Special Series: Menopause 101

Welcome to our Squiz Shortcuts Series, starting with Menopause 101

There’s no doubt about it - menopause is having a real moment... While generations of women have suffered in silence, we’ve now got a whole bunch of medical professionals and celebrities out there shouting that it doesn’t have to be this way. And earlier in the year, the Albanese Government committed $500 million to women’s health - with a big slice of that going towards funding better GP care and treatments for perimenopause and menopause.

So we’ve pulled together a 3-part series to get us across perimenopause and menopause, and we’re starting today with the help of Dr Sarah White from Jean Hailes for Women’s Health. Together we tackle the basics, including:

• what’s happening to women’s bodies during this stage?

• what are the common symptoms?

• and when is it time to head to see a doctor?

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Listen time: 14 minutes

Menopause 101 with Dr Sarah White

It’s so good this isn’t secret women’s business anymore…
I think it's us Gen Xers. We want to share, we want to talk, we don't want to go through that period of menopause as our mothers did, saying nothing.

OK the basics - what is perimenopause?
It’s just that lead up to when your periods finally stop. So during perimenopause, you've got your ovaries producing less estrogen, less progesterone. Your cycle becomes really irregular. You might miss a month, you might have really heavy bleeding one month. So it could be a period of some years. It differs by the individual, and it technically ends at menopause. When it’s been 12 months since your last period, you're in post menopause. 

It can be a rough ride… 
We know that hot flushes - we sometimes call them vasomotor symptoms - but hot flushes and night sweats are one of the common symptoms. That's about 70-80% of women will have those hot flushes, vaginal dryness, some genitourinary symptoms - so you might have UTIs or painful sex, for example. And then a lot of people talk about sleep issues, which is probably the night sweats more than the decreasing hormones. So there's a bit of a range of symptoms, and it's really hard sometimes to tell what's primarily because of those hormones decreasing and what's secondary to just feeling a bit rotten and not having that sleep. So things like anxiety and depression, for example. 

And there’s a bunch of other stuff we can’t see…
Yes - spot on. So we know that our bone health starts to go down as we get older, and certainly, there is a protective effect of estrogen on bone health. So you want to go and talk to your doctor about your heart health, your bone health, so that you can start to make some of those lifestyle changes that make sure you are ageing really well. We're living a third of our lives after menopause. So things like doing our weight-bearing activity, strength training, keeping active, and focusing on our diet. These are really important things, particularly after menopause. 

Us ladies gotta look after ourselves…
Absolutely. And it's not just menopause, either. You think about it, we power through things so often without seeking help. When we ask young women about heavy periods due to any sort of condition like endometriosis, lots of them don't go and see their doctor because maybe it's normal, or perhaps they're just a bit too embarrassed. We tend to deprioritise our own health.

And that can be an issue for mental health?
There are a lot of women who will be experiencing these things like anxiety or depression in midlife and just thinking they have to soldier on. So I'd always encourage you if you've got anything at all that is hard, or is affecting your quality of life, go and talk to your doctor about it. 

Which was our next question - when should we be seeing our doctor?
I would encourage everyone to go to the GP if you think you're in perimenopause and you’re having these symptoms. Because one of the challenges is that these symptoms can be a bit vague, and some of them can be caused by other things. So hot flushes could be a result of your thyroid not working well. So I actually would encourage this as an opportunity to go and have a good general health check to set yourself up to experience a really good menopause. Just keep your health in check.

How’s the average Aussie GP dealing with menopause?
That's a tricky question to answer. When Jean Hailes did the National Women's Health Survey back in 2023, we asked women 45-64yo, when you went and talked to your doctor about menopause, how reassured and believed did you feel? Most women said that they felt believed and reassured. We know though, that there are doctors out there who are not up on their knowledge or who are perhaps, not coming across as empathetic as they should be. 

So what do we do then?
If you come across someone who's not providing you with the sense that you are being believed, it is a case of going to find another doctor. Really, really hard when we say that for rural and regional women, but there are some really good telehealth options out there.  

What’s your take on HRT or Hormone Replacement Therapy? 
Look, MHT (Menopausal Hormone Therapy) - as we tend to call it now - is not a silver bullet. It's not going to suit everybody. Some people have MHT, and it doesn't really do much for them. Some people can't have MHT because they have a risk of clotting or stroke. But for most women, it is a really, really good option. And I know we've had scares in the past about the risks of MHT. Those risks are not zero, but they're certainly not large. I think it's really important you go along and have a conversation with the doctor who can talk to you about your own personal and family medical history.

What are the other things we can do?
It really is going to be about getting your exercise, eating well, trying to sleep well - and MHT can help with all those things, but you do need to look at your whole lifestyle, not just a silver bullet as a patch or a gel or a tablet.

It’s all about having options, right?
It's really important for women to have choice. There are some natural therapies that can help, MHT can help some, and there are now non-hormonal treatments that can help other women. And you know, sometimes this discussion around menopause and particularly around menopause hormone therapy can get really polarised and a little bit sort of nasty sometimes. It's really strange that we have this sort of polarised discussion around a medicine that's a first-line treatment and really effective for women going through menopause.

Yeah, not helpful when you’re just trying to make sense of things… 
There's a camp that thinks you just have to soldier through. There's a camp that thinks MHT will be a silver bullet. And really, I think it's important that women get as much good information as they possibly can. And that's from trusted sources, that's not necessarily from your TikTok or your Instagram. Really arm yourselves with a variety of information that's holistic.

Plant-based support for life's changes

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Onto our Recommendations

Reading - The Jean Hailes for Women’s Health website is terrific for all things menopause/perimenopause, including this handy checklist of symptoms to take to your GP.

Following - This guy Mitch Little has made some fabulously funny/accurate reels of what it’s like for women in perimenopause… It’s a good one to share with the blokes in your life.

Sharing - We reckon you’ll have a few people in your life who would benefit from the information we’re pulling together in this series. Please share this email with them, or if they’re podcast people, send them to the Squiz Today show on their podcasting app, and this episode is clearly marked in the feed.