July 17, 2024 • 23 mins
Normalising the discussion about Peri-Menopause and Menopause with Doctor Sarah White, CEO Jean Hailes for Women's Health.
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Speaker 1 (00:02):
Hey, it's Pats from The Christian O'Connell Show. Thanks for
downloading episode one of my new podcast series, Rage Against
the Menopause. Entering Perimenopause, you know, I was really grappling
for some clarity and reassurance. I kind of felt a
bit ripped off, to be honest, after a lifetime of
polycystic ovarian syndrome and endometriosis, I thought, hang on, now
(00:23):
I've got to go through this. I think this is
something that we need to talk about. And every time
I've touched on it on the show, We've had an
overwhelming response from listeners saying we need to talk about it,
and I agree. We need to remove the stigma. We
talk so much about pregnancy, conception, childbirth, why not menopause.
I'm out to change that. I do want to change
(00:46):
the narrative. I'm hoping that by me being candid about
my own experience that we can build a.
Speaker 2 (00:51):
Community of support for other women. It is a no
holds barred chat. We cover a lot of.
Speaker 1 (00:56):
Things, a lot of topics, helping to remove the stigma
and show the power strength that comes with menopause. This episode,
it's titled The Lady Garden. It features doctor Sarah White,
CEO of gene Hale's for Women's Health, Australia's first women's
health clinic, only the second in the world dedicated to menopause.
Speaker 2 (01:15):
I hope you get something from it.
Speaker 1 (01:18):
My very first and very special guest is doctor Sarah White,
who I have known for quite some time at the
Anti Cancer Council and the Quick Campaign.
Speaker 2 (01:28):
I think must be twenty years.
Speaker 3 (01:29):
Sarah, Well, you and I haven't known each other that long,
but yes, quit's been around for thirty years and you
and I have been talking.
Speaker 4 (01:35):
For oh seven or eight.
Speaker 1 (01:37):
Maybe seven or eight so, and you, of course are
at the gene Hales Foundation in Melbourne.
Speaker 2 (01:43):
Welcome, Thank you.
Speaker 1 (01:45):
Tell me about the gene Hales Foundation in Melbourne.
Speaker 4 (01:49):
Sure so.
Speaker 3 (01:50):
The gene Hales was an extraordinary doctor and she set
up the first menopause clinic in Australia and it was
only the second in the world because she recognized that
women just were not getting the care and attention. And
legend has it that the very first day she opened
the clinic, she had a little article in the newspaper
about it. And the second day she opened the clinic,
there were women lined up around the block to come
(02:12):
in and talk to doctor Hale's. Now tragically, doctor Hales
died at a relatively young age, and so her colleague
started the Gene Hales Foundation in her honor, and so
gene Hales for Women's Health Today is our training name,
if you like, and we cover a whole range of
women's health issues, not just menopause, but a whole range
of women's health issues that we sometimes called the lady
(02:34):
garden between the navel and the knees.
Speaker 2 (02:38):
So let's talk minopause.
Speaker 1 (02:39):
So it's something I am definitely going through. When I
look back on it, I actually think I probably started
at about thirty nine, because I can remember driving into
the studio and I just I've just come back from
Matt leave and I had this heat at the back
of my neck is where it started, and I thought
(03:01):
I've been rushing around, you know, dropping off at daycare
and trying to get to work on time.
Speaker 2 (03:06):
But now when I look back, I.
Speaker 1 (03:08):
Think it was a progression from that point. I think
that was like the start of my hot flushes. And
I also got vertigo. I remember we went to Queensland
for a family trip and my daughter was probably two,
and I found it really hard walking around the parks
because I was like spinning, and I thought it was
(03:30):
just I've got near infection or something. But I actually
think it was related to menopause when I think about it,
because my periods were starting to sort of hit and
miss and be erratic. What let's get to the basics.
What is menopause? How is it defined?
Speaker 3 (03:45):
Well, it's actually a really tricky definition in some ways
because you don't know that you've hit menopause until after
the fact. So menopause technically is twelve months to the
date after you've finished your last period, so you don't
really know until one day you look back and go, oh, gosh,
that was more than twelve months.
Speaker 4 (04:02):
I'm actually I've gone through that transition.
Speaker 3 (04:05):
Officially, postmenopause will now the period we usually talk about
when we say menopause, we actually mean perimenopause. So that's
the lead up to that point in time, twelve months
after periods have stopped. So there are some people who
get very angry we don't say perimenopause all the time,
but most people understand it as menopause. And that's the
(04:25):
period when estrogen levels start to fluctuate and then decrease,
and it's really because you're overrestop functioning. So it's the
end of that reproductive life, and you know, it's we
sometimes talk about it always as like this deficit thing,
your levels are dropping, your over reason.
Speaker 4 (04:44):
It's a completely negative thing.
Speaker 3 (04:46):
In some cultures, menopause is really embraced as the second age,
the coming of wisdom point. And if you're a woman
who's experienced really terrible periods, you know, very heavy bleeding,
regular periods, painful periods, pause can actually be a really
good time because all of that's behind you.
Speaker 1 (05:03):
Yeah, I've got polycystico thevery in syndrome and endometriosis as well.
And I sort of felt, to be honest, I felt
a little bit ripped off, Sarah, because I thought, hang on,
I've gone through infertility and all these other health issues,
and now you're telling me that I'm faced with this.
And what I find really frustrating is that perimenopausal period
(05:27):
that it's a tunnel and you don't know how far
through the tunnel you are, how long the tunnel is,
And you can go to a GP, even a specialist,
and they can't there's nothing definitive when you really want
I guess maybe I'm like a scientific approach kind of
person where it's blacker. It's it's like, well, am I
or aren't I? And the fact that you can't get no,
(05:47):
I can't answer it seems like a bit like a
it's telling me.
Speaker 3 (05:55):
Yeah, it would be great if we had a blood
test that said you are definitively now here and your
tunnel your tunnel is six and a half months, yes,
it's two point eight years, and then you're done and
unfortunately no.
Speaker 4 (06:06):
And you know, sometimes that's really.
Speaker 2 (06:08):
The hard thing to manage.
Speaker 3 (06:10):
And I find it because you know, I'm the same
as you got the hot flushes, got the insomnia occasionally.
Speaker 1 (06:16):
Thank god, the insomnia.
Speaker 4 (06:18):
What is that word? I've got that word.
Speaker 1 (06:21):
Yes, I'm trying to get it. A dead brain moment,
brain fog.
Speaker 4 (06:24):
You know, it's frustrated.
Speaker 3 (06:26):
It can be really frustrating, and I think we just
have to try and be really patient and manage the
symptoms and try not to worry how long our tunnel
is taking, because everyone's tunnel is different length, and you know,
if we stretch a really bad metaphor, you know, the
tunnel for some is really rocky and horrible and hard
and for others it's a four lane freeway.
Speaker 2 (06:46):
That's the thing. It's so different. Everyone's experience is so different.
Speaker 1 (06:51):
And I'm happy to say that not.
Speaker 2 (06:53):
Every day is a crap day. You have good days where.
Speaker 1 (06:56):
You actually do feel normal in inverted commas again, and
other days where you don't. I'm actually not taking anything.
I'm not saying that to say, oh look at me,
I'm so strong. That's not what your experience is different.
What I've found frustrating, and I've spoken to my gynecologist about,
is at what point, at what point do you know
(07:17):
you should be taking something? Like when do you know you.
Speaker 3 (07:23):
Know when those symptoms start to really impact your mental
and emotional wellbeing or impact your ability to do your
daily activities or your job.
Speaker 4 (07:31):
So if it gets to.
Speaker 3 (07:32):
The point where you are really struggling with something, then
you go and talk to your doctor. And if your
doctor says, oh, look it's just menopause, go to the
website of the Australasian Menopause Society, find a doctor who
has a real interest in metopause and go and see them.
Easier said than done for rural and regional people, for sure,
but menopause symptoms for about roughly, you know, rule of thumb,
(07:54):
twenty percent will have a really hard time, twenty percent
will not, and the rest fall somewhere in the middle.
People who need that support should not hesitate to go
and get it. If the symptoms are really interfering with
your life, you don't have to put up with anything. No.
Speaker 1 (08:07):
I think that's the point, isn't it. It's like my
mum always told me with periods, have you got pain?
I was like, actually, yeah, I think I actually feel
really rotten. And she used to say to me, well,
you don't you know, you don't.
Speaker 2 (08:20):
Actually have to put up with that, Like, take something
for it. Don't be a hero. If you need something,
absolutely take it.
Speaker 3 (08:28):
And we really know that there's a lot of women
who think that nothing can be done, and that's really
sad because in most cases, something can be done. And
if you're struggling with menopause symptoms, for example, I found,
you know, personally, I insomnia was the worst thing for me.
Always been a bit of an insomniac, much much worse
through this period. And I just went and got just
a little bit of like a sleepaid to start off with,
(08:49):
and I worked my way up a little bit and
talk to my doctor about what the options were. I'm
not on menopause hormone therapy. I would have no hesitation
on taking it if I need to. I've been fortunate
that I've been okay manageable symptoms. A lot of my
friends have had manageable symptoms. I've got one or two
friends who've really had a bad time where they've had
(09:10):
menopause hormone therapy and it's really helped.
Speaker 2 (09:12):
Let's talk about HRT.
Speaker 1 (09:14):
There's still a lot of cloud and kind of innuendo
around HRT.
Speaker 2 (09:20):
Is it safe for most people?
Speaker 3 (09:22):
It is about Look, it's a medicine. There's always side
effects of medicines. There's always concerns. But there was a
study done a number of years ago and the results
were not interpreted well.
Speaker 4 (09:33):
They were publicized really.
Speaker 3 (09:34):
Badly, and overnight a huge number of women ripped off
their menopause homone therapy or hormone replacement therapy patches. And
we're really worried about this increased risk of breast cancer.
But the risk is actually very small. The risk is small,
and so for some women who have a history of
breathasts cancer, for example, they need to.
Speaker 4 (09:53):
Talk to their doctor.
Speaker 3 (09:54):
You should talk to your doctor all the time when
you're gonna have a medicine. But it's certainly if you're
a doctor and you have that conversation and the doctor
says this could help, you shouldn't be afraid of taking it.
Speaker 1 (10:03):
And that's the thing too, I want to point out,
is the conversation. This is my whole point of doing
this podcast. It is experiencing it myself. We all talk
about fertility and about conception and pregnancy. Why aren't we
being open and honest and raw and organic about menopause?
Why is it such a dirty word. Why can't we
(10:26):
open the conversation. It's a perfectly normal stage of life.
Speaker 3 (10:31):
Every woman, every person with ovaries is going to go
through menopause, right, so it has been it has been
a bit of a taboo subject for a long time.
Speaker 4 (10:40):
I feel like that's.
Speaker 3 (10:40):
Really changed over the last few years.
Speaker 4 (10:42):
And I think it has to do with gendered ageism.
Speaker 3 (10:46):
To be honest, Yes, I think it's been seen as
a sign of and shown in popular culture of oh
you've hit the change, and now suddenly all this gray
headed old hag.
Speaker 2 (10:56):
And shovy up in the top pad get about you.
Speaker 4 (10:59):
Every productive year over soon.
Speaker 3 (11:00):
What's your point really, And that's just you know, I
think that's where a lot of women struggle. We live
about a third of our lives after menopause. We're still
incredibly productive. Not only we incredibly productive, we're incredibly wise.
We've reached a certain threshold of you know, don't care factor.
We're confident. So it's not something that we should be
(11:21):
worried about. But I think it's comes from that gendered agism.
Speaker 4 (11:26):
To be perfectly.
Speaker 1 (11:26):
Honest, I agree, and I think there is such a wisdom.
I'm fifty one now, but there is such a wisdom
I think about turning fifty. It's almost like, as opposed
to your flower dying and wilting away, it's actually starting
to bloom because I think you're starting to grow into
your skin and your confidence shines through, and you think,
you know what, I'm not going to make apologies anymore.
(11:48):
If no one likes me or how I am, that's
their problem, not mine. Sure, it's an interesting notion, absolutely.
Speaker 3 (11:56):
And there's actually only just very rich. Like within the
last three or four weeks, a study on chimpanzees reaching menopause.
So before then it was humans and it was whales.
You know, that's the only thing, because I don't know
what these scientists thought that suddenly older females of a
species just you know, I can't have children anymore, so
I just drop off the perch. And what they find
(12:17):
in certainly in the whales, is the grandmother's if you like,
or the older females are the ones who are responsible
for guarding the pod and looking after the young ones.
So you know, it shouldn't be seen as now I'm
done and dusted because my ovaries have stopped working.
Speaker 1 (12:34):
Yes, what do you think about menopause in the workplace?
What sort of statistics have we got about women in
the workforce struggling and productivity, that sort of thing.
Speaker 3 (12:45):
We don't have a lot, And what we do have
is based on what we call convenience samplings. So you
go to a group of women and say how has
menopause affected you? And the people who have been affected say, oh,
I'm going to fill in that survey. And the people
who haven't been affected say, oh, it's not relevant to me,
So I'm not going to fill it in because it
hasn't affected me. So gene Hails has just conducted the
National Women's Health survey and we asked women, you know,
(13:06):
have you missed days of work because you've had symptoms
that you thought were menopause, And about seven percent of
women said, in this forty five to sixty four age range,
about seven percent said I've missed days and about fourteen
percent said I've taken an extended break from work. Now,
we didn't define extended break, so it could have been
a week, it could have been a month, that could
have been a year. So we do know that it
(13:28):
has an effect on women. We do know that there
are going to be some jobs in some workplaces that
aren't very sympathetic. But I think there's a really there's
real scope to improve what we do in the workplace,
not just for menopause. I think we've got to be
really careful about focusing just on menopause. With workplace flexibility
for women, it has to also be for people who
(13:51):
have as you mentioned, you know, pecause, in demetriosis, all
these conditions where we need to have access to a bathroom,
you know, a bit of flexibility around pelvic pain. So
not just menopause. I'm getting right off track here, Patrina.
You know, I think we have to create an environment
where we normalize discussion.
Speaker 2 (14:12):
That's what I mean.
Speaker 1 (14:13):
We need to talk about it, don't be be honest
about it.
Speaker 3 (14:17):
Yeah, I mean we just turn it into a joke
around the office. You're easy to do it, Gene Hales,
to turn that into office. But you know, I've been
in meetings We've gone, oh, hang on a minute, hot
flush coming in, found myself and everybody has a giggle,
we move on. That's not going to happen in every workplace,
of course, but the more we have these sorts of discussions,
the more we normalize talking about hot flushes or brain
(14:38):
fog or you know, the better.
Speaker 2 (14:40):
We are brain fog.
Speaker 1 (14:42):
You know, being on air on the Christian O'Connell Show
and as the news reader on the show, there's been
several times where I've gone off on a tangent and
then completely forgotten about a word or it's it's so
humiliating as a broadcaster. It's like because I guess maybe
in a different office environment it's not as noticeable, but
(15:06):
when I do an on air it's there's a lot
of people.
Speaker 2 (15:10):
Of course here you stuff up.
Speaker 3 (15:12):
Absolutently and to Christian and Jack notice or do you
notice I.
Speaker 2 (15:15):
Don't think they do. I think it's me. I don't know.
I don't think they do.
Speaker 3 (15:19):
So coming back to that question around workplaces, I do
wonder if some of the reason why, you know, we
have when we do these surveys of people who say,
you know, why did you leave the work force, and
some will say because of menopause, And I wonder if
it's actually about a loss of confidence, because you know,
in some roles, imagine you're a barrister and you're cross
examining the witness and you suddenly lost that keyword.
Speaker 4 (15:43):
You know exactly what's the opposite of guilty again?
Speaker 3 (15:45):
You know?
Speaker 1 (15:46):
No, But it is as simple as that, It really is, absolutely,
you know. I think confidence is a big thing. I
think when you I know, when I had my daughter
and in that sort of here we go, there's a
rain fade again in the Matt Leaf period, you do
lose confidence because you not that your whole identity is
(16:09):
on what you do or who you are in that sense.
But it's I think it's just that routine of going
into it when you've done something like I had for
twenty years and that stopped down. And I think it's
the same with menopause. There's an anxiety. I know one
of my girlfriends has really bad anxiety from her menopause,
(16:30):
Like it's really disabling for her some days. Is that
obviously just a hormone impact.
Speaker 3 (16:36):
Yes, probably, And looks It's the thing with menopause is
it's really hard to disentangle from everything else that's going
on in our lives when we're that age. And I
saw I've adopted this phrase. I saw in an article
which is called was called about midlife collision. So we have,
you know, we have kids of a certain age, we
have increased responsibilities at our job. We've got a partner
(16:58):
that who may or may not be driving us by
because we've been together for twenty odd years.
Speaker 4 (17:01):
We've got elderly parents.
Speaker 1 (17:03):
Oldly parents who need more cares, all the socially.
Speaker 3 (17:06):
Labor of running households, and so this is a point
where you then add on some insomnia from menopause or
whatever else. It could be anything, and suddenly that midd
life collision becomes a catastrophe. So I'm always a little
bit wary about saying everything's due to menopause. It could
be secondary to lack of sleep. It really could be
(17:26):
about a lot of other factors in your life. So
if we put everything in the menopause basket, I think
we risk the opportunity of actually getting to the root
cause of what the challenge is for any one individual.
But certainly menopause has been associated with anxiety and depression,
definitely with you know, loss of labido, which can put
more pressure relations not.
Speaker 1 (17:47):
Even interested, which is actually like hit me in the face,
because it's that's something it was. It's really foreign us.
It's like, hang on, but not even.
Speaker 2 (17:57):
This is weird.
Speaker 1 (17:58):
It's like a tap that's just switched off.
Speaker 3 (18:00):
And you've also got this lovely phrase of vaginal atrophy,
so dryness and thin skin for some women though not
only is there a lack of interest in sex, but
sex becomes incredibly painful, you know. And these are the
sorts of things where we really want women to be
able to normalize that discussion and particularly go into the doctor.
That's something we don't wan to talk about in the
(18:21):
workforce potentially, but go to your doctor and talk to
them about it, because you can have those MHT creams
that you know, you can you can suffer get help.
Speaker 4 (18:31):
Absolutely.
Speaker 1 (18:31):
The other thing that you know we were talking, we
touched on earlier about the finish line, the end line,
which is different for everyone and we can't tell when
it is. But I will quite often stop and ask
myself and when will I feel like, what's what's on
the side, Like what happens once we are through and
we're officially in that menopause after the twelve months of
(18:55):
not having a period, Like, do we still get hot flushes?
Speaker 4 (18:58):
Is that?
Speaker 3 (18:59):
So? Hot flushes can last for a long time for
some women unfortunately, So there are some women who report,
you know, for even ten years after menopause they get
hot flushes. So I think this is important again and
keep checking in with your doctor. Should I still be
getting these things.
Speaker 4 (19:13):
The other thing that.
Speaker 3 (19:14):
Happens is you do have new health challenges when you're
in the post menopause will phase so things like your
bone health, you have to really watch that because that's
when you start to lose bone you do the bone density.
Things like your heart health, so estrogen has a protective
factor with the heart, so you start stop having that
estrogen and your risk of cardiovascular issues comes up. So
(19:38):
I think menopause is a great time to go and
talk to your doctor about your health check right now
is in your midlife, and then what do you need
to do to make sure you keep healthy in that
post menopause will phase as well.
Speaker 1 (19:48):
I touch you with my doctor quite regularly, but certainly,
and he always puts me up on the block. It's
like a twenty thousand KSE.
Speaker 2 (19:54):
Service every time.
Speaker 1 (19:55):
But blood tests every six to twelve months, keep up
with your breast checks absolutely. Perhaps smears which high five
are now only every five years.
Speaker 4 (20:06):
Yeah, definitely.
Speaker 1 (20:08):
But that's a good point.
Speaker 2 (20:09):
I think that's a really pivotal point.
Speaker 4 (20:10):
Look at fear heart health. You know, talk to your
doctor or talk to a.
Speaker 3 (20:14):
Nutritionist dietitian about making sure you're getting enough calcium. You
do have to actively there's nothing to do with menopause.
As we get to our midlife, whether you're a male female,
you have to start looking after health a bit more proactively.
Speaker 1 (20:29):
And that's the thing too with menopause is that middle middle.
Speaker 2 (20:33):
It's so hard to shift.
Speaker 4 (20:35):
I know, I know.
Speaker 3 (20:37):
So menopause and weight gain is a really contentious topic.
So we do know that your weight, your fat distribution
actually shifts to the abdominal section, which is not great.
It's not necessarily that menopause causes you to put on right.
But you do get that distribution and again probably midlife collision.
A lot of women from our survey tell us they
(20:58):
stopped exercising, which is, you know, the worst thing to
do if you need to keep carrying strength, you know,
strength exercise for your bones, it'll help your insomnia, it'll
help your mental health. But a lot of women get
to the i've got these bad symptoms, I'm just gonna
stop exercising.
Speaker 4 (21:15):
So, yes, we do have.
Speaker 3 (21:16):
To keep an eye and we probably need a few
less calories.
Speaker 4 (21:20):
She says that she looks longingly at her last in
front of her.
Speaker 2 (21:23):
You're allowed to have a coffee one.
Speaker 3 (21:25):
To day, So yeah, we do have to look after
a health more. And that's just a factor of getting old.
When it comes to menopause, there's a whole host of symptoms,
and then there are a bunch of symptoms that a
lot of women believe are due to menopause and they're not.
So there's a lack of knowledge around symptoms that I
think is not helpful.
Speaker 2 (21:44):
Let's bust some of them.
Speaker 3 (21:45):
Yeah, sure, so it's easy to go with the ones
that people don't recognize a part of menopause.
Speaker 4 (21:50):
So joint pain.
Speaker 1 (21:51):
For example, Oh my god, some days I'll walk like
an eighty year old woman.
Speaker 3 (21:55):
Yeah, so joint pain can definitely be a menopause factor.
But I was going to suggest that you can go
to gene Hale's website or to the Australasian Menopause Society
website and we both have questionnaires that you can fill
in and say, what are the symptoms I've got, what's
the extent of the problem. Just filling that in and
(22:16):
then taking it to your doctor can be a really
great way of tracking how you're doing, helping your doctor
focus on the issues, the most important issues for you,
because sometimes it's about symptom management, yes, and then also
you can keep tracking it to see how the symptoms
are resolving or not.
Speaker 1 (22:32):
It's like a snapshot, isn't it. Because I think as women,
as you say, we're busy. We might have families, we've
got elderly parents, where career women we're just it's like
a marathon each week just getting to the finish line
and we push our needs to the side.
Speaker 2 (22:45):
For everyone else, I think you do it, and it
takes probably.
Speaker 1 (22:48):
The five minutes to sit down, tick the boxes what
you need to and get that snap.
Speaker 3 (22:53):
Shot absolutely, and then where you do have you know,
we get lots of reports of doctors, Oh look, it's
just menopause.
Speaker 4 (22:59):
Don't worry about it. You have to deal with it.
Speaker 3 (23:00):
Oh no, no, no, you don't, you not. But filling
in something like a symptom checklist can help you go, well, actually.
Speaker 4 (23:08):
I don't have that or that or that or that.
You know that's a problem.
Speaker 3 (23:12):
Well, actually, so what else is going on in my
life that might be the problem here? Yeah, And I
think it's really important to dig into what the problem is,
not just immediately say oh, it's just menopause.
Speaker 4 (23:22):
No, no, no, we don't have to put up with it.
Let's work out what the real problem is.
Speaker 1 (23:25):
An address for more information, gene Hailes for Women's Health
provides free, evidence based health information for all women. You
can head to genehals dot org dot au. I'm Patrina
Giants and join me for episode two Miserable Magical Menopause,
where I chat to Ossie author Alison Daddo about her
bestseller Queen Menopause, Finding Your Majesty in the Mayhem
Hey, it's Pats from The Christian O'Connell Show. Thanks for
downloading episode one of my new podcast series, Rage Against
the Menopause. Entering Perimenopause, you know, I was really grappling
for some clarity and reassurance. I kind of felt a
bit ripped off, to be honest, after a lifetime of
polycystic ovarian syndrome and endometriosis, I thought, hang on, now
(00:23):
I've got to go through this. I think this is
something that we need to talk about. And every time
I've touched on it on the show, We've had an
overwhelming response from listeners saying we need to talk about it,
and I agree. We need to remove the stigma. We
talk so much about pregnancy, conception, childbirth, why not menopause.
I'm out to change that. I do want to change
(00:46):
the narrative. I'm hoping that by me being candid about
my own experience that we can build a.
Speaker 2 (00:51):
Community of support for other women. It is a no
holds barred chat. We cover a lot of.
Speaker 1 (00:56):
Things, a lot of topics, helping to remove the stigma
and show the power strength that comes with menopause. This episode,
it's titled The Lady Garden. It features doctor Sarah White,
CEO of gene Hale's for Women's Health, Australia's first women's
health clinic, only the second in the world dedicated to menopause.
Speaker 2 (01:15):
I hope you get something from it.
Speaker 1 (01:18):
My very first and very special guest is doctor Sarah White,
who I have known for quite some time at the
Anti Cancer Council and the Quick Campaign.
Speaker 2 (01:28):
I think must be twenty years.
Speaker 3 (01:29):
Sarah, Well, you and I haven't known each other that long,
but yes, quit's been around for thirty years and you
and I have been talking.
Speaker 4 (01:35):
For oh seven or eight.
Speaker 1 (01:37):
Maybe seven or eight so, and you, of course are
at the gene Hales Foundation in Melbourne.
Speaker 2 (01:43):
Welcome, Thank you.
Speaker 1 (01:45):
Tell me about the gene Hales Foundation in Melbourne.
Speaker 4 (01:49):
Sure so.
Speaker 3 (01:50):
The gene Hales was an extraordinary doctor and she set
up the first menopause clinic in Australia and it was
only the second in the world because she recognized that
women just were not getting the care and attention. And
legend has it that the very first day she opened
the clinic, she had a little article in the newspaper
about it. And the second day she opened the clinic,
there were women lined up around the block to come
(02:12):
in and talk to doctor Hale's. Now tragically, doctor Hales
died at a relatively young age, and so her colleague
started the Gene Hales Foundation in her honor, and so
gene Hales for Women's Health Today is our training name,
if you like, and we cover a whole range of
women's health issues, not just menopause, but a whole range
of women's health issues that we sometimes called the lady
(02:34):
garden between the navel and the knees.
Speaker 2 (02:38):
So let's talk minopause.
Speaker 1 (02:39):
So it's something I am definitely going through. When I
look back on it, I actually think I probably started
at about thirty nine, because I can remember driving into
the studio and I just I've just come back from
Matt leave and I had this heat at the back
of my neck is where it started, and I thought
(03:01):
I've been rushing around, you know, dropping off at daycare
and trying to get to work on time.
Speaker 2 (03:06):
But now when I look back, I.
Speaker 1 (03:08):
Think it was a progression from that point. I think
that was like the start of my hot flushes. And
I also got vertigo. I remember we went to Queensland
for a family trip and my daughter was probably two,
and I found it really hard walking around the parks
because I was like spinning, and I thought it was
(03:30):
just I've got near infection or something. But I actually
think it was related to menopause when I think about it,
because my periods were starting to sort of hit and
miss and be erratic. What let's get to the basics.
What is menopause? How is it defined?
Speaker 3 (03:45):
Well, it's actually a really tricky definition in some ways
because you don't know that you've hit menopause until after
the fact. So menopause technically is twelve months to the
date after you've finished your last period, so you don't
really know until one day you look back and go, oh, gosh,
that was more than twelve months.
Speaker 4 (04:02):
I'm actually I've gone through that transition.
Speaker 3 (04:05):
Officially, postmenopause will now the period we usually talk about
when we say menopause, we actually mean perimenopause. So that's
the lead up to that point in time, twelve months
after periods have stopped. So there are some people who
get very angry we don't say perimenopause all the time,
but most people understand it as menopause. And that's the
(04:25):
period when estrogen levels start to fluctuate and then decrease,
and it's really because you're overrestop functioning. So it's the
end of that reproductive life, and you know, it's we
sometimes talk about it always as like this deficit thing,
your levels are dropping, your over reason.
Speaker 4 (04:44):
It's a completely negative thing.
Speaker 3 (04:46):
In some cultures, menopause is really embraced as the second age,
the coming of wisdom point. And if you're a woman
who's experienced really terrible periods, you know, very heavy bleeding,
regular periods, painful periods, pause can actually be a really
good time because all of that's behind you.
Speaker 1 (05:03):
Yeah, I've got polycystico thevery in syndrome and endometriosis as well.
And I sort of felt, to be honest, I felt
a little bit ripped off, Sarah, because I thought, hang on,
I've gone through infertility and all these other health issues,
and now you're telling me that I'm faced with this.
And what I find really frustrating is that perimenopausal period
(05:27):
that it's a tunnel and you don't know how far
through the tunnel you are, how long the tunnel is,
And you can go to a GP, even a specialist,
and they can't there's nothing definitive when you really want
I guess maybe I'm like a scientific approach kind of
person where it's blacker. It's it's like, well, am I
or aren't I? And the fact that you can't get no,
(05:47):
I can't answer it seems like a bit like a
it's telling me.
Speaker 3 (05:55):
Yeah, it would be great if we had a blood
test that said you are definitively now here and your
tunnel your tunnel is six and a half months, yes,
it's two point eight years, and then you're done and
unfortunately no.
Speaker 4 (06:06):
And you know, sometimes that's really.
Speaker 2 (06:08):
The hard thing to manage.
Speaker 3 (06:10):
And I find it because you know, I'm the same
as you got the hot flushes, got the insomnia occasionally.
Speaker 1 (06:16):
Thank god, the insomnia.
Speaker 4 (06:18):
What is that word? I've got that word.
Speaker 1 (06:21):
Yes, I'm trying to get it. A dead brain moment,
brain fog.
Speaker 4 (06:24):
You know, it's frustrated.
Speaker 3 (06:26):
It can be really frustrating, and I think we just
have to try and be really patient and manage the
symptoms and try not to worry how long our tunnel
is taking, because everyone's tunnel is different length, and you know,
if we stretch a really bad metaphor, you know, the
tunnel for some is really rocky and horrible and hard
and for others it's a four lane freeway.
Speaker 2 (06:46):
That's the thing. It's so different. Everyone's experience is so different.
Speaker 1 (06:51):
And I'm happy to say that not.
Speaker 2 (06:53):
Every day is a crap day. You have good days where.
Speaker 1 (06:56):
You actually do feel normal in inverted commas again, and
other days where you don't. I'm actually not taking anything.
I'm not saying that to say, oh look at me,
I'm so strong. That's not what your experience is different.
What I've found frustrating, and I've spoken to my gynecologist about,
is at what point, at what point do you know
(07:17):
you should be taking something? Like when do you know you.
Speaker 3 (07:23):
Know when those symptoms start to really impact your mental
and emotional wellbeing or impact your ability to do your
daily activities or your job.
Speaker 4 (07:31):
So if it gets to.
Speaker 3 (07:32):
The point where you are really struggling with something, then
you go and talk to your doctor. And if your
doctor says, oh, look it's just menopause, go to the
website of the Australasian Menopause Society, find a doctor who
has a real interest in metopause and go and see them.
Easier said than done for rural and regional people, for sure,
but menopause symptoms for about roughly, you know, rule of thumb,
(07:54):
twenty percent will have a really hard time, twenty percent
will not, and the rest fall somewhere in the middle.
People who need that support should not hesitate to go
and get it. If the symptoms are really interfering with
your life, you don't have to put up with anything. No.
Speaker 1 (08:07):
I think that's the point, isn't it. It's like my
mum always told me with periods, have you got pain?
I was like, actually, yeah, I think I actually feel
really rotten. And she used to say to me, well,
you don't you know, you don't.
Speaker 2 (08:20):
Actually have to put up with that, Like, take something
for it. Don't be a hero. If you need something,
absolutely take it.
Speaker 3 (08:28):
And we really know that there's a lot of women
who think that nothing can be done, and that's really
sad because in most cases, something can be done. And
if you're struggling with menopause symptoms, for example, I found,
you know, personally, I insomnia was the worst thing for me.
Always been a bit of an insomniac, much much worse
through this period. And I just went and got just
a little bit of like a sleepaid to start off with,
(08:49):
and I worked my way up a little bit and
talk to my doctor about what the options were. I'm
not on menopause hormone therapy. I would have no hesitation
on taking it if I need to. I've been fortunate
that I've been okay manageable symptoms. A lot of my
friends have had manageable symptoms. I've got one or two
friends who've really had a bad time where they've had
(09:10):
menopause hormone therapy and it's really helped.
Speaker 2 (09:12):
Let's talk about HRT.
Speaker 1 (09:14):
There's still a lot of cloud and kind of innuendo
around HRT.
Speaker 2 (09:20):
Is it safe for most people?
Speaker 3 (09:22):
It is about Look, it's a medicine. There's always side
effects of medicines. There's always concerns. But there was a
study done a number of years ago and the results
were not interpreted well.
Speaker 4 (09:33):
They were publicized really.
Speaker 3 (09:34):
Badly, and overnight a huge number of women ripped off
their menopause homone therapy or hormone replacement therapy patches. And
we're really worried about this increased risk of breast cancer.
But the risk is actually very small. The risk is small,
and so for some women who have a history of
breathasts cancer, for example, they need to.
Speaker 4 (09:53):
Talk to their doctor.
Speaker 3 (09:54):
You should talk to your doctor all the time when
you're gonna have a medicine. But it's certainly if you're
a doctor and you have that conversation and the doctor
says this could help, you shouldn't be afraid of taking it.
Speaker 1 (10:03):
And that's the thing too, I want to point out,
is the conversation. This is my whole point of doing
this podcast. It is experiencing it myself. We all talk
about fertility and about conception and pregnancy. Why aren't we
being open and honest and raw and organic about menopause?
Why is it such a dirty word. Why can't we
(10:26):
open the conversation. It's a perfectly normal stage of life.
Speaker 3 (10:31):
Every woman, every person with ovaries is going to go
through menopause, right, so it has been it has been
a bit of a taboo subject for a long time.
Speaker 4 (10:40):
I feel like that's.
Speaker 3 (10:40):
Really changed over the last few years.
Speaker 4 (10:42):
And I think it has to do with gendered ageism.
Speaker 3 (10:46):
To be honest, Yes, I think it's been seen as
a sign of and shown in popular culture of oh
you've hit the change, and now suddenly all this gray
headed old hag.
Speaker 2 (10:56):
And shovy up in the top pad get about you.
Speaker 4 (10:59):
Every productive year over soon.
Speaker 3 (11:00):
What's your point really, And that's just you know, I
think that's where a lot of women struggle. We live
about a third of our lives after menopause. We're still
incredibly productive. Not only we incredibly productive, we're incredibly wise.
We've reached a certain threshold of you know, don't care factor.
We're confident. So it's not something that we should be
(11:21):
worried about. But I think it's comes from that gendered agism.
Speaker 4 (11:26):
To be perfectly.
Speaker 1 (11:26):
Honest, I agree, and I think there is such a wisdom.
I'm fifty one now, but there is such a wisdom
I think about turning fifty. It's almost like, as opposed
to your flower dying and wilting away, it's actually starting
to bloom because I think you're starting to grow into
your skin and your confidence shines through, and you think,
you know what, I'm not going to make apologies anymore.
(11:48):
If no one likes me or how I am, that's
their problem, not mine. Sure, it's an interesting notion, absolutely.
Speaker 3 (11:56):
And there's actually only just very rich. Like within the
last three or four weeks, a study on chimpanzees reaching menopause.
So before then it was humans and it was whales.
You know, that's the only thing, because I don't know
what these scientists thought that suddenly older females of a
species just you know, I can't have children anymore, so
I just drop off the perch. And what they find
(12:17):
in certainly in the whales, is the grandmother's if you like,
or the older females are the ones who are responsible
for guarding the pod and looking after the young ones.
So you know, it shouldn't be seen as now I'm
done and dusted because my ovaries have stopped working.
Speaker 1 (12:34):
Yes, what do you think about menopause in the workplace?
What sort of statistics have we got about women in
the workforce struggling and productivity, that sort of thing.
Speaker 3 (12:45):
We don't have a lot, And what we do have
is based on what we call convenience samplings. So you
go to a group of women and say how has
menopause affected you? And the people who have been affected say, oh,
I'm going to fill in that survey. And the people
who haven't been affected say, oh, it's not relevant to me,
So I'm not going to fill it in because it
hasn't affected me. So gene Hails has just conducted the
National Women's Health survey and we asked women, you know,
(13:06):
have you missed days of work because you've had symptoms
that you thought were menopause, And about seven percent of
women said, in this forty five to sixty four age range,
about seven percent said I've missed days and about fourteen
percent said I've taken an extended break from work. Now,
we didn't define extended break, so it could have been
a week, it could have been a month, that could
have been a year. So we do know that it
(13:28):
has an effect on women. We do know that there
are going to be some jobs in some workplaces that
aren't very sympathetic. But I think there's a really there's
real scope to improve what we do in the workplace,
not just for menopause. I think we've got to be
really careful about focusing just on menopause. With workplace flexibility
for women, it has to also be for people who
(13:51):
have as you mentioned, you know, pecause, in demetriosis, all
these conditions where we need to have access to a bathroom,
you know, a bit of flexibility around pelvic pain. So
not just menopause. I'm getting right off track here, Patrina.
You know, I think we have to create an environment
where we normalize discussion.
Speaker 2 (14:12):
That's what I mean.
Speaker 1 (14:13):
We need to talk about it, don't be be honest
about it.
Speaker 3 (14:17):
Yeah, I mean we just turn it into a joke
around the office. You're easy to do it, Gene Hales,
to turn that into office. But you know, I've been
in meetings We've gone, oh, hang on a minute, hot
flush coming in, found myself and everybody has a giggle,
we move on. That's not going to happen in every workplace,
of course, but the more we have these sorts of discussions,
the more we normalize talking about hot flushes or brain
(14:38):
fog or you know, the better.
Speaker 2 (14:40):
We are brain fog.
Speaker 1 (14:42):
You know, being on air on the Christian O'Connell Show
and as the news reader on the show, there's been
several times where I've gone off on a tangent and
then completely forgotten about a word or it's it's so
humiliating as a broadcaster. It's like because I guess maybe
in a different office environment it's not as noticeable, but
(15:06):
when I do an on air it's there's a lot
of people.
Speaker 2 (15:10):
Of course here you stuff up.
Speaker 3 (15:12):
Absolutently and to Christian and Jack notice or do you
notice I.
Speaker 2 (15:15):
Don't think they do. I think it's me. I don't know.
I don't think they do.
Speaker 3 (15:19):
So coming back to that question around workplaces, I do
wonder if some of the reason why, you know, we
have when we do these surveys of people who say,
you know, why did you leave the work force, and
some will say because of menopause, And I wonder if
it's actually about a loss of confidence, because you know,
in some roles, imagine you're a barrister and you're cross
examining the witness and you suddenly lost that keyword.
Speaker 4 (15:43):
You know exactly what's the opposite of guilty again?
Speaker 3 (15:45):
You know?
Speaker 1 (15:46):
No, But it is as simple as that, It really is, absolutely,
you know. I think confidence is a big thing. I
think when you I know, when I had my daughter
and in that sort of here we go, there's a
rain fade again in the Matt Leaf period, you do
lose confidence because you not that your whole identity is
(16:09):
on what you do or who you are in that sense.
But it's I think it's just that routine of going
into it when you've done something like I had for
twenty years and that stopped down. And I think it's
the same with menopause. There's an anxiety. I know one
of my girlfriends has really bad anxiety from her menopause,
(16:30):
Like it's really disabling for her some days. Is that
obviously just a hormone impact.
Speaker 3 (16:36):
Yes, probably, And looks It's the thing with menopause is
it's really hard to disentangle from everything else that's going
on in our lives when we're that age. And I
saw I've adopted this phrase. I saw in an article
which is called was called about midlife collision. So we have,
you know, we have kids of a certain age, we
have increased responsibilities at our job. We've got a partner
(16:58):
that who may or may not be driving us by
because we've been together for twenty odd years.
Speaker 4 (17:01):
We've got elderly parents.
Speaker 1 (17:03):
Oldly parents who need more cares, all the socially.
Speaker 3 (17:06):
Labor of running households, and so this is a point
where you then add on some insomnia from menopause or
whatever else. It could be anything, and suddenly that midd
life collision becomes a catastrophe. So I'm always a little
bit wary about saying everything's due to menopause. It could
be secondary to lack of sleep. It really could be
(17:26):
about a lot of other factors in your life. So
if we put everything in the menopause basket, I think
we risk the opportunity of actually getting to the root
cause of what the challenge is for any one individual.
But certainly menopause has been associated with anxiety and depression,
definitely with you know, loss of labido, which can put
more pressure relations not.
Speaker 1 (17:47):
Even interested, which is actually like hit me in the face,
because it's that's something it was. It's really foreign us.
It's like, hang on, but not even.
Speaker 2 (17:57):
This is weird.
Speaker 1 (17:58):
It's like a tap that's just switched off.
Speaker 3 (18:00):
And you've also got this lovely phrase of vaginal atrophy,
so dryness and thin skin for some women though not
only is there a lack of interest in sex, but
sex becomes incredibly painful, you know. And these are the
sorts of things where we really want women to be
able to normalize that discussion and particularly go into the doctor.
That's something we don't wan to talk about in the
(18:21):
workforce potentially, but go to your doctor and talk to
them about it, because you can have those MHT creams
that you know, you can you can suffer get help.
Speaker 4 (18:31):
Absolutely.
Speaker 1 (18:31):
The other thing that you know we were talking, we
touched on earlier about the finish line, the end line,
which is different for everyone and we can't tell when
it is. But I will quite often stop and ask
myself and when will I feel like, what's what's on
the side, Like what happens once we are through and
we're officially in that menopause after the twelve months of
(18:55):
not having a period, Like, do we still get hot flushes?
Speaker 4 (18:58):
Is that?
Speaker 3 (18:59):
So? Hot flushes can last for a long time for
some women unfortunately, So there are some women who report,
you know, for even ten years after menopause they get
hot flushes. So I think this is important again and
keep checking in with your doctor. Should I still be
getting these things.
Speaker 4 (19:13):
The other thing that.
Speaker 3 (19:14):
Happens is you do have new health challenges when you're
in the post menopause will phase so things like your
bone health, you have to really watch that because that's
when you start to lose bone you do the bone density.
Things like your heart health, so estrogen has a protective
factor with the heart, so you start stop having that
estrogen and your risk of cardiovascular issues comes up. So
(19:38):
I think menopause is a great time to go and
talk to your doctor about your health check right now
is in your midlife, and then what do you need
to do to make sure you keep healthy in that
post menopause will phase as well.
Speaker 1 (19:48):
I touch you with my doctor quite regularly, but certainly,
and he always puts me up on the block. It's
like a twenty thousand KSE.
Speaker 2 (19:54):
Service every time.
Speaker 1 (19:55):
But blood tests every six to twelve months, keep up
with your breast checks absolutely. Perhaps smears which high five
are now only every five years.
Speaker 4 (20:06):
Yeah, definitely.
Speaker 1 (20:08):
But that's a good point.
Speaker 2 (20:09):
I think that's a really pivotal point.
Speaker 4 (20:10):
Look at fear heart health. You know, talk to your
doctor or talk to a.
Speaker 3 (20:14):
Nutritionist dietitian about making sure you're getting enough calcium. You
do have to actively there's nothing to do with menopause.
As we get to our midlife, whether you're a male female,
you have to start looking after health a bit more proactively.
Speaker 1 (20:29):
And that's the thing too with menopause is that middle middle.
Speaker 2 (20:33):
It's so hard to shift.
Speaker 4 (20:35):
I know, I know.
Speaker 3 (20:37):
So menopause and weight gain is a really contentious topic.
So we do know that your weight, your fat distribution
actually shifts to the abdominal section, which is not great.
It's not necessarily that menopause causes you to put on right.
But you do get that distribution and again probably midlife collision.
A lot of women from our survey tell us they
(20:58):
stopped exercising, which is, you know, the worst thing to
do if you need to keep carrying strength, you know,
strength exercise for your bones, it'll help your insomnia, it'll
help your mental health. But a lot of women get
to the i've got these bad symptoms, I'm just gonna
stop exercising.
Speaker 4 (21:15):
So, yes, we do have.
Speaker 3 (21:16):
To keep an eye and we probably need a few
less calories.
Speaker 4 (21:20):
She says that she looks longingly at her last in
front of her.
Speaker 2 (21:23):
You're allowed to have a coffee one.
Speaker 3 (21:25):
To day, So yeah, we do have to look after
a health more. And that's just a factor of getting old.
When it comes to menopause, there's a whole host of symptoms,
and then there are a bunch of symptoms that a
lot of women believe are due to menopause and they're not.
So there's a lack of knowledge around symptoms that I
think is not helpful.
Speaker 2 (21:44):
Let's bust some of them.
Speaker 3 (21:45):
Yeah, sure, so it's easy to go with the ones
that people don't recognize a part of menopause.
Speaker 4 (21:50):
So joint pain.
Speaker 1 (21:51):
For example, Oh my god, some days I'll walk like
an eighty year old woman.
Speaker 3 (21:55):
Yeah, so joint pain can definitely be a menopause factor.
But I was going to suggest that you can go
to gene Hale's website or to the Australasian Menopause Society
website and we both have questionnaires that you can fill
in and say, what are the symptoms I've got, what's
the extent of the problem. Just filling that in and
(22:16):
then taking it to your doctor can be a really
great way of tracking how you're doing, helping your doctor
focus on the issues, the most important issues for you,
because sometimes it's about symptom management, yes, and then also
you can keep tracking it to see how the symptoms
are resolving or not.
Speaker 1 (22:32):
It's like a snapshot, isn't it. Because I think as women,
as you say, we're busy. We might have families, we've
got elderly parents, where career women we're just it's like
a marathon each week just getting to the finish line
and we push our needs to the side.
Speaker 2 (22:45):
For everyone else, I think you do it, and it
takes probably.
Speaker 1 (22:48):
The five minutes to sit down, tick the boxes what
you need to and get that snap.
Speaker 3 (22:53):
Shot absolutely, and then where you do have you know,
we get lots of reports of doctors, Oh look, it's
just menopause.
Speaker 4 (22:59):
Don't worry about it. You have to deal with it.
Speaker 3 (23:00):
Oh no, no, no, you don't, you not. But filling
in something like a symptom checklist can help you go, well, actually.
Speaker 4 (23:08):
I don't have that or that or that or that.
You know that's a problem.
Speaker 3 (23:12):
Well, actually, so what else is going on in my
life that might be the problem here? Yeah, And I
think it's really important to dig into what the problem is,
not just immediately say oh, it's just menopause.
Speaker 4 (23:22):
No, no, no, we don't have to put up with it.
Let's work out what the real problem is.
Speaker 1 (23:25):
An address for more information, gene Hailes for Women's Health
provides free, evidence based health information for all women. You
can head to genehals dot org dot au. I'm Patrina
Giants and join me for episode two Miserable Magical Menopause,
where I chat to Ossie author Alison Daddo about her
bestseller Queen Menopause, Finding Your Majesty in the Mayhem
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.