Podcast Summary: "The Perimenopause Diaries" from Ladies, We Need to Talk

Podcast: What's That Rash? / ABC News
Episode Air Date: April 17, 2025
Host: Yumi Steins
Featured voices: Professor Sue Davis, Siobhan, Jo

Overview

The first installment of "The Perimenopause Diaries" is a candid, evidence-based, and slightly rock n’ roll deep-dive into the often-misunderstood world of perimenopause. Host Yumi Steins—joined by real women and top endocrinologist Professor Sue Davis—explores the bewildering array of symptoms, the hormone chaos behind them, and what treatments and lifestyle changes can help. The episode brilliantly balances humor and science, aiming to shatter taboos, amplify women’s stories, and empower listeners with knowledge, practical advice, and hope.

Key Discussion Points & Insights

The Perimenopause Experience: Raw, Real Stories

• Symptoms shared by ordinary women:
  • Night sweats and disrupted sleep [01:03, 05:58, 08:07]
  • Unexpected weight gain and body changes [01:33, 05:02, 21:18]
  • Brain fog, mood swings, joint pain [01:23, 08:45]
  • Heavy or erratic periods, with vivid imagery ("blood plums") [06:55, 07:29, 12:04]
• Siobhan, in her 40s, describes her entry into perimenopause as a confusing journey, comparing her body to “just decid[ing] it wants to be a circle.” [01:33, 21:18]
• Jo, 57, shares the physical and emotional toll of years-long heavy bleeding and sleep deprivation, likening her mornings to “waking up to a crime scene.” [06:55]

The Science: Hormonal Chaos Explained

• Professor Sue Davis (Monash University) demystifies perimenopause:
  • Hormone levels ("jumping around all over the place") cause an unpredictable mix of symptoms: sometimes high estrogen (bloating, sore breasts), sometimes low (hot flushes, mood changes) [09:33, 10:07]
  • Perimenopause is best identified by changes in menstrual cycle regularity, but diagnosis can be harder for women without regular periods (due to hysterectomy, IUD, etc.) [10:13]

Notable Quote:

“If we were to draw blood and measure hormone levels in the perimenopausal woman… one minute they could look like a premenopausal woman, the next minute they could look like a postmenopausal woman, and in between… anything. So it’s just hormonal chaos.”
— Professor Sue Davis [09:33]

The Most Reported Symptoms & Their Causes

• Hot flushes & night sweats: Over three-quarters of women experience symptoms, a third severely.
  • These result from misfiring neurons in the hypothalamus, triggered by fluctuating estrogen, causing the body’s thermostat to go haywire [13:48]
• Heavy periods: Caused by erratic ovarian function and thickening of uterine lining without ovulation [12:20]
• Other symptoms discussed: Vaginal dryness and sexual changes (to be covered in future episodes) [10:54]

Notable Quote:

“Perimenopause is a bit of a bitch. She’ll keep you guessing. She’s hot and cold…”
— Yumi Steins [10:54]

Seeking Help: The Struggle for Decent Healthcare

• Many women face dismissive doctors and outdated attitudes:
  • Siobhan’s male GP was shocked at her HRT request, immediately steering her to antidepressants instead [14:28]
  • Resistance to prescribing Menopausal Hormone Therapy (MHT, formerly HRT) persists due to misinterpreted research and lack of GP training [16:34]
  • Toolkit for patients/doctors: "Practitioner Toolkit for Managing Menopause" (Monash University) recommended for ensuring evidence-based care [16:49]

Notable Quote:

“A lot of doctors still feel unprepared and under-skilled in prescribing hormone therapy and even uncertain sometimes at making a diagnosis...”
— Professor Sue Davis [16:34]

MHT, New Treatments, and Lifestyle

• Gold standard: MHT (estrogen + progestin for women with a uterus), effective for both symptom relief and long-term health (bones, sleep, brain) [17:26]
• New non-hormonal option: Phezilant, blocks the neurally triggered hot flushes but doesn’t address other symptoms [18:05]
• Holistic Health: Every woman should have a full health check (cholesterol, blood pressure, bone density) during this life phase [18:34]

Myths, Weight Gain, and Bone Health

• Weight gain:
  • Overall midlife weight gain isn’t due to menopause, but a change in body fat distribution is—more tummy fat, less muscle [22:10]
  • MHT may help fat distribution but isn’t a miracle for weight loss; diet and exercise are key [24:16, 24:39]
• Bone health:
  • Loss accelerates around menopause; impact exercise (hopping, skipping, jumping) is crucial—not just resistance training [25:04]
  • Osteoporosis risk can be mitigated with lifestyle changes and/or MHT [25:33]
• Midlife is not decline:
  • “Menopause is not the gateway to falling over and being decrepit. It’s the gateway to do a reality check... What am I doing to keep myself healthy?” — Professor Sue Davis [26:26]

Reclaiming Life, Empowerment, and Looking Forward

• Jo finds dramatic improvement from MHT and lifestyle changes: better sleep, fewer aches, less brain fog, improved mood and exercise [27:18]
• Siobhan's personal "diary" as she starts MHT shares the ups and downs, culminating in a “spring in my step” by day 16 [20:30, 29:32]
• Both women stress the importance of awareness, knowledge, and advocating for oneself [28:08]

Notable Quotes & Memorable Moments

• Candid humor:

  • “You can be waking up to a crime scene some mornings.” — Jo [06:55]
  • “It's like 45. My body's just decided it wants to be a circle.” — Siobhan [01:33, 21:18]
  • “If you have all these physical symptoms and you're thinking, is it Peri? Could it be? Go see your GP and if they don't listen…print them out the practitioner's toolkit and put it in their hot little doctor hands.” — Yumi Steins [29:58]

• Peri rock anthem intro:

  • “Gonna get a hot flash / Sore boobs / Gonna wipe the sweat / My face and my mustache / I’m gonna bleed through my undies in public /...That’s the feeling of my vagina drying up… It’s perimenopause! Yeah, perimenopause!” — Yumi Steins [01:50]

• Empowerment for listeners:

  • “Find out what treatments work for your body because no one knows you better than you do. Be kind to that body. Treat it well, but don’t expect it to look or behave exactly like it used to because it’s changed. It is changing and it will continue to change.” — Yumi Steins [29:58]

Timestamps for Key Segments

• [01:03]: First-hand accounts of perimenopausal sleep disruption
• [05:02 - 06:55]: Women describe physical symptoms, heavy periods, "blood plums"
• [09:33]: Prof. Sue Davis explains hormone chaos
• [12:20]: The science of heavy periods in perimenopause
• [13:48]: Why hot flushes/night sweats happen
• [14:28 - 15:12]: Siobhan's difficulty getting MHT from her GP
• [16:34 - 18:00]: MHT misperceptions, toolkit, and new treatments
• [22:10 - 24:47]: Weight gain, body changes, diet/exercise advice
• [25:04 - 25:52]: Bone health, impact exercise vs. weights
• [26:26 - 27:07]: Midlife is not decline; motivation to prioritise health
• [27:18 - 28:08]: Jo’s success with MHT, lifestyle changes
• [29:32 - 29:58]: Siobhan’s diary closes with improvement and hope; Yumi’s take-home message

Final Takeaway

This episode is an honest, informative mix of women’s voices, expert science, and no-nonsense advice. Perimenopause is unpredictable, often bewildering, but not insurmountable. Getting the right information, advocating for yourself, and finding support— medically and socially—are crucial. And, if in doubt, grab a skipping rope and rock out with your changing body.

Resources Mentioned

• Practitioner Toolkit for Managing Menopause (Monash Univ.)
• Full mini-series of The Perimenopause Diaries (ABC Listen app)
• Further episodes promised on sexual health, brain changes, and early perimenopause

For anyone baffled by changing periods, weird new sweats, or a midlife body that feels unfamiliar, this episode is a must-listen—and a musical, sisterly pep talk.