subtle some people can have quite a
Speaker 5: big impact. But when we do a neuropsychological assessment, which
Speaker 5: is when we assess someone's cognitive capacity, their actual ability
Speaker 5: to reason and to make judgments and to use their
Speaker 5: attention and their working memory and to learn, it's normally.
Speaker 4: In the normal range. So people during.
Speaker 5: Menopause, even those women who are experiencing brain fog, their
Speaker 5: actual core cognitive skills don't change, so they're still able cognitively.
Speaker 1: That's a really important It's almost more like imposter syndrome
Speaker 1: that you've ended up with. You think you can't do it,
Speaker 1: but you are still functioning well.
Speaker 4: Yes, but some people just need some support.
Speaker 5: So they might just need a bit more structure or
Speaker 5: a little bit more you know, time to do things,
Speaker 5: or a little bit less distraction while they're doing tasks.
Speaker 5: So it's just the support the scaffolding that people might
Speaker 5: need so their brains can continue performing at their best.
Speaker 2: I know, when I can't reach for a word or
Speaker 2: a name or so forth, all I really do need
Speaker 2: is a little bit of understanding and time, not idea
Speaker 2: when you're trying to record a podcast and it happens,
Speaker 2: but you know, all I need because I know it's there.
Speaker 2: And what I would prefer rather than someone maybe finishing
Speaker 2: my sentence or giving up on it, is just that
Speaker 2: time is it. Just give me a minute, it will
Speaker 2: come to me, you know, because I get more frustrated
Speaker 2: when I have to leave it and then go oh,
Speaker 2: and then it'll come to me in the middle of
Speaker 2: the night when we're awake, because we're awake.
Speaker 4: Through yes exactly. And it's not that helpful then. But
Speaker 4: that's the other thing that is.
Speaker 5: I think some people with they get anxious to try
Speaker 5: and find the right word or to try and think,
Speaker 5: and I think that anxiety can make the brain fog worse.
Speaker 5: So I think you said like a bit of time,
Speaker 5: I think that's like perfect just to try and you know,
Speaker 5: relax and not stress too much about it and just
Speaker 5: to back yourself and note like the word is still
Speaker 5: somewhere in my mind or I am still able to
Speaker 5: make decisions, but I just need a bit more space
Speaker 5: in my head to do that.
Speaker 3: And that what was thirty seconds? Maybe I don't know.
Speaker 2: I'd probably give up myself after about thirty seconds.
Speaker 1: I first, yeah, I sort of first mentioned it to
Speaker 1: my GP, probably before I even knew there was a
Speaker 1: thing called perimenopause. And she would say, she'd sort of
Speaker 1: say to me, Okay, tell me what it is that
Speaker 1: you can't remember. I go, oh, a name, or does it?
Speaker 3: Then she goes.
Speaker 1: And then I got to one scenario, Caroline, I said
Speaker 1: to it, I can't I couldn't remember where the mayonnaise
Speaker 1: was in the super market. And she went on, that's
Speaker 1: one that we might we might just make a note of.
Speaker 1: And she said, but it's never happened again. But I
Speaker 1: think that that was the first thing. The first thing
Speaker 1: a lot of women probably go to is, oh, my gosh,
Speaker 1: am I heading towards dementia, have id early on set dementia,
Speaker 1: And it could be very you know, it's easy to
Speaker 1: make that assumption.
Speaker 5: Oh, absolutely, because if you think about very superficially the
Speaker 5: kinds of experiences you have, like you know, forgetting where
Speaker 5: things are, forgetting names, losing your train of thought in
Speaker 5: a conversation like those things might sound very superficially like
Speaker 5: the early stages of dementia, but I think it's a
Speaker 5: few really key differences between menopausal brain fog and dementia are.
Speaker 5: One is age, So people aren't diagnosed with dementia generally
Speaker 5: of the Alzheimer's type, at least until the age of
Speaker 5: sixty five, and even early on. Said, it's sort of
Speaker 5: more fifty plus, So just because of someone's age alone,
Speaker 5: it's very unlikely that people are experiencing the early stages
Speaker 5: of dementia. And if it is early on set or
Speaker 5: young ones at dementia, that's quite rare, but it exists.
Speaker 5: But the presentation then often has more mood symptoms, more
Speaker 5: behavioral changes. It's not the same as that kind of
Speaker 5: forgetfulness or not finding the right word or so.
Speaker 4: I think they're some of the key differences.
Speaker 5: And often also with dementia, it's other people around you
Speaker 5: who become quite concerned rather than the person the individual themselves.
Speaker 4: Whereas in menopause it's very much the individual.
Speaker 1: Who's ghost So true.
Speaker 5: Yeah, So I think there's a few factors that are
Speaker 5: quite different, and certainly clinically and neuropsychologically, the presentations are
Speaker 5: really quite different when you drill down.
Speaker 2: So what other issues are you seeing when it comes
Speaker 2: to cognitive and mental health issues with women?
Speaker 5: So the other clinical question I have been receiving a
Speaker 5: lot in recent years is women who present and they've
Speaker 5: got these cognitive changes and their menopausal and they're questioning
Speaker 5: where they've got ADHD.
Speaker 4: So this is a new thing that's popped up.
Speaker 5: It wasn't a question that came up, I don't know,
Speaker 5: five years ago or so, but.
Speaker 4: It's more and more frequently people are.
Speaker 5: Questioning this, and there's sometimes it's because the peri apause.
Speaker 5: A woman has children and they've been diagnosed with ADHD,
Speaker 5: and through taking a children through that journey, they've you know,
Speaker 5: obviously been made aware of what ADHD is and what
Speaker 5: the symptoms look like, and they've identified so many of
Speaker 5: the characteristics in themselves, and then they've felt like they're
Speaker 5: really experiencing this and they've always been experiencing the symptoms
Speaker 5: of ADHD or the characteristics of ADHD, but they've kind
Speaker 5: of managed, but they've got to a point where they
Speaker 5: can't manage anymore. So that's often the presentation of people.
Speaker 5: And in that case, like clinically to tease apart, is
Speaker 5: this like a new onset of brain fog.
Speaker 4: That looks a bit like ADHD?
Speaker 5: Or is this a genuine ADHD, like a brain type,
Speaker 5: a neurodevelopmental condition that someone's always had. We spend a
Speaker 5: lot of time talking to someone and really understanding their
Speaker 5: history and understanding what their presentation is. So just for
Speaker 5: people who are unaware, so ADHD attention deficit high practicivity disorder.
Speaker 5: It can present quite commonly for females as just the
Speaker 5: inattentive component, So that's things like forgetting things, losing things,
Speaker 5: losing your train of thought, sitting in a conversation and
Speaker 5: then realizing you've just missed most of the conversation, haven't
Speaker 5: been listening. So that's one presentation of ADHD inattentive. The
Speaker 5: other presentation is that hyperactive impulsive where people feel like
Speaker 5: they're on the go, they've got a motor inside them,
Speaker 5: they sort of talk excessively or butt into conversations.
Speaker 4: And people can also have a combined presentation, but the.
Speaker 5: Undiagnosed woman is often the one who has that inattentive ADHD,
Speaker 5: and I think a lot of people look at inattentive
Speaker 5: ADAH and it's very easy to tick those bloxes. Like
Speaker 5: we all forget things from time to time. We all
Speaker 5: sit in a conversation and our brains drift off and
Speaker 5: we're not present and we miss things. So a lot
Speaker 5: of the characteristics of inattentive ADHD are really common. Sometimes
Speaker 5: it means that they can be missed, but I think
Speaker 5: in terms of a clinical diagnosis, it has to be
Speaker 5: that they're kind of pervasive and that they really are
Speaker 5: present in more than one setting, and that they impair functioning.
Speaker 5: So it's really separating out, you know, what is normal
Speaker 5: degrees of inattention that we all experience from time to
Speaker 5: time from something that is someone's neurodevelopmental brain conditional brain
Speaker 5: type where it's really causes challenges. And often people have
Speaker 5: a history where they've managed or they've been misdiagnosed with
Speaker 5: depression and anxiety and all sorts of things, and then
Speaker 5: they get to this point and it's quite clear that
Speaker 5: they've always had this, but it just hasn't been diagnosed,
Speaker 5: and so sometimes that's quite a big journey for people
Speaker 5: to go on to get a late diagnosis and to
Speaker 5: you know, all the what ifs iphony are known and
Speaker 5: so yeah, it can be quite confronting for people, but
Speaker 5: also there can be an element of relief for some
Speaker 5: people as well when they do have a diagnosis later
Speaker 5: in life and a new understanding, a new lens to
Speaker 5: understand their world.
Speaker 1: That's a lifetime of what in our family we call
Speaker 1: the aha moments. My daughter was diagnosed at thirteen and
Speaker 1: we spent a year going oh ah, you know, like
Speaker 1: because everything kind of fell into place and things like that,
Speaker 1: so that came back. Imagine how that's overwhelming. If that's
Speaker 1: a lifetime of those. Yeah, absolutely, yes, I think it's
Speaker 1: probably like everything, Caroline. When we have a symptom, it's
Speaker 1: really important to, you know, make sure you're talking thoroughly
Speaker 1: to your gp about it and not presuming it's just
Speaker 1: one thing or the other. It's like, there's such a
Speaker 1: massive list, isn't there of menopausal symptoms, And yes, a
Speaker 1: lot of the time they do. That's what they are.
Speaker 1: It is to do with the hormones. But you've always
Speaker 1: got to make sure that you're just double checking that
Speaker 1: there's not something else at play and something else going on.
Speaker 5: Yeah, absolutely, yes, definitely always worth having if you're concerned
Speaker 5: and it's you know, occupying your mind and in thinking
Speaker 5: about it, always worth having a chat to your healthcare provider.
Speaker 1: You're listening to the little things and our guest on
Speaker 1: the podcast today is clinical neuropsychologist doctor Caroline Gerbert, talking
Speaker 1: about how our hormones impact our brains and our mental health.
Speaker 1: Will be back shortly after the break. Welcome back, Carolin.
Speaker 1: Maybe we could talk about some tips to help us
Speaker 1: through all this, how we can manage it If our
Speaker 1: mental health is suffering, is medication the best option? Or
Speaker 1: can lifestyle and dietary changes and things help?
Speaker 5: So I think a combination of everything can be most helpful.
Speaker 5: So I think you can always start with kind of
Speaker 5: behavior change lifestyle change, but if that's not helping, I
Speaker 5: think it's definitely recommended that people go and have a
Speaker 5: chat to your GP and make sure you've got a
Speaker 5: GP who has a really good understanding of menopause because
Speaker 5: it's not everyone's area of specialty, and so if someone's
Speaker 5: experiencing sort of a new onset depression around menopause, they
Speaker 5: might want to be speaking to their GP about different
Speaker 5: types of hormone therapies or antidepressants if hormone therapies aren't
Speaker 5: appropriate for them, and for the sort of brain foggy
Speaker 5: cognitive symptoms as well. Might want to be thinking about
Speaker 5: really practical things that people can do just to support
Speaker 5: their cognitive health during the menopause transition.
Speaker 4: So that's things like, you know, using.
Speaker 5: Your diary, like feeling comfortable to put everything in your
Speaker 5: diary so you don't have to hold it in your head,
Speaker 5: and using lists to remember what to do, kind of
Speaker 5: doing the brain dumps to get all those thoughts that
Speaker 5: are floating around in your head onto a piece of
Speaker 5: paper to clear some space so you.
Speaker 4: Can think clearly.
Speaker 5: And you know, in workplaces, making sure people put things
Speaker 5: in an email so they don't shout them out in
Speaker 5: the corridor. And then you're trying to hold more bits
Speaker 5: of information in your head, so put the onus on
Speaker 5: other people to structure things for you and email them
Speaker 5: through and help with prioritization if need be. So I
Speaker 5: think there's kind of practical things. There's medication options, but
Speaker 5: I also think midlife and menopause is a really good
Speaker 5: opportunity to sit back and reflect on your lifestyle. And
Speaker 5: think about healthy lifestyle and what's good for our kind
Speaker 5: of brain health. So it's the same things that we
Speaker 5: say for heart health, it's exactly the same for brain health.
Speaker 5: So it's things like exercise is super important, and exercise
Speaker 5: on its own can also help mood. So making sure
Speaker 5: people exercise and get moving is very important. Making sure
Speaker 5: as much as possible that you get good sleep, and
Speaker 5: there's help out there if you're not sleeping well, again,
Speaker 5: speak to your doctor about it. It's really sleep is crucial,
Speaker 5: you know, Making sure do you have time out so
Speaker 5: you're not on the go all the time, making.
Speaker 6: Sure your brain is stimulated, making sure you've got a
Speaker 6: good balanced diet like Mediterranean diet, and making sure you're
Speaker 6: not using alcohol as a coping strategy because that's not
Speaker 6: going to help your brain that I think, you know,
Speaker 6: some people kind of turn to alcohol as as a
Speaker 6: quick fists and makes them feel better temporarily, but.
Speaker 4: It's not going to help in the long run.
Speaker 5: So there's lots of kind of healthy lifestyle things that
Speaker 5: people can do. And I think you know, midlife is
Speaker 5: a great time to reflect on your own lifestyle.
Speaker 2: Yes, and we've covered a lot of those points it
Speaker 2: was one of the reasons for doing this in the
Speaker 2: first place, was how how to help ourselves and sit
Speaker 2: I know, for me, exercises a big one and I
Speaker 2: really know when I can't the impact it has on me. Yes,
Speaker 2: with same with diet and getting that time out can
Speaker 2: sometimes be one of the hardest parts.
Speaker 4: Absolutely, but it might not even be.
Speaker 5: It's not like you have to go and spend a
Speaker 5: day a week in a spa, although that might be nice,
Speaker 5: but it might just but you know, having making sure
Speaker 5: that you have, you know, five minutes just to go
Speaker 5: for a walk by yourself with no phones, no stimulation,
Speaker 5: just some actual switch off or just a breather in
Speaker 5: the middle of the day, have a cup of tea
Speaker 5: or whatever it is.
Speaker 4: But just little bits of switch off where you're not
Speaker 4: your brain isn't bombarded with stimulation.
Speaker 3: Any breaks.
Speaker 1: I like that, Yeah, many breaks, Everything's many these days, Caroline.
Speaker 1: Conversation ahead with women quite often when they have symptoms
Speaker 1: to do with their mood, maybe low mood and things
Speaker 1: like that, maybe they're not sleeping as well on things.
Speaker 1: Often we're all having the same conversation with our GPS.
Speaker 1: Do we need HI or do we need any depressants.
Speaker 1: How do we make that decision.
Speaker 5: It's such a good question and we actually don't know
Speaker 5: the answer. So we're trying to run a clinical trial
Speaker 5: at the moment where we're trying to do this head
Speaker 5: on head comparison and antidepressants and hormone therapy because that
Speaker 5: hasn't been done, so we don't know that answer at
Speaker 5: the moment. Our clinical guidelines say to go with the
Speaker 5: antidepressants because they've got a stronger evidence base, but there
Speaker 5: just hasn't been as much research with hormone therapy for
Speaker 5: mood so I think that's why there's not as much
Speaker 5: evidence there. Although the guidelines do say that you can
Speaker 5: try hormone therapy for moods as well, it's just not
Speaker 5: the first line treatment that's recommended. So I just think
Speaker 5: it's really important to go and have a really good
Speaker 5: discussion with your GP, and you can look at the
Speaker 5: Australasian Menopause Society is a really good place to read
Speaker 5: up and they've got literature for anyone who wants to
Speaker 5: have a look at what the recommendations are for that
Speaker 5: to go to your GP with that see a.
Speaker 4: Bit more equipped to have the conversations.
Speaker 1: And be honest about it. I think if you've never
Speaker 1: really suffered from mental health, then it's quite hard to
Speaker 1: go in and have that conversation and sort of put
Speaker 1: it on the tables. But it's important that we do
Speaker 1: how far along is that research. Can we just rush
Speaker 1: that along a bit love to.
Speaker 4: Russia.
Speaker 5: We're working through as quick as we can, and.
Speaker 3: How slow research can be.
Speaker 4: It can be really slow. Funding can be really hard
Speaker 4: for every research as well.
Speaker 5: So we're doing the best that we can to try
Speaker 5: and learn more and get those answers.
Speaker 4: But I think also you know, if you're not.
Speaker 5: Someone who's experienced depression in your life and your hormones
Speaker 5: change and your experienced depression for the first time, maybe
Speaker 5: trying to replenish those hormones might be a good place
Speaker 5: to start. But have that conversation with your GP.
Speaker 2: And I think the good news there is that there
Speaker 2: are resources like the Australian Minipause or society. There are
Speaker 2: more resources with even in space research that we do
Speaker 2: have that women can themselves with or do that research
Speaker 2: before they go to see someone. And if you don't
Speaker 2: get the answers that you think you need, or if
Speaker 2: you feel like you're getting brea off, try try again
Speaker 2: with somebody else prehaps.
Speaker 5: Yes, exactly, And I think that's hard, Like often when
Speaker 5: you're feeling vulnerable and you build up the courage to
Speaker 5: go and speak to a GP. If you do get dismissed,
Speaker 5: which can sometimes happen if it's not someone's area of specialty,
Speaker 5: it can be hard to try again. But I think
Speaker 5: you know, always try and find that new self to
Speaker 5: keep trying until you get to a point where you
Speaker 5: feel better.
Speaker 1: You mentioned before, you know, will we hit this sort
Speaker 1: of period of our lives, it is a good time
Speaker 1: to sort of have a little bit of a reset
Speaker 1: and think about our cognitive health. But should we always
Speaker 1: be looking after it like shou should we be saying
Speaker 1: to it? Should we be sort of more aware of
Speaker 1: out even our older teenagers and things like that near
Speaker 1: cognitive health and putting in good practices.
Speaker 5: Now Absolutely, I think all through our lives we should
Speaker 5: do what we can to do the best for ourselves
Speaker 5: to optimize our brains and our physical health always, but
Speaker 5: I think people probably have other priorities, as you know, teenagers,
Speaker 5: and so I think midlife is a great time if
Speaker 5: you haven't already implemented some of those things like you know,
Speaker 5: a regular exercise routine and a healthy diet. It's not
Speaker 5: too late to start to still, you know, there are
Speaker 5: things that these they modify our risk of later life
Speaker 5: dementia and things like that. We do have some degree
Speaker 5: of control and we can try and do our best
Speaker 5: to have some of those healthy lifestyle approaches and they
Speaker 5: have short term benefits and longer term benefits as well.
Speaker 2: I'm going to ask a really dumb question, and I'm
Speaker 2: blaming it on minopause. Okay, our brain is a muscle, right, our.
Speaker 4: Brain, It adapts.
Speaker 5: So our brain they often use the words of being,
Speaker 5: you know, plastic, it's malleable.
Speaker 4: So it keeps changing always.
Speaker 5: And so you know, the more we do good things
Speaker 5: for our brain, our brain will respond and will adapt.
Speaker 5: And that's why people recommend things like you know, learning
Speaker 5: a new skill or taking up new hobby or you know,
Speaker 5: challenging yourself because that builds new connections in the brain
Speaker 5: and strengths and connections in the brain. So, yes, our
Speaker 5: brain keeps changing as we as we grow.
Speaker 1: That's what's so cool about it. As we can improve it,
Speaker 1: it can grow and get better. That's what's so neat
Speaker 1: about it.
Speaker 4: Yeah, yes, yes, always, yes, you know.
Speaker 1: It's interesting. I was gonna ask you, you know, we
Speaker 1: really need to support each other a lot more going
Speaker 1: through this period of time and how we can do that.
Speaker 1: But I wonder whether the best thing that we could
Speaker 1: do is get our partners to listen to this podcast. Yeah,
Speaker 1: because I think most women, we were all we are
Speaker 1: quite understanding of what other women are going through. Yes,
Speaker 1: and as Lu said before, we're having a lot more
Speaker 1: conversations about it. But I think probably where we struggles
Speaker 1: and other environments, like in the workplace.
Speaker 5: Yes, yes, exactly, and I think some workplaces are more
Speaker 5: progressive and there's more conversations about menopause and menopause in
Speaker 5: the workplace and supporting women through menopause and yeah, but
Speaker 5: I think the more conversations that happen, it just becomes,
Speaker 5: you know, part of our dialogue and it's not such
Speaker 5: a big deal and it's not so taboo and there's
Speaker 5: less stigma if there's more conversations. And I think, you know,
Speaker 5: at the heart of it, in terms of the workplace,
Speaker 5: we want to be able to keep women and all
Speaker 5: their talents and that diversity in the workplace, and there's Sadly,
Speaker 5: far too many women who get to a point and
Speaker 5: for whatever reason, whatever's going on for them, they leave
Speaker 5: work during those menopause transition years, and you know that's terrible,
Speaker 5: rather than seeking the right supports and then being able
Speaker 5: to do their best to thrive during this time. So
Speaker 5: I think it's really important that there's support coming from
Speaker 5: all different places so everyone can be at their best.
Speaker 2: It's not as if we're using it as an excuse
Speaker 2: for any kind of poor behavior or poor work outcomes
Speaker 2: or anything like that. So it's a knit win, right
Speaker 2: if it's not, and like you say, just giving us
Speaker 2: that moment if we need it or I know there's
Speaker 2: a lot of talk about uniforms, people who work in
Speaker 2: places where they wear uniforms where they're not practical.
Speaker 3: When you have when you have a hot flush.
Speaker 4: Yes, exactly, exactly.
Speaker 3: Sometimes, Yeah, we're not just talking about the corporate workplace.
Speaker 3: We're talking about across the board.
Speaker 5: Yes, sometimes people need layers so they can adapt to
Speaker 5: however whatever their body temperature is feeling for them.
Speaker 2: I mean, we have arguments all the time about the
Speaker 2: airct and in our building.
Speaker 5: Yes, yes, so golden here, yes, yeah, exactly, Yes, it
Speaker 5: depends who has the controller.
Speaker 1: When it comes to our cognitive health and the other
Speaker 1: things that we've been talking about. Caroline, I suppose if
Speaker 1: you do want to reach out and get some help,
Speaker 1: the first place you go to is your GP.
Speaker 4: Yes, definitely always yeah, go and have a chat to
Speaker 4: your GP.
Speaker 5: And also the other place is good websites like the
Speaker 5: Australasia Menopause Society, where there's good resources, evidence based resources.
Speaker 5: So I think, you know, looking at those kinds of
Speaker 5: websites as well as having a chat to your GP.
Speaker 1: Doctor Caroline Goovich, thank you so much for talking to
Speaker 1: us day and normalizing our irritability and our rage and
Speaker 1: our you know, our low mood and everything else and
Speaker 1: our brain fog, everything else that comes with that.
Speaker 3: We really appreciate it.
Speaker 1: Fantastic tips, yeah yeah, and the men O D questionnaire
Speaker 1: that's going to be that's going to be a brilliant
Speaker 1: tool for people. So thank you so much.
Speaker 4: Thank you, Francisca and Louise, thank you for having me.
Speaker 1: How good is doctor Caroline Goovitch. I just love the
Speaker 1: fact that it's all evidence based, science based. There is
Speaker 1: a reason that you have this irritability and this rage
Speaker 1: and that everything that the world is. You know, it
Speaker 1: seems to be changing around you.
Speaker 2: I hang on every word, and I only wish that
Speaker 2: perhaps I did have more of an understanding of that.
Speaker 2: I'm not even kidding. In my late thirties and early forties,
Speaker 2: which is when I would say, I was at my
Speaker 2: lowest EBB mental health wives and it wasn't related to
Speaker 2: the birth of a baby or anything else. Like, there's
Speaker 2: nothing else to put my finger on except for a
Speaker 2: lot of probably a lot of.
Speaker 1: But there was also a lot going on in your
Speaker 1: life at that point.
Speaker 2: Yes, well, as she explained it as often, it offers
Speaker 2: that horrible kind of convergence of everything of everything.
Speaker 3: Yeah, but I think you're right.
Speaker 2: I think this one is for the boys too, and
Speaker 2: actually was just reflecting and maybe for my kids just
Speaker 2: I'll just take some snippets out and send it to them,
Speaker 2: because that might.
Speaker 3: Just explain those Raigie drives to school. Did you ever
Speaker 3: have those? You just screamed at the children all the
Speaker 3: way to school?
Speaker 1: No, once I put the horn on. Oh yes, I
Speaker 1: feel like that was that was I just we were
Speaker 1: driving through the lights and I were arguing, and I
Speaker 1: just put the horn on. But we were quite close
Speaker 1: to school, so of course they were mortified because everyone
Speaker 1: was staring at us and until when they stopped off
Speaker 1: the wall. So we had it, had a good day.
Speaker 2: There was the mother of five that winteresso and I'm
Speaker 2: not gonna I got it. And literally I remember walking
Speaker 2: the kids to school and you're driving past what she
Speaker 2: got the horn on.
Speaker 3: The minivan for? And then she explained it.
Speaker 1: Yeah, no, I think I think I got it off her.
Speaker 1: And I remember using what's going That was actually pretty effective.
Speaker 1: Hey really quickly though, Caroline mentioned a questionnaire you can
Speaker 1: do if you're just trying to work out sort of
Speaker 1: what level your symptoms are at your perimenopausal symptoms. It's
Speaker 1: called meno dno slash D. If you google that, you'll
Speaker 1: take you through to the questionnaire and it's from the
Speaker 1: mon Nash University and it's great for you to maybe
Speaker 1: use as a tool. But if you're struggling to maybe
Speaker 1: you know, explained and listened to by your GP, you
Speaker 1: could always sort of maybe print out and take it
Speaker 1: in and go, look, here we go. I've done a
Speaker 1: bit of a this is where I'm at, this is
Speaker 1: what we need to do something with, So that could
Speaker 1: be potentially a really great tool. Just just want to
Speaker 1: touch on one other thing. I found that really interesting,
Speaker 1: the sensitivity and how they've worked out how some people
Speaker 1: are more sensitive to hormone fluctuations in it, but we
Speaker 1: can't quite work out why.
Speaker 3: Yeah, a little bit probably to do on that. I'm
Speaker 3: sure they'll get to it.
Speaker 2: The Australasian and menopause Al Society is also really good,
Speaker 2: a really good point of reference for and more information
Speaker 2: and I'm pretty sure that's their name of their website
Speaker 2: as well, so and that will keep you up to
Speaker 2: date with research as well. It's it's a full time,
Speaker 2: it's a frull time. And I think we've touched on
Speaker 2: lots of elements of menopause, but not done a specific
Speaker 2: one about.
Speaker 1: This, about that age, mood and the things like that.
Speaker 1: I think I think we often talk about other things
Speaker 1: a little bit more than we open up about that
Speaker 1: hemnopause maybe, or we try and we do. We do
Speaker 1: try and laugh it off because what else gotta do?
Speaker 1: Cry and ray and put your horn on and just
Speaker 1: leave your hand on that horn for as long as
Speaker 1: you're lining. Maybe that's my joy of the week, just
Speaker 1: exprussing yourself, just you know, put your hand on the
Speaker 1: horn and just let it blair and let everyone look
Speaker 1: at you and just let it out.
Speaker 3: Then just give them the evidence.
Speaker 5: Yeah.
Speaker 3: Yeah, well that's a good joy.
Speaker 6: I like that.
Speaker 5: Do you have one.
Speaker 3: I'm full of a cold, so I my joy is coming.
Speaker 2: I'm feeling very grateful for good health when you have it.
Speaker 2: So yeah, it's just a cold, but my god, it's
Speaker 2: really it's kind of doing a number on me.
Speaker 1: Well, we know what happens to Louise, which you can't exercise.
Speaker 1: You know, I get a bit range, you get a
Speaker 1: bit rangy. There we go. Thanks for joining us on
Speaker 1: our new zealanderial podcast, Serious Little Things. We hope you
Speaker 1: share this podcast with the women in your life. We
Speaker 1: can all live with a little less rage.
Speaker 2: You can follow this podcast on iHeartRadio or where ether
Speaker 2: you get your podcasts, and for more episodes from us
Speaker 2: on other topics, head to zid Herald dot co dot
Speaker 2: ZT and we'll catch you next time on the Little
Speaker 2: Thanks