WEBVTT - The midlife rage no one warns you about 0:00:03.320 --> 0:00:06.080 Hi, I'm Louise Ari and I'm Francesca Brudkin, and this 0:00:06.200 --> 0:00:09.239 is season five of our New Zealand Hell podcast, The 0:00:09.360 --> 0:00:10.960 Little Things. It's good to have you with us. 0:00:11.240 --> 0:00:13.600 In this podcast, we talk to experts and we find 0:00:13.600 --> 0:00:15.280 out all the little things you need to know to 0:00:15.320 --> 0:00:17.319 improve all the years of your life and cut through 0:00:17.560 --> 0:00:20.520 the confusion and the overload of information out there. 0:00:20.800 --> 0:00:24.160 We've got such good topic today, have looyd Owiz. We're 0:00:24.200 --> 0:00:27.159 going to talk about midlife rage, midlife emotions. And I 0:00:27.200 --> 0:00:28.920 think at this point my family would quite like to 0:00:28.960 --> 0:00:33.240 take over and have their two cents we've maybe contribute 0:00:33.320 --> 0:00:36.080 to this conversation. I'll keep them a million miles away 0:00:36.080 --> 0:00:41.120 from this. As a child, I was quite explosive, not 0:00:41.200 --> 0:00:44.040 all the time, but I could. I was quite unpredictable 0:00:44.080 --> 0:00:47.640 and I could definitely let loosen and rage a little bit. 0:00:48.520 --> 0:00:53.160 And as an adult, and you've known me as an adult, Louise, 0:00:54.400 --> 0:00:58.760 I've worked really really hard to I suppose, calm things 0:00:58.800 --> 0:01:03.320 down and challenging moments and you know, I've you know, 0:01:03.360 --> 0:01:05.640 as immature, you learn lots of ways of dealing with things. 0:01:05.720 --> 0:01:08.479 If you know that your responsive, you know, i'd maybe 0:01:08.520 --> 0:01:10.160 just say to people. That's great, I'll have a think 0:01:10.200 --> 0:01:11.959 about it and come back to talk about things like. 0:01:12.000 --> 0:01:14.039 I just learned all these little ways of remaining calm, 0:01:14.080 --> 0:01:17.160 and actually to the point that when I got really angry, 0:01:17.560 --> 0:01:20.720 I got quite quiet, and then i'd slow down my 0:01:20.880 --> 0:01:24.360 talking to a patronizing kind of spit on the ski 0:01:24.520 --> 0:01:27.759 fields and I'd talk very slowly like this, And when 0:01:27.760 --> 0:01:31.160 that happens, my kids got, oh shit, she's really angry. 0:01:31.319 --> 0:01:32.840 Like like, I learned that. That was when I was 0:01:32.840 --> 0:01:36.399 really really angry. But then I hit my forties, probably 0:01:36.400 --> 0:01:40.640 my mid forties, and this explosiveness just came back, all 0:01:40.680 --> 0:01:43.560 this complete lack of patience for what was going on 0:01:43.680 --> 0:01:46.399 around me, and you'd never know what would set me off. 0:01:46.440 --> 0:01:48.200 I mean, still not the big stuff. I can still 0:01:48.240 --> 0:01:50.080 when all the big stuff happens, I'm still very calm 0:01:50.080 --> 0:01:53.680 and but but there'd be just little things that would 0:01:53.720 --> 0:01:56.160 happen and I finally could no longer cope, and I 0:01:56.200 --> 0:01:59.760 would just verbalize everything going through my head while at 0:01:59.760 --> 0:02:03.920 the same time going, you should really just be saying 0:02:03.960 --> 0:02:06.480 this in your head. You should not be letting this out. 0:02:06.520 --> 0:02:08.320 But I couldn't. I couldn't stop it. I'd be like 0:02:08.720 --> 0:02:12.400 I just been like, who is this person? Then discovered 0:02:12.480 --> 0:02:16.799 hit and thankfully we've kind of got a middle ground now. 0:02:16.840 --> 0:02:21.560 But I'm still I'm still slightly I'm actually slightly embarrassed 0:02:22.440 --> 0:02:27.079 about that behavior, and I'm also still slightly shocked at 0:02:27.080 --> 0:02:29.920 how it kind of crept up on me over again. 0:02:29.760 --> 0:02:32.520 I think you should not be too hard on yourself 0:02:32.600 --> 0:02:37.120 because because certainly not alone for starters. I mean, I'm 0:02:37.120 --> 0:02:40.200 impressed that you worked on your explosiveness throughout your life, 0:02:40.280 --> 0:02:42.160 and I do think as I got to know you more, 0:02:42.160 --> 0:02:45.160 I did put into practice some of your measured sort 0:02:45.160 --> 0:02:47.960 of responses to things. Not all the time, but sometimes 0:02:48.320 --> 0:02:51.280 I don't think I did it nearly so much, and 0:02:51.320 --> 0:02:52.000 I think I could be. 0:02:52.120 --> 0:02:53.200 I was quite a ragy mum. 0:02:53.200 --> 0:02:56.600 I think the kids would say, I mean, there's some stories, 0:02:56.600 --> 0:02:59.640 but I mean I even hurt them, But there were 0:02:59.639 --> 0:03:03.079 some same we're just thrown into baths. I guess they 0:03:03.120 --> 0:03:07.560 don't need them. I believe they got flashed out of 0:03:07.560 --> 0:03:11.399 the toilet. But but look, weirdly, my health, Cristi has changed. 0:03:11.639 --> 0:03:14.079 I feel deduced with the kids in the mouth of 0:03:14.120 --> 0:03:18.320 the time, and you were through the sandwichesn't meet them. 0:03:18.400 --> 0:03:20.239 Yes see, I would have stopped and going, I'm just 0:03:20.280 --> 0:03:22.040 going to clean that up. That'd be really annoying. 0:03:22.240 --> 0:03:24.760 Oh, I said they had to eat them, but they 0:03:24.760 --> 0:03:30.359 didn't obviously eat them. They got out of the fun the. 0:03:30.360 --> 0:03:33.919 Toilet and dully they ate them. So there you go. 0:03:34.480 --> 0:03:36.680 So that was that was I. 0:03:36.640 --> 0:03:39.040 Feel like my kids have missed out. Maybe maybe I 0:03:39.040 --> 0:03:40.440 shouldn't let loose a little bit more. 0:03:40.480 --> 0:03:43.400 It's probably the worst one, to be fair, And I 0:03:43.440 --> 0:03:46.480 mean we do laugh about it now anyway, but my 0:03:46.560 --> 0:03:50.640 health christis changed that that ragey little bit, because I mean, 0:03:50.680 --> 0:03:52.640 I don't know, maybe it was the universe talking to me, 0:03:52.680 --> 0:03:55.400 but I felt less irritated by every little thing because 0:03:55.400 --> 0:03:57.920 something big had happened. But they said, I can get 0:03:57.960 --> 0:04:01.400 set off. And and I want to know. I guess 0:04:01.480 --> 0:04:03.640 if it's whether you know that thing about getting to 0:04:03.640 --> 0:04:05.920 a certain age and not giving two shits anymore? Is 0:04:05.920 --> 0:04:09.000 it that or is it realizing life is too short? 0:04:09.160 --> 0:04:10.800 Or is it hormonal or is it a big old 0:04:10.840 --> 0:04:11.720 mixture of all of them. 0:04:12.240 --> 0:04:15.120 If you didn't give two shits anymore, or if you're 0:04:15.120 --> 0:04:17.400 realizing life's too short, then you probably wouldn't react at all, 0:04:17.440 --> 0:04:17.760 would you. 0:04:18.320 --> 0:04:19.279 Hmm? Good point. 0:04:19.480 --> 0:04:21.359 I mean, you'd probably go, why am I going to 0:04:21.360 --> 0:04:22.719 antagonize you one? Why am I going to put this 0:04:22.720 --> 0:04:24.960 out there? If you just roll your eyes and move on. 0:04:25.120 --> 0:04:27.440 Well, that's why I can't the keep all worry stuff 0:04:27.440 --> 0:04:29.960 gets to me because I can't understand why if you're 0:04:29.960 --> 0:04:32.400 that full of vitriol and hate. 0:04:32.720 --> 0:04:34.039 Yeah, yeah, what's up? 0:04:34.279 --> 0:04:36.400 Judgment and opinion and yeah all the rest of it, 0:04:37.080 --> 0:04:40.600 keep it to yourself. Well maybe it's good we let 0:04:40.600 --> 0:04:44.680 it out somewhere, but somehow more something more productive. 0:04:44.760 --> 0:04:47.480 Healthy, that's our healthy way. But maybe they're just all 0:04:47.520 --> 0:04:49.760 struggling with midlife rage. 0:04:49.800 --> 0:04:52.919 Who knows? They can't just think No. 0:04:53.000 --> 0:04:54.840 I think there's a lot of rage about everything, and 0:04:55.240 --> 0:04:57.320 you know, isn't there at the moment in the world. 0:04:57.760 --> 0:05:00.520 But look, we hear about women struggle with their mood 0:05:00.560 --> 0:05:02.960 and women dealing with mental health issues such as anxiety 0:05:02.960 --> 0:05:06.440 and depression, sometimes for the first time in their life 0:05:06.440 --> 0:05:09.160 as perimenopause sets, and if they even know about peri 0:05:09.240 --> 0:05:13.600 mortive menopause, it can be so destabilizing for your relationships, 0:05:13.600 --> 0:05:17.320 your marriage, your job. Does menopause make pre existing anxiety 0:05:17.360 --> 0:05:20.480 and depression relapse or intensify? And what can we do 0:05:20.600 --> 0:05:23.600 to help ourselves. Joining us today is doctor Caroline Gervich. 0:05:23.640 --> 0:05:27.880 Caroline is a clinical neuropsychologist. She is the Deputy director 0:05:28.000 --> 0:05:32.240 of her Center Australia, head of the Cognition and Hormones Group, 0:05:32.279 --> 0:05:35.920 and an associate professor at Monash University. She has a 0:05:35.960 --> 0:05:39.080 research interest in the neuropsychology of women's health and the 0:05:39.160 --> 0:05:42.720 role hormones play on cognition. Welcome Caroline, thanks so much 0:05:42.720 --> 0:05:43.719 for being with us. 0:05:44.080 --> 0:05:46.320 Hi Francesca, thank you for inviting me to talk to 0:05:46.320 --> 0:05:46.800 you today. 0:05:47.240 --> 0:05:50.560 Should we start, maybe at the beginning and talk about 0:05:50.600 --> 0:05:54.679 what hormones are the ones that are impacting our mood 0:05:54.880 --> 0:05:56.000 and our mental health. 0:05:56.960 --> 0:06:02.040 Yes, So during these life phases where our hormones change, 0:06:02.080 --> 0:06:05.880 like menopause, the key hormones we're talking about are estrogen 0:06:06.040 --> 0:06:07.000 and progesterone. 0:06:07.120 --> 0:06:10.560 So these are sex hormones and they're the hormones. 0:06:10.160 --> 0:06:12.880 That regulate our reproductive function, and that's often what we 0:06:12.920 --> 0:06:15.680 think about when we talk about estrogen and progesterone, but 0:06:15.720 --> 0:06:19.839 they actually do a whole lot more than just regulating 0:06:19.880 --> 0:06:23.400 our reproductive functions. So they can cross over our blood 0:06:23.440 --> 0:06:26.960 brain barrier and enter our brains and have quite potent 0:06:27.000 --> 0:06:30.640 effects on different brain areas and particularly brain areas that 0:06:31.000 --> 0:06:34.160 regulate our mood and regulate our thinking skills. So that's 0:06:34.200 --> 0:06:39.880 why these times of life where our hormones change, we 0:06:39.880 --> 0:06:43.680 can also experience changes in mood and thinking skills. 0:06:43.360 --> 0:06:45.280 As well, because we often think of them as the 0:06:45.320 --> 0:06:47.640 six hormones, but there's so much more to them than that. 0:06:48.400 --> 0:06:51.320 Yes, yes, so much more so. That's right. 0:06:51.320 --> 0:06:54.000 They are the sex hormones and as I said, regulate 0:06:54.120 --> 0:06:58.760 reproductive function. But these hormones, so we know probably a 0:06:58.760 --> 0:07:01.160 bit more about estrogen and how that works in the brain, 0:07:01.200 --> 0:07:04.120 and we've learned a lot about how estrogen works in 0:07:04.160 --> 0:07:08.479 the brain from animal research, and these studies show that 0:07:08.560 --> 0:07:12.720 these hormones actually are quite potent sex steroids in the brain, 0:07:12.800 --> 0:07:14.840 so that means that they have an impact. 0:07:15.080 --> 0:07:18.560 They actually change the thickness or density of. 0:07:18.480 --> 0:07:21.520 Our connections between our different neurons and the way different 0:07:21.560 --> 0:07:23.080 parts of our brains communicate. 0:07:23.480 --> 0:07:27.200 They also have an influence on neurotransmitter systems. 0:07:27.240 --> 0:07:29.920 So these are chemicals in the brain, and you will 0:07:29.960 --> 0:07:33.240 have probably heard of things like dopamine and serotonin, So 0:07:33.320 --> 0:07:35.960 these are chemicals in the brain or neurotransmitter systems in 0:07:36.000 --> 0:07:39.080 the brain that are really important for regulating our mood 0:07:39.160 --> 0:07:43.360 and regulating our thinking skills. So at times when our 0:07:43.400 --> 0:07:49.000 hormones either fluctuate or gradually decline, our brains react to this. 0:07:49.080 --> 0:07:51.840 And some people are sensitive to these hormone changes in 0:07:51.920 --> 0:07:53.720 terms of their mood and thinking skills, and. 0:07:53.680 --> 0:07:54.360 Some people aren't. 0:07:54.400 --> 0:07:58.040 So it's not a uniform conclusion that we draw that 0:07:58.080 --> 0:08:00.480 when your hormones change, your mood will change, because that's 0:08:00.560 --> 0:08:03.400 absolutely not the case. But for some people, they're just 0:08:03.480 --> 0:08:07.000 sensitive to hormone changes. But all this animal work that's 0:08:07.040 --> 0:08:10.240 been done has really laid that scientific basis for us 0:08:10.280 --> 0:08:13.040 to have a really good guess at why some people 0:08:13.160 --> 0:08:16.560 might be more sensitive to times of hormonal change. 0:08:16.960 --> 0:08:21.160 So throughout our reproductive lives, we go from puberty through 0:08:21.160 --> 0:08:24.840 pregnancy up to perimenopause. Is that the impact we're seeing 0:08:24.960 --> 0:08:27.320 is it? Are some of us more sensitive all the 0:08:27.320 --> 0:08:29.120 way through or can it vary? 0:08:30.080 --> 0:08:33.360 Yes, it's such a good question. I think there's both scenarios. 0:08:33.400 --> 0:08:37.320 So there's certainly some people who are sensitive to hormones always. 0:08:37.640 --> 0:08:39.880 So there's some people who during. 0:08:39.600 --> 0:08:43.480 Their reproductive years when they're experiencing a menstrual cycle for women, 0:08:43.559 --> 0:08:46.000 or people assigned female at birth, when they're experiencing a 0:08:46.000 --> 0:08:50.880 menstrual cycle. Each menstrual cycle has little fluctuations in estrogen 0:08:51.040 --> 0:08:54.720 and progesterone, and the time of the menstrual cycle that 0:08:54.760 --> 0:08:58.360 most people who are sensitive to hormone changes experience mood 0:08:58.400 --> 0:09:03.120 symptoms is in that pre menstrual so in the few 0:09:03.200 --> 0:09:06.960 days before someone gets their period, and at that time, 0:09:07.040 --> 0:09:10.840 in terms of our hormones, our progesterone levels are increasing 0:09:10.880 --> 0:09:12.800 and our estrogen levels are a bit lower than our 0:09:12.840 --> 0:09:16.480 progesterone levels at that point. So the thought is that 0:09:16.520 --> 0:09:20.600 it's the progesterone that is some people are sensitive to, 0:09:20.760 --> 0:09:24.880 and not even the progesterone itself, but the progesterone has metabolites, 0:09:24.920 --> 0:09:27.040 which is kind of when it breaks down and flow 0:09:27.040 --> 0:09:30.000 on effects from the progesterone, and so one of them 0:09:30.040 --> 0:09:33.960 is called alopregnant alone. But that is what the theory is, 0:09:33.960 --> 0:09:36.480 that some people are sensitive to an increase in this 0:09:36.640 --> 0:09:42.040 alopregnant alone, and when that increases, some people experience these 0:09:42.080 --> 0:09:45.679 mood symptoms. So some people experience that. Then there's some 0:09:45.720 --> 0:09:50.320 people who experience quite significant mood changes in the postnatal period, 0:09:50.400 --> 0:09:53.280 and there's lots of significant hormone changes that happen both 0:09:53.360 --> 0:09:57.520 during pregnancy and in the post natal period. I should 0:09:57.559 --> 0:10:01.199 also say that having a baby is a huge life 0:10:01.280 --> 0:10:03.160 change as well, so we can't just say, well, it's 0:10:03.200 --> 0:10:06.240 all hormones, because there's lots that happens when someone has 0:10:06.240 --> 0:10:09.360 a baby, but there's also quite significant hormone changes, and 0:10:09.400 --> 0:10:12.280 so it's thought that some people again are sensitive to 0:10:12.320 --> 0:10:13.480 those hormone changes. 0:10:13.800 --> 0:10:15.080 And then the next life. 0:10:14.880 --> 0:10:18.840 Phase for females that a lot of people are sensitive 0:10:18.840 --> 0:10:22.080 again to hormone changes is in that perimenopause, so the 0:10:22.120 --> 0:10:27.880 menopause transitioneers and early postmenopause. So sometimes we see someone 0:10:27.960 --> 0:10:30.920 in perimenopause and it's the same person who's been sensitive 0:10:30.920 --> 0:10:33.200 at different life phases to hormone changes. 0:10:33.480 --> 0:10:36.640 But then sometimes someone's had none of that. They've not 0:10:36.760 --> 0:10:37.520 had any kind. 0:10:37.400 --> 0:10:40.600 Of pre menstrual mood symptoms, they haven't had any postnatal 0:10:40.679 --> 0:10:44.679 depression or post natal anxiety, but during menopause they experience 0:10:44.720 --> 0:10:47.080 for the very first time a big change in their mood. 0:10:47.280 --> 0:10:50.320 So I think there's both types of people. Some people 0:10:50.360 --> 0:10:50.719 are just. 0:10:50.720 --> 0:10:55.680 Sensitive to hormone changes, and some people experience mood changes 0:10:55.720 --> 0:10:59.520 for the first time during menopause, and whether that's a 0:10:59.559 --> 0:11:03.640 hormone sensitivity or a number of other factors contributing to it. 0:11:03.679 --> 0:11:07.680 We're still kind of learning and understanding why those mood 0:11:07.720 --> 0:11:10.880 changes come about, but it seems to be related for 0:11:10.920 --> 0:11:12.520 a lot of people the hormone changes. 0:11:12.679 --> 0:11:15.440 And have we been able to work out why someone 0:11:15.559 --> 0:11:16.640 might be sensitive. 0:11:17.920 --> 0:11:21.640 No, that's a really good question. So there's probably a 0:11:21.800 --> 0:11:24.840 number of factors. So there's probably some genetic factors our 0:11:24.880 --> 0:11:30.000 genetic makeup. Some people might carry certain combination of genes 0:11:30.000 --> 0:11:32.959 that makes them a bit more sensitive to changes in hormones. 0:11:33.400 --> 0:11:36.920 There's also a theory that some people who have experienced 0:11:36.960 --> 0:11:40.679 trauma throughout their lives and have got a sensitive or 0:11:40.880 --> 0:11:45.559 a more sensitive endocrine access that governs our stress response, 0:11:46.200 --> 0:11:49.960 that person might also be more sensitive to changes. 0:11:49.640 --> 0:11:51.080 In our reproductive hormones. 0:11:51.120 --> 0:11:53.880 So there's a bit of a crossover between these different 0:11:54.000 --> 0:11:57.360 endocrine axes that govern different That are hormones that govern 0:11:57.400 --> 0:12:01.319 different responses, so stress response, reproductive hormones, or sex hormones. 0:12:01.880 --> 0:12:04.520 So there's also a theory that those who have experienced 0:12:04.520 --> 0:12:07.719 trauma of some sort, and trauma can be lots of 0:12:07.800 --> 0:12:11.320 different things. It's a really personal I mean, somethings are 0:12:11.320 --> 0:12:14.520 obviously trauma, and some things are not necessarily considered trauma, 0:12:14.520 --> 0:12:17.640 but for an individual that you know, poor attachment when 0:12:17.640 --> 0:12:20.679 they were younger, or peer bullying or things like that 0:12:20.720 --> 0:12:23.959 can constitute trauma for an individual. And so all sorts 0:12:24.000 --> 0:12:27.640 of things might make someone more sensitive to hormones. And 0:12:27.679 --> 0:12:31.080 then sometimes we're I mean, it could be a combination 0:12:31.120 --> 0:12:34.600 of genetics of trauma for some people, or yeah, I 0:12:34.600 --> 0:12:37.360 guess we just don't really know exactly why some people 0:12:37.400 --> 0:12:38.240 are more sensitive. 0:12:39.040 --> 0:12:41.360 It makes me very grateful I suppose that we're in 0:12:41.400 --> 0:12:44.000 a slightly more enlightened age where we're talking about these 0:12:44.000 --> 0:12:47.679 things before they happen. Because freendiscin I both confessed to 0:12:47.760 --> 0:12:51.920 not really having any clue about perimidopause for a long time, 0:12:52.280 --> 0:12:55.040 and it has sort of come into the social consciousness 0:12:55.080 --> 0:12:58.000 a little bit more, particularly for women obviously, and I 0:12:58.120 --> 0:13:02.480 just sometimes think about, you know, the jokes around what's 0:13:02.520 --> 0:13:07.920 the one before you get your period, premist tension, Yeah, yeah, 0:13:08.440 --> 0:13:11.720 foggy brain and in middle life rage and all of 0:13:11.720 --> 0:13:14.160 that sort of thing, and you know, we do, we 0:13:14.200 --> 0:13:18.120 do laugh things off because we don't understand them. 0:13:17.600 --> 0:13:17.920 M m. 0:13:18.200 --> 0:13:21.439 Yes, And sometimes that's fine, Like for some people the 0:13:21.800 --> 0:13:23.080 mood changes the brain fog. 0:13:23.120 --> 0:13:25.040 It's kind of mild and you can laugh it off. 0:13:25.080 --> 0:13:27.600 It's a coping mechanism, and it's absolutely fine to do that, 0:13:27.840 --> 0:13:29.120 and it can be. 0:13:29.040 --> 0:13:30.760 Pretty subtle and it's not a big deal. 0:13:31.160 --> 0:13:33.600 But then there are other people where it's it's not 0:13:33.640 --> 0:13:35.640 so subtle and it is more of a big deal 0:13:36.120 --> 0:13:37.280 and it's a bit more. 0:13:37.520 --> 0:13:39.880 They can't just laugh it off, you know, they're really struggling. 0:13:39.920 --> 0:13:43.160 So I think there's a whole spectrum of experiences that 0:13:43.720 --> 0:13:49.160 people have, and yeah, the different sort of coping mechanisms 0:13:49.240 --> 0:13:52.040 or help that people need can also be really varied. 0:13:52.600 --> 0:13:56.800 So, Caroline, during perimenopause, in menopause, how are our hormones 0:13:56.800 --> 0:13:59.880 impacting our brains and our mental health? 0:14:00.480 --> 0:14:04.480 So as we transition from our reproductive years into menopause, 0:14:04.480 --> 0:14:08.760 there's this timeframe, this transition timeframe called perimenopause, and that 0:14:08.800 --> 0:14:13.720 can span four to eight ten years for different people. 0:14:14.240 --> 0:14:18.680 And during that transition time, we move from having the 0:14:18.760 --> 0:14:23.000 reproductive regular menstrual cycle for people who aren't taking any 0:14:23.080 --> 0:14:27.400 kind of hormone or contraceptive, and then our sex hormones 0:14:27.560 --> 0:14:32.920 estrogen progesterone, instead of fluctuating in a regular cyclical pattern 0:14:33.240 --> 0:14:36.720 start to be a bit more erratic, and they can 0:14:36.880 --> 0:14:40.800 fluctuate quite rapidly, and at the same time, the estrogen 0:14:40.920 --> 0:14:45.400 and progesterone are also gradually declining, So that happens, as 0:14:45.400 --> 0:14:48.400 I said, over four to ten years. The things that 0:14:48.440 --> 0:14:51.880 we can notice during that time in terms of our 0:14:51.920 --> 0:14:55.520 menstrual cycle, that can become irregular, and that's often what 0:14:55.600 --> 0:14:59.000 the basis of diagnosis of perimenopause is that your mental 0:14:59.080 --> 0:15:00.880 cycle can be come irregular. 0:15:01.640 --> 0:15:04.920 But often just before that happens, people can start to 0:15:04.960 --> 0:15:08.680 notice changes to their mood and their thinking skills. So 0:15:08.720 --> 0:15:11.640 that's the brain fog of menopause or perimenopause that people 0:15:11.680 --> 0:15:16.560 talk about. And the mood changes, the rage, the irritability, 0:15:16.760 --> 0:15:22.160 paranoid thinking, anxiety, depression, a whole spectrum of different symptoms 0:15:22.160 --> 0:15:25.240 that fall under that umbrella of kind of a perimenopausal 0:15:25.280 --> 0:15:30.000 depression that can happen early on in that perimenopausal transition. 0:15:30.040 --> 0:15:32.080 They can be some of the first signs that happen, 0:15:32.720 --> 0:15:36.680 and it might be that our brains start to become 0:15:36.720 --> 0:15:40.960 a bit sensitive to the fluctuations in our estrogen levels 0:15:41.000 --> 0:15:44.320 and that gradual decline and progesterone. But if it's happening 0:15:44.400 --> 0:15:45.760 early in the perimenopause. 0:15:45.840 --> 0:15:50.520 It's probably our bodies and brains reacting to the fluctuations 0:15:50.560 --> 0:15:55.000 in estrogen and progesterone levels that happen during the early 0:15:55.040 --> 0:15:58.960 stages of that perimenopause and that transition phase. 0:16:00.560 --> 0:16:01.520 That's fascinating. 0:16:01.680 --> 0:16:03.960 Gosh, that's really making me think back to my late 0:16:04.040 --> 0:16:06.320 that is an early forties, to be honest, And so 0:16:06.960 --> 0:16:10.320 would you call it a common phenomenon for women and perimenopause. 0:16:10.840 --> 0:16:16.240 So in terms of the mood symptoms, it really varied 0:16:16.400 --> 0:16:19.120 depending what literature you look at. It's probably about a 0:16:19.160 --> 0:16:22.840 third of women will experience some depression and about two 0:16:22.960 --> 0:16:25.640 thirds of women will experience some degree of brain fog. 0:16:25.920 --> 0:16:29.040 But I think there can be kind of secondary depression 0:16:29.160 --> 0:16:30.760 secondary brain fog. 0:16:30.840 --> 0:16:33.440 So if people start to experience things like poor sleep, 0:16:34.320 --> 0:16:37.280 like anyone knows that if you're not sleeping well, it 0:16:37.280 --> 0:16:39.400 can impact your mood, it can impact. 0:16:39.120 --> 0:16:42.640 Your ability to think clearly, So that can happen as well. 0:16:42.680 --> 0:16:45.960 But people can also experience just the mood changes or 0:16:46.040 --> 0:16:49.760 just the brain fog on its own. And there's also 0:16:49.840 --> 0:16:53.120 a link potentially between the vasomotor symptoms of the hot 0:16:53.160 --> 0:16:56.640 flushes there's a theory that if you're experiencing hot flashes 0:16:56.720 --> 0:16:58.840 during the night, then that disrupts your sleep, then you 0:16:58.880 --> 0:16:59.520 have poor sleep. 0:16:59.560 --> 0:17:02.640 Then you have a flow and effect mood changes and 0:17:02.680 --> 0:17:04.800 to brain fog. 0:17:05.240 --> 0:17:07.520 But also, as I said, there's the people who don't 0:17:07.520 --> 0:17:09.679 experience any of that but just have the mood changes. 0:17:09.720 --> 0:17:12.520 It might be more directly related to the hormone changes 0:17:12.520 --> 0:17:13.000 in the brain. 0:17:13.720 --> 0:17:15.040 Can I just ask you a quick question. 0:17:15.080 --> 0:17:18.920 You're talking about contraception, and this is a thing that's 0:17:18.920 --> 0:17:20.879 been on my mind, but I haven't known who to 0:17:20.920 --> 0:17:22.719 ask and you may not be able to answer. So 0:17:24.359 --> 0:17:28.760 does contraception have any impact on perimenopausal symptoms? 0:17:29.400 --> 0:17:33.320 Yeah, so it can, absolutely so, because it flattens out 0:17:33.400 --> 0:17:39.359 the natural fluctuations in our hormones across menstrual cycles, but 0:17:39.440 --> 0:17:44.280 then adds in synthetic hormones that kind of replicate that. 0:17:45.280 --> 0:17:48.359 But if you don't take the sugar pills, so if 0:17:48.359 --> 0:17:51.840 you're just taking the active hormonal contraception, then it's kind 0:17:51.880 --> 0:17:54.960 of flattened out, and so you lose some of the 0:17:54.960 --> 0:18:00.600 effects of a menstrual cycle and you have less fluctuals. 0:18:01.119 --> 0:18:04.719 So I think the Australian menopause or Australasian Menopause Society, 0:18:04.720 --> 0:18:08.240 which extends to New Zealand, suggests that you can keep 0:18:08.280 --> 0:18:11.560 taking hormonal contraceptives in consultation with your doctor until about 0:18:11.560 --> 0:18:14.520 the age of fifty And yeah, so that can have 0:18:15.880 --> 0:18:20.280 a beneficial impact on mood for some people, but some 0:18:20.320 --> 0:18:23.760 people might also need to consider and talk to their 0:18:24.160 --> 0:18:27.800 healthcare professional about different options if it's if it's not enough. 0:18:27.920 --> 0:18:29.639 Yeah, and there are there are different options. But I 0:18:29.720 --> 0:18:33.920 found it really helpful just for when those when the 0:18:34.359 --> 0:18:38.959 metal cycle became really erratic and have to started having 0:18:38.960 --> 0:18:40.800 a little bit an impact on life. You know, it 0:18:40.920 --> 0:18:42.320 was one way to be able to It was just 0:18:42.359 --> 0:18:45.680 another tool to use to try and kind of stabilize 0:18:45.720 --> 0:18:51.880 things control. Yea, So how many women who have never 0:18:52.119 --> 0:18:54.920 you know, we talked about the sensitivity and things towards 0:18:56.480 --> 0:18:59.840 hormone fluctuations and things. I'm sure it must be quite 0:19:00.119 --> 0:19:03.159 a surprise for a lot of women to get to 0:19:03.640 --> 0:19:05.280 sort of middle age and all of a sudden be 0:19:05.400 --> 0:19:09.639 dealing maybe for the first time with anxiety or a 0:19:09.680 --> 0:19:13.040 panic attack or this irritability in things. 0:19:13.560 --> 0:19:13.879 Oh. 0:19:13.920 --> 0:19:17.600 Absolutely, And I think you say middle aged, but I 0:19:17.600 --> 0:19:19.520 think for some women it's sort of forty, like it's 0:19:19.600 --> 0:19:22.840 quite early that some women experience some of the mood 0:19:22.880 --> 0:19:23.960 changes because they can be some of. 0:19:23.960 --> 0:19:25.680 The earliest changes. 0:19:25.720 --> 0:19:29.199 So the median age of menopause is fifty one, but 0:19:29.359 --> 0:19:32.920 if perimenopause, that transition can go up to ten years, 0:19:32.920 --> 0:19:35.280 it can be sort of forty early forties. So some 0:19:35.320 --> 0:19:37.960 people don't even have menopause on their radar, so they 0:19:38.000 --> 0:19:41.680 don't necessarily know why they're starting to feel a bit anxious, 0:19:41.720 --> 0:19:44.520 a bit paranoid, irritable. 0:19:44.920 --> 0:19:47.360 So the connection might not be there. 0:19:47.200 --> 0:19:49.040 And it might come a bit out of the blue, 0:19:49.080 --> 0:19:50.560 and it can be really hard to deal with. 0:19:51.080 --> 0:19:55.439 And I think the timing of menopause is now with 0:19:55.640 --> 0:19:58.239 our lifestyles, is often at a time of life that 0:19:58.560 --> 0:20:02.159 people are really quite particularly women, are quite stretched and 0:20:02.200 --> 0:20:04.120 quite busy. So in the middle of your life, you're 0:20:04.160 --> 0:20:06.880 often at the prime of your career. You might have 0:20:07.280 --> 0:20:10.320 teenage children, perhaps elderly parents who might be managing house, 0:20:10.520 --> 0:20:12.880 the household, like you might be doing a whole lot 0:20:12.880 --> 0:20:17.000 of things, and so you're just really busy and stretched, 0:20:17.320 --> 0:20:20.800 and with that often comes stress, and so I think 0:20:20.920 --> 0:20:23.960 that's a huge factor that sometimes we forget to take 0:20:24.000 --> 0:20:28.880 into the into consideration. When we think about the impact 0:20:28.920 --> 0:20:31.560 of these hormonal changes, it can sometimes be like the 0:20:31.880 --> 0:20:34.119 tipping point. You can kind of cope and then you 0:20:34.119 --> 0:20:35.919 get to this point where you just can't cope with 0:20:35.960 --> 0:20:39.040 all of that pressure and stress anymore. 0:20:39.200 --> 0:20:43.040 And so it might be the hormones that are triggering things. 0:20:43.040 --> 0:20:45.520 But then if we look at the whole story and 0:20:45.600 --> 0:20:48.080 take a holistic approach, is often a lot going on 0:20:48.160 --> 0:20:49.600 for that person at the same time. 0:20:49.880 --> 0:20:50.920 Well, that's that's right. 0:20:51.040 --> 0:20:55.080 So that leads nicely into the you know, that rage 0:20:55.119 --> 0:20:59.520 and that irritability, that sort of almost breaking point. Then 0:20:59.520 --> 0:21:01.679 you kind of have little all out and then regroup. 0:21:02.320 --> 0:21:07.560 Yes, yes, and I think within that presentation of depression, 0:21:08.240 --> 0:21:10.760 we've done a bit of work at her Center, which 0:21:10.800 --> 0:21:14.640 is at Monish University where I work, led by Professor j. Shukulcanni, 0:21:14.680 --> 0:21:19.159 where we've looked at characterizing that perimenopausal depression, which is 0:21:19.160 --> 0:21:22.280 a bit different to a clinical depression at other life 0:21:22.320 --> 0:21:23.200