March 22, 2023 • 23 mins
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We're going to discuss what is perimenopause.
We're going to discuss, what are perimenopausal symptoms, could I potentially be in perimenopause?
And then I've got a bit of sexy research for you at the end. I know that you think research can't be sexy, but wait, I'm gonna prove you wrong.
The information shared in this podcast does not substitute working with your primary health care provider; it is general in nature and not considered personalised advice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Kirstey Holland (00:00):
I'm so delighted to have you here to
discuss all things, Peri.
We're going to discuss what isperimenopause.
We're going to discuss, what areperimenopausal symptoms, could I
potentially be in perimenopause?
And then I've got a bit of sexyresearch for you at the end.
And I know that you thinkresearch can't be sexy, but
wait, I'm gonna prove you wrong.
My name's Dr.
Kirsty Holland.
(00:21):
I'm the founder and principalpractitioner of the Holland
Clinic in Melbourne, Australia,and I'm absolutely delighted to
be helping woman over the age of35 rescue themselves from this
crazy rollercoaster of perimenopause.
Let's get started.
Little bit of a medicaldisclaimer.
Of course, I'm not your medicaldoctor.
This relationship really needsto be one-on-one.
(00:42):
It's really important for you tofind a practitioner that you
trust and adore and you need toknow that your praccy knows what
you're talking about.
You need to be seen, you need tobe heard.
And and of course you want themto have some credentials.
I think it's imperative for youto have a really good
relationship with people thatare taking care of things that
mean most to you.
(01:02):
I mean, people's health impactsevery single aspect of their
lives.
The women in my clinic tell meso much about the fact that you
know, their health impacts,their parenting.
Their relationships and ofcourse their professional lives
too.
So it's so important to havethat intact, and particularly in
perimenopause, you know, thatmum agro really impacts our kids
from time to time.
And I know a lot of the women inmy clinic come in talking to me
(01:24):
about the relationship agro, Idunno about you, but many of the
women share those stories aboutyou know, I asked you to take
out the bin, damnit, you know?
And yeah, we, we wanna enjoy ourchildren and we want our
children to enjoy us.
We certainly don't want to befrazzled and exhausted and feel
like we've got nothing left inthe tank when it gets to the end
of the day around them.
(01:44):
So, topics for today, frequentlyasked questions.
Just the very, very basics, youknow, what is perimenopause?
What happens in perimenopause?
What are perimenopausal symptom?
You know, I know I see so manywomen in my clinic who are
blatantly perimenopausal and,you know, we're still confused.
And it's so interesting, like Iwas discussing with a a
perimenopausal journalist whohas been a journalist for 25
(02:08):
years, and she was shocked bythe fact that she was in
perimenopause when it finallycame home to roost for her.
And believe it or not, I've beentreating perimenopausal women.
For 23 years in my clinic inMelbourne, Australia.
And when I started to experienceexacerbated anxiety, at one
point I thought it was all ofthe stresses in my life.
But when I looked at, when Ilooked around you know, life has
(02:31):
been pretty tricky and andpretty stressful.
Being a, a single mum for thelast 13 years, and my stressors
hadn't necessarily changed, butI started to experience this
real physical.
So sometimes it's reallynuanced, you know, these, these
menopausal symptoms.
And I was like, oh, hang on.
This is the progesteronedeficiency anxiety.
This isn't just the, you knowthere are lots of different
(02:52):
kinds of anxiety.
Let me not downplay this.
Ellen Vora, who wrote the book,the the Physiology of Anxiety.
I think that's what it's called.
Don't quote me.
Absolutely brilliant book.
She'll really talk about all thekinds of anxiety, but I know for
a fact that one of my firstperimenopausal symptoms was this
true progesterone deficiencykind of physical anxiety.
So what are perimenopausalsymptoms?
(03:13):
And then not so frequently askedquestions, lemon balm and its
impact on libido.
Okay, what is perimenopause?
Perimenopause is thetransitional phase leading up to
menopause.
So menopause is the point when awoman's menstrual period stops
permanently and she's no longerable to become pregnant
(03:34):
naturally.
So menopause is actually onlyone day you reach menopause when
you have not had a bleed or acycle for a full 12 months and
one.
So you have had no period, nospotting, no staining.
For 12 months.
You have then reached menopause,and then after that one day you
(03:56):
are post-menopausal, believe itor not.
So that happens quickly duringperimenopause.
A woman's hormone levels startto drop and fluctuate causing
changes in her menstrual cycle.
Progesterone is the hormone thattends to decrease.
Progesterone is this beautifulimmune modulating mind,
(04:17):
modulating cool, calm, collectedhormone.
So when she starts to dropfirst, estrogen starts flailing.
So estrogen is uncontrollablewhen progesterone is not
controlling her.
Let's just say that.
So this phase typically occursin women between their late
thirties and early fifties, andmay last for several years
(04:38):
before menopause begin.
Now I'm here to tell you thatunfortunately for some, and I
certainly am one of those womenthat started to experience
perimenopausal symptoms prettyyoung, and maybe that's why I'm
so passionate about having amore graceful experience.
For some of us, it can really,be in our lives for at least 15
years, and I'm here to tell youthat even at that point when you
(04:59):
are menopausal, unfortunatelythe research shows that those
crazy unwanted symptom canactually last for an additional
six years post that day when youdo reach menopause, which is
usually around 50 or 51 years ofage in Australia.
This phase typically occurs inwomen between their late
thirties and early fifties, andmay last for several years
before menopause begins.
(05:21):
On average perimenopause lastsfour to six years, but it can be
as short as one year for somelucky ones, or as long to as
long as 10 to 15 unfortunatelyI'm more in the 10 to 15
category.
And like I said, perhaps that'sprobably why I'm so passionate
about trying to make this moreof a graceful experience.
To date, I've probablyexperienced most of the symptom.
(05:43):
Woman can continue to experienceunwanted symptoms for six years
after they reach menopause, as Imentioned before.
I just want you to know thateverything that I'm saying is
backed in evidence-basedscience.
I absolutely love the research.
I am not gonna bore you with it.
I won't read through theresearch articles, but I've got
them on hand.
You're welcome to my slides, soplease let me know if you'd like
(06:06):
a copy.
DM me book a clarity call if youwanna talk through the research.
I am such a research tech nerd.
I would absolutely love to and Iwould love to share these with
you.
Let me know if you want them.
Okay.
What happens in perimenopause?
So perimenopause is thetransitional phase leading up
to.
During which a woman's bodyundergoes various hormonal and
(06:28):
physiological changes.
Here are some of the key eventsthat occur during perimenopause.
Hormonal fluctuations, estrogen,progesterone levels begin to
fluctuate during perimenopause.
Progesterone generally starts todecrease first, and then because
progesterone is decreasing andshe usually has this beautiful
modulating effect on estrogen,estrogen does start to flail.
(06:50):
These hormone fluctuationscontribute to the various
symptoms experienced during thistime, changes in the menstrual
cycle.
Women often notice that theirmenstrual cycles are either
shorter or longer or morepainful.
Sometimes there's more clottingin the menstrual cycle.
As the hormone levels change, awoman's menstrual cycle may
become irregular.
(07:11):
So many perimenopausal womencoming to my clinic going, God,
I thought I was pregnant.
You know, my 28 day cycle was,out at 37 days and I was
experiencing all these crazysigns and symptoms.
My breasts hurt.
I had a headache.
It was kind of like a migraine.
God, that's all I needed.
At the tender age of 47 to bepregnant and be mindful that
(07:31):
during premenopause youabsolutely can fall pregnant.
So please be careful.
It's not over yet Periods maybecome heavier or lighter, and
the duration between periodsmay, may become shorter or
longer.
Going from a 28 day cycle, youmight now have a 24 day cycle,
which shows that there's thisdeficiency in progesterone
creating a shorter luteal phase.
(07:51):
Or suddenly you can start tohave this 37 day cycle.
So we have anovulatory cycles inperimenopause, so sometimes we
don't ovulate and sometimes,believe it or not, we can match
it magically, ovulate twice inone month.
That's why we quite often haveidentical twins in women in
their forties.
Ask lots of gynecologist womenin their forties can quite often
fall pregnant twice in the samemonth.
(08:13):
Yeah, I mean, it doesn't happenall the time, but it happens.
It's a thing.
Alright, so some women may alsoexperience skip periods
ovulation changes, as Imentioned before, ovulation may
become irregular, even ceasealtogether during peri.
This leads to decreasedfertility, although it's still
possible for women to becomepregnant until she reaches
menopause, as I was talkingabout before.
(08:35):
And then the physical symptomsor these brain symptoms.
Many women experience physicalsymptoms during perimenopause,
including hot flashes, nightsweats, vaginal dryness, and
changes in sexual function.
These symptoms can vary inintensity and frequency.
Boy, do I have something for youif you've lost that little bit
of sexy.
(08:55):
Emotional symptoms too.
How about how about the mumrage?
You know, how about the, justlosing it at the kids and going,
oh my God, I don't even know whoI am anymore.
My kids don't like me.
My husband's worried.
I'm worried.
You know, it's really importantfor us to enjoy ourselves and
enjoy our homes.
You know, this beautiful human.
(09:17):
This is where you live.
You want it to be a reallygorgeous experience.
So we don't wanna have all ofthese crazy symptoms, you know,
the mood swings, theirritability, the anxiety, the
depression, their commonemotional symptoms during fair
menopause.
These may be due to hormonalchanges as well as the physical
symptoms and life stressesassociated with the stage of
life.
Don't we know it, man?
(09:37):
Oh man.
We've, we've generally got agingparents.
You know, lots of us have, haveteenage children.
We have established or newrelationships.
Careers, dogs, you name it,we've got the responsibility
going on.
We're in the prime of our lives.
We certainly don't needpremenopausal signs and symptoms
to get in our way.
And that's kind of my why.
Women are so important.
(09:58):
They're the nucleus.
And you know, of course men areimportant too, but you know, a
lot of the time the women arethe caregivers in the
householders and, and themothers, you know, the mother
that earth energy.
It's so important.
Sleep disturbance.
So we're meant to do all of thison like zero.
Difficulty falling asleep, whichis usually a circadian rhythm
disruption, which quite oftencomes along with you know, high
(10:20):
levels of cortisol and and adecreased initiation of
melatonin.
Insomnia and sleep disturbancescommon during perimenopause,
often due to hot flashes.
So the hot flashes can wake usat night.
As well as that that cortisolbeing too high as well as
emotional symptoms like anxiety.
One of my patients describes.
When she gets into bed at nightand lies next to her husband,
she has this real sense of panicand anxiety and has no real
(10:43):
reason to be experiencinganxiety or panic.
So really does identify it asthat progesterone deficiency
anxiety.
Glad to report that she'sactually doing, you know, really
well at the moment.
Bone loss.
The decrease in estrogen levelsduring perimenopause can lead to
a loss of bone density,increasing the risk of o,
increasing the risk ofosteoporosis.
So this is not something that wewanna be doing.
(11:05):
We certainly wanna be keeping aneye on our trace mineral levels.
We wanna be making sure thatwe've taking vitamin D in K2 to
get that calcium into the boneso that the calcium doesn't
deposit anywhere else.
Creating oxalate deposits eitherin the kidney or in the lung or
in the vagina no, no thank you.
no oxalate deposits in the eyesof the vagina.
Changes in cardiovascularhealth.
(11:26):
Estrogen helps protect the.
So estrogen helps to protectagainst heart disease.
So the decrease in the estrogenlevels during perimenopause may
increase the risk ofcardiovascular issues.
Yeah, so many people go, oh, youknow, I've got hot flushes
they're really annoying.
But unfortunately that vasosymptom is actually, it's a
cardiovascular disease risk.
So it's really important for usto do what we can to get that
(11:47):
under control and also make surethat we're doing heart
protective things.
So it's important to note thatevery woman's experience of
perimenopause is really uniqueand the symptoms and their
intensity can varysignificantly.
If you're concerned about yoursymptoms or need advice on
managing them, consult yourhealthcare provider.
Really important.
Supporting research againbecause I'm a tech research data
(12:10):
nerd.
Here are all the studies.
Like I said, please DM me book aclarity call.
We'd love to chat to you aboutthe research too, and happy to
share these slides.
I am here just creatingawareness.
The research also shows thatthere's a huge capacity in
society to allow for women to.
So to generally suffer duringour menstrual years as well.
Quite often when, when youngwomen are talking about the fact
(12:32):
that they need to take time offwork because they have, you
know, significant pain anddebilitating periods,
endometriosis or polycysticovarian syndrome, society sort
of, you know, nods, nods along.
So we have this capacity toallow women to suffer and we
certainly don't need to.
It doesn't need to be this way,and we certainly don't need to
suffer in premenopause either.
Bone loss, cardiovascular.
(12:54):
Now, what are the officialperimenopausal symptoms?
There are like a trillion ofthem.
Professor Pryor talks about amuch shorter list.
I think she's got about nine sysymptoms on her list, but that,
that's technically you know,extremely clinically trial
based.
And she talks about if you haveany three of those who are most
likely in perimenopause.
Because remember, this is not adisease state.
(13:16):
This is just a transitional.
And it should be treated assuch.
Perimenopause is certainly not adisease but the symptoms can be
extremely varied.
So perimenopausal symptoms varyfrom woman to woman as well.
But here is a comprehensive listof common symptoms experienced
during this transitional phase.
So irregular periods, as wementioned before, changes in the
(13:36):
menstrual cycle includingheavier or lighter bleeding,
shorter or longer cycles ormissed periods, entirely hot
flushes, sudden feelings of.
It kind of feels like you havethis internal heater and
somebody just kind of turned upthe volume.
Initially, it's quite a kookyfeeling.
You sort of think like, oh God,is it me?
(13:58):
Or is it just like really hot inhere?
Oh yeah.
The other night I had a reallyinteresting hot flash.
I was like, oh, whoa, whoa.
And it kind of overtook me.
Yeah, it was really, reallyinterest.
Sudden feelings and warmth,usually in the face, neck and
chest, often accompanied bysweating and redness.
I haven't had the sweating andredness yet, but you know, I'm
(14:20):
ready for it.
I'm ready for it.
Night sweats, hot flushes thatoccur during the sleep, causing
excessive sweating anddisrupting sleep.
Believe it or not, lots of womenin our clinic talk about their,
hot flushes when they're on themost appropriate individualized
precis.
Evidence-based safesupplementation that you can
really tone down the volume onthose, on those night sweats and
(14:41):
hot flushes, sleep disturbances,difficulty falling asleep,
difficulty staying asleep, orwaking up too early.
Mood changes the irritability,anxiety, depression may become
more common.
Vaginal dryness.
A decrease in estrogen levelscan cause dryness, itching, or
discomfort during inter.
Lots of per menopausal womensuddenly start to experience
(15:05):
like a thrush type sensation orstart to have a lot of UTIs.
The vaginal microbiome is reallyimportant.
We really need to keep an eye onthe vaginal microbiome and make
sure that we are doing the rightthings to ensure that it's as
healthy as it possibly can be.
We want those mucus membranes tobe moisturized from the inside
out, and we want thosebeneficial bacteria to be on our
(15:26):
side and not working against.
A decreased libido, changes inhormonal levels can lead to
reduced interest in sex drive aswell as a reduced interest in
the householderresponsibilities.
So, you know, some that we findourselves going, oh, really
can't be bothered cleaning thehouse really can't be bothered.
Vacuuming.
I don't necessarily think thatthese are such a bad idea.
(15:48):
I quite like those ones justsaying.
So the urinary issues increasedfrequency and urgency or incon.
And breast tenderness.
Breast may feel sore or tenderor more so than usual weight
gain.
We often see changes inmetabolism and hormonal
fluctuations, and particularlythat weight gain around the
(16:08):
middle, you know, just where youzip those genes up, you know
Joint and muscle pain very, verycommon in premenopause frozen
shoulder and suddenly a sorehip.
And suddenly my knees are doingsomething really strange, you
know, aches and stiffnesses inthe joints and the muscles, and.
I'm here to tell you that I'msomebody that's had so many
accidents in her life,unfortunately.
(16:30):
And I wouldn't necessarily sayI'm clumsy but you know, car
accident at the age of you know,18 months of age in traction for
six months.
I dislocated my back and crackedmy cocky skiing when I was about
21.
I had a knee injury a couple ofyears ago broke my left arm I
have a screw in nine plates, soI'm here to tell you that the
joint and muscle pain reallyresonates with me.
(16:50):
With that fluctuating estrogenlevels.
So particularly when my estrogenis lower in my cycle, it's
really important for me tolubricate from the inside out as
much as I possibly can.
So I take like, you know, lotsand lots of proresolving
mediators, I take lots of fishoil and I really hammer the
magnesium.
One of my favorite supplementsin the whole world is something
(17:12):
called Synergesic it's a really,really, really high dose
turmeric with a couple of safe,effective botanical painkillers,
absolutely fantastic stuff.
Headaches.
went through a phase where I hadthese two, I had these just
random headaches and I'm notsomebody that has headaches
either, so you may haveexperienced them as well.
An increase in that headache ormigraine.
And quite often we have that youknow, wo, women will notice that
(17:33):
they'll have that, that migraineor that headache cyclically.
So it'll be like, ah, every timejust before my period.
Or if it's an iron deficiencyheadache, it's quite often a, a
depleted headache after yourperiod.
But there are a lot ofprogesterone deficiency
migraines and headaches in myclinic that I see quite
regularly.
But these are also pretty easyto treat Fatigue, the
generalized.
There has never been a time inyour life where you have been
(17:54):
more inflamed with less energy.
So yeah, that's per menopause.
But there is a way to increaseyour energy levels and decrease
that inflammation.
So feeling more tired or lackingthat energy.
Memory and concentrationproblems.
You know, women talk about brainfog or, you know, walking into
the room and going, what am Idoing in here?
Or Have you ever put your keysin the fridge?
(18:17):
And the cocoa pops, you know, inthe freezer, it's that kind of
thing.
Or like, where the hell did Ipark the car?
Oh my God, I've totallyforgotten.
Like I just cannot remember, orjust very confidently
interjecting the completely inincorrect word, straight into
the sentence, with fullconfidence, or forgetting the
(18:40):
word completely and not beingable to access it at all..
So difficulty focusing,remembering or thinking clearly,
that can certainly be a sign ofperimenopause.
Have you noticed the spatialawareness?
I know that that's not writtenon here, but so many women
report this like just.
Walls are suddenly jumping outat you.
You know, like just bumping intowalls all over the place or, or
(19:01):
finding yourself just bumpinginto the corner of the table, or
just not getting just not justnot getting it right.
You know, like when you'redriving and you have to know
where the car begins and ends,you know?
Have you sort of lost that senseof where you begin and end and
suddenly you're just bumpinginto everything or dropping
things?
I remember saying to my partner,I was like, oh, before I get my
(19:22):
period, I just like drop thingsand then I was like, ah, I don't
think it's just before I get myperiod.
I think I'm just starting togenerally drop things.
Changes in skin and hair.
So our skin tends to dry out.
Sadly, everything is drying outright?
So dry eyes, ears, nose, vagina.
We need to moisturize everythingfrom the inside out.
(19:44):
You can't get enough MCT oil.
You can't get enough avocado oilenough olive oil, all the good
oils.
Butter.
Go for it.
Acne.
Yeah.
Suddenly women are coming intomy clinic going, oh my God.
Like I had acne when I was, youknow, prepubescent.
What's going on?
I feel prepubescent now.
Well, actually I'm here to tellyou that perimenopause is the
(20:04):
second puberty.
It's literally, I think it'sactually worse.
I think perimenopause is worsethan puberty.
Hair thinning too.
But there's a lot you can doabout that.
You can make sure that you'renot detoxifying your androgens
or your male hormones down thefemale pattern boldness pathway.
And you can also make sure thatyour iron's okay, thyroid
(20:24):
issues, iron and androgendetoxification, really talk into
that hair thinning.
Keep in mind that not all womenwill experience every symptom.
Lucky ducks, and the intensityand the duration of symptoms can
vary greatly.
It's essential to consult ahealthcare professional if
you're concerned about anypremenopausal symptoms you're
experiencing.
(20:44):
And then I have a little treatfor you.
This is honestly a godsend.
Lemon balm and it is so gentle.
I mean, honestly, a beautiful,beautiful herb like lemon balm
Lemon balm and libido.
Lemon balm is, a little bitsexy.
I absolutely love this study.
It looked into how Lemon balm,also known as Melissa Officialis
(21:08):
L, can help with sexualdysfunction in women.
It's pretty awesome.
They had 89 women with reducedsexual desire.
Either one gram of lemon balmextract or placebo daily.
And guess what?
The results were superpromising.
Those who took the lemon balmexperienced significant
improvements in arousal,lubrication, orgasm and sexual
(21:31):
satisfaction and even painreduction compared to the
placebo group.
So, you know, oftenperimenopausal vaginas are drier
and the mucosal membrane isthinner, so sex can actually
become quite painful.
There's so much you can do aboutthat too.
But yeah, so this really helpedthat as well.
So, come on.
I mean, my goodness, we don'twanna lose the sexy just because
(21:51):
we are transitioning and we'rein the prime of our lives.
The cherry on top, theparticipants were keen to
continue treatment.
So generally in a clinicaltrial, when participants are
keen to continue treatment, youknow that it's working, cuz why
would you be doing it if itwasn't working for you?
So if you're a perimenopausalwoman looking for a little boost
in the bedroom, lemon balm mightbe worth a try.
(22:13):
Just remember, it's always bestto chat with your healthcare
professional before starting newsupplements.
And this is just forinformational and educational
purposes.
But please have a look at thisresearch.
It's absolutely compelling.
My name is Dr.
Kirsty Holland.
I'm the founder and practitionerof the Holland Clinic in
Melbourne, Australia.
And it's been my absoluteprivilege to bring you this
(22:36):
informational peri chat Thankyou so much, and I'll see you
next time.
Bring your lover, bring yoursister, bring your cat, bring
your.
I'm trying to raise awarenessfor perimenopausal women because
this is not just in our headsand quite frankly, women are
really sick and tired of thehead tilt and the you know
that's about right for your agelove.
It doesn't need to be this way.
(22:57):
We certainly can thrive and havean incredible experience
transitioning from our fertileyears into our menopausal.
And I'm here for it.
I'm here to help you do it.
I'm here to teach you how toaccess alternative fuel sources.
I'm here to bring you research.
I'm having such a great timetalking to so many
perimenopausal women worldwideabout what they're experiencing
(23:20):
and what they need to know.
And I'm just so delighted thatyou took the time out with me
tonight.
Thank you so much for beinghere.
Absolute pleasure to be in yourcompany.
Take it easy and have a gorgeousevening.
And let me know what you need toknow more of you can find me on
Instagram and Facebook and reachout on my Facebook page or my
website.
Super easy to find.
(23:40):
Take it easy.
I'm so delighted to have you here to
discuss all things, Peri.
We're going to discuss what isperimenopause.
We're going to discuss, what areperimenopausal symptoms, could I
potentially be in perimenopause?
And then I've got a bit of sexyresearch for you at the end.
And I know that you thinkresearch can't be sexy, but
wait, I'm gonna prove you wrong.
My name's Dr.
Kirsty Holland.
(00:21):
I'm the founder and principalpractitioner of the Holland
Clinic in Melbourne, Australia,and I'm absolutely delighted to
be helping woman over the age of35 rescue themselves from this
crazy rollercoaster of perimenopause.
Let's get started.
Little bit of a medicaldisclaimer.
Of course, I'm not your medicaldoctor.
This relationship really needsto be one-on-one.
(00:42):
It's really important for you tofind a practitioner that you
trust and adore and you need toknow that your praccy knows what
you're talking about.
You need to be seen, you need tobe heard.
And and of course you want themto have some credentials.
I think it's imperative for youto have a really good
relationship with people thatare taking care of things that
mean most to you.
(01:02):
I mean, people's health impactsevery single aspect of their
lives.
The women in my clinic tell meso much about the fact that you
know, their health impacts,their parenting.
Their relationships and ofcourse their professional lives
too.
So it's so important to havethat intact, and particularly in
perimenopause, you know, thatmum agro really impacts our kids
from time to time.
And I know a lot of the women inmy clinic come in talking to me
(01:24):
about the relationship agro, Idunno about you, but many of the
women share those stories aboutyou know, I asked you to take
out the bin, damnit, you know?
And yeah, we, we wanna enjoy ourchildren and we want our
children to enjoy us.
We certainly don't want to befrazzled and exhausted and feel
like we've got nothing left inthe tank when it gets to the end
of the day around them.
(01:44):
So, topics for today, frequentlyasked questions.
Just the very, very basics, youknow, what is perimenopause?
What happens in perimenopause?
What are perimenopausal symptom?
You know, I know I see so manywomen in my clinic who are
blatantly perimenopausal and,you know, we're still confused.
And it's so interesting, like Iwas discussing with a a
perimenopausal journalist whohas been a journalist for 25
(02:08):
years, and she was shocked bythe fact that she was in
perimenopause when it finallycame home to roost for her.
And believe it or not, I've beentreating perimenopausal women.
For 23 years in my clinic inMelbourne, Australia.
And when I started to experienceexacerbated anxiety, at one
point I thought it was all ofthe stresses in my life.
But when I looked at, when Ilooked around you know, life has
(02:31):
been pretty tricky and andpretty stressful.
Being a, a single mum for thelast 13 years, and my stressors
hadn't necessarily changed, butI started to experience this
real physical.
So sometimes it's reallynuanced, you know, these, these
menopausal symptoms.
And I was like, oh, hang on.
This is the progesteronedeficiency anxiety.
This isn't just the, you knowthere are lots of different
(02:52):
kinds of anxiety.
Let me not downplay this.
Ellen Vora, who wrote the book,the the Physiology of Anxiety.
I think that's what it's called.
Don't quote me.
Absolutely brilliant book.
She'll really talk about all thekinds of anxiety, but I know for
a fact that one of my firstperimenopausal symptoms was this
true progesterone deficiencykind of physical anxiety.
So what are perimenopausalsymptoms?
(03:13):
And then not so frequently askedquestions, lemon balm and its
impact on libido.
Okay, what is perimenopause?
Perimenopause is thetransitional phase leading up to
menopause.
So menopause is the point when awoman's menstrual period stops
permanently and she's no longerable to become pregnant
(03:34):
naturally.
So menopause is actually onlyone day you reach menopause when
you have not had a bleed or acycle for a full 12 months and
one.
So you have had no period, nospotting, no staining.
For 12 months.
You have then reached menopause,and then after that one day you
(03:56):
are post-menopausal, believe itor not.
So that happens quickly duringperimenopause.
A woman's hormone levels startto drop and fluctuate causing
changes in her menstrual cycle.
Progesterone is the hormone thattends to decrease.
Progesterone is this beautifulimmune modulating mind,
(04:17):
modulating cool, calm, collectedhormone.
So when she starts to dropfirst, estrogen starts flailing.
So estrogen is uncontrollablewhen progesterone is not
controlling her.
Let's just say that.
So this phase typically occursin women between their late
thirties and early fifties, andmay last for several years
(04:38):
before menopause begin.
Now I'm here to tell you thatunfortunately for some, and I
certainly am one of those womenthat started to experience
perimenopausal symptoms prettyyoung, and maybe that's why I'm
so passionate about having amore graceful experience.
For some of us, it can really,be in our lives for at least 15
years, and I'm here to tell youthat even at that point when you
(04:59):
are menopausal, unfortunatelythe research shows that those
crazy unwanted symptom canactually last for an additional
six years post that day when youdo reach menopause, which is
usually around 50 or 51 years ofage in Australia.
This phase typically occurs inwomen between their late
thirties and early fifties, andmay last for several years
before menopause begins.
(05:21):
On average perimenopause lastsfour to six years, but it can be
as short as one year for somelucky ones, or as long to as
long as 10 to 15 unfortunatelyI'm more in the 10 to 15
category.
And like I said, perhaps that'sprobably why I'm so passionate
about trying to make this moreof a graceful experience.
To date, I've probablyexperienced most of the symptom.
(05:43):
Woman can continue to experienceunwanted symptoms for six years
after they reach menopause, as Imentioned before.
I just want you to know thateverything that I'm saying is
backed in evidence-basedscience.
I absolutely love the research.
I am not gonna bore you with it.
I won't read through theresearch articles, but I've got
them on hand.
You're welcome to my slides, soplease let me know if you'd like
(06:06):
a copy.
DM me book a clarity call if youwanna talk through the research.
I am such a research tech nerd.
I would absolutely love to and Iwould love to share these with
you.
Let me know if you want them.
Okay.
What happens in perimenopause?
So perimenopause is thetransitional phase leading up
to.
During which a woman's bodyundergoes various hormonal and
(06:28):
physiological changes.
Here are some of the key eventsthat occur during perimenopause.
Hormonal fluctuations, estrogen,progesterone levels begin to
fluctuate during perimenopause.
Progesterone generally starts todecrease first, and then because
progesterone is decreasing andshe usually has this beautiful
modulating effect on estrogen,estrogen does start to flail.
(06:50):
These hormone fluctuationscontribute to the various
symptoms experienced during thistime, changes in the menstrual
cycle.
Women often notice that theirmenstrual cycles are either
shorter or longer or morepainful.
Sometimes there's more clottingin the menstrual cycle.
As the hormone levels change, awoman's menstrual cycle may
become irregular.
(07:11):
So many perimenopausal womencoming to my clinic going, God,
I thought I was pregnant.
You know, my 28 day cycle was,out at 37 days and I was
experiencing all these crazysigns and symptoms.
My breasts hurt.
I had a headache.
It was kind of like a migraine.
God, that's all I needed.
At the tender age of 47 to bepregnant and be mindful that
(07:31):
during premenopause youabsolutely can fall pregnant.
So please be careful.
It's not over yet Periods maybecome heavier or lighter, and
the duration between periodsmay, may become shorter or
longer.
Going from a 28 day cycle, youmight now have a 24 day cycle,
which shows that there's thisdeficiency in progesterone
creating a shorter luteal phase.
(07:51):
Or suddenly you can start tohave this 37 day cycle.
So we have anovulatory cycles inperimenopause, so sometimes we
don't ovulate and sometimes,believe it or not, we can match
it magically, ovulate twice inone month.
That's why we quite often haveidentical twins in women in
their forties.
Ask lots of gynecologist womenin their forties can quite often
fall pregnant twice in the samemonth.
(08:13):
Yeah, I mean, it doesn't happenall the time, but it happens.
It's a thing.
Alright, so some women may alsoexperience skip periods
ovulation changes, as Imentioned before, ovulation may
become irregular, even ceasealtogether during peri.
This leads to decreasedfertility, although it's still
possible for women to becomepregnant until she reaches
menopause, as I was talkingabout before.
(08:35):
And then the physical symptomsor these brain symptoms.
Many women experience physicalsymptoms during perimenopause,
including hot flashes, nightsweats, vaginal dryness, and
changes in sexual function.
These symptoms can vary inintensity and frequency.
Boy, do I have something for youif you've lost that little bit
of sexy.
(08:55):
Emotional symptoms too.
How about how about the mumrage?
You know, how about the, justlosing it at the kids and going,
oh my God, I don't even know whoI am anymore.
My kids don't like me.
My husband's worried.
I'm worried.
You know, it's really importantfor us to enjoy ourselves and
enjoy our homes.
You know, this beautiful human.
(09:17):
This is where you live.
You want it to be a reallygorgeous experience.
So we don't wanna have all ofthese crazy symptoms, you know,
the mood swings, theirritability, the anxiety, the
depression, their commonemotional symptoms during fair
menopause.
These may be due to hormonalchanges as well as the physical
symptoms and life stressesassociated with the stage of
life.
Don't we know it, man?
(09:37):
Oh man.
We've, we've generally got agingparents.
You know, lots of us have, haveteenage children.
We have established or newrelationships.
Careers, dogs, you name it,we've got the responsibility
going on.
We're in the prime of our lives.
We certainly don't needpremenopausal signs and symptoms
to get in our way.
And that's kind of my why.
Women are so important.
(09:58):
They're the nucleus.
And you know, of course men areimportant too, but you know, a
lot of the time the women arethe caregivers in the
householders and, and themothers, you know, the mother
that earth energy.
It's so important.
Sleep disturbance.
So we're meant to do all of thison like zero.
Difficulty falling asleep, whichis usually a circadian rhythm
disruption, which quite oftencomes along with you know, high
(10:20):
levels of cortisol and and adecreased initiation of
melatonin.
Insomnia and sleep disturbancescommon during perimenopause,
often due to hot flashes.
So the hot flashes can wake usat night.
As well as that that cortisolbeing too high as well as
emotional symptoms like anxiety.
One of my patients describes.
When she gets into bed at nightand lies next to her husband,
she has this real sense of panicand anxiety and has no real
(10:43):
reason to be experiencinganxiety or panic.
So really does identify it asthat progesterone deficiency
anxiety.
Glad to report that she'sactually doing, you know, really
well at the moment.
Bone loss.
The decrease in estrogen levelsduring perimenopause can lead to
a loss of bone density,increasing the risk of o,
increasing the risk ofosteoporosis.
So this is not something that wewanna be doing.
(11:05):
We certainly wanna be keeping aneye on our trace mineral levels.
We wanna be making sure thatwe've taking vitamin D in K2 to
get that calcium into the boneso that the calcium doesn't
deposit anywhere else.
Creating oxalate deposits eitherin the kidney or in the lung or
in the vagina no, no thank you.
no oxalate deposits in the eyesof the vagina.
Changes in cardiovascularhealth.
(11:26):
Estrogen helps protect the.
So estrogen helps to protectagainst heart disease.
So the decrease in the estrogenlevels during perimenopause may
increase the risk ofcardiovascular issues.
Yeah, so many people go, oh, youknow, I've got hot flushes
they're really annoying.
But unfortunately that vasosymptom is actually, it's a
cardiovascular disease risk.
So it's really important for usto do what we can to get that
(11:47):
under control and also make surethat we're doing heart
protective things.
So it's important to note thatevery woman's experience of
perimenopause is really uniqueand the symptoms and their
intensity can varysignificantly.
If you're concerned about yoursymptoms or need advice on
managing them, consult yourhealthcare provider.
Really important.
Supporting research againbecause I'm a tech research data
(12:10):
nerd.
Here are all the studies.
Like I said, please DM me book aclarity call.
We'd love to chat to you aboutthe research too, and happy to
share these slides.
I am here just creatingawareness.
The research also shows thatthere's a huge capacity in
society to allow for women to.
So to generally suffer duringour menstrual years as well.
Quite often when, when youngwomen are talking about the fact
(12:32):
that they need to take time offwork because they have, you
know, significant pain anddebilitating periods,
endometriosis or polycysticovarian syndrome, society sort
of, you know, nods, nods along.
So we have this capacity toallow women to suffer and we
certainly don't need to.
It doesn't need to be this way,and we certainly don't need to
suffer in premenopause either.
Bone loss, cardiovascular.
(12:54):
Now, what are the officialperimenopausal symptoms?
There are like a trillion ofthem.
Professor Pryor talks about amuch shorter list.
I think she's got about nine sysymptoms on her list, but that,
that's technically you know,extremely clinically trial
based.
And she talks about if you haveany three of those who are most
likely in perimenopause.
Because remember, this is not adisease state.
(13:16):
This is just a transitional.
And it should be treated assuch.
Perimenopause is certainly not adisease but the symptoms can be
extremely varied.
So perimenopausal symptoms varyfrom woman to woman as well.
But here is a comprehensive listof common symptoms experienced
during this transitional phase.
So irregular periods, as wementioned before, changes in the
(13:36):
menstrual cycle includingheavier or lighter bleeding,
shorter or longer cycles ormissed periods, entirely hot
flushes, sudden feelings of.
It kind of feels like you havethis internal heater and
somebody just kind of turned upthe volume.
Initially, it's quite a kookyfeeling.
You sort of think like, oh God,is it me?
(13:58):
Or is it just like really hot inhere?
Oh yeah.
The other night I had a reallyinteresting hot flash.
I was like, oh, whoa, whoa.
And it kind of overtook me.
Yeah, it was really, reallyinterest.
Sudden feelings and warmth,usually in the face, neck and
chest, often accompanied bysweating and redness.
I haven't had the sweating andredness yet, but you know, I'm
(14:20):
ready for it.
I'm ready for it.
Night sweats, hot flushes thatoccur during the sleep, causing
excessive sweating anddisrupting sleep.
Believe it or not, lots of womenin our clinic talk about their,
hot flushes when they're on themost appropriate individualized
precis.
Evidence-based safesupplementation that you can
really tone down the volume onthose, on those night sweats and
(14:41):
hot flushes, sleep disturbances,difficulty falling asleep,
difficulty staying asleep, orwaking up too early.
Mood changes the irritability,anxiety, depression may become
more common.
Vaginal dryness.
A decrease in estrogen levelscan cause dryness, itching, or
discomfort during inter.
Lots of per menopausal womensuddenly start to experience
(15:05):
like a thrush type sensation orstart to have a lot of UTIs.
The vaginal microbiome is reallyimportant.
We really need to keep an eye onthe vaginal microbiome and make
sure that we are doing the rightthings to ensure that it's as
healthy as it possibly can be.
We want those mucus membranes tobe moisturized from the inside
out, and we want thosebeneficial bacteria to be on our
(15:26):
side and not working against.
A decreased libido, changes inhormonal levels can lead to
reduced interest in sex drive aswell as a reduced interest in
the householderresponsibilities.
So, you know, some that we findourselves going, oh, really
can't be bothered cleaning thehouse really can't be bothered.
Vacuuming.
I don't necessarily think thatthese are such a bad idea.
(15:48):
I quite like those ones justsaying.
So the urinary issues increasedfrequency and urgency or incon.
And breast tenderness.
Breast may feel sore or tenderor more so than usual weight
gain.
We often see changes inmetabolism and hormonal
fluctuations, and particularlythat weight gain around the
(16:08):
middle, you know, just where youzip those genes up, you know
Joint and muscle pain very, verycommon in premenopause frozen
shoulder and suddenly a sorehip.
And suddenly my knees are doingsomething really strange, you
know, aches and stiffnesses inthe joints and the muscles, and.
I'm here to tell you that I'msomebody that's had so many
accidents in her life,unfortunately.
(16:30):
And I wouldn't necessarily sayI'm clumsy but you know, car
accident at the age of you know,18 months of age in traction for
six months.
I dislocated my back and crackedmy cocky skiing when I was about
21.
I had a knee injury a couple ofyears ago broke my left arm I
have a screw in nine plates, soI'm here to tell you that the
joint and muscle pain reallyresonates with me.
(16:50):
With that fluctuating estrogenlevels.
So particularly when my estrogenis lower in my cycle, it's
really important for me tolubricate from the inside out as
much as I possibly can.
So I take like, you know, lotsand lots of proresolving
mediators, I take lots of fishoil and I really hammer the
magnesium.
One of my favorite supplementsin the whole world is something
(17:12):
called Synergesic it's a really,really, really high dose
turmeric with a couple of safe,effective botanical painkillers,
absolutely fantastic stuff.
Headaches.
went through a phase where I hadthese two, I had these just
random headaches and I'm notsomebody that has headaches
either, so you may haveexperienced them as well.
An increase in that headache ormigraine.
And quite often we have that youknow, wo, women will notice that
(17:33):
they'll have that, that migraineor that headache cyclically.
So it'll be like, ah, every timejust before my period.
Or if it's an iron deficiencyheadache, it's quite often a, a
depleted headache after yourperiod.
But there are a lot ofprogesterone deficiency
migraines and headaches in myclinic that I see quite
regularly.
But these are also pretty easyto treat Fatigue, the
generalized.
There has never been a time inyour life where you have been
(17:54):
more inflamed with less energy.
So yeah, that's per menopause.
But there is a way to increaseyour energy levels and decrease
that inflammation.
So feeling more tired or lackingthat energy.
Memory and concentrationproblems.
You know, women talk about brainfog or, you know, walking into
the room and going, what am Idoing in here?
Or Have you ever put your keysin the fridge?
(18:17):
And the cocoa pops, you know, inthe freezer, it's that kind of
thing.
Or like, where the hell did Ipark the car?
Oh my God, I've totallyforgotten.
Like I just cannot remember, orjust very confidently
interjecting the completely inincorrect word, straight into
the sentence, with fullconfidence, or forgetting the
(18:40):
word completely and not beingable to access it at all..
So difficulty focusing,remembering or thinking clearly,
that can certainly be a sign ofperimenopause.
Have you noticed the spatialawareness?
I know that that's not writtenon here, but so many women
report this like just.
Walls are suddenly jumping outat you.
You know, like just bumping intowalls all over the place or, or
(19:01):
finding yourself just bumpinginto the corner of the table, or
just not getting just not justnot getting it right.
You know, like when you'redriving and you have to know
where the car begins and ends,you know?
Have you sort of lost that senseof where you begin and end and
suddenly you're just bumpinginto everything or dropping
things?
I remember saying to my partner,I was like, oh, before I get my
(19:22):
period, I just like drop thingsand then I was like, ah, I don't
think it's just before I get myperiod.
I think I'm just starting togenerally drop things.
Changes in skin and hair.
So our skin tends to dry out.
Sadly, everything is drying outright?
So dry eyes, ears, nose, vagina.
We need to moisturize everythingfrom the inside out.
(19:44):
You can't get enough MCT oil.
You can't get enough avocado oilenough olive oil, all the good
oils.
Butter.
Go for it.
Acne.
Yeah.
Suddenly women are coming intomy clinic going, oh my God.
Like I had acne when I was, youknow, prepubescent.
What's going on?
I feel prepubescent now.
Well, actually I'm here to tellyou that perimenopause is the
(20:04):
second puberty.
It's literally, I think it'sactually worse.
I think perimenopause is worsethan puberty.
Hair thinning too.
But there's a lot you can doabout that.
You can make sure that you'renot detoxifying your androgens
or your male hormones down thefemale pattern boldness pathway.
And you can also make sure thatyour iron's okay, thyroid
(20:24):
issues, iron and androgendetoxification, really talk into
that hair thinning.
Keep in mind that not all womenwill experience every symptom.
Lucky ducks, and the intensityand the duration of symptoms can
vary greatly.
It's essential to consult ahealthcare professional if
you're concerned about anypremenopausal symptoms you're
experiencing.
(20:44):
And then I have a little treatfor you.
This is honestly a godsend.
Lemon balm and it is so gentle.
I mean, honestly, a beautiful,beautiful herb like lemon balm
Lemon balm and libido.
Lemon balm is, a little bitsexy.
I absolutely love this study.
It looked into how Lemon balm,also known as Melissa Officialis
(21:08):
L, can help with sexualdysfunction in women.
It's pretty awesome.
They had 89 women with reducedsexual desire.
Either one gram of lemon balmextract or placebo daily.
And guess what?
The results were superpromising.
Those who took the lemon balmexperienced significant
improvements in arousal,lubrication, orgasm and sexual
(21:31):
satisfaction and even painreduction compared to the
placebo group.
So, you know, oftenperimenopausal vaginas are drier
and the mucosal membrane isthinner, so sex can actually
become quite painful.
There's so much you can do aboutthat too.
But yeah, so this really helpedthat as well.
So, come on.
I mean, my goodness, we don'twanna lose the sexy just because
(21:51):
we are transitioning and we'rein the prime of our lives.
The cherry on top, theparticipants were keen to
continue treatment.
So generally in a clinicaltrial, when participants are
keen to continue treatment, youknow that it's working, cuz why
would you be doing it if itwasn't working for you?
So if you're a perimenopausalwoman looking for a little boost
in the bedroom, lemon balm mightbe worth a try.
(22:13):
Just remember, it's always bestto chat with your healthcare
professional before starting newsupplements.
And this is just forinformational and educational
purposes.
But please have a look at thisresearch.
It's absolutely compelling.
My name is Dr.
Kirsty Holland.
I'm the founder and practitionerof the Holland Clinic in
Melbourne, Australia.
And it's been my absoluteprivilege to bring you this
(22:36):
informational peri chat Thankyou so much, and I'll see you
next time.
Bring your lover, bring yoursister, bring your cat, bring
your.
I'm trying to raise awarenessfor perimenopausal women because
this is not just in our headsand quite frankly, women are
really sick and tired of thehead tilt and the you know
that's about right for your agelove.
It doesn't need to be this way.
(22:57):
We certainly can thrive and havean incredible experience
transitioning from our fertileyears into our menopausal.
And I'm here for it.
I'm here to help you do it.
I'm here to teach you how toaccess alternative fuel sources.
I'm here to bring you research.
I'm having such a great timetalking to so many
perimenopausal women worldwideabout what they're experiencing
(23:20):
and what they need to know.
And I'm just so delighted thatyou took the time out with me
tonight.
Thank you so much for beinghere.
Absolute pleasure to be in yourcompany.
Take it easy and have a gorgeousevening.
And let me know what you need toknow more of you can find me on
Instagram and Facebook and reachout on my Facebook page or my
website.
Super easy to find.
(23:40):
Take it easy.
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