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00:00What happens when you take a group of opinionated Australians?
00:05One hot-button topic close to their hearts.
00:08Why don't you just shut your face?
00:10No, we've got to go there.
00:11They're called love handles for a reason.
00:13Throw in three courses.
00:15How is that okay?
00:17It just depends what...
00:18Wait, wait, wait.
00:19Wow.
00:20Too much information.
00:21You have to look fuckable.
00:22You often get distracted during sex.
00:24And me.
00:26I'm Mark Fennell and this is Tell Me What You Really Think.
00:30It affects half of the world's population for up to a third of their life.
00:37And yet, for centuries, it was rarely talked about.
00:41Or not anymore.
00:42I think menopause gets a really bad rap.
00:45Your perimenopause is showing.
00:47Three supplements I take to feel great on menopause.
00:50This week, we are going inside the menopause gold rush.
00:54I use badge of honour.
00:56And the new generation smashing taboos and shouting from the rooftops.
01:01I'm not afraid of perimenopause anymore!
01:07Is it finally making up for decades of neglect or just catastrophising ageing bodies?
01:12Women are being preyed upon by companies that are making products that say they do stuff that they don't do.
01:19Plus, the groundbreaking science that could change everything.
01:23You can have at least a decade of delay in menopause.
01:26And if you do it even earlier than that, you could potentially have 30, 40 years of delay and technically eliminate menopause if you've done this early enough.
01:37Come in.
01:38Hi Mark.
01:39Hello.
01:40How are you?
01:41Hi.
01:42I should have checked if you were a handshake or a hug person.
01:44Oh, hi.
01:45Are you a hug person?
01:46Hug.
01:47For sure.
01:48Alright.
01:49So, everybody's got a seat.
01:50Grab a seat.
01:51Sit down.
01:52Now, are you actually going to eat?
01:53Because people get all nervous when they're presented with food.
01:55Joining me tonight, author Cathy Lett.
01:58Actually, you're so cute.
01:59As long as we have you for dessert.
02:01And menopause doctor, Liz Raymond.
02:06I'm the closest, so I get the biggest.
02:09Do you want to know what's on the menu?
02:11Yes, please.
02:12Apart from apparently me.
02:13Fashion entrepreneur, Julia Brown.
02:16True fashion, because that's one of the things I do.
02:18Well, obviously.
02:19We can see that.
02:20Hello.
02:22Journalist and women's health advocate, Shelley Horton.
02:25Are we okay to say that we give zero fucks now?
02:28Yes.
02:29Traditional Chinese medicine practitioner, Anissa Ao.
02:32I think we can help ourselves.
02:34Um, so, thank you all for coming.
02:38Well, suddenly you went all serious, didn't you?
02:40Yeah, we're just paying attention to you.
02:41I just wanted to start with something that I don't think happens enough on national television.
02:45I want to hear your menopause symptoms.
02:48Oh.
02:49Your face, your eyes went so wide then.
02:51Do you want to start?
02:52Oh, how long have you got?
02:53Well, yeah, what's up to you?
02:54Where do you want to start, Cathy?
02:55Well, first of all, you sweat more than Donald Trump doing your sedation.
02:58And that's a surprise, isn't it?
03:02And the other thing I hated was the brain fog.
03:05I was on the phone to my sister one day and I was going,
03:08I've lost my phone.
03:09I've lost my phone.
03:10I can't cope without my phone.
03:11And she goes, Cathy, what are you on?
03:14But a doctor, I mean, we've got proper medical people can back this up.
03:18A doctor told me recently that, yes, when women lose some cognitive ability during the menopause,
03:25we just go down to a level where most men are.
03:27And she had clinical studies to show that.
03:31Yeah, clinical studies to show that.
03:33So I thought much better then.
03:34Lovely.
03:35What about you?
03:36Well, mine was a big surprise because I went into perimenopause at 45.
03:43But I thought I'd never heard the word perimenopause before.
03:46I thought menopause was just for old ladies with grey hair and they had hot flushes and their periods stopped.
03:51So I was a fox, you know, didn't, it wasn't even on my radar.
03:56So my symptoms were actually pretty horrific, perimenopausal depression,
04:01and I have never had mental health issues before in my life.
04:04So I had the depression, the anxiety, didn't have hot flushes.
04:08I was just like three degrees hotter than I'd ever been for a long time.
04:12And then, and we are going to have to talk periods and stuff here,
04:16but I had an Armageddon period where I flooded through my clothes.
04:21Oh my God.
04:22And so I went to a GP, a female GP, who also didn't know anything about perimenopause.
04:29And she said, oh, with this bleeding, it might be cancer.
04:32Oh my gosh.
04:33So I was sent off for an internal ultrasound.
04:36And when I got the results back, she said, great news.
04:39It's not the big C. You just must be stressed.
04:42Maybe you should take up a hobby.
04:43Oh, disgusting.
04:45So I then didn't get any help for nine months
04:48till I was at the point where I was circling the drain and considering self-harm.
04:53It was that bad.
04:54And I am very lucky.
04:56I have an earth angel of a husband.
04:58And he, I got to the point where I wanted to quit my job.
05:01I was having trouble getting out of bed.
05:03And he just sat me down and he said,
05:06I don't think there's anything wrong with you,
05:08but I think there's something wrong with the chemicals in your brain.
05:11You haven't been yourself.
05:12Let's go see a doctor together.
05:14Yeah.
05:15Amazing.
05:16And it makes me want to cry.
05:17Oh.
05:18But it was, and that's when I got help.
05:20Julia, how was the experience for you?
05:22Well, I discovered that I was perimenopausal.
05:25Because we have to make that distinction, right?
05:27We need to know the words.
05:28That's right.
05:29During COVID.
05:30But initially, I thought I, I mistook my perimenopausal symptoms for COVID symptoms.
05:36Oh, God.
05:37So I had a hot flush and the night sweats.
05:42And I also had really bad headaches.
05:45So at that time, we were only doing telehealth right.
05:47So I was telling my then GP, because I've been through quite a few.
05:50I sense a theme developing.
05:51Yes.
05:52Yes.
05:53About my symptoms.
05:56And he actually said, I think you're actually menopausal.
06:00A lot of my symptoms were like brain symptoms.
06:03So even though I did initially have a hot, like a hot flush and a bit of the night sweats,
06:10as you probably hear from people, it's not like you just have one set of symptoms and that's it.
06:16With me, it was like, seemed to be after those initial things, which I thought were bodily things,
06:21I've since found out they're all to do with the brain.
06:24Then it was brain fog, which was really bad.
06:27And it's, oh, God, sorry.
06:29I don't want to.
06:30It's so scary sometimes when you can't, and you think, am I getting dementia?
06:34It's so scary when you, as I say, the word's going down the hallway and it's not got to the door.
06:39That's how I describe it.
06:41But I was having terrible time with brain fog.
06:44The next stage was the intolerance stage, where I was just like, just so angry, like picking fights.
06:53And like your amazing angel husband, my husband very gently said to me,
06:59you're just having a go at, sorry, I don't want to get upset.
07:03You're having a go at our daughter and she's done nothing wrong.
07:06Like, this isn't like you.
07:08I think you need to go back and see someone about this.
07:12Anyway, sorry, I didn't want to get.
07:14It's important to share this.
07:15Yeah, yeah, I'm fine, I'm fine.
07:17I just want to bring in Dr. Liz here.
07:20Perimenopause, menopause, what is it that people should know more about the difference between them?
07:25Menopause is just one day in your life and it's the day that you have your last menstrual period.
07:31And you can't establish that until you've had no periods for 12 months.
07:35So it's a retrospective diagnosis is what we call it.
07:38Whereas perimenopause is the period of time peri in the Greek language or from the Greek language means surrounding.
07:46So it surrounds the actual day of your menopause and it goes from when your symptoms start to the year after the menopause.
07:55So it sort of goes around the perimenopause and that can last between, you know, on average four to six years.
08:02But the actual range is from zero to 11 years because 20% of ladies don't...
08:07More than a decade.
08:09Yeah, exactly.
08:10Of feeling like shit.
08:11But not for everybody.
08:12Not for everybody.
08:13Not for everybody.
08:14But for a lot of women.
08:15Can I ask, there's another part of this as well, which is early menopause, which is something you've experienced as well.
08:21Can you talk to us about that?
08:22Yeah, so 10% of ladies will get what's called an early menopause between the age of 40 and 45.
08:27I unfortunately experienced the perimenopause.
08:30You know, 40-year-old, clinical practice, working on a board, public speaking, three young kids, a renovating house, elderly mother, corporate husband,
08:40and...
08:41So not much going on then.
08:42Not much.
08:43You're pretty relaxed.
08:44I'm not alone like that.
08:45This is a typical story for a woman in the midlife, juggling everything.
08:48We juggle so much we could be in the circus on that.
08:51Yeah, exactly.
08:52Exactly.
08:53Anyway, I was in a board meeting and I was speaking and boom, I got a biggest first hot flush, sweating, couldn't find my words, lost my word fluency and palpitations.
09:06And I came out of the boardroom afterwards with a colleague and done me for a few years and he said, what went on there?
09:12You know, you suddenly developed anxiety, it looked like.
09:15And I said, I have no idea.
09:17Wow.
09:18That was incredible.
09:19I'd worked in Obstangaini, I'd done qualifications for the Royal College of Obstangaini and I was treating people with menopause, this is 12 years ago, but I was in denial as well.
09:31I thought it's stress and I thought, this can't be happening to me.
09:34Anyway, I got diagnosed with early menopause and got onto treatment.
09:38And I was lucky, but I was well informed at that point anyway.
09:42Can we just establish you that God is a man?
09:44Yes.
09:45Because these are all the things that women go through.
09:48First of all, you're taken hostage while your hormones as a teenager, you know, you get your periods once a month.
09:53Then you've got pregnancy where everything swells to sumo wrestler proportions.
09:56Then you have, you know, childbirth where you stretch your vagina, the customer in what, five, six kilometres.
10:01Then you have mastitis, then you have the menopause and then just when everything goes quiet, you grow a beard.
10:06And I'm like, well, thank you.
10:08I want to bring Anissa in here though, because Anissa, you're in your early 50s at the moment.
10:13I am, I'm 53.
10:14Okay.
10:15Are you experiencing symptoms at the moment?
10:17No, I'm not.
10:18So I kind of represent the other people who actually are breezing through perimenopause.
10:25I have noticed some differences within my own menstrual cycle, but none of these symptoms that you ladies are talking about.
10:34So the fact that you're not experiencing some of the symptoms that everyone else has here, what do you put that down to?
10:40I have kind of investigated throughout my life different techniques of how to maintain my own health going into menopause,
10:48being a Chinese medicine practitioner myself.
10:51So the focus within Chinese medicine is very much about kidney and liver health and also your energy reserves as you're going into menopause.
11:00So that's been my focus going into this.
11:03I look after my sleep.
11:05I look after my lifestyle.
11:07I moderate my stress levels.
11:09So there's been techniques that I've used throughout my 40s to deal with stress.
11:14Like I've had the stresses that you've had.
11:16We use, we use wine.
11:17Yeah.
11:18The real stuff.
11:19Yeah, the real stuff.
11:20Yes, wine's a good one.
11:21Yeah.
11:22So I would largely say through natural health.
11:24How does Chinese traditional medicine view this period of your life?
11:28Well, the term second spring is used with menopause.
11:31So we often think of it as a time where the woman gets to focus on herself, on her passions, on her interests.
11:38Menopause is very natural.
11:40It's just part of life.
11:41So that's how we view it rather than seeing it as a pathogen or a disease.
11:45Can I jump in?
11:46Yeah, go for it.
11:47With respect, yes, it's natural, but it doesn't mean that people like us need to suffer.
11:54No, absolutely.
11:55So when I have spoken to world experts about menopause, I had a brilliant example from Dr. Kelly Casperson, who is a urologist from America.
12:04And she said, we have a bit of a strong push for it's just natural.
12:09You can, you know, put up with it.
12:11She said, if you want it to be natural, a natural life, everyone hand over their reading glasses because your eyesight deteriorating is natural.
12:18But we take care of our eyes.
12:20Yeah.
12:21So for me, natural doesn't mean we have to suffer.
12:24And that's, I would say that Chinese medicine would actually endorse that.
12:27Yeah, okay.
12:28Yeah.
12:29Everyone's journey and experience is so different.
12:32Only 20% have severe, severe symptoms.
12:3520% have, you know, no symptoms or extremely mild symptoms.
12:40Whereas 80% of ladies, the majority have no mild or moderate symptoms.
12:45So whilst we represent the 20% having severe symptoms, I don't want to instill fear into everyone watching, you know.
12:54No, absolutely.
12:55But at the same time, I'm sorry, but I slipped through the quacks.
12:58So I'm that 20% and I could easily not be here.
13:02Yeah, so for sure.
13:03I would rather that the pendulum went too far and we educated everyone.
13:07No, but there's a lot of value in hearing the narratives of the people who have had severe symptoms because that's what makes change, isn't it?
13:14Yeah.
13:15Because I remember my mother's generation, they talked about, I remember them being in a cardigan coven in the corner of the kitchen talking about the change, you know, as Voldemort was coming.
13:25I think, what's the change?
13:26And everyone was terrified.
13:27The change.
13:28The change.
13:29Yeah.
13:30The change.
13:31And you know, at least my generation have helped take, we take the stigma out of menopause.
13:36Yes.
13:37We talked about it openly for the first time.
13:39Yes.
13:40You know, now this is amazing that now there's a TV show where we're addressing it.
13:43I love it.
13:44And also that we've got a male host and I want to say how much I love that we have you doing this.
13:47Although, by the way, you'll be ovulating by the end.
13:49I may have already started, who knows.
13:52Actually, I did want to ask about that.
13:54Did the men in your various lives, did they know anything about menopause?
13:58They didn't know anything, but we had some great empathetic husbands.
14:02I want more men talking about menopause because it's not a women's issue, it's a society issue.
14:08Yeah.
14:09It affects workplaces, it affects, you know, your loved ones, your sisters, your mothers, your, you know, everyone.
14:15So, therefore, we need men as allies in this.
14:19And, you know, we also need them to know about it so they can sometimes spot the symptoms.
14:23Right.
14:24Because when you're in it, it's hard to see it.
14:26And I wrote a novel called HRT, Husband Replacement Therapy.
14:30Because a lot of women leave their husbands while they're going through the menopause
14:34because of the lack of understanding and sympathy and empathy.
14:37Secret women's business doesn't help women.
14:40Yeah.
14:41We need to talk about it.
14:42That's interesting.
14:43Menopause is, perhaps surprisingly, extremely rare in the animal kingdom.
14:48Only a handful of species are known to outlive their fertility, most of them whales.
14:54Take the orca.
14:55Scientists believe that by going into menopause, female orcas can focus on being good grandmas.
15:01You know, spoiling me grandkids with fish.
15:04The first recorded reference we have to menopause comes from around 350 BCE,
15:09when Aristotle wrote that women could expect to go into menopause around their 40th birthday.
15:15That is, if they lived that long.
15:18In the 1500s, there is a book about witchcraft that claimed that menopausal women were prone to dark thoughts,
15:24usually associated with witches.
15:27And things didn't get better in a hurry.
15:30In Victorian England, menopause was seen to cause insanity and could land you in an asylum.
15:35Supposed cures included bloodletting and leeching.
15:40With the 20th century, in came the idea that menopause was a disease that could be cured with drugs.
15:46And the marketing, it seems, was targeted just as much to men to stop their wives becoming,
15:51and I stress this as a quote, dull and unattractive and to make them, quote, more pleasant to live with.
15:58Yeah.
15:59The thing is, even late into the 20th century, these ideas that menopause is just in your head.
16:05Yeah, that didn't go away.
16:07A lot of the symptoms are psychological and not physical.
16:12It's the fact that we are afraid that we are losing our youth, that wrinkles are coming up, that men won't find us attractive.
16:20But I think more and more women are finding out that, after all, if women are ageing, men are ageing as well.
16:26I mean, you know, I see a lot of bald-headed men around the place, big tummy because of the beer drinking.
16:33They're not such a hot sight themselves.
16:36And the taboos around menopause, yeah, they didn't go away either.
16:41Many women in my study, they said their girlfriends weren't all that interested,
16:46that if they mentioned that I've had a diagnosis of menopause, that's why, you know, that's why I've been feeling the way I feel,
16:55their friends would say, oh, well, you know, that's nice, okay, and change the subject.
17:01Why do you think it was stigmatised for so long?
17:05I think part of it was that women thought that once they hit the menopause, they had passed their amuse-by date.
17:12Yes.
17:13That this idea that if you're no longer fecund, if you're no longer fertile, what use were you?
17:18A very low number of women will actually raise the issue in a consult, and that's so sad.
17:22And I always bring it up, and they're so thankful because they, and then they'll say they didn't feel they could ever raise that with somebody.
17:28Can I just mention that Liz is a unicorn?
17:30Exactly.
17:31So I feel a lot of medical professionals minimise women's pain and women's problems, and I think part of that problem is that we don't have enough education for GPs.
17:42Yes, I understand that completely.
17:44But Liz, can you tell Mark how many hours GPs study menopause?
17:49Because there were headlines last year that GPs in Australia only get one hour of training in menopause.
17:54You tell me if it's true.
17:55I'm not sure that's true, to be honest.
17:56I have had many GPs tell me they've had zero.
17:59That's her job.
18:00I feel like Liz is like the one doctor on the table, so let's give you a bit of space so you don't have to answer every grievance of the medical industry.
18:10No, but I just want to finish.
18:12So, Shelley, GPs definitely need to be not dismissing women and understand the differences for different population groups, the different average ages of menopause, all the different possible presentations, and be able to manage.
18:27Very frustrating.
18:28If I could just say that I think there's the perception of how much training needs to be done at different stages of your medical career, needs to be, because I've been asked, should, why isn't it in the medical student curriculum?
18:41As in, it is, it was when I was there.
18:44You have to learn about menopause, but what depth you need to learn about things.
18:48It's just like, what depth do you learn cardiology or obs and gynae?
18:53I know, but I get really frustrated around this, because I have lived experience of having completely appalling, appalling behaviour by GPs.
19:04Same here.
19:05It's just, I think they, I think even, and I am not attacking, I am just suggesting, there is a big, please do better.
19:13Please do better for women.
19:15Oh, yes, for sure.
19:16And that's why this is so fabulous.
19:17I don't want to have to flip this table, but I might.
19:19Please don't, it's a really lovely table.
19:21No, so I'm not dismissing that at all, I'm acknowledging this.
19:24Where's that HRT?
19:25I know, I need a little bit more estrogen right now.
19:26Emergency, HRT, emergency.
19:28But this is why the narrative and the voice of women now of our age is going to change things, and it has changed things.
19:38It has.
19:39After the break.
19:40What did you buy?
19:41So many things.
19:42In a brown paper bag, that's a worry.
19:44Menopause remedies under the microscope.
19:46No evidence.
19:47There's no data.
19:49It's not effective.
19:50Women are being preyed upon by companies that are making products that say they do stuff that they don't do.
19:57And the great menopause gold rush.
20:00This stuff is magic.
20:03It's like whipped cream for your face.
20:05Why doesn't she monetize it?
20:07If a man did that, he'd be an entrepreneur.
20:09I just had to come out here and get something off my chest.
20:14I'm not afraid of perimenopause anymore!
20:20Menopause is getting a Hollywood makeover.
20:23This stuff is magic.
20:26It's like whipped cream for your face.
20:28I use badge of honour.
20:31It's been described as the menopause gold rush.
20:35The global menopause market is set to be worth around $40 billion by the end of the decade.
20:40But all of these pills and remedies, do they actually work?
20:45To find out, I've enlisted leading endocrinologist Dr. Susan Davis.
20:49Suddenly people have come out of the woodwork and self-proclaimed themselves of being menopause experts
20:54with minimal training and disseminating a lot of misinformation and creating a lot of confusion.
21:01And potentially doing harm.
21:03So I've been shopping.
21:04Oh, good!
21:05What did you buy?
21:06So many things.
21:07In a brown paper bag, that's a worry.
21:10One here is a bunch of products that claim to help the symptoms of menopause.
21:17So this one has black cohosh in it.
21:22Okay, so black cohosh in the really most robust studies, not effective.
21:30Menopause tea.
21:32Yeah.
21:33Green tea, no evidence that...
21:35Licorice root, no evidence.
21:37Ginkgo, bioba and cinnamon.
21:39Those are things.
21:40Rose petals, ginger root, lavender flowers.
21:43There's no evidence in any of these.
21:45They might taste nice, might be calming, but no.
21:50So this is menopause skin cream.
21:55So this is going to restore my skin.
21:57Apparently.
21:58The main things that will restore skin and wrinkles is, you know, retinoic acid and the retinoids.
22:04And I can't see any of those listed here.
22:07This one has something called red clover in it.
22:11Parmencil's been around for years.
22:13No benefit for vasomal symptoms, hot flushes, night sweats.
22:17And the evidence for mood is...
22:19There's no data.
22:20Chinese Western herbal medicine.
22:23It's got vitamin D in it.
22:24That's good for you.
22:25So these are intimate wipes.
22:28My goodness.
22:29They're paraben free.
22:30That's good.
22:31Great.
22:32There is no evidence that using wipes for your vagina is going to improve your vaginal tissue.
22:40I personally see no place for things like this.
22:45I just think it's really clever marketing and women are being preyed upon by companies
22:55that are making products that say they do stuff that they don't do.
23:01And I think that's really wrong for women.
23:03How have we ended up here that it's become such a contested space?
23:07I think it's been a contested space because the medical fraternity dropped the ball.
23:13American researchers shut down a major study into hormone replacement because of serious health concerns.
23:19Hormone replacement therapy, or HRT, has long been the first line of medical treatment for menopause symptoms.
23:26The world's longest and largest clinical trial on HRT was abruptly cut short.
23:31And the first headline blast, 2002, was HRT increases breast cancer, plastered across the world.
23:39There were more adverse effects than beneficial effects.
23:42And when I heard that I was quite frightened.
23:44As time has passed and people have gone back and re-analyzed and re-looked at the data,
23:52there is indeed a small statistically significant increase in risk of breast cancer with the formulations used in that study.
24:01With the oestrogen-only arm, hysterectomised women, there was no increased risk of breast cancer.
24:07But that was published after the first alarm bells went off.
24:10And in the 18 years of follow-up, what's been seen is basically there's no increased likelihood of dying from heart disease or breast cancer,
24:21whether you do or don't take the hormone therapy in that study.
24:24In all, between 150 and 200,000 Australian women went off HRT after the scare.
24:31Many Australian women have turned to alternative treatments.
24:34We're definitely still experiencing a fallout from that study.
24:38And I see that because I see women who are very reluctant to take hormone therapy
24:43because they're scared that there could be dangers in it.
24:46And equally, we are still encountering practitioners who will not prescribe because they believe it causes breast cancer.
24:54And that was a fallout from that study.
24:56Because women were not taking HRT, it opened up this big space that could be filled by over-the-counter products.
25:05Alright, I like to keep things stupid simple.
25:07Three supplements that I think all women in periomenopause should be taking.
25:11Do you want to know why I feel so good?
25:14Well, it's all in this tiny, one-a-day pill.
25:18I feel like at the moment, menopause has been the most visible I can remember in my lifetime.
25:24How do you feel about that shift?
25:26I think it's fantastic to normalise conversation about life changes.
25:31But I think there are a lot of people putting out there that menopause is likely to be a catastrophic experience.
25:38For the majority of women, it is not a catastrophic experience.
25:42It's a life change.
25:44For some women, that's a relief.
25:45If you've been having really heavy bleeding and suddenly you stop bleeding, you've been having menstrual migraines and they stop.
25:51For many women, it's just even a non-event.
25:54So, it's great to talk about it, but let's get the record straight about what's evidence and what's not.
26:00If you want more tips to be healthy on menopause, make sure to follow me.
26:06In the last year, there were three separate women's health organisations that warned against, and I'm going to quote here, catastrophising menopause.
26:13Yes.
26:14Fuck.
26:15I don't know.
26:16See, I wonder what Shelley thinks.
26:18No, yes.
26:19Is that fair?
26:20Is there a trend at the moment to catastrophise menopause?
26:26Do you think, Liz?
26:27It's not being catastrophised.
26:29Okay.
26:30It is that women have a voice.
26:32And it's a very important message that will empower women, change people's lives going forward.
26:40I feel furious when people say catastrophising or medicalising menopause.
26:46So, to me, I feel like that needs to be shh.
26:51Anissa, sorry, one sec.
26:52Anissa, as somebody here who's had a very different experience, do you think some of the way menopause is talked about can be unhelpful, can make people fearful of something?
27:01Definitely.
27:02Definitely.
27:03I do think that if we keep talking about it, and I think education is the big thing.
27:08Yes.
27:09A lot of women, it just comes upon them, and they don't know what to do.
27:14There are things that you can do, like HRT, but there's also things that you can do, like natural medicine.
27:19But they both need to be done correctly.
27:22And a toy boy, also.
27:24Excellent.
27:25Have you ever prescribed one of those leaves?
27:27No.
27:28I do.
27:29One hot toy boy.
27:32I think, also, I'm not a big believer for herbal medicine.
27:37But I am a big believer for choice.
27:39Yes.
27:40So, as long as whoever's going through their perimenopause has made an educated choice, I'm happy with that.
27:47I've had acupuncture for my hot flushes and it worked.
27:50So, you know, I just am not big on the herbs.
27:52There's something else that's changed in the last couple of years around menopause, which is every celebrity under the sun is talking about it.
28:00And I'm wondering how you feel that's changed the conversation.
28:03The celebrities are very much involved in talking about it, but also involved in commercial ventures as well.
28:08As you've got, you know, Drew Barrymore screaming about it on the top of a roof now, literally, on her Instagram.
28:15Don't say that dismissively.
28:17No, I'm not.
28:18But what I'm interested in is how it changes the conversation.
28:21Well, it just means there is a conversation, whereas once there wasn't.
28:25So, I don't mind who wants to scream from the rooftops about it.
28:29Because the more we talk about it, the more we take the stigma out of it.
28:32So, it can only be a good thing, as far as I'm concerned.
28:35As long as they don't, when you say they're monetising it, as long as they're not, they don't start promoting some airy-fairy, the feng shui or aura with this, you know, this...
28:45A jade egg.
28:46A jade egg.
28:47Yeah.
28:48A Gwyneth.
28:49Yes, as long as they don't go all Gwyneth on it.
28:51Right.
28:52But I think that's where respecting the evidence comes in.
28:54Yes.
28:55You know, respect the evidence, respect the global consensus on what the best treatment is for menopause baths.
29:00There are a lot of celebrities that are actually giving great evidence-based information.
29:05Now, the other thing about monetising it.
29:08So, yeah, Naomi Watts has a skincare range.
29:10She has a lube called the Vag of Honour, which I love.
29:13Oh, I love it.
29:14Why doesn't she monetise it?
29:16If a man did that, he'd be an entrepreneur.
29:19So, just why?
29:21Well, does it change the equation if they're also selling products?
29:25Why?
29:26I'm curious.
29:27Does anyone else think it does change the equation?
29:28I think it depends what they're selling.
29:29If they're selling supplements that are just expensive wee.
29:32Like, this is where I get very cranky with...
29:34So, it depends on the product then, is that what you're saying?
29:36Yes, and how much medical evidence is backing it up.
29:40So, if you're not getting information, the right information from your doctor, then you go to your friends and you discuss it with them.
29:46And they'll be like, well, I heard that this really works for me, which has happened to me.
29:51So, this is the thing.
29:52Yes, fair enough.
29:53There's people trading off it, but they're only trading off it because there's a gap.
29:58Yeah.
29:59And I, my mother was very much the soldier on stiff upper lip.
30:04She was...
30:05Stiff upper labia.
30:06Oh, Mum's going to love that.
30:09I don't think she says that word.
30:12But when she went through it, she was put on HRT and doing really well.
30:18And then the WHI study came out saying it caused breast cancer.
30:21Yes.
30:22Her doctor binned the HRT.
30:24She went straight back into medical menopause and got no help.
30:27Yeah.
30:28No help.
30:29At 75, she's still having hot flushes.
30:32Oh, my...
30:33Medically, she's called a super flusher.
30:34I think that's the term, which is awful.
30:36But that is the catastrophic effect of how that WHI study was...
30:41..was sort of presented because it's affected a whole generation of women.
30:45Yeah, it did.
30:46Cathy, did you ever try alternative treatments?
30:48Yes.
30:49So talk me through what you tried.
30:50I tried something called black cohosh.
30:51Cohosh.
30:52Yeah.
30:53Right.
30:54Well, yeah.
30:55I mean, and I spent a fortune on vitamins and things.
30:56I mean, I might as well have just taken all that money, put all that stuff in the bin,
30:59taken all that money and given it to a charitable cause.
31:02Yes.
31:03I wasted a fortune until I talked to my girlfriends and they all were just like, just HRT, HRT, HRT.
31:10So, and once I started taking HRT, it was like rocket fuel.
31:13And all it does is, it takes you back to how you used to feel.
31:16That's all it's doing.
31:17It's topping up your hormones to where you were before it all, everything just evaporated.
31:22So it's not, don't be Einstein to work out why that works for you.
31:27So I would just say to any woman watching, I mean, I'm so sorry.
31:30I'm just not into the herbal thing.
31:33It's probably just my, you know, my mistakes.
31:36But I would say just get on the HRT as fast as possible.
31:39Get your juices back and your joy and your energy and your zest and just go forth and be fabulous.
31:46So the fact that I have a clinic and I see women that are on HRT speaks that it's not the golden bullet that solves every issue.
31:55But is it important that you are seeing them and it's integrative rather than...
32:00Oh, absolutely.
32:01Absolutely.
32:02They can co-exist.
32:03They can absolutely co-exist.
32:04Yeah.
32:05But I think there's a point to be made about the use of complementary and alternative medicines in the management of menopause.
32:12And that's where you, as a clinician who's, if you're doing a good menopause consult, you use the evidence base.
32:22The best treatment for menopause is menopause hormone therapy.
32:28It's the gold standard.
32:29It's evidence base.
32:30It's the gold standard.
32:31But you really look at what herbal supplements, acupuncture they might have tried or what they want to try, but you don't tell them it's going to fix the hot flushes.
32:39There's no current evidence.
32:41But I say to my women, so long as it's doing no harm, if you want to have that in your healthcare sort of treatment plan package, go and have acupuncture.
32:51Go and do yoga for all the other health benefits that that can bring.
32:55And you design it around the lady as an individual.
32:58Julia, what's been your experience with HRT, MHT?
33:02So like you say, it's not like a cure-all like you've like, woo!
33:06You know what I mean?
33:07Like, yay!
33:08Well, it was for me.
33:09Totally.
33:10But I think it's, like you say, it was like from where, like looking at my journal, because I kept a journal of my symptoms, and especially with my tolerance level.
33:19And I think, like you say, you're allowed to be less tolerant as you get older.
33:23That's right!
33:24But it definitely, like that thing I told you about my family, it's improved so much that I do feel balanced.
33:31So yes, overall, I just feel, I feel myself.
33:35Shelley, how different are you after hormone replacement therapy?
33:39Everything has changed for me.
33:41And I really love what you said, that it's not the golden ticket.
33:46Like for me, it wasn't like a quick fix.
33:48I had to do some real work, particularly because my mental health was so severely damaged.
33:54So I, it took me years.
33:57I had to try four different types of HRT to find the right one.
34:01And then we introduced some testosterone.
34:03So it was a real process for me.
34:05So I don't want people to think you slap on a patch and everything's great.
34:09Again, everyone's experience is different.
34:12And that's okay.
34:13And it takes time.
34:14It takes time.
34:15To find the right HRT that will treat your symptoms, make you feel well again.
34:19And we do know that the benefits of HRT far outweigh any risk.
34:23Any risk.
34:24Any risk.
34:25It's good for your bones.
34:26It's good for your mental health.
34:27It's, it's good for your energy.
34:28I think that that message doesn't get out there enough.
34:30No.
34:31There's a lot of fear mongering around the negatives of HRT, but there's not enough projection about
34:36the positives.
34:37Cathy and I will be buried without HRT.
34:39So, so I actually said, so I said the same as you.
34:45No one's taking my HRT off me.
34:47And then I got to 50 and popped in for my mammogram and boom.
34:52I was diagnosed with breast cancer.
34:53Oh no.
34:54Yeah.
34:55100% estrogen positive.
34:56And it wasn't my HRT that caused that.
34:59One in seven Australian women will get breast cancer, which is why we need to make sure
35:04everyone's examining the breasts and going for all the screening that's available.
35:07So, then you look at non-hormonal options and optimize your health across all those facets
35:14as best you can.
35:15Anissa, you've had lots of experiences.
35:19Would you ever consider HRT, MHT?
35:21I would consider it temporarily.
35:24I always want to bring my body back to balance through the methods I know.
35:27I respect that women have a choice.
35:29I think that's a really good thing.
35:31I just don't think it's the only option.
35:33No.
35:34And it's not.
35:35No.
35:36No.
35:37It's definitely not.
35:38And I think that's about respecting a patient's perspective.
35:40Absolutely.
35:41Their health beliefs, their cultural beliefs.
35:43And despite being presented with all the evidence, you're choosing to manage it in what
35:48the individual choice.
35:49Some of them might just need a divorce.
35:50Yeah, individual choice.
35:51Individual choice.
35:52Some of them might just need a divorce.
35:53Because you can also work wonders wonders.
35:55It's a miracle drug.
35:56MHT is not going to fix your relationship if there's a relationship issue.
35:59Well, can I just turn it over?
36:00No.
36:01If there are relationship difficulties.
36:02That's what I'm saying.
36:03Oh, yeah, yeah, yeah.
36:04So, it can make you feel well and more likely to swing off the chandelier.
36:08I've got one question.
36:09One danger I thought might be, because if you get the gel, you put it on your thighs.
36:14And I thought one day, one day my boyfriend started talking about soft furnishings.
36:19And he cried at the puppy dog out.
36:21And I thought, did he lick my thighs too far after I put the gel on?
36:26Could he actually be getting a estrogen?
36:28Yes, Liz.
36:29Can you answer that one for us?
36:30Liz!
36:31That comes into...
36:32Have you ever been asked that question before?
36:34No.
36:35I don't think anyone's ever asked that question on television, ever.
36:38At all.
36:39It's how I counsel ladies about how to correctly use the estrogen gel.
36:44Or if they're taking testosterone for other reasons, how to use that.
36:48And you have to let it absorb and be dried before someone licks your thighs.
36:55You know?
36:56I like how Liz goes.
36:57Someone licks your thighs now.
36:58I love it.
36:59Still to come, the controversial procedure that could spell the end of menopause.
37:05You could eliminate menopause if you've done this early enough.
37:08And if the effect starts to wear off, it's theoretically as easy as a topper.
37:13Kind of, oh, that's like having Botox treatments, you know, like you'll just keep going back.
37:17I've got no problem with ageing.
37:19I just want to age well.
37:20Yeah.
37:21So don't try and tell me to avoid menopause.
37:24And life after menopause.
37:26And I also think sex gets better and better and better.
37:30Here at the Yale School of Medicine, work is underway that may just transform how we think
37:36about menopause.
37:37One of the sometimes comments you see that, well, you know, menopause is a natural process.
37:42Why are we fiddling with this?
37:43Well, death is a natural process.
37:45But a lot of things we do is to avoid death, right?
37:48In the world of fertility science, Dr Kutluk Octay is kind of a big deal.
37:53So I performed the first ovarian transplant with cryopreserved tissue in 1999.
37:58And it works like this.
38:00He takes ovarian tissue from a woman and then puts it in deep freeze.
38:04Years later, it can be defrosted and transplanted to restore fertility and hormone production.
38:10Traditionally, we've developed this procedure for helping cancer patients who would normally
38:17lose their fertility due to cancer treatments.
38:20But now Dr Octay wants to use the procedure for an entirely new purpose.
38:25To delay menopause.
38:27If you look at women who naturally have late menopause, at age 55 or later, they have less
38:34risk of depression, cardiovascular diseases, diabetes, and they actually live longer.
38:40So it is possible that if we delay menopause for about 10 years, women may live healthier
38:46and longer lives.
38:47The idea is to take ovarian tissue from a woman in, say, her 20s or 30s, and then re-implant
38:54it before she reaches menopause.
38:56Especially if you do this under age 35 or so, you can have at least a decade of delay in menopause.
39:04And if you do it even earlier than that, you could potentially have 30, 40 years of delay
39:11and technically eliminate menopause if you've done this early enough.
39:15And if the effect starts to wear off, it's theoretically as easy as a top-up.
39:20As a matter of fact, I told this to one of my patients and she said, kind of, oh, that's
39:24like having Botox treatments, you know, like you'll just keep going back.
39:28But this procedure is not without its critics.
39:31I'm very supportive of using frozen ovarian tissue to be replaced in young women after
39:37they've been treated for something that wipes out their ovaries, like chemotherapy for example.
39:41I am not supportive of using it to delay menopause because we know that the later your menopause is,
39:49like if you go through menopause at 55 versus 50, that is associated with a greater risk of breast cancer.
39:56So I don't believe there's sufficient safety involved in that process and sufficient thought being given to that.
40:08Actually, many women that consider this procedure are not phased by this.
40:13And given all the screening methods and et cetera, when you see all the benefits,
40:17other benefits you gain from it, you know, it's a bit like taking birth control pills.
40:22There is a slight increase in breast cancer risk, but there are many benefits that women take for decades.
40:29So this potentially changes the game completely.
40:33No, it doesn't.
40:34What, if it was an option available to you, you wouldn't have taken it?
40:39I've got no problem with ageing. I just want to age well.
40:42Yeah.
40:43So don't try and tell me to avoid menopause.
40:45But the thing is, is that you're saying it doesn't 100% stop it.
40:49So you're saying if, say, for instance, like us, you get severe symptoms,
40:53do you really want severe symptoms in your 70s with other things that you've got going on in your life?
40:58So we've got to consider that as well.
40:59Yeah.
41:00Liz, there's somebody who went through early menopause.
41:02Does something like this have potential value for you?
41:04No appeal at all.
41:05No appeal at all.
41:06Because you just have to ask, why would you choose that?
41:08It's a surgical procedure.
41:10Yes.
41:11And with risk, there's no long-term safety data, you know, that's been established.
41:16And we've got very good evidence-based menopause hormone therapy to treat the symptoms.
41:21And are we stigmatising ageing?
41:23Yes.
41:24And I hate the idea of anti-ageing.
41:26Yeah.
41:27Or anti-ageing creams.
41:28I'm like, I'm pro-ageing.
41:29Yeah.
41:30What's life like post-menopause?
41:32I think, you know, that women can have the most sensational second act.
41:37Because the second act, I think for women, life is in two acts.
41:40The trick is surviving the interval, which is the menopause, which is awful, as we've discussed.
41:43But once you're through that, it's the best time of your life.
41:46No period cramps.
41:47No pregnancy scares.
41:48You've got all that tampon money to spend.
41:51I mean, and you do sort of come into your true self.
41:54It's quite liberating, isn't it?
41:55Yes.
41:56And it's also because for the first time you've cut the psychological umbilical cord,
41:59because your kids have grown up.
42:01Yes.
42:02So it is a time of liberation.
42:03It's the menopausal zest.
42:04Yes, exactly.
42:05It takes a lot of energy to go through a cycle every single month.
42:08And you get to reinvest the energy that might have been your period into you.
42:13Yes.
42:14Yes.
42:15But that's not celebrated in Western culture.
42:16Basically, once you can't reproduce in Western culture, you're sort of surplus to requirements.
42:24But in other cultures, they see it as, like you say, a rebirth.
42:29And it's like...
42:30The wise one.
42:31Yeah.
42:32And that's where the problem is.
42:33That's how we need to reframe it in a very positive, from a very positive perspective.
42:36It is a liberation.
42:37It's a time where we get to feel empowered about who we are.
42:40And I also think sex gets better and better and better too.
42:43Because you...
42:44Well...
42:45I'm dry as...
42:46Tell me what you really think.
42:47I can't believe I'm even...
42:48I nicknamed my box the Sahara Desert.
42:49Well, I can't believe I'm even vertical right now.
42:50Because, you know, good sex is about being comfortable in your skin and being totally relaxed.
43:02And of course, once you've gone through the menopause and you...
43:05You know, you just...
43:06You no longer care what people think anymore.
43:08Just invest in some lube.
43:09Yeah.
43:10Put it this way.
43:12We don't just lie back and think of Canberra.
43:15No.
43:16No one should.
43:17Sure.
43:18But I find with my friends what's happening, the women, they're on the HRT.
43:22They suddenly want to take on the world.
43:23They want to climb Everest.
43:25They want to go down the Amazon.
43:26They want to...
43:27You know, they want to take up tango dancing in Brazil, whatever.
43:30But when the men retire, they want to stay at home and nest.
43:34I think that's because their testosterone's dropping and their estrogen's coming up a little bit.
43:38And the women are like, I've nested.
43:40I've about 4,000 acres of toast.
43:43I've roasted 4 million flocks of lamb.
43:46You know, I want to now go for the first time in my life, put myself first and have fun and frivolity with my friends.
43:52And there's a big dichotomy in what older men and women want.
43:56And unless Australian men pull up their psychological socks and keep up with their wives or their female partners,
44:02they're going to find themselves alone.
44:05So it's a big issue to address, I think.
44:07Shelley, do you still feel a bit angry that nobody warned you about the severity of your symptoms?
44:11Yes.
44:13I used to be angry at my mum for not giving me a heads up.
44:17And now, with hindsight, I'm angry for her.
44:20Because she didn't have the help.
44:22She wasn't given the tools.
44:24So now I've got less anger and more empathy and compassion.
44:29But I want to make sure that no one else slips through the cracks like I did.
44:33If you could go back and talk to the younger version of Shelley...
44:36In fact, let's role play it.
44:38Yeah.
44:39What would you say...
44:40That's right, I'm playing you.
44:42What would you say to the younger version of you?
44:44I...
44:45What would you warn her?
44:46What would you promise her?
44:47First of all, I'd give her a big cuddle.
44:48Oh.
44:49Because it was hard.
44:50Yeah.
44:51And I would just make sure that she was educated.
44:55That she knew what perimenopause was.
44:57That she knew what the symptoms to look out for.
44:59That she had a good health practitioner who was her ally.
45:03That she didn't feel alone.
45:07Yeah.
45:08I want women to be educated so they don't feel alone.
45:10And that was my biggest thing.
45:12I just shrunk.
45:14Julia, what would you tell your younger self?
45:18Um, I'd say self-advocate.
45:23That's the biggest thing I'd say, self-advocate.
45:25I mean, the onus shouldn't be on us.
45:27It shouldn't be on us.
45:29But it's really important that if you're worried about yourself to self-advocate.
45:34Don't be dismissed.
45:37Like me, if you don't like what you hear, go on to the next one.
45:41Knowledge is power.
45:42Yes.
45:43So, the earlier that you...
45:45And if you're empowered by knowledge, it's not such a hard journey.
45:49Because you will know what to go and ask for.
45:52You will be very well prepared when you go to your consultation.
45:56And it's not as scary as you think it's going to be.
45:59Anissa, your experience is very different from a lot of people here.
46:03But I'm equally interested in what you would say to the younger version of yourself entering this period.
46:08To the younger version of myself, I actually think I've never been so comfortable in my skin.
46:12Yeah.
46:13I think this is a very powerful time.
46:14It is.
46:15For women.
46:16I think this is a time for me to shine, really.
46:18Yeah.
46:19You know, because I feel comfortable.
46:20Yes.
46:21Exactly.
46:22When you are going through a change in your life, especially the menopause, lean into your female friends.
46:26Just talk.
46:27Yeah.
46:28Just go on a girls' night out.
46:29It's much cheaper than therapy.
46:30And we strip off to our emotional underwear in about 3.6 seconds and tell each other everything.
46:35We haven't got time for this, shall I ship?
46:36We go deep.
46:37We go deep.
46:38And it's because we share these, it's because God is a bloke and we've shared all these biological,
46:45you know, upheavals that we cut to the chase very quickly.
46:49And I find, I always say women are each other's human wonder bras, uplifting, supportive and making each other look bigger and better.
46:55Here are the human wonder bras today.
46:57You're an honorary girl at the moment.
46:59Yes.
47:00It's not the first time I've become an honorary one.
47:03To sharing that little bit of your glorious second spring with anyone.
47:08Cheers.
47:09Thanks.
47:11Cheers.
47:12I can't believe, it's much better you've done.
47:15Thank, thank, thank, thank, thank, thank.
47:25You
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