Best of 2022: Top 5 episodes as voted by you!

Sonya: My name is Sonya Lovell, and I am obsessed with helping women navigate the magical, messy, and, let's be honest, more hysterical moments of this thing called menopause. I'm a personal trainer and breast cancer survivor turned menopause coach. I help women understand what's going on, why, and what they can do to navigate the menopausal transition. Gloss over the real talk? No way. Exhaustion, brain fog, loss of libido, loss of confidence and anxiety are just some of the topics that we'll chat about. Consider this a juicy happy hour with your new bestie and her friends. Settle in and get ready to learn and laugh. This is the Dare Menopause podcast. Hello, and welcome to an episode with a difference. So today I am recapping the top five episodes voted by you in 2022. Dear Menopause began for me in May of 2022. I had wanted to have a podcast, particularly around this topic, of menopause and women and women's health, for quite some time, and it had taken me a little while to land on exactly what that was going to look like. And I launched the very first couple of episodes of their Menopause on my birthday in early May this year, 2022. And it has literally been an absolute roller coaster ride since. And I wanted to take this opportunity to first of all, thank you. Thank you so very much for listening in every week to the amazing interviews and episodes that I've been so, so blessed to be able to put together for you. Your loyalty, your feedback that I have received from the most amazing women in the form of emails. I've had reviews left on different platforms, I've had social media messages sent to me. There are so many of you that have reached out and told me how important their menopause has been to you, and I am so incredibly, incredibly grateful that you have shared that information back with me. I'd also like to say thank you so very much to every single guest that I have had on Dear Menopause this year. I have been, again, so blessed and lucky that everyone I have reached out to has said, hell yes. And some of these people are highly qualified experts in their field, recognized globally as well as nationally. And they have given up their time and their knowledge and their expertise to share with you and with me on Dear Menopause. And I'm so incredibly grateful to them and the support that so many of them have given me outside of the time they gave us over the episode. So a huge thank you, a huge full heart from me as we wind up 2022. So, as I said, I have decided to recap the top five episodes. So these are the top five episodes that have been downloaded this year to date, and there'll be no surprises with some of them, but there might be surprises with the other. There certainly was for me. And we are going to kick things off by starting at number five. So the number five most downloaded episode for 2022 was my chat with Professor J. Ashri Kulkhani. This was episode 22. If you want to go back and listen to the full episode, I highly recommend it. So Professor J. Ashri Kulkarni is one of Australia's leaders in research and treatment of menopausal depression. And I truly believe that this episode is the most important episode I have been able to bring to you, my dear menopause audience. In the episode, Professor Kulkarni speaks about mental health and the part that our hormones play in this area in a way that just makes this topic so easy to understand and relatable. I've included a short snippet from that episode that's coming up next for you. Enjoy a few minutes with Professor J. Ashri Kulkani.

Prof Kulkarni: I moved into the research very quickly, and I've always been in research and clinical work side by side, and I find that very rewarding because it means that I can ask the questions in a research sense that are relevant and vital to the women patients I'm seeing, and their families will raise issues and so on. So I think it keeps us grounded as researchers in a reality base. And then the things we discover in research, we can offer back fairly quickly as treatments. So, for example, in this area, the more and more and more research I did, the more obvious it became that in a certain number of women, not all women, who were approaching menopause in their mid 40s who suddenly developed depression or some other mental health problem or who had a relapse of a perfectly previously well controlled condition that these two groups of women were now experiencing a new sort of depression. Menopausal depression. And so looking at research studies, we conducted clinical trials to understand whether we could help this condition with particularly different sorts of hormone strategies. And we have published a lot on these. But then in our clinic, we could offer that back because we weren't doing anything that was like a drug XYZ that isn't even out there. We're talking about HRT or HT as it's now called, which is hormone treatment that is widely available, and we know about the side effects and so on. But it was offering it to women as a treatment for depression rather than hot flushes, which everybody associates with menopause. But hot flushes are kind of late in the piece. They're almost the last lot of symptoms. So stopping periods or having erratic periods. And hot flushes is about eight years into a process. Menopause is about 1012 years of a process, yeah.

Sonya: So how often do you believe that women with mental health issues, which can be attributed to perimenopause, go undiagnosed?

Prof Kulkarni: Look, unfortunately, I think it's very common. I'd say that's the more common situation than somebody actually going, maybe it's menopause. So because I think we're still kind of siloing mental health and physical health, which is terrible. People with mental health, women with mental health issues, particularly if they've got a major depressive condition, the pattern of their presentation will be that she'll sort of start to develop sadness intermittently, not all the time. And this is the other problem. It's cyclical. It doesn't just come on and stay on. There's no cyclical pattern.

Sonya: And is that linked to the cyclical changes of the hormones?

Prof Kulkarni: Yes, but the problem is, once it's a cyclical pattern, then she's got to contend with a few different things. One is that some bright spark will diagnose bipolar disorder, which is just wrong. And unfortunately, if she goes down that path, she'll get a lot of medications that may not hit the mark and give her a lot of side effects too. That's first problem. Second problem is sometimes her validity, whether she's really got something, gets questioned because, hang on, how come you're in such a blubbering, dreadful mess today that you can't even get out of bed? And yet last week you were partying like there's no tomorrow. And there's a sort of sense of is this real? Is this entity real? Or is she putting it on for attention? Et cetera, et cetera.

Alison: So there's that horrible, almost a diminishing.

Sonya: Isn'T it, of what she's experiencing.

Prof Kulkarni: And that's another side that many women talk about that they almost like their best suffering, but then they have to convince people that they're suffering, which is really not on. And then the third part of it is that it's a stuttering but worsening condition. And so the problem is that many health care practitioners will send the patient to psychiatrists or psychologists and of course, you dig enough, you'll find stuff. So he or she is talking about the ratty adolescence or the fact that her job isn't all that satisfying or that her 20 year relationship isn't as exciting as it was and so on. And then it becomes that sort of issue that that's where the problem is, et cetera, et cetera. Of course it's helpful if she's getting supportive psychotherapy to help prop her up when she down times. Everyone can do with that, but it's not the answer. And then, of course, the antidepressants are used, and they're used very quickly in this age group, they're used very quickly. And unfortunately, I would estimate that there's a bit of a response to the antidepressant, but not a great response. So most women I see tell me things like, oh, I got that 30% better. And then when people sense that there's some improvement, they'll go, oh, yes, well, we just got to keep trying with a bigger dose.

Sonya: We'll up the dose, or we'll add.

Prof Kulkarni: In another one, or we'll add in a mood stabilizer, we'll add in an antipsychotic, and on it goes. And so you can see that this is where you ask the question about diagnosis. And I think the problem is that everyone was more comfortable with a major depressive episode or major depressive illness diagnosis. And even to say things like, menopausal depression is like, what are you talking about? What do you mean, menopausal depression? There's no such thing. And I've had that comment come back and back and back at me, whereas the women themselves go, oh, yeah, you're right, you're right. I haven't followed like this before. And there's nothing new. That's the other thing to look for. What else is going on in this woman's life that's new? Because I take the opposite view. I reckon you get to 45 and you got a pretty good handle on things by that point.

Sonya: Very true.

Prof Kulkarni: Pretty good at juggling this, that, and the other thing. And unless, of course, look, things can go horribly wrong. People around you can die, you can get diagnosed with some terrible disease, or you can lose your job, or stuff can happen. But if stuff hasn't happened and she suddenly develops a depression, then you've got to request the concept of is this major depressive disorder or is this the x factor, which is the hormone factor?

Sonya: The biggest piece of information that you would like to share with women listening today?

Prof Kulkarni: So what I'd like to share is that hormones have a big impact on mental health, and it is real. So it is not just something that you're making up. It's not an excuse for bad behavior or any of the labels that we've had. It is real, but there are solutions. And it's always important, I think, for every woman to back herself. She knows what is going on for her. I really think we call it the old fashioned women's intuition, whatever it is. But most women have got pretty good insight into their own bodies and minds, and so it's really important to back yourself. And if you think there's something going on that is unusual for you, that is really making you depressed and you think it's your hormones, then tell your doctor. And don't just keep it hidden. Back yourself all the way, because there are solutions out there. And you keep going until you find the treatment that helps you and fixes the problems for you by you.

Sonya: Heading up. The number four position is episode number 26, which I recorded with Amanda Thiebe. So Amanda is a force, and she's someone that I had admired and still admire for quite some time, following her on Instagram, reading her book, being very familiar with her website. And so recording our chat was a little bit of a bucket list moment for me, but it was also a whole lot of fun, and I hope that you enjoy it as much as I did. Here comes a little bit of time with Amanda, literally feeling quite proud of.

Amanda: Myself, thinking, look at me. I'm fit, I'm healthy, I'm winning at life. And then I just wasn't then I wasn't able to just function, participate, just even live well and I went through a medical system that supported me but couldn't find answers for a couple of years. And it was very frustrating thinking that this was the new me, that I was in this place that I didn't recognize. I was a person I didn't recognize. Eventually, a gang of colleges said, hey, it's perimenopause and I can help you. But it took a couple of years to get there. And then after that, I just started talking very openly about it. Nothing was off topic. I started being really frank about my experience, about the mishandling of it in the medical community. And my doctor listened to me, and I presented with symptoms like most women do, where they all go, I don't feel right, something's not right. And you go and speak to the doctor, but you don't typically go in and go, I'm struggling with perimenopause. Can you help me? You typically go in and go, I'm super anxious, or I'm not sleeping, or I've got migraines, or I have depression. And essentially that was me. I had migraines with aura, but nobody even could diagnose those. It was just a loss of balance, equilibrium. Like, I would lose feeling in my face and my hands and then throw up everywhere. Be in Bedford is and then I had depression. Anyway, so my story is the same as many women's out there, and mine isn't unique in that respect, but it's just tires them that we're all having the same experience, right? And we know that there's a lack of education in the medical. You spoke to my colleague, Ardell Piper, really? Amazon GP she gynecologist. She really wants to help doctors become more educated. And most doctors are willing to learn. They just were never given the opportunity to learn. I then moved to the US. Where I had stellar healthcare because I was in that privileged class that I was working, and I had healthcare. It's a completely broken system, but I happened to be in the system where it worked for me. And so anyway, I just started talking about it. I wrote the book based on my experience, on the evidence as we know it. It's very factual, very evidence based.

Sonya: It is.

Amanda: And then it's very solution based, because I want women to feel I don't want them to feel fearful going into menopause. And unfortunately, I feel like that's sometimes, the narrative. I want them to feel capable. I want them to feel in control. I want them to promote autonomy so that they can go and advocate for themselves. And I think every woman deserves to have that.

Sonya: One of the things that I love and respect the most about you is you are a fierce advocate, particularly on social media. I can see you grinning smugly behind the screen. You know where this is going. What I love is that you have stepped into a space where you are not afraid of calling out and holding other influences, for want of a better expression, to account when it comes to ageism and wankery, as I think you like to call it, in the health and wellness and the beauty industry. How did you step into that space? Like, has that been a natural part of your personality or your life? Or is that something that you've evolved into?

Amanda: I wonder? I've never really thought about it, but I definitely have always been drawn to evidence based information. And it's interesting because you and I both have the same background, and nutrition science is hard to learn, but the basics are quite simple. The concepts are quite simple, as is exercise physiology, right? We know what stimulates hypertrophy, muscle growth and all of the benefits of it. So it's just that what I was seeing when I was talking about menopause is people were making these really wild claims, and I was sat back the longest time thinking, have I missed a chapter in the book? Did I miss a whole part of the course? Because I don't remember that happening. I don't remember anything like that happening. And then I was thinking, I have, like, reputable credentials. And then I was looking at people calling themselves hormone balancing coaches, and I'm like, what? How what? They're not endocrinologists? They're not like gynecologists. How can they explain that? And so I sort of sat back and was, like, scratching my head for a little bit, thinking, there's a rabbit off here. Something doesn't feel right about this. And I'm a born skeptic for sure. And I just was like, I need to reach out to people who I really trust in the medical field and in the nutrition field. So I literally armed myself with a whole load of reputable experts like Jen, Gunter, Abbie Langa, the Nadolski brothers. There's a whole bunch of them that have become my friends now. And I would say to them, hey, is this right? I mean, is this okay that people are saying that? And it was around the time I was writing my book, so I was knee deep in the research. And when I was reading research papers and I didn't understand them, I reached out to experts to help me to understand them. So I actually really put the time and effort into try and understand it. And then that's when I'm seeing all these crazy claims, and I'm like, no, I think I'm just going to say it's not true. And so I try and do it in a respectful way. I try and do it in a way that is a little bit funny, but really it makes a point, right? I actually don't personally call out influences. I actually don't do that because I've set some pretty strong boundaries about my own emotional health. But I'll call out companies. I've noticed there's a couple of really trashy companies in Australia, the Better Body Company and Better Me Coaching, that are absolute *****. Oh, my God. And they say the worst things. The advertisement is toxic. If you follow me on Instagram, you'll know exactly what I'm talking about. It's toxic, it's predatory. They talk about women's imperfections and they talk about how they can fix you and none of it has evidence behind it. And so I just have no problem calling them out. I tag them. I want them to reach out to me and say, what's your problem, Amanda? Why have you got an issue with this? Because I want them to show me the data. And if they do, I'll put my hand up and go, you know what? I was wrong. And we know that this is the case now, because the menopause industry is worth billions now and women are preyed upon, and I do call it wellness wankery. Actually, an Australian friend of mine gifted me that term. I think she called it wellness **** wankerie, which is even better. I hope I'm not going to get on this beeped out.

Sonya: But anyway, no.

Sonya: We'Re going to head all the way back to episode number two. One of the very first episodes that I was able to launch their menopause with was with the incredibly warm and generous Shelley Horton. So Shelley took out number three spot as our most downloaded episode of 2022. Shelley is the personification of confidence. She's a journalist, TV presenter, MC, and runs her own media company. But she was absolutely sideswiped by perimenopause and has been very, very generous with sharing her story far and wide so that women can learn from her. Enjoy a few moments with Shelley Horton.

Shelley: I am so excited to be here. I love talking perimenopause and menopause because not enough people do it.

Sonya: I could not agree with you more. So that's why I'm really excited. We are going to have one juicy conversation. We've already set the ground rules. Nothing is off the table.

Shelley: No rules.

Sonya: Strap in, ladies, we're going to hit the ground running here. So, Shelley, let's start off, share a little bit for us about your personal perimenopausal story.

Shelley: Well, basically, it hit me like a bus and I wasn't expecting it at all. I didn't even know what the word perimenopause meant. And that, I think, is the thing that I want to change the most, is if you're prepared for it and you're looking for symptoms, it won't hit you like a bus like it did for me. So my problem was it started when I was 46, but the year was 2020 and we're in the middle of COVID So every single symptom that popped up, I put down to stress because of COVID So first things first. After and again, nothing's off limits here. So I have had shocking like armageddon periods from age twelve. And so I was put on the pill for years, which we all know is the worst thing you can do for terrible periods. And it turns out I have polycystic ovary syndrome. None of that was really going to help. But then I discovered this little plastic hook called the marina and it changed my life and I love it and I can't, you know, praise it enough. So I basically now I'm on my third marina. And you keep a marina inside. It's an IUD for five years. So I'm up to nearly 13 years of not even having a period, which is a dream, particularly when I was a girl who would flood through a temp on Empad and it'd be all over the bed.

Sonya: Wow.

Shelley: Horrendous. So then in 2020, my period came back.

Sonya: Even though you had the the marina.

Shelley: In, I've got the marina. Like, there should be wow, it overrode the marina. But of course I just went, jeez, I'm really stressed. Like, it must be really bad for me to be to be bleeding again. And it just came as a very normal, fairly heavy seven day period. And then it went away again and I'm like, oh my God, how's that? My body is telling me I'm struggling because of keeping the business afloat. Every single thing could be handed to COVID stress. Then I've never really had any mental health issues. I'm very lucky. I certainly have felt depressed and sad, but that's been for very valid reasons, like a divorce. But I've never really had problems with my mental health. And then I got depressed and I didn't again, just thought it was the stress of covered. So I was crying nearly every day. Not for long, not dramatically, but just there would be a moment during the day that I'd feel so overwhelmed that I'd have a couple of big fat tears would lie down my face. And then that got a bit worse and I was having a couple of times where I didn't want to get out of bed. And that has never happened to me before. And then I was just not finding joy in anything. So one of my joys is my work at Channel Nine. Like, who wouldn't want to be on TV debating Ben Fordham about any and everything, every topic. I would get almost like a bit of a high after that normally. And I would be driving home from Channel Nine and the thoughts in my head were, well, you just embarrassed yourself on national TV. No one's going to want you on TV. And again, you're hopeless. Just this horrific negative self talk.

Sonya: Yes, you're in a mean girl. She really came out.

Shelley: She was a ******* *****.

Sonya: She can be at the best of times. So if you've noticed that, that's elevated.

Shelley: I've always had the negative self talk with regards to body image, but not with my work ethic. That's the one thing I've always been really proud of is I work really hard. But for this, I was just like, I didn't want to work. I didn't want to do anything anyway. It was my husband who just went hey, this is not you. I think we need to speak to someone about it. And then by then, I got my second period, and again, it was like the same thing where it was only went for a week. And so I went to my regular GDP and got a little bit of information and she mentioned perimenopause and then she said a couple of things like, we've got a gel for you to put on. And I thought it was like you had to put it up your *****. And I'm like, oh, I probably do that. And I just didn't really listen or I don't know, I just didn't take it on board. I had to blood test. But then this is when I started to really pay attention in November. So September. October. Yeah, November. I started bleeding and I didn't stop bleeding for 60 days.

Sonya: Whoa, Shelly.

Shelley: Yeah. And it was heavy enough that I would need a tampon. So it wasn't just like spotting.

Sonya: It wasn't so I went back to.

Shelley: My GP, and by this stage, I'm in floods of tears. I'm feeling run down, like, it was just everything was awful.

Sonya: And this was all sorry, just refresh me. This is all over about a three month period.

Shelley: About three months, yeah. And then, obviously, doctors have to be very careful. So she's like, you will need to go and get an internal ultrasound. We need to check that it's not ovarian cancer, cervical cancer. We need to check if the marina has been dislodged somehow, all of that stuff. So I went in there, had that done, also had a PAP test, which I have always had, pretty regular ones, but I did have HPV when I was, like, 25 or something. 80% of the population has HPV, so I'm not going to have any shame associated with that. But, yeah, so I've been pretty good. Everything came back normal with my looking at my ovaries and the marina was in the right spot and everything, and my PAP test came back saying quite a few abnormal cells. So then I was convinced I had cervical cancer. Convinced?

Sonya: Yeah.

Shelley: And I had to go and see a gynecologist to have a colposcopy where they take the cone biopsy. All of this is still happening and I'm still feeling depressed. And I haven't had anyone even say, maybe we need to look at this a bit further, and went and saw the gynecologist. The gynecologist was lovely, but she was like, Your cervix? Because I haven't had children. Child free by choice, she said it was like slam shut, like a rusted gate.

Sonya: I'm so sorry. That most hilarious.

Shelley: She could not get in there right, so she did the colposcopy in the uterus, but she said she couldn't actually get up into the cervix because it was so tight. She's like you're quite perimenopausal. And again, I'm like, what the hell? And she said, Look, I will get up as far as I can. This is going to hurt. Freeze. And she also had a massive TV screen where she was watching it. And I'm like, I'm pretty up for all that medical stuff, but at the moment, I just didn't want to see my inside. She got it. And yeah, it hurt a fair bit, but she's like, look, if I'm not happy with the amount of cells that I've got, then you're going to have to have a general anesthetic for me to actually crack that thing open and get up there.

Sonya: Get out the doors of life and wedge your open, right?

Shelley: It's honestly like a robber cracking a safe.

Sonya: So that brings us to number two. Number two takes us to episode number nine. And episode number nine was an incredibly long episode, which blows my mind that this continues to be our second most downloaded episode. And that was with Ange Clark around nutritional changes through perimenopause and beyond. So Ang is an incredible woman and she's so generous with the information that she shares in this episode. She has a passion for helping active, paramenopausal women uncomplicate nutrition, and this allows them to achieve sustainable results and also means that they can nourish a high performing and active lifestyle. Here's a few minutes with and. But I highly recommend that if this topic is of interest to you, you go back and listen to the full episode.

Sonya: Yeah, so low energy availability, it's really just describing a position in your life where you're not actually giving yourself enough nutrition. So we don't have enough energy and we can talk about calories or kilojoules of energy unit measures of where we get that from as food and drink. So what we eat and how we drink is going to contribute to us surviving. Now, of course, we need to eat to live. So to be human, to be functioning, we all need a level of nutrition. How best we do that nutrition is going to relate to how optimally we're going to be functioning. And I will often have sat in many client meetings where my client is active. So I work with an active population, but that doesn't mean they're elite. I have worked with the elites, but I've worked across a broad spectrum of what I call everyday weekend warriors or just lifestyle athletes. And I always say you are an athlete and you need to start thinking about yourself as an athlete. If you train with intention, if you train with purpose, and you're consistent in what you're doing, so that might mean you're training Zumba three times a week. You're an athlete, you've got the intention. You don't necessarily need to enjoy it all the time. I would argue that you should be doing exercise that you enjoy, but if you're really devoted to your health, if you've got a health value, if you are training and exercising and just moving in general, then if you start to then coin just a. Perspective or a lens of treating yourself like an athlete. Those small little principles that I've learned over the course of my working with the elites, once they filter down to the everyday population, they can have the most profound impact. And that's what I was finding with a lot of the scenarios where low energy availability was there. It was just because they weren't feeding themselves a enough to just cover what we call your basal metabolic rate. So this is just the energy that your body requires you to get up, function, beat your heart, work your lungs, breathe, do all these sorts of things. That is just a normal part of human behavior and movement. So that requires a certain amount of energy. So first and foremost, we need to let women know that they have to have permission to eat. We cannot survive on literally nothing. So the second to that is when you're adding that exercise on top of that. Because if you do have a health value, we're trying to look for ways to move that then increases your energy expenditure. And so it's a formal way of doing it, but you're burning more energy in a way that you are exercising, and that's using up a little bit more energy. We also have incidental activity. So you just might find that just because you live in a house that has stairs in it, you're actually burning more calories going up and down those stairs every day compared to somebody that lives on a low level house. All these factors are combined. And then there's another factor in terms of energy expenditure with what you eat. So the more you eat, the more you burn calories for digestion and eating as well. So all these factors involve if you add that now to the basal rate of what you need energy wise, then you add your activity factors and all the stuff that you're doing day to day, and then of course, you end up with a certain amount of energy that you should be required to eat. Now, what happens with women is they perpetually and chronically undereat. And unfortunately, they end up in a scenario where they can go for so long, but their hormones will then override that and it will become basically a fight or flight survival system, will create really high stress levels or cortisol in our body. And you will tend to probably what we call overeat or binge eat at certain times. And I have lots of women come to me and say, angel, I don't eat bad. And I was like, yeah, that's fine. There's no judgment here. I don't eat bad, I don't eat KFC, I don't eat McDonald's, and I can't lose weight. Well, first and foremost, you're not in a deficit, so we need to figure out what that deficit is. But unfortunately, most women, sorry, they lie in a low energy available state for maybe five days of the week. And then their weekends, they go into two bigger surplus, which then chronically, does this yoyo pattern of dieting. And then you go straight back again, start back at Monday, start the diet again, and then start to then chronically under fuel. So if you can think about it, most of my women come in and they're not eating a, properly enough to support their day to day what I call fundamental nutrition, which is their health. B, they're not supporting their training, nutrition, so they're starving their training, so they want to lose more fat, so they don't eat around training, which is counterintuitive at its best. And as a sports dietitian, that was one of my major things to be able to be giving people fuel to support the training that they're doing. So if we can do that, you're not going to be in a state where you're not having the energy that's required for your body to utilize when it needs it. Okay, long periods of fasting, intermittent fasting, I mean we could talk about all the different diets out there but particularly fasting I find for women, particularly active women is so, so detrimental because it doesn't give our body the available energy that it needs a function B to support your exercise. And like nobody really likes to be hungry a long long period of time. So at some point, like I said, you'll probably over consume, you'll binge it some other aspect of the day and then you'll blow out your deficit anyway. So this is the perpetual cycle I see women in taken to its chronic level. If you do that for a long period of time in the sporting realm, we term that red S. So that becomes the syndrome of relative energy deficiency in sport. And that's obviously then looking at the disparity between that bigger gap of low energy availability between what you need to survive and then adding exercise on top of that. So if you are training pretty consistently and you're always after more fuel, your body at some point is going to reduce or what I call it, I call it like put yourself on low power mode when it comes to your endocrine system. Obviously your menstrual cycle is going to get affected. So your hypothalamic pituitary axis is going to be down regulated, your whole metabolism is going to drop, you're probably likely to lose muscle, your functionality is going to go down the gurgler. And then you look at all the reasons why you want to be training to get strong enough to get fitter and you're not doing any of those jobs, not fueling.

Sonya: It's a fascinating subject and I think the biggest takeaway there that I feel would be relevant to the everyday woman that is listening is that yes, we all acknowledge and know that we need to be in a deficit if losing weight is our goal. But what I think the most important message that we can get across is that that deficit is personalized and individual for every single person. So when you come across these weight loss programs that they provide you with a set amount of calories kilojoules per day, they're horrifying because they are not personalized to what you said. Your basal needs are, let alone what your everyday incidental exercise, and then your intentional exercise is on top of that. Yeah, we could talk about this for hours, but I think that is such a key takeaway for women, particularly women over 40, who are experiencing changes to their body shape that they haven't perhaps tried to achieve. It just is naturally happening. And then they start seeking out ways to make that change and they get into all sorts of trouble. Okay, cool. Hopefully we've got a really good understanding now of what low energy availability is and the impacts of that on our body as a woman. So when your clients come back to you, they're 40 plus, they're starting to see these changes. Can you explain to us a little bit about why those changes are happening from a hormonal perspective?

Sonya: Yeah, absolutely. So here we start to see and now we talk about paramedicause as being this kind of five to ten year I call it a **** show roller coaster of hormones where they're kind of going up and down. You don't know what the hell's going on. Again, you added the very valid point of it being personalized and individual to you. So your experience is not going to be I mean, it's very similar because we see a lot of women reporting the symptomology of going through perimenopause. And the reason for that, we believe we don't exactly know for sure, but what we believe is that because of that decline in female sex hormones, estrogen, progesterone, testosterone in there as well. I'll throw that into the mix. But obviously our major two hormones, and in particular estrogen, when I'm looking at this from a perspective of why it becomes more important that we have to be doing nutrition and exercise a little bit differently to mitigate the loss of the decline in that estrogen as we age. So we know that this happens past 35. You know, when we talk about paramenopause as is kind of maybe in your 40s ish thereabouts we talk about menopause being mid 50s, but you know, everyone's different. And as you can attest, you were pushed into menopause probably a lot earlier than what an age related normal woman should be pushed into it. So there's many different reasons that we can end up in a situation where we have low estrogen. And so as a result of low estrogen, what do we see happen to the female body now? It's very interesting. When I looked at this, I look at it from a physiology perspective. So we have less lean muscle mass, so we tend to lose muscle, which of course, then includes strength and functionality. So if you think about one of the key factors in terms of aging and the female aging is independence, right? So if we lose our independence and our functionality, that becomes completely debilitating. And then, of course, we end up older, but not necessarily living out our best years. And that's something that I'm really passionate and have always been passionate about doing resistance training to counteract that loss.

Sonya: All right, we have arrived at our destination. The number one downloaded episode for 2022 belongs to Allie daddo. I loved this chat with Ali. Ali was episode seven, so she was very early in the dear menopause episode catalog, but has remained a very firm favorite for very obvious reasons. When you listen into this chat, you will have such an incredible sense of Ellie's warmth and generosity and sense of humor and vulnerability that she's just not afraid to share with other women, knowing that it is going to help them. So I'm going to stop talking so that you can enjoy a few minutes with Ellie dado.

Alison: Is there a silver lining? Is there something I can look forward to? And there is. And I really wanted that to be a big part of the book as well. So we're not just drowning in our sorrows. Yeah, look, well, I was journaling anyway because I've always done journaling and particularly through challenging times, I find that journaling has been a lifesaver for me for many, many years. So I was always journaling anyway. The idea of putting it in the book didn't come until I started writing it and I was a few months in and I actually went to my journal to see what else can I write more about what I'm experiencing? And then I'm like, I'm actually just going to go word for word, which is exactly what is in the book. It's word for word what is in my journal. I still kind of shake my head going, was that a really good idea? Because no one reads my journal. And here I am putting my most intimate thoughts down on paper. But it really made a lot of sense to me to have those entries in there, because, as you say, it was as raw and as honest as I could get. Because it was at that point in time, it was only me reading it. But I wanted it in there because I wanted it to be relatable to so many women that can't often put words to how they're feeling. Because even in my relationship with Cam and my conversation, I actually couldn't say those words to him. He was still lost in all the menopausal stuff. He still didn't get it because I couldn't communicate it as well as I could on paper. So that's what I really wanted to add that in there. So, yeah, it started off with just me going, I'm just going to write about how I feel. And then what ended up happening, though, what was really interesting which I didn't expect from the book, was this thread that kept on taking me back through my life and going, oh, how does this connect with that experience and this experience and who I was as a young girl? And what was I like going through puberty? How have I changed? How have I emerged through this experience of menopause? So it became this sort of through line of who actually am I now as a woman in comparison to who I was as a younger woman and as a teenager? And that really assisted me to write the book, and it really assisted me as a person to grow as I wrote the book as well. And I love that.

Sonya: And I think for me, one of the biggest surprises for me from your book was how much of your personal story you share.

Alison: Yeah, well, it impacted, certainly physically, it definitely impacted. I totally lost my libido, and I feel like I lost it because of not only what was happening scientifically and medically, but also internally. What I was attempting to just deal with day in and day out felt so overwhelming to me. Obviously, I had a little extra challenge there because I had just moved from America to Australia. We'd been there for 25 years. I'd left all my friends, all my community, all my support I had left in America. So I was here in Australia not really having any friends, any support group around me, and women need that, and women really need that, I think, through this time, because we've got to be able to turn to our friend and go, holy ****, I feel like this, that and the other, and I didn't have that. And that was hard. So as I said, there was all these different layers going on that sort of exacerbated the loneliness that I was feeling. And I did feel like I didn't know quite what to do about this libido issue. And I couldn't force myself. I could not force myself to have sex. It just was not in me. I didn't want to do it. I wasn't going to do it. I didn't feel I had to do it because I thought, My God, I've been married to this man for a long time. I am not going to lay bare my body and go through some kind of painful experience to keep him happy. I could not do that. So it was really hard because as I've said many times and understanding this from Cam's point of view, his whole love language is touch and it's physical, and that's how he feels close to me. And once he feels physically close to me, he's all right. Everything's all right with the world. And he wasn't getting that. And so he was really confused and really concerned and didn't know what to say. And he just thought it was about, you know, a I wasn't attracted to him anymore. It was not that you know, AI would never want sex again. It wasn't that. It just and it was hard to sort of explain again exactly like what was going on. It was it was just the last thing on my mind as well, was to have sex. That was the last thing. There was too many other things going on.

Sonya: I quite often describe it like I would rather have gone and had an upper lip wax than had sex.

Shelley: Absolutely.

Alison: I think I say in the book, I'd rather just walk to the fridge and get a piece of chocolate.

Sonya: Yeah, that too. More pleasure in that than the zip wax.

Alison: And again, that's why I really wanted to write that chapter for the partners. Because how hard would that be for the partners? Here we are, everything's going along seemingly okay, we're still making love. And then, wait, you don't want to do it anymore. You don't want me to touch you. When is this going to stop? When is this you're angry with me? What did I do? It's all very confusing. There is a lot of separation and divorce around our age.

Sonya: And I love you. Share a story in the book, actually, about a gentleman that came up to you. I think you had a conversation with an older gentleman. Can you share that with us? Because I thought that was an amazing insight and so honest of him to share with you.

Alison: It was it was such a big impetus for me to know that I was on the right track about writing about menopause, and particularly around the partnership in menopause. So, yeah, we were just at some event and he was this lovely fellow, probably late sixty s, I think, and he said, what do you do? And I said, Well, I'm a teacher and I'm writing a book. Oh, what's your book about? I said, oh, something you'll never be interested in. It's about menopause. And he said, I wish I had of read more about menopause because maybe I could have saved my marriage. My wife went through so much and we couldn't stay together. And I just it was heartbreaking to you. It had been a few years, it had been like ten years, but it's still like the depths of his sorrow was still really there. And I thought, oh man, if we can save some relationships by talking about this and it would be really, really important.

Sonya: What an incredibly diverse group of women that took out those top five places. And I can absolutely understand why all five were chosen as your favorite episodes by voting with your ears. So thank you. Thank you. Thank you for listening in to all of this. Please do go back and listen to the full episodes of any of those that grabbed your attention that you perhaps haven't listened to previously. Again, from the bottom of my heart, thank you for supporting Dare Menopause in 2022 and giving me validation that I'm on the right track with this podcast that is so incredibly important to me but I now also know is incredibly important to you. There are some very exciting things happening in 2023 for my business, Stellar Women, but also Dare Menopause. The podcast. You are not going to see a change in format, so don't freak out about anything. But what we are going to be bringing to you is a series of Dare Menopause live events. Now, these won't be podcast recordings live. They will be the opportunity for some very special women to sit in a room with some of my amazing guests. Women that you perhaps have a yet to meet, as well as some firm favorites joining us. We will be in Brisbane, we'll be in Sydney, and we'll be in Melbourne. Dates are all yet to come, but if you want to get a little sneak peek into when these might be happening, you can go to my website, stellarwoman.com dot au. Click on the Events tab and you'll see there a whole list and host of events that will be happening in 2023. And I'm incredibly proud of the Dear Menopause live events that will be traveling around the country. Thank you so much for listening. I appreciate you. I appreciate the opportunity that I have to create this media, these interviews, these chats. I hope you have all had an amazing year and I hope that the year to come will be even better. Take care. Thank you for listening today. I am so grateful to have these conversations with incredible women and experts, and I'm grateful that you chose to hit play on this episode of Dear Menopause. If you have a minute of time today, please leave a rating or a review. I would love to hear from you because you are my biggest driver for doing this work. If this chat went way too fast for you and you want more, head over to Stellarwomen.com Au podcast for the show Notes. And while you're there, take my Midlife quiz to see why it feels like Midlife is messing with your head.