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Welcome to the Dear Menopause podcast.
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I'm Sonia Lovell, your host Now.
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I've been bringing you conversations with amazing menopause experts for over two years now.
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If you have missed any of those conversations, now's the time to go back and listen, and you can always share them with anyone you think needs to hear them.
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This way, more people can find these amazing conversations.
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Needs to hear them.
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This way, more people can find these amazing conversations, jo.
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Welcome to this week's Hot Take.
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Hi, sonia, I feel like it's been quite a while.
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It has been since they called the election.
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It was the last time that we had a conversation because we had been talking a lot about the announcements that were being made and the lead up to the election being called around women's health and funding and yeah, but that kind of.
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I felt like everything kind of paused for a period of time there, like not just the election stuff but also what was happening in our space a little bit outside of politics.
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I felt like there was this little lull, but there's been some good stuff happening and we have come back together to talk it all out.
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Where do you want to start?
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And there are a long list of things to talk about.
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Well, don't freak everyone out, it's not that long.
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Okay, how about I give everyone a brief overview of what we're going to talk about, so that no one does get freaked out and think that we're here for five hours?
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Okay, so we're going to start talking about the infamous podcast episode that was released, probably about a week ago now, between Dr Rachel Rubin and Dr Peter Atiyah, so we're going to dive into that.
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We're going to talk about an interesting fact that I learned recently while listening to a completely different podcast about Jamila Rizvi, who is an Australian journalist, so I want to talk about her.
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And then we are going to do some political talk, because we now know that the Labor Party is back in power, we know that there's been some shift in cabinet seats and things like that, so we're going to chat through all of that.
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How's that sound?
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Sounds absolutely brilliant, all righty.
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Sounds absolutely brilliant, all righty.
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Let's get the ball rolling then with the amazing podcast that we all learned about last week between Dr Rachel Rubin who, for anyone that's listening and doesn't know, is a urologist, and she is an American urologist and she sat down to talk to Dr Peter Atiyah.
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Now, peter Atiyah kind of sits for me in that bro podcasting kind of space.
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He's a medical doctor, he is an active doctor, he sees patients, but he is known for those big, long bro kind of fitness, longevity, health kind of podcasts, and so I was really surprised to see him sit down with Rachel, really excited to listen to it.
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It's a two and a half hour podcast, so it is much longer than podcasts I would normally listen to for sure.
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So I broke it down.
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Here's my hot tips for listening to it Break it into chunks, oh.
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And the other thing that I did, which I've never done before, which I think helped as well, was I actually watched the YouTube version of it rather than listening to just the audio, and I found that that kept me much more engaged for a longer period of time, watching them actually go back and forth and have a conversation.
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So the topic of the podcast was about predominantly menopause, hrt, specifically vaginal health, and GSM, because Rachel being a urologrologist, that's a big part of her field, but a lot oh my god it was.
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It was just like everything that you could possibly want and need to know about menopause and perimenopause in this one conversation in one podcast, I agree.
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So when I saw how long it was, I was like like gosh.
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But yeah, like you, I broke it down into a couple of different walks with my dog and I've actually now listened to it twice because you get to a point I don't know if you do, sonia like I've been very immersed in this space now for three years, and then personally, before that, I was sort of like, oh, can there be that much new in there?
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And yeah, there's so much that I was like, oh, I've never heard explained like that or I took away new information.
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It's also sparked a whole lot of curiosity.
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So, you know, one of the things that I think I mentioned to you before was Rachel talks about a whole lot of MHT products which I had never heard of and which made me clearly go well, they're not in Australia and then why aren't they in Australia?
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And now I want to know more about them, and why can't Australian women have that breadth of choice?
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So yes, I've already started down a rabbit hole of like oh, vaginal rings for MHT.
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I want to know more about that.
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Yeah, that was fascinating when she was talking about that.
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There was a piece that I really nerded out on that like this was a piece that I really nerded out on that like this.
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No, I don't expect anyone else to nerd out on this, but I absolutely did.
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They were talking about pathology tests and particularly when they're doing pathology tests to measure hormone levels in the blood, and they got really nerdy around the different serums that are used or the different assays that are used within different pathology testing companies and the impacts that they had on some of the molecules in the blood which would then mask the actual, true hormone levels.
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And so it was like I use this company, you know, and this is why.
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And he was like, yeah, the same, I've found that that company is.
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And I was like, man, this is nuts that it can even come down to and this is obviously American information, but I'd be keen to know what the similar situation is here.
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It can even come down to what pathology company tested your bloods as to the accuracy of those results yeah, that made my brain hurt, because then I was like now I want to know in Australia, are there, is there similar differences across lab testing and pathology, and they go into a lot of detail on a couple of different things which, yeah, I really liked as well.
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You know, I think you know everything about your period, but Rachel used this really cool car analogy to engage.
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She's like Peter, I hear you know you love cars and Formula One and the way she described it.
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I'm actually going to, you know, love cars and formula one and um, and the way she described it.
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I'm actually gonna, you know, get my daughter to listen to it because it for me, it was the clearest description that I've ever had of of what happens to your estrogen levels, um, across your cycle and then in perimenopause, that it basically you, your car has run out of fuel and it is, it is empty, and it just really crystallized to me.
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Oh, that explains a lot, and so I thought there was something in it that would be very easy for if you don't have a, you know, particularly medical understanding of how it works.
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It just it just jumped out at me as something.
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It's a really great visual analogy, isn't it?
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Yeah, and it really connected with him.
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One of the other things that I really liked about listening to the two of them have a conversation was it was two peers.
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Excuse my Kiwi accent on that, I'm not talking about fruit Two peers speaking to each other at the same level.
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There was no fangirling or fanboying.
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There was no.
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I'm the doctor, you're just a podcast host.
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There were two equals meeting to have a conversation that was highly evidence-based, very clinically and anecdotally evidence-based as well, because they spoke a lot about well, I see patients in my clinic and this is how I've treated them and this is what I've seen and this is how I manage this type of patient.
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Just the two of them together.
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I got so much more than this than I ever could have expected to.
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No, no, I'm the same, and I've actually sent it to everyone in my network today saying you have to listen.
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Yeah, and I did too.
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I think I actually even went out on a limb and did a social media story where I just said this is the best podcast that has been recorded to date on this topic.
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And it's also very accessible.
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In that, Rachel, just I mean I guess Peter does as well I've never listened to one of his podcasts before, but it is just very.
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You don't realise that you're listening to something that's over two hours because you're so engaged in the conversation.
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It's medical but not medicalized, so you're sort of like wanting to know where it's going to go next and what they're going to talk about, and it just feels like a conversation amongst friends yeah, a hundred percent.
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And I actually had coffee with a good friend of mine who's a little bit of a mentor in the business space as well as he's very invested in health and women's health A guy in his late forties and the first thing he said to me was have you listened to the Rachel Rubin, peter Atiyah podcast?
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I was like, yeah, what did you think?
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He was like the best, the best.
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And I was like, okay, cool.
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Well, if it's connecting with him and it's connected with us in the same way, that says a lot.
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Yeah, I agree, so you can connect it in the show notes.
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Show notes 100%.
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I'll put the link to the YouTube version and to an audio version so that people can pick and choose which one they want.
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That sounds great.
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Now you were telling me about another excellent podcast.
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As a podcaster, I listen to lots of podcasts and lots of variety of podcasts, and one of my kind of go-tos when I'm driving in the car actually often is Conversations, which is an ABC-based podcast and it's very much storytelling.
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They were interviewing Jamila Rizvi who, for anybody that doesn't know, jamila is in her early 30s.
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She is a renowned Australian journalist.
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Her early 30s she is a renowned Australian journalist.
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When she was 31, she was a new mum, so she was postnatal.
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She kind of got the sense that something was kind of off in her health.
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Now this is the bit that really piqued my interest.
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She missed a period which for her, was very unusual and just on top of kind of what else was going on for her health-wise was enough to send her off to the GP practice to have a bit of a check-up and check in with her GP.
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I'm going to go out on a limb here and assume that she had a really great GP who went okay, cool, this is not normal for you, this is not just a new mum thing, let's see what's going on and sent her off for a whole barrage of tests.
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One of the things that came back in that testing was that her hormones were suppressed, so her estrogen progesterone were suppressed.
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She literally kind of was like sitting at zero, which explains no period, but what her ultimate diagnosis was that she had this very rare brain tumor and it was the fact of where the tumor was growing in her brain that was impacting the release of her hormones.
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So, first of all, fantastic episode.
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Go and listen to it.
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She's amazing.
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She's actually just also co-published a book with Rosie Waterland which is called Broken Brains.
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Because they were good friends, they have different stories about their brains, but they've brought them together into this book.
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Go, have a listen to the podcast, because it's A it's just a fascinating story, but B for me it was just this really simple reminder that a missed period isn't just going to be something that you should put down to.
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It's perimenopause or oh, I'm a new mom.
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Any change in our health that's out of the ordinary must be checked, because there are a myriad of reasons as to why something like that might happen and you kind of think, gosh, imagine if she had just put that down to.
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I've heard all this talk about perimenopause.
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It must just be something like that, so I'm not going to go and worry about it that she did take herself off to the and worry about it.
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You know that she did take herself off to the GP and have that checked.
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So my takeaway from that conversation for everyone listening is any change that you're experiencing that's not normal.
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Please get it checked out yeah, that sounds really interesting.
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um, and I have noticed her book um come up in my feed and have been wanting to have a look at that, but I know I hadn't realized that's how she learned about her diagnosis was through a missed period, but it's like it's quite mind blowing to think about that.
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It really is.
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Something so simple was the symptom of something so severe yeah, well, I had something I wanted to mention, um, but you know I haven't done a deep dive on it yet.
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Um, but it has come up in my feed over the last uh 24 to 48 hours.
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Um, but there's been an article um published in clinical endocrinology, um on sex hormones and risk of incident dementia in men and post-menopausal women.
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Um, and this sparked my curiosity because obviously in the menopause space there is a lot of discussion about what impact sex hormones may or may not have on cognition and brain health in later life.
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And this study is super fascinating because it took data from the UK Biobank.
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It's like 300,000 women and men that they've actually yeah, it was a huge cohort.
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And that was the thing that really caught my eye, when I looked at the paper as well, was this isn't one of those studies.
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That's just we took 500 people.
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This is a huge cohort.
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And the other thing that I noted, too is, yes, they use the UK Biobank their cohort source.
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It's a Chinese study.
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This is a study out of China.
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Yeah, I'd noticed that as well, and all the authors are based in universities in China.
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But basically the conclusion is that their findings revealed that lower free testosterone concentrations do seem to be associated with higher incidence of all-cause dementia and Alzheimer's disease and obviously encouraging further studies to determine if there's causality.
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But it was really interesting.
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I sent it to my mother-in-law, dr Linda Thompson, who has a PhD in biology, because I often get her to read papers with her PhD hat on, and she also flagged a really interesting point that hadn't jumped out at me at the start.
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But when you look at the age of the participants, they followed them for 12 years during this study, which is quite amazing.
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But they started off.
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I think the women were almost 60, the mean age, and the men were a bit younger, they were more like 56.
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But which actually means that at the end of the 12 years either cohort of age was that old, and she pointed out that often that is roughly the ages when you might start to see um, any sort of alzheimer's um or dementia um, and so it'd be interesting to see you know in another it's ongoing, you know?
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yeah, are they continuing to follow them?
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whether that had changed.
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But yeah, I really fascinating, especially given we've heard quite a bit about the thinking about estrogen and its impact on the brain, but not so much about testosterone.
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I think we'll probably see more studies looking at this in the future, which is really exciting.
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Anything that, anything that could potentially have a positive impact on reducing dementia risk, is pretty exciting.
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Oh, 100% the other thing that I liked about it too.
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When I took a very brief look at it, they did note who had been on MHT at the time of doing the baseline testing and who hadn't.
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So that's also reflected in, I'm assuming, if you dig into the more nuanced results.
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If we can note who had taken MHT and marry that up with some of the results, I think that's so incredibly helpful and beneficial.
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Oh, I'm going to have another look at that and get Linda to have another look at that as well.
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Excellent, another job for.
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Linda, All right.
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So the other thing we want to talk about and we will probably dive into this a little bit deeper because it is a bit of a passion project for both of us, and that is where the political landscape lies now we're post-election, Specifically in relation to a whole bunch of those promises.
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We had the outcomes of the Senate inquiry and then we had a whole bunch of promises that were made, big dollar figures that were thrown around.
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I interviewed Jed Carney to discuss, you know, how that was going to be spent and all the breakdown of that.
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How about a bit of an update on where we sit now, post-election?
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I know.
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It's sort of like where to start.
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So very exciting.
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There are even more women in parliament after this election than there were for the record breaking parliament before that.
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But also two party leaders are now female, whether they were parties that you voted for or not.
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The fact that we have, of the three major parties, that two of those parties are now led by women, and women that fall into our demographic.
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Yes, I know, and the beautiful Larissa Waters I know.
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I mean that was very exciting to see Senator Waters become the leader of the Greens.
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Obviously that was as a result of Adam Bandt losing his seat in Melbourne, which was a bit of a surprise loss and a real disappointment for the Greens.
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But interestingly both Adam and Peter Dutton, who also lost his seat on election night, both lost to women standing for the first time.
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So you know that amount of new female candidates has meant that the Labor caucus is now dominated by women and the Labor cabinet is now gender equal, which goes to show over the years, especially maybe from more conservative sides of politics, there's been a lot of negativity around the quota system that was introduced, I think around 1994.
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But I think what we're seeing now is that that has really paid off and we have a parliament that is gender equal.
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We saw in the last parliamentary term that having gender equality does really deliver for women and for a lot of the issues that are really important to women and families.
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You know we saw improvements in pay conditions for workers, like in childcare and aged care.
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You know we saw better childcare policies.
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We saw all the women's health.
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You know initiatives, the creation of the National Women's Health Advisory Council.
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So when you have that kind of representation, it does mean that the issues that are important to 51% of the population are more likely to get a greater hearing.
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I was interested and pleased to see that the Liberal Party elected Susan Lay as their new leader.
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With Dutton's defeat, a part of me is a little bit nervous that look, I don't think we're saying anything that hasn't already been said.
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The Liberal Party got absolutely smashed in the election and we don't need to go into all the reasons why, but I suspect that their lack of women candidates definitely played a role in that.
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So the fact that they've now got a female leader I think is really exciting.
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But I am a little concerned that you know, susan has been given a glass cliff, an impossible challenge.
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It's going to be very hard to rebuild.
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And look, you're right.
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There has been a lot of talk in the media as well about the glass cliff, and it's interesting because it's not something that I've seen spoken about so openly in the media before the glass cliff.
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I don't think everyone knows what it means, and if you are intrigued as to what a glass cliff is, please go Google it because you will be fascinated.
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I really hope it's not.
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I really, really hope that this is the opportunity for a female leader in Australia to show that they have what it takes to lead a party and have longevity in that role and be respected by the media, the opposition.
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Unfortunately, the only benchmark that we have for that in Australia is how Julia Gillard was treated, which was absolutely appalling and disgraceful, and I hope that we never, ever see a repeat of that, yeah, so I really hope it's not a glass cliff.
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I hope that we really do see someone step into this and be given the opportunity to lead.
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Yeah, exactly Me too.
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Which brings us to, I guess, the portfolios that we are passionate about.
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So a lot of the ministers kept their portfolios, which I think will allow for a lot of stability in this next year following the election.
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But we saw a small change in a minister that I think was close to everyone's heart in this space, with Jed being moved to a new portfolio, which they are very lucky to have, her, and I think she will.
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And it's an important portfolio as well.
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It is an area that needs someone like Jed.
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I think I'm excited to see what she does.
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Violence, domestic violence, the killing of women let's be completely honest is a significant issue that needs to be addressed at a political level, and I really, really hope that Jed can turn things around and make a difference in this space, but I'm brokenhearted that she's left us.
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Exactly.
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She did her Assistant Minister of Health job so well.
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She's been rewarded with an even more challenging portfolio.
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So we wish you all the luck, deb, and hope you have the same success in that portfolio.
00:20:50.289 --> 00:21:06.859
But it means that we will have a new Assistant Minister for Health and that is Rebecca White, who is a first-time Federal Minister from Tasmania and she looks super energetic and keen, judging by what I've seen on her Insta so far.
00:21:06.859 --> 00:21:18.049
She doesn't have a background in health, which is something that Jed did bring to the role, but I think that she's got a lot of experience in state politics and this is her first time being in a federal seat.
00:21:18.049 --> 00:21:32.730
So I'm putting money on she's going to be super enthusiastic, super keen to make a mark and very keen to, I guess, progress all of the work that Jed and the government had started in their last term.
00:21:32.849 --> 00:21:51.271
And I think one of the things that is exciting me a little is, with Labor having control of the House of Representatives and having such a decisive win in terms of the seats that they now have, that they can be really brave and bold with a lot of policy and keep pushing forward in this space.
00:21:51.271 --> 00:22:08.846
So I think that'll be really an opportunity for all the people that we work with and talk to and all the advocates to reach out to Rebecca and Mark and continue to raise the issues that are really important to us and follow up on those promises I guess were made on the 9th of February.
00:22:08.846 --> 00:22:23.353
And I'm particularly keen to follow up on the commentary that Mark made in Feb around and I think we've discussed it before, sonia like around the PBS and making sure it really works for women, because there's a lot of gender inequity in the drugs that are on the PBS.
00:22:23.353 --> 00:22:31.473
And then, like we just mentioned with the Rachel Rubin podcast, there's heaps of drugs out there in the world that aren't even in Australia, so someone please bring them in.
00:22:31.473 --> 00:22:33.881
Yeah, so I'm feeling super excited.
00:22:33.901 --> 00:22:34.563
What were your thoughts?
00:22:35.443 --> 00:22:37.208
Yeah, same, very similar to you.
00:22:37.208 --> 00:22:43.148
As I said, heartbreaking to see jed leave an area where she was making such a huge difference.
00:22:43.148 --> 00:22:51.231
But I have, I have gone and done a little bit of online stalking of rebecca as well and she certainly appears to be, as you said, some she's.
00:22:51.231 --> 00:22:51.779
You know she's.
00:22:51.779 --> 00:23:02.096
She's younger, she's got a lot of energy, she seems to be very smart, very well-spoken and very well regarded and respected in Tasmania.
00:23:02.096 --> 00:23:09.834
So I'm really interested to hear the response to those promises that were made on February 9th.
00:23:09.834 --> 00:23:14.852
You know, yes, the PBS stuff is really important, but there was a whole lot of other stuff that was promised alongside that.
00:23:14.852 --> 00:23:17.368
The community education campaign.
00:23:20.007 --> 00:23:24.126
I think there's a lot to wait and see, but I'm excited for where we're headed.
00:23:24.867 --> 00:23:50.630
And the other thing that's just occurred to me that is also exciting about her portfolio is and something different from Jed is she's also being given the Assistant Minister for Women portfolio, so she'll be working to Minister Butler and Minister Gallagher on women and health, so it's the first time those two things have been brought together, so I think that'll be a really interesting combination.
00:23:50.630 --> 00:23:54.042
And she's also the Assistant Minister for Indigenous Health as well.
00:23:54.845 --> 00:24:01.184
I think the three do go really well together in this current climate that we have in the space that you and I work in, this current climate that we have in the space that you and I work in.
00:24:01.184 --> 00:24:33.868
But even if we look outside of other areas of women's health endometriosis and period pain and heavy menstrual bleeding and all the aspects of women's health that deserve so much support they need even more in the Indigenous space, and I'm excited to announce actually, let's talk about this for just a moment and I'm excited to announce actually let's talk about this for just a moment I am interviewing next week Professor Odette Best for the Dear Menopause podcast to talk about the specifics into Indigenous women's health, particularly when it comes to menopause and midlife health and the research that she's been involved in.
00:24:33.868 --> 00:24:36.509
So you know, I think that's an area we don't talk about enough.
00:24:37.599 --> 00:24:57.488
I mean I was actually just about to bring up Professor Best that is hilarious straight minds because I believe that she had applied for an MRFF last year specifically wanting to do a deep dive research piece into Indigenous women and the menopause transition, because there isn't any data.
00:24:57.488 --> 00:25:12.612
I remember seeing her speak at the so Hot Right Now medical conference in Sydney in March and I mean her presentation was just like a punch in the guts in terms of the lack of information and data.
00:25:12.799 --> 00:25:14.185
I'm interviewing her next week.
00:25:14.299 --> 00:25:27.182
It'll be a couple of weeks before the podcast episode drops, but, yeah, really excited to be talking to her next week and you've actually made me think of something else which we haven't discussed whether we're going to discuss it, so I'm just going to throw it out there.
00:25:27.182 --> 00:25:58.179
Sonia, I have very mixed emotions about the announcement of 50 million for endometriosis research in I think it was UNSW, which is a huge amount of money and I think it really builds on the investment that the government has done into endometriosis research over the last few years and it's really wonderful to see yes, there was all the media I saw around it no one was touching on the fact about where that money has come from.
00:25:58.179 --> 00:26:18.074
I feel that it's good to be excited about such big investments into women's health research, but I do feel that it's important to show the nuance and that that money has come from a family that has made a lot of wealth from gambling and manufacturing and selling pokey machines globally, which you know.
00:26:18.074 --> 00:26:19.217
It made me feel uncomfortable.
00:26:20.025 --> 00:26:25.196
Yeah, and it's really interesting because I had read that headline and I got super excited.
00:26:25.196 --> 00:26:42.848
I sent it to our group chat you know how do we get this for menopause and then you came straight back, gave me the rundown on who the family was and where they had made their money and the potential PR exercise behind a big announcement like that and how that makes them look in the public eye.
00:26:42.848 --> 00:26:52.469
And I'm not saying that was what was going on, but it could be perceived that way that I didn't read beyond the headline and I didn't do my due diligence and I didn't look into who the family was that had made the donation.
00:26:52.469 --> 00:26:55.755
And you're right, it does matter, it really does.
00:26:55.855 --> 00:27:09.246
Yes, this is great, we need the research, we need big investments like this, but I think sometimes it's also worth just taking a little bit of a deeper dive into where that money actually came from in the first place, because gambling is an illness.
00:27:09.246 --> 00:27:23.796
It is an illness that is perpetuated by institutions that create the industry to start with, like this family was involved in it's clubs and pubs and all of those that use these as an income source.
00:27:23.796 --> 00:27:33.315
And then people lose their lives, people lose families, people lose an awful lot of money to gambling, and it is something that we should definitely not be putting up on a pedestal.
00:27:37.684 --> 00:27:40.393
I know and it did get me thinking because I was I was like, well, who could do things like a big research funding for menopause?
00:27:40.393 --> 00:27:46.509
And it is really hard because often those who have the most wealth tend to have gotten it by.
00:27:46.509 --> 00:27:51.525
Uh, well, let's just say, someone might have been exploited in that process.
00:27:51.525 --> 00:27:55.613
You know, you think about, yeah, you think about gas.
00:27:55.613 --> 00:28:02.798
You know it's really complicated and I think it's really great that australia does need a bit more, I think, philanthropic endeavor.
00:28:02.798 --> 00:28:08.553
But yeah, just, it just raised all sorts of questions for me and lots of complicated feelings.
00:28:10.557 --> 00:28:12.993
Um, and it does make me like 50 million is a good amount.
00:28:12.993 --> 00:28:15.426
Like that is an amount that will actually have an impact.
00:28:15.426 --> 00:28:23.493
And I think we've mentioned before um, the welcome leap, who gave lisa musconi 50 million for the work that she does on the brain and estrogen.
00:28:23.493 --> 00:28:26.587
So these are, they're the types of money that can actually make.
00:28:26.587 --> 00:28:29.315
That does it makes a difference, heaps of difference.
00:28:29.315 --> 00:28:36.433
I think there's a goal for um rebecca white, I still want that 100 million medical research future fund for menopause.
00:28:36.433 --> 00:28:48.026
So, yes, we'll have to organise to do a bit of advocacy on that, I think, sonia, and that way the government can fund it, yes, and then there'll be no complicated feelings.
00:28:48.487 --> 00:28:50.069
Exactly, Awesome, Jo.
00:28:50.069 --> 00:28:53.516
I know there was just one other topic you wanted to wrap us up on today.
00:28:53.516 --> 00:28:54.376
Let's go there.