The perimenopause diaries from Ladies, We Need to Talk

Summary

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

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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.

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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]

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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]

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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

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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.

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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

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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.

Transcript

[Audi Narrator]

That's the sound of the fully electric Audi Q6E Tron and the quiet confidence of ultra smooth handling. The elevated interior reminds you this is more than an ev. This is electric performance redefined.

[Host 1]

So, Tegan, we're big fans of knowing the why behind what's going on in our bodies on what's that rash, Aren't we?

[Jo]

Yes.

[Host 2]

Although there's often a lot of shenanigans involved when we get into the why. But it's why we wanted to bring you this episode from the Ladies we need to Talk podcast, hosted by Yumi Steins. This one's all about perimenopause.

[Yumi Steins]

Yeah.

[Host 1]

The ladies team has made a mini series called the Perimenopause Diaries, looking at the science behind the changes that occur for women during this transition and how it can affect things like sleep, mood, brain fog, fertility, and sexual function.

[Host 2]

So all four episodes are now available on the ABC Listen app and all of the usual podcast places.

[Host 1]

But as a special treat for you, our wonderful what's that Rash listeners, here's the first installment of the Perimenopause Diaries, which looks at what happens to the body during menopause and importantly, what help is available for women.

[Jo]

I'd be woken up, you know, five, ten times during a night, and you'd have to throw everything off, try to cool yourself down.

[Siobhan]

I think one of the most confusing things about perimenopause, and I guess figuring out that you're in it, is that it really hits during that calamity sweet spot of life.

[Professor Sue Davis]

One minute a woman's got sore breasts, bloating, bleeding, and then a few days later, she's got hot flushes, night sweats, irritability, anxiety.

[Siobhan]

It's like 45. My body's just decided it wants to be a circle.

[Yumi Steins]

Ah.

[Jo]

Yeah. It's not what I was expecting. I just wish that you knew what was coming up.

[Yumi Steins]

I'm 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. Oh, yeah. That's the feeling of my vagina drying up. Vagina drying up. It's perimenopause. Yeah, Perimenopause. Oh, hi there. Welcome. I've been working on this song for a while now. What do you think? Do you like it? It's for a new band I'm starting called Ovarian Ret. Now, I wanted to rock out because if you're a person with ovaries, at some point, if you live long enough, you will Go through perimenopause, the period when your ovaries start to run out of eggs and your hormone levels bounce all over the shop. For some women, this means a suite of symptoms from irritability and night sweats to brain fog and heavy bleeding. And look, that's just the obvious stuff. It's a huge transition that the body goes through. But for a long time we didn't talk about the change and women suffered in silence. We made an episode on Perimenopause and Mental Health last season. Go back in the feed and have a listen if you haven't already. But we had a huge response to that episode and it made us realise that there is a huge appetite for information that is straight up and evidence based. We are not trying to sell you stuff. Or maybe tickets to our show and some band T shirts. There's no celebrities, no supplements. There's absolutely no woo Woo. So here it is. The Perimenopause World Tour. Yeah, we're going to be playing four shows to figure out what the hell is going on when it comes to our sex lives, our changing brains, and what it's like to be a young woman in her prime going through perimenopause. But first, for opening night. What in God's name is going on with our bodies during this transition? Haywire periods. Sheets covered in sweat, Aching joints, Trouble sleeping, Sore boobs. Ugh. And what can we try to do to feel like ourselves again? I'm Umi Steins and ladies, we need to talk out and rock out about our bodies in perimenopause.

[Siobhan]

It really feels like a journey into the unknown world of perimenopause. My mum never talked about this.

[Yumi Steins]

As mentioned, our band is ovarian retirement. What's up, Australia? Let me introduce you to Siobhan on lead guitar. She's now 45 and started noticing changes to her body in her early 40s. There was a cocktail of things going on that plucked the strings of Siobhan's Perimenopause Stratocaster.

[Siobhan]

Weight gain and like weight gain that just won't budge all around dryness. Like my hair is now this wiry, witchy texture, My skin is drier, and the all time menopausal cliche Hot Flushes. It was Hot Flushes and just overall being so freaking hot at nighttime that kind of made me join the dots that I'm on my way to menopause, man.

[Yumi Steins]

Hot Flushes and Night Sweats are songs played on high rotation when people tune into Perimenopause radio. They're like the Hotel California of aging. But when we asked you to share your Peri stories with us, so many of you mentioned raging changes to your body temperature. Because guess what? They are the most reported symptoms for Siobhan. Her night sweats would fluctuate, keeping her guessing.

[Siobhan]

One minute you're hot as hell, wishing your bed was in an igloo. Then they dissipate and you wake up reaching for the covers again, only to wake up later all sweaty. It's such a vicious cycle of hell. My poor husband would wake up freezing and I'd be like, don't even think about turning off the air con.

[Yumi Steins]

Siobhan's just starting to figure out what's going on with her perimenopause and how to manage her symptoms. She's going to update us on her progress throughout the series. We'll come back to her in a little while. But I want you to meet the next member of the band. On percussion, please welcome Jo. Jo wrote into ladies, we need to talk with an email that had a lot of exclamation marks and rightly so. Jo's 57 and she's had obnoxiously heavy periods for the last decade.

[Jo]

You can be waking up to a crime scene some mornings or, you know, scrubbing your undies, scrubbing your clothes, wearing liners to make sure I don't have the accidents in between if I don't get to things in time.

[Yumi Steins]

Along with the full on flow, Jo also has sizable blood clots.

[Jo]

You think it's going to be enough to feed the cat?

[Yumi Steins]

Oh, Jo. I know.

[Jo]

Grotesque, I know. But it's those things where you go, oh, dear God, how is this happening Still? But yeah, I'm hoping it's going to ease off.

[Yumi Steins]

How big is that? Is that like a walnut or bigger?

[Jo]

They had been walnut size, they had been smaller. They've been slightly larger, I hate to say, but usually smaller.

[Yumi Steins]

Usually. Okay, okay. So more like a blood plum. Literally a blood plum. Quite literally. Jo's issues didn't end with fruit salad. At around the same time as her periods got heavier. Surprise, surprise. Like Siobhan, Jo also started having night sweats.

[Jo]

It started with just, oh, gosh, I'm hot and I stick my feet out of the covers. That's how it started. And I had no idea that night sweats were actually a symptom or a.

[Yumi Steins]

Sign of perimenopause for someone who hasn't experienced it. Jo, what does it feel like to have night sweatshirt?

[Jo]

You know, you would have Sweat over your face, sweat under your armpits, sweat, you know, in all the crevices and cracks and just wait until that whole feeling of being so overheated would wind down. Now that can take 5, 10 minutes for that to happen. And then of course, by that stage, you're wide awake and it's getting yourself back to sleep again. So you repeat that time and time again during the night and then do that week after week, day after day, month after month, year after year. It is quite debilitating.

[Yumi Steins]

Jo also suffered from aching joints and brain fog.

[Jo]

I was just not feeling myself. And that's what a lot of women say. They just don't feel like themselves anymore.

[Professor Sue Davis]

In that period we call the perimenopause, the ovaries basically stutter, they stop, start, and so the hormone levels are jumping around all over the place.

[Yumi Steins]

Ladies, no rock band is complete without a manager. A kick ass one, preferably. When it comes to perimenopause, Professor Sue Davis knows what's going on. Sue is an endocrinologist and head of the Women's Health Research Program at Monash University. She understands what's going on with our hormones better than just about anyone. Now, you might think that perimenopause is all about low or declining hormones, but that's just not right.

[Professor Sue Davis]

What's happening in the perimenopause? One minute a woman's got sore breasts, bloating, bleeding, these are all symptoms of a lot of hormones. And then a few days later she's got hot flushes, night sweats, irritability, anxiety, and they're all symptoms of low estrogen. So if we were to draw blood and measure hormone levels in the perimenopausal women, one minute they could look like a premenopausal woman, the next minute they could look like a post menopausal woman, and in between they can look like anything. So it's just hormonal chaos.

[Yumi Steins]

Chaos. Is there any way to test whether someone is in perimenopause?

[Professor Sue Davis]

So the easiest situation is when a woman's been having regular menstrual cycles, and then they start to vary in duration by a week or more, so they get closer together or further apart. That's classic of perimenopause. With or without symptoms of hot flashes, swollen sweats, et cetera. The problem comes if a woman is not regularly menstruating when she enters perimenopause. So if a woman's had hysterectomy, has a hormonal iud, or for Some reason enters perimenopause already having irregular cycles, then the diagnosis is much more difficult.

[Yumi Steins]

Okay, quick band huddle. Perimenopause is a bit of a bitch. She'll keep you guessing. She's hot and cold, but there are some signs that she's hanging around. Hot flushes, night sweats, daytime sweats, mood swings, feeling inexplicably low irritability, anxiety, poor sleep, waking up, feeling unrefreshed, changes in short term memory, and for Asian women, musculoskeletal pain. Yay. And if you're wondering why we haven't talked about vaginal dryness and issues around sexual. Yes, this will hit a lot of us. And we'll have a lot more about how perimenopause affects sex in an upcoming episode. Yes, I'm teasing. Forward. I asked Dr. Sue how many of us go through this natural, feminine, divine hellscape of perimenopausal symptoms?

[Professor Sue Davis]

So our Australian data. So we looked at over 2,000 women, and we found that 78% of women will experience some symptoms, but about 30% of women experience moderate to severe symptoms.

[Yumi Steins]

30%.

[Professor Sue Davis]

Around one in three women.

[Yumi Steins]

Yep, one in three. So if that's not you, it's plenty of people. You know, I wanted to understand what's going on with Jo's blood plums, So I asked Dr. Sue what's happening for women with heavy periods during this phase.

[Professor Sue Davis]

When the ovaries are not working so well, as you enter perimenopause, then the brain produces more and more of this hormone called fsh, and you can get overstimulation of the ovaries, where the ovaries briefly produce masses of estrogen. The lining of the uterus thickens up, but ovulation doesn't occur. And then you get the massive bleeding from a thickened lining of the uterus.

[Yumi Steins]

Let's talk about those night sweats. It's such a stereotype. You know, the sweating menopausal woman. Can you please explain what is happening physiologically?

[Professor Sue Davis]

So there's. In the central part of the brain, the hypothalamus, there's a group of neurons. We call them kindi neurons. So think of kindergarten. And these kindi neurons are important for switching on puberty, but they're also important in terms of the reproductive cycle. Once puberty's switched on, and when estrogen levels drop, these kidney neurons start to effectively misbehave, and they discharge chemicals onto the center of the brain that controls our thermostat, and they start misfiring. And triggering inappropriate sweating or flushing, even when it's not actually hot in the room.

[Yumi Steins]

Right, so that's why people in Peri can get so sweaty their thermostat's cooked. These raging night sweats are also why a lot of women like Jo and Siobhan wake up in the middle of the night and then find it hard to get back to sleep. The chemical surge in the brain that leads to a hot flush also gives out an adrenaline rush, putting the body on high alert. Speaking of Siobhan, after a few years of struggling with symptoms and not knowing really what was going on, she started to think, hmm, maybe I'm in perimenopause. And booked an appointment with her GP to chat about options.

[Siobhan]

I explained all my symptoms and said I'd been doing a bit of research and I'd like to start hrt. And he looked so shocked, like I just asked him to give me a shot of cyanide or something like he literally ignored a majority of my symptoms and just lent into the mentioning of anxiety and not feeling myself and suggested I try antidepressants instead. And I just couldn't believe it. It is worth mentioning that my doctor is a man in his late 50s. No judgment.

[Yumi Steins]

Bit of judgment. Siobhan pushed back against her GP and insisted that she wanted to try hormone therapy.

[Siobhan]

He wanted me to go and have a round of bloods done and another mammogram before even discussing it further.

[Yumi Steins]

Siobhan went away and did the tests her doctor ordered.

[Siobhan]

I've jumped through all his hoops, I've done all his requests and in just over an hour is my follow up appointment. So hopefully I'm going to get a prescription for HRT to start today, so wish me luck.

[Yumi Steins]

Just quickly. What Siobhan calls HRT is these days now called menopausal hormone therapy, or mht. We'll check back in with her soon and see where she's at. Siobhan's experience with her GP is not unique. So many of you have told us about going to your doctor to talk about peri symptoms and being brushed off, or worse, ignored. So mht, or HRT as it used to be known, suffered some reputational damage after a study was published linking the treatment to high rates of breast cancer. That link has since been debunked, but there is still some lingering resistance by some doctors to prescribe MHT to their patients. Professor Davis says as well as the hangover from this study, there's also a lack of knowledge about perimenopause.

[Professor Sue Davis]

A Lot of doctors still feel unprepared and under skilled in prescribing hormone therapy and even uncertain sometimes at making a diagnosis and uncertain who to prescribe for.

[Siobhan]

Psst.

[Yumi Steins]

Did you know that there's a guide that you can download and bring to your gp? It was developed by experts, including Professor Davis, that we're talking to in this episode at Monash University to help doctors know how to help women in this stage of life. It's called the Practitioner Toolkit for Managing Menopause. Print it out, put it in a binder, stick it to your wall, do what you've got to do to get your doctor to listen to you. Despite the issues around getting an MHT prescription, it is the gold standard in care for a lot of perimenopausal women.

[Professor Sue Davis]

So the best treatment is indeed hormone replacement therapy, and the primary effect is from the estrogen therapy. Anyone who still has a uterus has to take a progestin to protect the lining of the uterus from thickening up with estrogen by itself. And then if it thickens up, it causes irregular bleeding and after many years can cause changes that can be precancerous. So estrogen is the most effective therapy taken with a progestin if a woman has her uterus.

[Yumi Steins]

Dr. Su, what about other treatments outside of MHT?

[Professor Sue Davis]

There is a new completely non hormonal medication, Phezilant, that specifically targets the chemicals that are being released onto the thermostat center of our body. Doesn't help mood, it doesn't help anything else. You know, it doesn't protect your bones, doesn't protect your heart, but it does stop the flushes and sweatshirts.

[Yumi Steins]

Perimenopause is a time when the body is going through a lot of changes. Some are noticeable and some are hidden.

[Professor Sue Davis]

Every single woman should have a health check because in addition to the symptoms, women get changes in their blood cholesterol, they get changes in their bone health, and they might even a subset of women even find that their blood pressure increases as they go through menopause. So every woman should have a health check to look at the whole health profile of the woman to make sure that these changes don't persist into the second half of their life.

[Yumi Steins]

What do you make of the argument that menopause has been over medicalised?

[Professor Sue Davis]

I think we've got an unusual situation. Now. We do have women who have no symptoms, who are being prescribed hormone therapy with the belief that it's gonna protect them against a whole range of different diseases and conditions which have not been substantiated and I think that's over medicalization. On the flip side, we have a whole lot of women with horrible symptoms who should be getting hormone therapy and their treatment has been undermedicalized. So I think we're seeing both situations. That's not a single thing of over or under medicalization. We're just seeing a mishmash of care right now. And getting some consistency in care is really important.

[Yumi Steins]

Back to ovarian retirement. Bantam mate, Siobhan. So she went through the tests her doctor wanted to do before starting mht and she got the all clear.

[Siobhan (later update)]

Well, I've just got back from the chemist and I've got my first course of Estrogel and progesterone tablets in my hot little hand. So I guess my journey starts now, which is very exciting.

[Yumi Steins]

Siobhan had high hopes for what MHT could do for her peri symptoms.

[Siobhan]

Okay, so day three. I don't think I was expecting a miracle recovery, but the only effects I've felt so far, I think being really tired. Like, I feel a little bit more fatigued more than anything. And my youngest told me last night that I was cranky Mummy. So that's always nice to hear. Day seven. I'm actually sleeping a lot better, but also I'm feeling, like, really groggy in the morning and tired. Apparently it takes a few weeks to settle in. So anyway, holding hope.

[Yumi Steins]

Another big change that Siobhan noticed over the past year was weight gain.

[Siobhan]

It's like 45. My body's just decided it wants to be a circle.

[Yumi Steins]

I can almost hear you out there nodding in furious agreement like, where the heck did this midlife bod come from?

[Siobhan]

And I haven't changed anything, like, anything to my diet or exercise regime. My thighs are definitely, like, a lot bigger and my stomach, like, just around my waist. And just that. I guess that that pudgy bit below your belly button is just. Yeah. I don't know if I'm hoping that HRT is going to get rid of that. No, I am hoping that HRT is going to get rid of that.

[Yumi Steins]

This sounds like something for band manager sue to answer. So I asked her what the deal is with perimenopause and weight gain of.

[Professor Sue Davis]

The studies where women have been assessed in every single year over several years as they've gone through the menopause. What? These studies have shown that the overall creep of increase in weight, which is about half a kilo a year in the population around midlife, is not due to menopause. So the absolute Weight gain is not due to menopause. But the kicker is, forget the weight gain about getting on the scales. When estrogen levels drop, our bodies move fat from our bums and our hips into our tummies. So even if a woman's weight does not change, you see between 20 to 40% increase in intra abdominal fat. That's the fat inside the abdomen. And also total body fat increases. So our body composition changes so that we start to replace some muscle with body fat.

[Yumi Steins]

This redistribution of fat means that for some women, their midsection gets more round. But the story doesn't end there. As we get older, our bodies start to replace some muscle with fat.

[Professor Sue Davis]

That's because of the drop in estrogen. Estrogen is incredibly important for fat metabolism and muscle function and the way we handle sugar. So when estrogen drops, we gain central abdominal fat. And that's a real physiological change that, you know, you can't do anything about unless you take estrogen.

[Yumi Steins]

Ladies, I hate to break it to you, but there is no secret code to crack here. While estrogen is involved in preventing muscle loss, if you're taking MHT thinking it's going to lead to weight loss, cool your jets, because. But there are other things that you can do to manage your weight during this phase and beyond. It's boring. But exercise and diet are key, so.

[Professor Sue Davis]

Women do need to look at that and not blame everything on the menopause. Have I just slackened off a bit in what I tend to eat? Am I having two lattes instead of a coffee with a bit of milk added or cups of tea or. Cause if you just change a small amount in your diet, but you do it over months, you will gain weight.

[Yumi Steins]

Yeah, it's true. And you know, back to that half a kilo per year that we all put on, what's the mitigation for that?

[Professor Sue Davis]

It's food intake and exercise. I mean, as one of my medical colleagues said years ago, it's calories in and calories out. Our bodies are really good accountants.

[Yumi Steins]

Ugh, bloody accountants. Look, if you've been near the Internet or a Pilates studio recently, you'll know that resistance training is all the rage for women of a certain age. But when it comes to protecting your bones, Dr. Sue says we need to think differently.

[Professor Sue Davis]

The biggest impact on bone health is not through resistance training, it's through impact. So when women go through menopause, even if they do not have symptoms, the average woman will lose 6 to 8% of their bone, which starts about two years before the last menstrual period and continues to accelerate into the first two years post menopause. And then the loss sort of slows up.

[Yumi Steins]

Loss of bone density can lead to osteoporosis. But there are things you can do to reduce bone loss.

[Professor Sue Davis]

The best way to protect it is with impact exercise. So hopping, skipping, jumping, anything that causes some degree of impact. Just walking around holding a latte is.

[Yumi Steins]

Not gonna work, damn it. It's my skill.

[Professor Sue Davis]

The impact training is the most important.

[Yumi Steins]

Okay, why have I not heard about that? I was told to push weights.

[Professor Sue Davis]

Weights are good, but for your hip, which is where we worry about too, you need to have a little bit of impact, which is, it doesn't have to be hard, but just gentle. Hopping, skipping, jumping.

[Yumi Steins]

Dr. We're living much longer now, so the post menopausal period might be more than half our whole lives. We wanna be strong, we wanna have sex, we wanna be able to lift big heavy things and not fall over. What is your message to women listening who are worried that this is just a big symbol saying your life from here on is decline. It is continual, nonstop growing decrepitude.

[Professor Sue Davis]

It's absolutely not. I swim twice a week and I swim with women in their 80s and they're not unique. But the trick is paying attention to your own health. So women at midlife are usually self sacrificing for those around them. They're the givers, they're the linchpin of the family. They're the ones running themselves ragged to look after everybody else. So take some time to look after yourself. So menopause is not the gateway to falling over and being decrepit. It's the gateway to do a reality check and saying, what am I doing to keep myself healthy?

[Yumi Steins]

Jo, who we met earlier with the sweaty sheets and heavy periods, has started on mht. Added to that, she's making some meaningful lifestyle changes.

[Jo]

What has helped me, number one, looking after my health and my wellness, and number two, the hormone therapy that I'm currently on. It is an absolute godsend because now I'm sleeping really well, I'm feeling great, and I know it's doing so much benefit for me, for my bones, my body. I can sleep during the night without being woken up multiple times is huge. The mere fact that I don't have aching joints and sore muscles, that means that I can exercise a heck of a lot more freely now. And just having brain fog, I can have a conversation without forgetting what I was talking about. That's absolute gold.

[Yumi Steins]

To help with her heavy periods, Jo has started on a drug called Tranexamic. And she's still hoping that every period she gets will be her last. There's a few things that Jo wishes she had understood when she was younger.

[Jo]

I wish that I knew what could possibly happen to me. What are some symptoms and signs that you can look out for and then what can you do to try to minimise those? And what can you do to look after your health? Because really now, whatever we do now is going to have a huge impact on what our future health is going to be like.

[Yumi Steins]

Our friend Siobhan had high hopes when starting on mht. After a plodding start, she did notice some changes.

[Siobhan]

Okay, day 10. I could be reading into this. It could be a bit of the placebo effect, I guess, but I do feel like, well, first of all, I'm definitely sleeping better. I do feel a little bit groggy in the morning still, but I'm definitely sleeping better.

[Yumi Steins]

One of the biggest shifts that Siobhan has experienced is that her night sweats have levelled out.

[Siobhan]

I still think I get hotter at night than I ever used to, but it just doesn't come in those crazy instant waves of heat anymore. I'm much more a constant hot mess than one that fluctuates up and down.

[Yumi Steins]

Like a butterfly emerging from its chrysalis. By day 16, Siobhan was feeling a sense of. Of transformation.

[Siobhan (later update)]

I feel like I've got a spring in my step almost, and I just feel like I haven't had that for a while. So I'm gonna say, yeah, it's definitely been a positive.

[Yumi Steins]

Right now.

[Siobhan (later update)]

I'm feeling really happy.

[Yumi Steins]

Woo. Thanks for coming to the show. Yeah, Rock and roll. I'm sweaty, but I think it's from the moshing. I feel like we got through some big hits in that set. Like, 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 or you feel like they're allergic to, you know, women's business, print them out the practitioner's toolkit and put it in their hot little doctor hands. 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. And like Van Halen said, and so did criss cross jump, get yourself a skipping rope or play basketball or football or dance. And if you know someone who needs to hear this episode? Yes. Share it with them. Now, who's ready for an encore? Who needs to hear our hit song, blood Plums? This podcast was produced on the lands of the the Gundungara and Gadigal peoples. Ladies, we need to Talk is mixed by Anne Marie debettencourt. It's produced by Elsa Silberstein. Supervising producer is Tamar Cranswick, and our executive producer is Alex Lback. This series was created by Claudine Ryan.