October 4, 2025 • 28 mins
Hey Outlouders! For this week's Sunday special, we're dropping an episode of our sister podcast Well into your feed - because we know you'll love this conversation as much as we do. We're talking all things peri and menopause.
Does your endometriosis put you at a higher risk of early menopause? Did a pig castrator really perform the first-ever C-section? And if you've had a hysterectomy, do you still need to see a gynaecologist?
On this episode of Well Claire Murphy chats to Professor Susan Davis, a founder of Jean Hailes for Women's Health and past president of the Australasian Menopause Society, to find out what's fact and what's fiction when it comes to the science of perimenopause.
They unravel common myths, including “disappearing labia” and talk about why some things you're being sold on social media - like weighted vests and special supplements - may not be as miraculous as they might seem.
Plus, talk about the latest research on delaying the onset of menopause and why it might not be a good idea for everybody.
THE END BITS
All your health information is in the Well Hub.
Listen to more episodes of Well
For more information on perimenopause and menopause, Professor Susan Davis and Dr Mariam recommend the Australasian Menopausal Society, the Endocrine Society, the International Menopause Society and Jean Hailes For Women’s Health.
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CREDITS
Hosts: Claire Murphy and Dr Mariam
Guest: Professor Susan Davis
Senior Producers: Claire Murphy and Sally Best
Audio Producer: Scott Stronach
Video Producer: Julian Rosario
Social Producer: Elly Moore
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Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
You're listening to a Mamma Mia podcast.
Speaker 2 (00:13):
Mamma Mia acknowledges the traditional owners of land and waters
that this podcast is recorded.
Speaker 1 (00:18):
On out louders.
Speaker 2 (00:20):
It's Holly here, Welcome to your Sunday special. We like
to drop your little treat sometimes in the feed, and
today we're bringing you an episode of Mamma MIA's women's
health podcast, well hosted by Dr Mariam and Claire Murphy,
with whom you are very familiar because she often pops
up on out loud. And this episode is all about
(00:40):
Perry menopause. Yes, that very important topic. They will be
sorting the facts from the fiction in here, including whether
or not your labbya really does start disappearing when you
hit Perry, and they'll unpack whether some of the things
you're being sold on social media, like weighted vests and
special supplements and protein everything, are really everything they're cracked
(01:02):
up to be. They're also going to take you to
med school where Dr Mariam and Claire are going to
talk about the origin of the c sex and they're
going to do a quick little consult to find out
whether you still need to see a guynecologist if you've
had a hysterectomy. Please enjoy this episode of Well.
Speaker 3 (01:25):
Hi there, I'm Claire Murphy, Australian Women. Welcome to your
full body health check. As I have established if you've
been listening over the last few weeks, I am deep
in Perry menopause territory and I would like to say
I think I'm finally getting a handle on it. It's
taken me a bit, but I feel like I'm there,
which is good.
Speaker 1 (01:42):
I love it. And I'm doctor Mariam, I'm an Australian GP.
It's time our training reflected reality. Females deserve better because
a lot more women deserve more than silence when it
comes to this transition in their life.
Speaker 3 (01:57):
Coming up today, Mariam, the science of Perry, menopause and menopause.
What do you recall from your training about menopause Little
to nothing. Well, if it's any consolation, I've been chatting
to a band student to try and find out how
(02:17):
much they're getting now and he did say to me, yes,
they have had a full year in obstetrics and part
of that has been a focus on menopause and like
endometriosis and things that are impacting women quite significantly, and
they are getting more training now.
Speaker 1 (02:31):
So hobst generation I hope. So.
Speaker 3 (02:34):
I mean, I've also got a friend whose doctor is GENZT,
like the eldest of the gen zs are now old
enough to be your doctor, which makes me feel ridiculously old.
There's so much happening around the discussion and menopause. There's
a lot happening online right now. You might have seen
if you are in the same threads as me, weighted vests,
(02:55):
vaginal estrogen disappearing, labia, more protein, more fiber. So we're
going to unpack a lot of those things today, and
you've probably been told a lot of these things in
your social media feed. We're going to find out what
is actually benefit official and what is actually useful when
it comes to menopause. Will also pop in a time
for a quick consult for Adek today.
Speaker 1 (03:16):
Now she's had her uterus out.
Speaker 3 (03:19):
She's quite happy about that, to be honest, but she's
not sure if she still needs to keep up certain
health checks now that it's gone. We're also going to
head to med school too, because Mariam, you know me.
You know I'm a history nerd, and I've been delving
back into a little bit of medical history.
Speaker 1 (03:33):
I love this stuff.
Speaker 3 (03:34):
This week, tell me, do I have a story for you.
I Am going to tell you how a pig car
strator helped change how we give birth.
Speaker 1 (03:44):
That's happening school next, Welcome to med school.
Speaker 3 (03:48):
Okay, we have established I'm a history nerd. Anything that
delves back into the past I'm writing into and from
researching this show, I've been able to really tap into
medical history stuff, which is it's a wild place to be.
When we figured out how to do stuff to humans,
Like the way we did that not acceptable in today's terms,
but like back then, we just did what we had
(04:09):
to do right. So I was literally today years old
when I found out the origin of the first ever
reportedly allegedly because we don't know fo one hundred percent
sure successful caesarean section okay on a human being yep,
Because this was happening on animals before it was happening
on humans. It was not done by a doctor. It
(04:30):
was done by a Swiss pig guilder. Oh okay, what
is a pig guilder?
Speaker 1 (04:35):
We will get to that.
Speaker 3 (04:37):
It's the year fifteen hundred. Elizabeth is pregnant, she is
about to have a child. She is a wife of
a man named Jacob Nufa. Now, she was struggling to
give birth. As you know, we know, the ability for
women to survive childbirth back then was nowhere near what
we have today. She'd been in labor for days and
(04:58):
despite the best efforts of all the midwives who were
around her, none of them could deliver that baby. Now, Jacob,
you might remember, as I mentioned, is a pig guilder.
It essentially means he dissexes p so he lobs the
nuts off the boys, and he whips out the uteruses
of the girls unless they are the breeding kind. So
he was also though used to helping those pigs give birth,
(05:20):
and in some of those instances they had to remove
the piglets surgically. He's feeling pretty desperate by this point, right,
He's looking at his beautiful wife Elizabeth and seeing her struggle,
and he wants to save both the life of his
wife and his unborn child. He decides to step in
and save her himself. Now, he had done similar surgeries
like this, as I mentioned, but not just on pigs.
(05:41):
He'd done it on cows, He'd done it on horses,
so he kind of had a little bit of an
idea what to do. Back then, pig carstraders would sometimes
do sea sections if they thought the mother might die,
just to save the babies, and midwives were aware of
the method, but in the early fifteen hundred, sea sections
were only allowed if the mother had died, so it
wasn't to save her life, it was to save the
(06:03):
baby's life. Jacob had to get special permission from authorities
to perform this surgery because Elizabeth was still very much alive,
so he got the permission. He caught in a bunch
of midwives to help him out, thirteen in fact, but
only two of them would agree to do this because
it was so much against regulations. Using a razor blade,
he cut open Elizabeth, removed their stuck baby, sewed her
(06:27):
back up, and she survived. The baby also survived.
Speaker 1 (06:32):
And not only did Elizabeth survive this surgery, she went
on to have five more children, including a set of twins,
which means he did a decent enough job that her
uterus was still fully functional after all. My god, I'm
eagle parts horrified and impressed, right like, no sterile gloves,
no anobetic no antibiotics, oh my god, no antibotics. And
(06:53):
he just had a razor blade. I hope it wasn't
one that he had pigs. Hopefully he washed his hands beforehand.
And that's all. She survived and went on to have
five more, like I can barely survive day care drop off.
Speaker 3 (07:07):
I know her Elizabeth, Like what an absolute champion, Jacob
geez look at. Some historians do debate whether the pregnancy
was actually in uterine, so there is some debate about that.
But this wasn't actually discovered until eighty years after it happened,
when someone translated a French physician's diary and they discovered
what had happened. But I can tell you now that
(07:29):
baby lived until they were seventy seven years old. But
fun fact, the origin of the word cesarian obviously comes
from the old Roman days. And I mean this is
also debated too. This was part of this whole idea
that you could only cut the baby out if the
mother was pretty much dying or dead. And it was
something that Julius Caesar put out there and said, like
that's the way that you're allowed to cut out a baby.
(07:50):
So it was called a Caesar Ah.
Speaker 1 (07:53):
The section park came a little bit later, very un
brand for the romans to make it dramatic.
Speaker 2 (07:58):
But there you go.
Speaker 3 (07:59):
A history lesson for today. Thank you Jacob Nufa and
Pig car Strator and caesarean section.
Speaker 4 (08:05):
Do it is?
Speaker 3 (08:07):
It's just so cool, all right, get into the reason
we are here today, the science of perimenopause. There's a
lot happening in discussions around the world about it right now.
We are about to bust some myths for you.
Speaker 1 (08:19):
Let's do it.
Speaker 4 (08:20):
It's time for the checkup.
Speaker 3 (08:23):
Mariam, what did the wise old women in your life
tell you about menopause?
Speaker 1 (08:28):
Honestly nothing, yep, not much at all. It was like
whispered slide comments like she's moody, she's sweat and buckets,
but no one said the word menopause. I was referenced
it as the change, the change, No big chat, no guidance,
just silence and suffering with the side of peppermint tea.
Yeah yeah, so I feel like the female's mom and
(08:49):
grandma was strong, but they were also left in the dark.
But now we have the science, we've got the language,
we've got the platforms, so we should happily say the
words perimenopause and menopause out loud. Yeah. One hundred percent.
I was the same.
Speaker 3 (09:02):
I heard nothing, And I think my understanding of menopause
was probably similar to many other peoples in that you
suffered some hot flashes and then period stopped, and that
was the definition of menopause for a long time.
Speaker 1 (09:14):
And it would happened over a really short period of time. Yeah,
it was just you know, a little.
Speaker 3 (09:18):
Like you hear your rainy fifties or something. Maybe, yeah,
and then it's all over. And it was only when
and I've mentioned this Mum and Mia held the very
peary summit, that I understood that it was a whole
bunch more than that, and that all the symptoms that
go with it, and then it can be something you
suffer through for ten years or more for some people
if you go through menopause really early, so it can
be a bit of a wild ride. Is the Australian
(09:39):
medical industry well versed enough you think about this stage
of women's lives?
Speaker 1 (09:43):
Short answer, not yet. Okay, the Australian medical system is
getting better, but definitely going in the right direction. But
I think we've still got a bit of cat shop
when it comes to perimenopause and menopause. Most gps want
to help absolutely, but the reality is women's midlife health
hasn't been prioritized in our medical training. It's great that
(10:05):
your friend mentioned that it is something that's starting to
change and something that they're but many doctors simply weren't
taught how to recognize or treat it appropriately. And then
there's a lot of outdated fears and lots of fear
for prescribing, as we've mentioned the World Health WHI study
back in two thousand and two, and then you've got
a lot of women told to just write it out
(10:27):
or you know, just write it out.
Speaker 4 (10:29):
Try.
Speaker 3 (10:29):
I cannot imagine if someone told me to ride this out,
like goodness, yeah, that's really tough.
Speaker 1 (10:34):
But now we've got brilliant resources. The Australasian Menopausal Society
has got some amazing information for doctors and patients and
a growing number of us are upskilling, which is so
nice to see because a lot more women deserve more
than silence when it comes to this transition in their life.
So no, we're not there yet, but the conversation is
(10:55):
finally happening loudly and that is a good start. Amazing.
We do have a lot to get through today. Let's
do it.
Speaker 3 (11:02):
Professor Susan Davis is going to help us unravel and
unpack perimenopause and menopause science claims, So stick around.
Speaker 1 (11:08):
She's going to join us.
Speaker 3 (11:09):
Next scrolling menopause reels, or pery talk as it's referred
to Lovatt. There are millions of different things that we're
being told are beneficial about this phase of your life,
which look to be honest, is better than deadly silence.
(11:30):
We want it to be out there, but as we know,
and as we've discussed with lots of different women's health issues,
it can be misleading, and you've got to read between
the lines that sometimes you're being sold something rather than
something that might actually be beneficial. And this was described
to me a little while ago that women who are
now of perimenopausal or menopausal age are potentially the last
(11:52):
cohort of women who were really marketed weight loss stuff
and now that they're no longer really in that period.
And also with the introduction of weight loss medications, as
we've discussed in the past two the focus has shifted
to start marketing menopause related items to so we need
to really tread carefully and figure out what is actually
(12:13):
true and what is fact and fiction in this So
with all of that information and potential misinformation, maybe we're
not sure what to make of it all. So Monash
University's professor Susan Davis is going to help us unravel
that peri fact from menofiction today. She is one of
the five founders of Gene House for Women, is a
past president of the Australasian Menopause Society, which you've mentioned
(12:36):
a few times, Mariam, and also the International Menopause Society.
And we started off by asking Susan about the claim
that having endometriosis increases your chance of going into metopause early.
Speaker 4 (12:49):
I'm not aware of any day that that supports endometriosis
as a condition causing an earlier menopause, but a lot
of women who've had endometriosis have lots of surgeries, and
we do know if you have a lot of abdominal
surgeries related to the uterosity overreas, you can impair the
blood supply and that can potentially trigger a slightly slightly
earlier menopause. And the hysterectomy, for example, is associated with
(13:12):
a very slightly earlier menopause.
Speaker 3 (13:15):
Is it true that the earlier you get your period,
the earlier you're likely are to hit menopause.
Speaker 4 (13:21):
That's not necessarily the case. In fact, the biggest predictor
of when you're going to go through menopause is when
your mother or your older sister went through menopause. The
other factors that are associated with earlier menopause, as I said,
hysterectomy and smoking, but those factors only pushed the menopause
earlier by maybe twelve months, not many, many years.
Speaker 3 (13:41):
I guess we have to get our moms to actually
start talking about when they got into menopause. It wasn't
a conversation they had a lot. I was also reading
that menopause might exacerbate other issues. So when you do
hit that period, when your hormones start to go a
little bit wild, can it start to interact with other conditions,
say dyslexia and ADHD and things like that.
Speaker 4 (14:02):
One of the most common symptoms of menopause is sleep deprivation,
so erratic sleep, waking up not feeling refreshed. So if
your sleep is impaired, any other health condition will be exacerbated,
whether it be your ostereoarthritis, your mental health issues, your
rheumatological issues, any other condition you've got will be exacerbated
(14:23):
by sleep deprivation. So it's not really an interaction between
hormones and a particular condition necessarily, but rather all these
other changes in your body is suddenly happening and that
will influence any other health condition.
Speaker 1 (14:36):
Can we talk about vaginal estrogen.
Speaker 3 (14:39):
We've done a whole topic of MHT, so we've got
a good understanding of taking it orally and viraygel or
a patch. But there's a lot of conversation around vaginal
estrogen and a lot of us are under the impression
that you only really used that for vaginal dryness, but
the conversation now is around it potentially protecting you from UTIs.
(15:00):
Do we understand that to be the case?
Speaker 4 (15:01):
Okay, So vaginal dryness and vaginal symptoms tend to emerge
in late perimenopause early menopause. It's not one first symptoms.
And the symptoms of the go along with vaginal dryness
are urinary frequency, like getting up multiple times in the
night to pee, a sense you've just got to rush
to the toilet. You're in the urgency, and vaginal estrogen
(15:26):
can alleviate those symptoms. But one of the best studies
was done in the nineteen seventies that showed that even
a symptomatic women who used vaginal estrogen had less urinary
tract infections. So even a sixty year old or a
seventy year old woman who has no other menopausal symptoms
probably should still be using vaginal estrogen twice a week
(15:47):
to protect her bladder and her vaginal tissues.
Speaker 3 (15:50):
There is a lot of research going on right now,
but I think the one that really stood out for
me when it comes to menopause is a lot of
people are looking into various ways of delaying the onset
of menopause, Like, for example, there's one that is looking
at engineering young ovarian support cells and developing drugs that's
lower varying depletion, and then if it is successful, for example,
(16:10):
it raises the question of whether women need to.
Speaker 1 (16:12):
Go through menopause at all.
Speaker 3 (16:14):
How far along do you think we are in the
science of menopausal delay.
Speaker 4 (16:18):
Okay, so there's a philosophical issue about the concept of
menopausal delay. If you've got a thirty five year old
woman who's about to have major surgery and radiation for
a condition that's going to affect her ovar east removing
those overaries, freezing them and putting them back in when
she's leisure recovered makes a huge amount of sense to me,
and that is being done now successfully. However, what we
(16:40):
do no categorically is that the laser you go through
menopause see Grady or breast cancer risk is so, if
you've got a fifty five year old woman who's gone
through menopause versus a fifty five year old woman who hasn't,
the one who's gone through menopause will have a lower
risk of breast cancer. Now she goes on estrogen, we
are not going to give her as much estrogen as
(17:02):
she would be getting as if she was still menstruating
and ovulating. So the hormone replacement therapy gives back estrogen,
but not to the level that you had when you
were young and your ovaries were working. If we delay
menopause and women in their sixties and even seventies are
still ovulating, the danger is that we are going to
(17:23):
increase risks of other conditions. Our bodies are not designed
to go through menopause in our sixties and seventies, and
there will be other risks and there's no controlling it.
Whereas we can control the hormone levels. Do you want
to be having PMS when you're sixty five.
Speaker 1 (17:40):
Or even just a period when your seventy sounds awful?
Speaker 4 (17:42):
Yes, So if we delay menopause and keep functioning over is,
we're going to have all those issues going on to
women in their sixties, all the things that women are
relieved to get away from by going through menopause. So
it's a different gain to hormone replacement therapy.
Speaker 3 (17:58):
He is it really true that you're in a LaBier
can disappear when you hit menopause.
Speaker 4 (18:02):
No, your labia do not disappear. Your vaginal tissue can
shrink a bit, they don't disappear.
Speaker 3 (18:09):
Should menopause A women be wearing weighted vests when exercising.
This is the thing that's been marketed at me and
quite a few of my friends quite heavily.
Speaker 1 (18:19):
Is it beneficial?
Speaker 3 (18:20):
We know that weight bearing exercise is beneficial for our
bone density, for example, at this stage of life, but
is wearing something like a weighted vest going to help.
Speaker 4 (18:27):
Exercise is critically important for women of all ages, and
whether you wear a weighted vest or not, it's really
it's a commercial thing. I mean, you should do a
whole range of different exercises. You should be doing exercise
to keep your heart rate up and benefit your heart.
You should be doing exercise that's impactful for your bones,
(18:49):
but you can do that without a weighted vest.
Speaker 3 (18:52):
There's a lot of dietary advice as well coming at
menopausal women right now, but the overwriting message seems to
be that women in this phase of life need more
protein and more fiber in their diet. Would you say
yes or no to that?
Speaker 4 (19:03):
Women in their entire life need more protein and more fiber.
So don't wait till menopause to start focusing on these things.
Start focusing on that when you're twenty and thirty and forty,
So when you get to menopause, it's not even the drama.
Speaker 3 (19:17):
Menopause is having his moment in the sun, though, which
is really important because it hasn't had its moment and
we have been overlooked as women in the healthcare system
in this moment of our lives. But it's also going
to come with a lot of people trying to make money.
Speaker 1 (19:32):
Off of us.
Speaker 3 (19:33):
So I guess we need to be really wary of
claims that aren't medically substantiated, where do you suggest women
go to be informed about menopause at this time.
Speaker 4 (19:43):
I think some of the best websites are the Osculation
Menopause Society has great fact sheets, The International Menopause Society
has podcasts for the general public and for doctors, and
gin House for Women's Health in Australia. They're all great.
We have great resources in Australia, so people should use them.
Speaker 3 (20:02):
I'd love to know from you too, when are Australian
women in perimenopause? Because we're told it's a symptoms based thing.
When the symptoms are bad, like when our periods start
to get a little bit out of control, that's when
we're officially in perimenopause. But do we have a definitive
way of actually knowing when it's arrived.
Speaker 4 (20:21):
So the onset of perimenopause is based on symptoms and
what our study published in July showed very clearly that
the screaming marker of the perimenopause is new on set
hot flushes or night sweats. So women who even find
that their periods have become dramatically heavier or lighter, if
(20:41):
they have hot flushes and night sweats, they're probably in perimenopause.
Now those when will go their doctor and their doctor
will say, oh, but your periods are still regular. Well,
we've shown that simply having new on set hot flushes
and night sweats in combination with some change in your
menstruation is a very solid indicator. The tricky part is
(21:03):
women who have a hormone liud, a hysterectomy, or have
had an endometrial ablation aren't menstruretting, so they don't know
when their periods are going to change. And again we
would suggest if those women suddenly start getting hot flushes
in night sweats, they are entering Perry menopause. That's the
greatest market we could find.
Speaker 3 (21:23):
So waking up in a puddle of your own sweat
on a regular basis, so not just like a ones off,
but regularly, that's really the market to say, hey, Perry's arrived.
Speaker 4 (21:33):
Yes, and every woman experiences differently. Someone was saying I
don't have a hot flush, but then they're throwing the
bed covers off or they feel like they're burning inside,
but they don't flush, So it's the language we use.
But really, loss of heat control is a really major symptom.
Speaker 3 (21:49):
Mariam, what do you think about what Professor Davis said
about the science of pery and menopause. There is so
much misinformation around.
Speaker 1 (21:56):
Prof Davis is a much needed voice of reason. There's
so much noise and misinformation around pery and menopause. Right
now it's having its moment. That's amazing, but it'll also
becoming a bit of a cash grab. So everywhere you look,
someone's trying to sell a supplement, or a hormone cream
or a miracle menopause diet. But she reminds us that
(22:19):
this is a natural life stage, a transition. It's not
a disease, and while the symptoms can be disruptive, there
are evidence based treatments that are hormonal or non hormonal
that can work for you. But we need to be careful.
Just because it's finally getting its time in the sun,
it doesn't mean every product being pushed online is legitimate
(22:42):
and will work for you. Being informed is powerful and
protects us from being exploited. I loved her short, sharp chin.
Speaker 3 (22:50):
It's still some of those that's what we need in
this day and age. All right, next, it's time for
today's quick consult. A Deck's had a procedure, which means
she no longer has some.
Speaker 1 (22:57):
Of her reproductive organs. So does that mean she no
longer ever has to see a certain.
Speaker 3 (23:02):
Doctor ever again?
Speaker 1 (23:03):
We'll find out alrighty.
Speaker 3 (23:10):
For those of you wondering how you get a question
to our good Dr Mariam, who will give you general advice,
as we stress, general advice which you can then arm
yourself with and take to your own GP. There is
a few ways you can do so shoot us an
email well at mammamea dot com dot au as you
are wildly scrolling through your social media just hold for
(23:31):
a second, especially hopefully if you're looking at Wells social media,
send us a DM we will read it. Or you
can be anonymous and pop into the waiting room. There
is a link to that in our show notes and
you can tell us like what topic you want to
talk about and what your exact question is it, or
guide you through it step by step. The doctor will
see you.
Speaker 5 (23:50):
Now.
Speaker 4 (23:50):
Just through here to consort room one.
Speaker 1 (23:54):
Okay, Mariam, it is time. Thank you for waiting. How
can I help you? Mariam?
Speaker 3 (23:58):
I'm going to take the answer that you give to
a day today to some of my friends who have
some very recently but some quite a time ago had
their uterize uterine uteruses. However, you say it removed, because
I feel like this is something that I would want
to know the answer to it does well. So A
Deck wrote in and she said.
Speaker 5 (24:20):
I'm forty nine and I had a hysterectomy twenty two
years ago now and I haven't seen a gynecologist since.
Is this something I should still be doing?
Speaker 1 (24:31):
Great question. The impact really depends on the type of
hysterectomy you had and whether or not your ovaries were
removed during the process. So a total hysterectomy, which she's
mentioned she's had, a full hysterectomy removes both the uterus
and the cervix, while a subtotal hysterectomy removes the uterus
but leaves the cervix intact. Sometimes the ovaries are also
(24:54):
removed during the procedure, and that's called a bilateral upherectomy,
and that's when you can get kicked into menopause. Really,
that's right, So why does this matter? If your ovaries
were removed, you'll enter surgical menopause and that can affect
your bone and heart health over time. But if your
over ears were left, then you'll experience a natural menopause
but without periods, so it can be harder to tell
(25:17):
when you're in that perimenopause transition. That's why knowing the
signs of perimenopause and when to see care is important.
So yes, it's a good idea to have, like a
midlife health review, even if you feel fine. A GP
not necessarily a gynecologist is a good place to start,
and they can review your bone and heart health. Check
for any eurogenital symptoms like bladder issues, vaginal changes, or
(25:40):
libido changes. Discuss hormonal therapy or non hormonal therapy if
that's something you want to explore, and shure you're up
to date with other screenings like your mammograms, your bow
cancer screenings, etc. So what about cervical cancer screening formerly
known as perhaps ME. If your cervix was removed and
your cervical screening history was normal prior, then you don't
(26:02):
need further cervical cancer screening or PAP tests. But if
you had a subtotal so your cervix is still in
city still there, or you had abnormal screenings prior to
the surgery, you should continue regular cervical cancer screening as
advised by your doctor or the National program. If you're
not sure what type of hysterectomy you had, your GP
(26:25):
or gynecologists can help check your records and go from there.
But yeah, so hysterectomy changes how we screen, but it
doesn't mean stepping back from your health. At forty nine,
it's a perfect time for a proactive health check, so
definitely start by seeing your GP.
Speaker 3 (26:40):
So not having a uterust does not remove you from
getting that area checked. No, he is the short answer
for that. That is such a good question. I didn't
even think about that. Yeah, in that instance, like you
would presume that if you don't have anything there, that's it.
Speaker 1 (26:56):
Look at what I get it looked at. That makes sense.
Speaker 3 (26:59):
Thank you for that great question a deck, and also
thank you to people who've been sending us.
Speaker 1 (27:03):
Some really great feedback of late, like it's.
Speaker 3 (27:06):
Really nice to read what you guys think of the
show and what you've been doing with the information that
you've been getting from us and taking it to your GPS.
And also, look, I've got a bit of a cheeky
ask if you wouldn't mind going and rating and reviewing us, Oh,
please do.
Speaker 1 (27:21):
In a podcast. I've been getting great reviews from health
professionals as well, which I.
Speaker 3 (27:25):
Have been getting some feedback from lots of doctors so nice. Yeah, yeah,
it's amazing, So thank you so much people who do that.
But if you do rate and review us, it means
like we can potentially get into some more people's ears too,
So if you would not mind. Of course, as we
do every week, we need to remind you that everything
that you have heard here today, all this information is
general advice.
Speaker 1 (27:43):
It is not specific to you.
Speaker 3 (27:45):
Even if you really resonate with it and feel like
that is something that you're experiencing, it might be for
a different reason. You might have a different level of it.
You might need different treatments than we've discussed today too,
So make sure you take all that information to your
own GP and get that specialized advice that is just
right for you. Now, if you have questions about perimenopause, menopause, HRT,
(28:08):
SLASH as we call it, everything in between, get cracking now,
because next week we're going to have our Q and
A with yourself, Mariam and with some of our experts,
so excited who are going to answer a lot of
these questions. So, as we mentioned before, there's a few
ways you can get questions to us emails DM's waiting
room in the show notes, Get on it, Mariam, Thank
you again.
Speaker 1 (28:28):
We'll see you for your appointment next week. Bye Bye.
Speaker 3 (28:30):
Well is produced by me Claire Murphy, senior producers Sasha
Tanic and Sally Best, with audio production by Scott Stronik,
video production by Julian Rosario, and social production by Ellie Moore.
Speaker 2 (28:45):
If you want to hear more about women's health, Well
is your full body health check and it drops every
week on a Thursday.
You're listening to a Mamma Mia podcast.
Speaker 2 (00:13):
Mamma Mia acknowledges the traditional owners of land and waters
that this podcast is recorded.
Speaker 1 (00:18):
On out louders.
Speaker 2 (00:20):
It's Holly here, Welcome to your Sunday special. We like
to drop your little treat sometimes in the feed, and
today we're bringing you an episode of Mamma MIA's women's
health podcast, well hosted by Dr Mariam and Claire Murphy,
with whom you are very familiar because she often pops
up on out loud. And this episode is all about
(00:40):
Perry menopause. Yes, that very important topic. They will be
sorting the facts from the fiction in here, including whether
or not your labbya really does start disappearing when you
hit Perry, and they'll unpack whether some of the things
you're being sold on social media, like weighted vests and
special supplements and protein everything, are really everything they're cracked
(01:02):
up to be. They're also going to take you to
med school where Dr Mariam and Claire are going to
talk about the origin of the c sex and they're
going to do a quick little consult to find out
whether you still need to see a guynecologist if you've
had a hysterectomy. Please enjoy this episode of Well.
Speaker 3 (01:25):
Hi there, I'm Claire Murphy, Australian Women. Welcome to your
full body health check. As I have established if you've
been listening over the last few weeks, I am deep
in Perry menopause territory and I would like to say
I think I'm finally getting a handle on it. It's
taken me a bit, but I feel like I'm there,
which is good.
Speaker 1 (01:42):
I love it. And I'm doctor Mariam, I'm an Australian GP.
It's time our training reflected reality. Females deserve better because
a lot more women deserve more than silence when it
comes to this transition in their life.
Speaker 3 (01:57):
Coming up today, Mariam, the science of Perry, menopause and menopause.
What do you recall from your training about menopause Little
to nothing. Well, if it's any consolation, I've been chatting
to a band student to try and find out how
(02:17):
much they're getting now and he did say to me, yes,
they have had a full year in obstetrics and part
of that has been a focus on menopause and like
endometriosis and things that are impacting women quite significantly, and
they are getting more training now.
Speaker 1 (02:31):
So hobst generation I hope. So.
Speaker 3 (02:34):
I mean, I've also got a friend whose doctor is GENZT,
like the eldest of the gen zs are now old
enough to be your doctor, which makes me feel ridiculously old.
There's so much happening around the discussion and menopause. There's
a lot happening online right now. You might have seen
if you are in the same threads as me, weighted vests,
(02:55):
vaginal estrogen disappearing, labia, more protein, more fiber. So we're
going to unpack a lot of those things today, and
you've probably been told a lot of these things in
your social media feed. We're going to find out what
is actually benefit official and what is actually useful when
it comes to menopause. Will also pop in a time
for a quick consult for Adek today.
Speaker 1 (03:16):
Now she's had her uterus out.
Speaker 3 (03:19):
She's quite happy about that, to be honest, but she's
not sure if she still needs to keep up certain
health checks now that it's gone. We're also going to
head to med school too, because Mariam, you know me.
You know I'm a history nerd, and I've been delving
back into a little bit of medical history.
Speaker 1 (03:33):
I love this stuff.
Speaker 3 (03:34):
This week, tell me, do I have a story for you.
I Am going to tell you how a pig car
strator helped change how we give birth.
Speaker 1 (03:44):
That's happening school next, Welcome to med school.
Speaker 3 (03:48):
Okay, we have established I'm a history nerd. Anything that
delves back into the past I'm writing into and from
researching this show, I've been able to really tap into
medical history stuff, which is it's a wild place to be.
When we figured out how to do stuff to humans,
Like the way we did that not acceptable in today's terms,
but like back then, we just did what we had
(04:09):
to do right. So I was literally today years old
when I found out the origin of the first ever
reportedly allegedly because we don't know fo one hundred percent
sure successful caesarean section okay on a human being yep,
Because this was happening on animals before it was happening
on humans. It was not done by a doctor. It
(04:30):
was done by a Swiss pig guilder. Oh okay, what
is a pig guilder?
Speaker 1 (04:35):
We will get to that.
Speaker 3 (04:37):
It's the year fifteen hundred. Elizabeth is pregnant, she is
about to have a child. She is a wife of
a man named Jacob Nufa. Now, she was struggling to
give birth. As you know, we know, the ability for
women to survive childbirth back then was nowhere near what
we have today. She'd been in labor for days and
(04:58):
despite the best efforts of all the midwives who were
around her, none of them could deliver that baby. Now, Jacob,
you might remember, as I mentioned, is a pig guilder.
It essentially means he dissexes p so he lobs the
nuts off the boys, and he whips out the uteruses
of the girls unless they are the breeding kind. So
he was also though used to helping those pigs give birth,
(05:20):
and in some of those instances they had to remove
the piglets surgically. He's feeling pretty desperate by this point, right,
He's looking at his beautiful wife Elizabeth and seeing her struggle,
and he wants to save both the life of his
wife and his unborn child. He decides to step in
and save her himself. Now, he had done similar surgeries
like this, as I mentioned, but not just on pigs.
(05:41):
He'd done it on cows, He'd done it on horses,
so he kind of had a little bit of an
idea what to do. Back then, pig carstraders would sometimes
do sea sections if they thought the mother might die,
just to save the babies, and midwives were aware of
the method, but in the early fifteen hundred, sea sections
were only allowed if the mother had died, so it
wasn't to save her life, it was to save the
(06:03):
baby's life. Jacob had to get special permission from authorities
to perform this surgery because Elizabeth was still very much alive,
so he got the permission. He caught in a bunch
of midwives to help him out, thirteen in fact, but
only two of them would agree to do this because
it was so much against regulations. Using a razor blade,
he cut open Elizabeth, removed their stuck baby, sewed her
(06:27):
back up, and she survived. The baby also survived.
Speaker 1 (06:32):
And not only did Elizabeth survive this surgery, she went
on to have five more children, including a set of twins,
which means he did a decent enough job that her
uterus was still fully functional after all. My god, I'm
eagle parts horrified and impressed, right like, no sterile gloves,
no anobetic no antibiotics, oh my god, no antibotics. And
(06:53):
he just had a razor blade. I hope it wasn't
one that he had pigs. Hopefully he washed his hands beforehand.
And that's all. She survived and went on to have
five more, like I can barely survive day care drop off.
Speaker 3 (07:07):
I know her Elizabeth, Like what an absolute champion, Jacob
geez look at. Some historians do debate whether the pregnancy
was actually in uterine, so there is some debate about that.
But this wasn't actually discovered until eighty years after it happened,
when someone translated a French physician's diary and they discovered
what had happened. But I can tell you now that
(07:29):
baby lived until they were seventy seven years old. But
fun fact, the origin of the word cesarian obviously comes
from the old Roman days. And I mean this is
also debated too. This was part of this whole idea
that you could only cut the baby out if the
mother was pretty much dying or dead. And it was
something that Julius Caesar put out there and said, like
that's the way that you're allowed to cut out a baby.
(07:50):
So it was called a Caesar Ah.
Speaker 1 (07:53):
The section park came a little bit later, very un
brand for the romans to make it dramatic.
Speaker 2 (07:58):
But there you go.
Speaker 3 (07:59):
A history lesson for today. Thank you Jacob Nufa and
Pig car Strator and caesarean section.
Speaker 4 (08:05):
Do it is?
Speaker 3 (08:07):
It's just so cool, all right, get into the reason
we are here today, the science of perimenopause. There's a
lot happening in discussions around the world about it right now.
We are about to bust some myths for you.
Speaker 1 (08:19):
Let's do it.
Speaker 4 (08:20):
It's time for the checkup.
Speaker 3 (08:23):
Mariam, what did the wise old women in your life
tell you about menopause?
Speaker 1 (08:28):
Honestly nothing, yep, not much at all. It was like
whispered slide comments like she's moody, she's sweat and buckets,
but no one said the word menopause. I was referenced
it as the change, the change, No big chat, no guidance,
just silence and suffering with the side of peppermint tea.
Yeah yeah, so I feel like the female's mom and
(08:49):
grandma was strong, but they were also left in the dark.
But now we have the science, we've got the language,
we've got the platforms, so we should happily say the
words perimenopause and menopause out loud. Yeah. One hundred percent.
I was the same.
Speaker 3 (09:02):
I heard nothing, And I think my understanding of menopause
was probably similar to many other peoples in that you
suffered some hot flashes and then period stopped, and that
was the definition of menopause for a long time.
Speaker 1 (09:14):
And it would happened over a really short period of time. Yeah,
it was just you know, a little.
Speaker 3 (09:18):
Like you hear your rainy fifties or something. Maybe, yeah,
and then it's all over. And it was only when
and I've mentioned this Mum and Mia held the very
peary summit, that I understood that it was a whole
bunch more than that, and that all the symptoms that
go with it, and then it can be something you
suffer through for ten years or more for some people
if you go through menopause really early, so it can
be a bit of a wild ride. Is the Australian
(09:39):
medical industry well versed enough you think about this stage
of women's lives?
Speaker 1 (09:43):
Short answer, not yet. Okay, the Australian medical system is
getting better, but definitely going in the right direction. But
I think we've still got a bit of cat shop
when it comes to perimenopause and menopause. Most gps want
to help absolutely, but the reality is women's midlife health
hasn't been prioritized in our medical training. It's great that
(10:05):
your friend mentioned that it is something that's starting to
change and something that they're but many doctors simply weren't
taught how to recognize or treat it appropriately. And then
there's a lot of outdated fears and lots of fear
for prescribing, as we've mentioned the World Health WHI study
back in two thousand and two, and then you've got
a lot of women told to just write it out
(10:27):
or you know, just write it out.
Speaker 4 (10:29):
Try.
Speaker 3 (10:29):
I cannot imagine if someone told me to ride this out,
like goodness, yeah, that's really tough.
Speaker 1 (10:34):
But now we've got brilliant resources. The Australasian Menopausal Society
has got some amazing information for doctors and patients and
a growing number of us are upskilling, which is so
nice to see because a lot more women deserve more
than silence when it comes to this transition in their life.
So no, we're not there yet, but the conversation is
(10:55):
finally happening loudly and that is a good start. Amazing.
We do have a lot to get through today. Let's
do it.
Speaker 3 (11:02):
Professor Susan Davis is going to help us unravel and
unpack perimenopause and menopause science claims, So stick around.
Speaker 1 (11:08):
She's going to join us.
Speaker 3 (11:09):
Next scrolling menopause reels, or pery talk as it's referred
to Lovatt. There are millions of different things that we're
being told are beneficial about this phase of your life,
which look to be honest, is better than deadly silence.
(11:30):
We want it to be out there, but as we know,
and as we've discussed with lots of different women's health issues,
it can be misleading, and you've got to read between
the lines that sometimes you're being sold something rather than
something that might actually be beneficial. And this was described
to me a little while ago that women who are
now of perimenopausal or menopausal age are potentially the last
(11:52):
cohort of women who were really marketed weight loss stuff
and now that they're no longer really in that period.
And also with the introduction of weight loss medications, as
we've discussed in the past two the focus has shifted
to start marketing menopause related items to so we need
to really tread carefully and figure out what is actually
(12:13):
true and what is fact and fiction in this So
with all of that information and potential misinformation, maybe we're
not sure what to make of it all. So Monash
University's professor Susan Davis is going to help us unravel
that peri fact from menofiction today. She is one of
the five founders of Gene House for Women, is a
past president of the Australasian Menopause Society, which you've mentioned
(12:36):
a few times, Mariam, and also the International Menopause Society.
And we started off by asking Susan about the claim
that having endometriosis increases your chance of going into metopause early.
Speaker 4 (12:49):
I'm not aware of any day that that supports endometriosis
as a condition causing an earlier menopause, but a lot
of women who've had endometriosis have lots of surgeries, and
we do know if you have a lot of abdominal
surgeries related to the uterosity overreas, you can impair the
blood supply and that can potentially trigger a slightly slightly
earlier menopause. And the hysterectomy, for example, is associated with
(13:12):
a very slightly earlier menopause.
Speaker 3 (13:15):
Is it true that the earlier you get your period,
the earlier you're likely are to hit menopause.
Speaker 4 (13:21):
That's not necessarily the case. In fact, the biggest predictor
of when you're going to go through menopause is when
your mother or your older sister went through menopause. The
other factors that are associated with earlier menopause, as I said,
hysterectomy and smoking, but those factors only pushed the menopause
earlier by maybe twelve months, not many, many years.
Speaker 3 (13:41):
I guess we have to get our moms to actually
start talking about when they got into menopause. It wasn't
a conversation they had a lot. I was also reading
that menopause might exacerbate other issues. So when you do
hit that period, when your hormones start to go a
little bit wild, can it start to interact with other conditions,
say dyslexia and ADHD and things like that.
Speaker 4 (14:02):
One of the most common symptoms of menopause is sleep deprivation,
so erratic sleep, waking up not feeling refreshed. So if
your sleep is impaired, any other health condition will be exacerbated,
whether it be your ostereoarthritis, your mental health issues, your
rheumatological issues, any other condition you've got will be exacerbated
(14:23):
by sleep deprivation. So it's not really an interaction between
hormones and a particular condition necessarily, but rather all these
other changes in your body is suddenly happening and that
will influence any other health condition.
Speaker 1 (14:36):
Can we talk about vaginal estrogen.
Speaker 3 (14:39):
We've done a whole topic of MHT, so we've got
a good understanding of taking it orally and viraygel or
a patch. But there's a lot of conversation around vaginal
estrogen and a lot of us are under the impression
that you only really used that for vaginal dryness, but
the conversation now is around it potentially protecting you from UTIs.
(15:00):
Do we understand that to be the case?
Speaker 4 (15:01):
Okay, So vaginal dryness and vaginal symptoms tend to emerge
in late perimenopause early menopause. It's not one first symptoms.
And the symptoms of the go along with vaginal dryness
are urinary frequency, like getting up multiple times in the
night to pee, a sense you've just got to rush
to the toilet. You're in the urgency, and vaginal estrogen
(15:26):
can alleviate those symptoms. But one of the best studies
was done in the nineteen seventies that showed that even
a symptomatic women who used vaginal estrogen had less urinary
tract infections. So even a sixty year old or a
seventy year old woman who has no other menopausal symptoms
probably should still be using vaginal estrogen twice a week
(15:47):
to protect her bladder and her vaginal tissues.
Speaker 3 (15:50):
There is a lot of research going on right now,
but I think the one that really stood out for
me when it comes to menopause is a lot of
people are looking into various ways of delaying the onset
of menopause, Like, for example, there's one that is looking
at engineering young ovarian support cells and developing drugs that's
lower varying depletion, and then if it is successful, for example,
(16:10):
it raises the question of whether women need to.
Speaker 1 (16:12):
Go through menopause at all.
Speaker 3 (16:14):
How far along do you think we are in the
science of menopausal delay.
Speaker 4 (16:18):
Okay, so there's a philosophical issue about the concept of
menopausal delay. If you've got a thirty five year old
woman who's about to have major surgery and radiation for
a condition that's going to affect her ovar east removing
those overaries, freezing them and putting them back in when
she's leisure recovered makes a huge amount of sense to me,
and that is being done now successfully. However, what we
(16:40):
do no categorically is that the laser you go through
menopause see Grady or breast cancer risk is so, if
you've got a fifty five year old woman who's gone
through menopause versus a fifty five year old woman who hasn't,
the one who's gone through menopause will have a lower
risk of breast cancer. Now she goes on estrogen, we
are not going to give her as much estrogen as
(17:02):
she would be getting as if she was still menstruating
and ovulating. So the hormone replacement therapy gives back estrogen,
but not to the level that you had when you
were young and your ovaries were working. If we delay
menopause and women in their sixties and even seventies are
still ovulating, the danger is that we are going to
(17:23):
increase risks of other conditions. Our bodies are not designed
to go through menopause in our sixties and seventies, and
there will be other risks and there's no controlling it.
Whereas we can control the hormone levels. Do you want
to be having PMS when you're sixty five.
Speaker 1 (17:40):
Or even just a period when your seventy sounds awful?
Speaker 4 (17:42):
Yes, So if we delay menopause and keep functioning over is,
we're going to have all those issues going on to
women in their sixties, all the things that women are
relieved to get away from by going through menopause. So
it's a different gain to hormone replacement therapy.
Speaker 3 (17:58):
He is it really true that you're in a LaBier
can disappear when you hit menopause.
Speaker 4 (18:02):
No, your labia do not disappear. Your vaginal tissue can
shrink a bit, they don't disappear.
Speaker 3 (18:09):
Should menopause A women be wearing weighted vests when exercising.
This is the thing that's been marketed at me and
quite a few of my friends quite heavily.
Speaker 1 (18:19):
Is it beneficial?
Speaker 3 (18:20):
We know that weight bearing exercise is beneficial for our
bone density, for example, at this stage of life, but
is wearing something like a weighted vest going to help.
Speaker 4 (18:27):
Exercise is critically important for women of all ages, and
whether you wear a weighted vest or not, it's really
it's a commercial thing. I mean, you should do a
whole range of different exercises. You should be doing exercise
to keep your heart rate up and benefit your heart.
You should be doing exercise that's impactful for your bones,
(18:49):
but you can do that without a weighted vest.
Speaker 3 (18:52):
There's a lot of dietary advice as well coming at
menopausal women right now, but the overwriting message seems to
be that women in this phase of life need more
protein and more fiber in their diet. Would you say
yes or no to that?
Speaker 4 (19:03):
Women in their entire life need more protein and more fiber.
So don't wait till menopause to start focusing on these things.
Start focusing on that when you're twenty and thirty and forty,
So when you get to menopause, it's not even the drama.
Speaker 3 (19:17):
Menopause is having his moment in the sun, though, which
is really important because it hasn't had its moment and
we have been overlooked as women in the healthcare system
in this moment of our lives. But it's also going
to come with a lot of people trying to make money.
Speaker 1 (19:32):
Off of us.
Speaker 3 (19:33):
So I guess we need to be really wary of
claims that aren't medically substantiated, where do you suggest women
go to be informed about menopause at this time.
Speaker 4 (19:43):
I think some of the best websites are the Osculation
Menopause Society has great fact sheets, The International Menopause Society
has podcasts for the general public and for doctors, and
gin House for Women's Health in Australia. They're all great.
We have great resources in Australia, so people should use them.
Speaker 3 (20:02):
I'd love to know from you too, when are Australian
women in perimenopause? Because we're told it's a symptoms based thing.
When the symptoms are bad, like when our periods start
to get a little bit out of control, that's when
we're officially in perimenopause. But do we have a definitive
way of actually knowing when it's arrived.
Speaker 4 (20:21):
So the onset of perimenopause is based on symptoms and
what our study published in July showed very clearly that
the screaming marker of the perimenopause is new on set
hot flushes or night sweats. So women who even find
that their periods have become dramatically heavier or lighter, if
(20:41):
they have hot flushes and night sweats, they're probably in perimenopause.
Now those when will go their doctor and their doctor
will say, oh, but your periods are still regular. Well,
we've shown that simply having new on set hot flushes
and night sweats in combination with some change in your
menstruation is a very solid indicator. The tricky part is
(21:03):
women who have a hormone liud, a hysterectomy, or have
had an endometrial ablation aren't menstruretting, so they don't know
when their periods are going to change. And again we
would suggest if those women suddenly start getting hot flushes
in night sweats, they are entering Perry menopause. That's the
greatest market we could find.
Speaker 3 (21:23):
So waking up in a puddle of your own sweat
on a regular basis, so not just like a ones off,
but regularly, that's really the market to say, hey, Perry's arrived.
Speaker 4 (21:33):
Yes, and every woman experiences differently. Someone was saying I
don't have a hot flush, but then they're throwing the
bed covers off or they feel like they're burning inside,
but they don't flush, So it's the language we use.
But really, loss of heat control is a really major symptom.
Speaker 3 (21:49):
Mariam, what do you think about what Professor Davis said
about the science of pery and menopause. There is so
much misinformation around.
Speaker 1 (21:56):
Prof Davis is a much needed voice of reason. There's
so much noise and misinformation around pery and menopause. Right
now it's having its moment. That's amazing, but it'll also
becoming a bit of a cash grab. So everywhere you look,
someone's trying to sell a supplement, or a hormone cream
or a miracle menopause diet. But she reminds us that
(22:19):
this is a natural life stage, a transition. It's not
a disease, and while the symptoms can be disruptive, there
are evidence based treatments that are hormonal or non hormonal
that can work for you. But we need to be careful.
Just because it's finally getting its time in the sun,
it doesn't mean every product being pushed online is legitimate
(22:42):
and will work for you. Being informed is powerful and
protects us from being exploited. I loved her short, sharp chin.
Speaker 3 (22:50):
It's still some of those that's what we need in
this day and age. All right, next, it's time for
today's quick consult. A Deck's had a procedure, which means
she no longer has some.
Speaker 1 (22:57):
Of her reproductive organs. So does that mean she no
longer ever has to see a certain.
Speaker 3 (23:02):
Doctor ever again?
Speaker 1 (23:03):
We'll find out alrighty.
Speaker 3 (23:10):
For those of you wondering how you get a question
to our good Dr Mariam, who will give you general advice,
as we stress, general advice which you can then arm
yourself with and take to your own GP. There is
a few ways you can do so shoot us an
email well at mammamea dot com dot au as you
are wildly scrolling through your social media just hold for
(23:31):
a second, especially hopefully if you're looking at Wells social media,
send us a DM we will read it. Or you
can be anonymous and pop into the waiting room. There
is a link to that in our show notes and
you can tell us like what topic you want to
talk about and what your exact question is it, or
guide you through it step by step. The doctor will
see you.
Speaker 5 (23:50):
Now.
Speaker 4 (23:50):
Just through here to consort room one.
Speaker 1 (23:54):
Okay, Mariam, it is time. Thank you for waiting. How
can I help you? Mariam?
Speaker 3 (23:58):
I'm going to take the answer that you give to
a day today to some of my friends who have
some very recently but some quite a time ago had
their uterize uterine uteruses. However, you say it removed, because
I feel like this is something that I would want
to know the answer to it does well. So A
Deck wrote in and she said.
Speaker 5 (24:20):
I'm forty nine and I had a hysterectomy twenty two
years ago now and I haven't seen a gynecologist since.
Is this something I should still be doing?
Speaker 1 (24:31):
Great question. The impact really depends on the type of
hysterectomy you had and whether or not your ovaries were
removed during the process. So a total hysterectomy, which she's
mentioned she's had, a full hysterectomy removes both the uterus
and the cervix, while a subtotal hysterectomy removes the uterus
but leaves the cervix intact. Sometimes the ovaries are also
(24:54):
removed during the procedure, and that's called a bilateral upherectomy,
and that's when you can get kicked into menopause. Really,
that's right, So why does this matter? If your ovaries
were removed, you'll enter surgical menopause and that can affect
your bone and heart health over time. But if your
over ears were left, then you'll experience a natural menopause
but without periods, so it can be harder to tell
(25:17):
when you're in that perimenopause transition. That's why knowing the
signs of perimenopause and when to see care is important.
So yes, it's a good idea to have, like a
midlife health review, even if you feel fine. A GP
not necessarily a gynecologist is a good place to start,
and they can review your bone and heart health. Check
for any eurogenital symptoms like bladder issues, vaginal changes, or
(25:40):
libido changes. Discuss hormonal therapy or non hormonal therapy if
that's something you want to explore, and shure you're up
to date with other screenings like your mammograms, your bow
cancer screenings, etc. So what about cervical cancer screening formerly
known as perhaps ME. If your cervix was removed and
your cervical screening history was normal prior, then you don't
(26:02):
need further cervical cancer screening or PAP tests. But if
you had a subtotal so your cervix is still in
city still there, or you had abnormal screenings prior to
the surgery, you should continue regular cervical cancer screening as
advised by your doctor or the National program. If you're
not sure what type of hysterectomy you had, your GP
(26:25):
or gynecologists can help check your records and go from there.
But yeah, so hysterectomy changes how we screen, but it
doesn't mean stepping back from your health. At forty nine,
it's a perfect time for a proactive health check, so
definitely start by seeing your GP.
Speaker 3 (26:40):
So not having a uterust does not remove you from
getting that area checked. No, he is the short answer
for that. That is such a good question. I didn't
even think about that. Yeah, in that instance, like you
would presume that if you don't have anything there, that's it.
Speaker 1 (26:56):
Look at what I get it looked at. That makes sense.
Speaker 3 (26:59):
Thank you for that great question a deck, and also
thank you to people who've been sending us.
Speaker 1 (27:03):
Some really great feedback of late, like it's.
Speaker 3 (27:06):
Really nice to read what you guys think of the
show and what you've been doing with the information that
you've been getting from us and taking it to your GPS.
And also, look, I've got a bit of a cheeky
ask if you wouldn't mind going and rating and reviewing us, Oh,
please do.
Speaker 1 (27:21):
In a podcast. I've been getting great reviews from health
professionals as well, which I.
Speaker 3 (27:25):
Have been getting some feedback from lots of doctors so nice. Yeah, yeah,
it's amazing, So thank you so much people who do that.
But if you do rate and review us, it means
like we can potentially get into some more people's ears too,
So if you would not mind. Of course, as we
do every week, we need to remind you that everything
that you have heard here today, all this information is
general advice.
Speaker 1 (27:43):
It is not specific to you.
Speaker 3 (27:45):
Even if you really resonate with it and feel like
that is something that you're experiencing, it might be for
a different reason. You might have a different level of it.
You might need different treatments than we've discussed today too,
So make sure you take all that information to your
own GP and get that specialized advice that is just
right for you. Now, if you have questions about perimenopause, menopause, HRT,
(28:08):
SLASH as we call it, everything in between, get cracking now,
because next week we're going to have our Q and
A with yourself, Mariam and with some of our experts,
so excited who are going to answer a lot of
these questions. So, as we mentioned before, there's a few
ways you can get questions to us emails DM's waiting
room in the show notes, Get on it, Mariam, Thank
you again.
Speaker 1 (28:28):
We'll see you for your appointment next week. Bye Bye.
Speaker 3 (28:30):
Well is produced by me Claire Murphy, senior producers Sasha
Tanic and Sally Best, with audio production by Scott Stronik,
video production by Julian Rosario, and social production by Ellie Moore.
Speaker 2 (28:45):
If you want to hear more about women's health, Well
is your full body health check and it drops every
week on a Thursday.
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