Life's Booming

Menopause: The other side with Jean Kittson & Dr Ginni Mansberg

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The stigma around menopause is slowly peeling away, but many of us still suffer in silence. In this episode, we take a lighter look at the often unglamorous side-effects of menopause – from hot flushes and brain fog to facial hairs and mood swings – hearing from Aussie comedian Jean Kittson, who is living her best life on the other side, and getting the medical rundown from celebrity GP and passionate women’s health advocate Dr Ginni Mansberg.

About the episode – brought to you by Australian Seniors.

Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life’s Booming explores life, health, love, travel, and everything in-between

Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life’s Booming podcast – Is This Normal? – we’re settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself.

Jean Kittson has been entertaining audiences for decades with her wit and humour, both of which she brings to the fore in her candid and hilarious take on menopause, You're Still Hot to Me, the book she wished she had read during the momentous time in her life.

Dr Ginni Mansberg is a well-known celebrity doctor based in Sydney, with television appearances in Embarrassing Bodies Down Under, Sunrise, The Morning Show, and Things You Can't Talk About on TV. She is also the author of The M Word: How to thrive in menopause.

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SSMR0502_240229_Menopause the other side_Final

James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to.

There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it.

And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions.

So think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know.

When it comes to women's health in older years, it turns out that the hot flushes, the brain fog, the facial hair, the mood swings can all be linked back to the one thing and that's menopause. In this episode, Menopause the Other Side, let's take a look in some detail at the common symptoms, the experiences, and life on the other side of it.

We'll get some answers about menopause, the ‘M’ word, from the queen of morning television, Dr Ginni Mansberg. But it gives me great pleasure to welcome, of course, to thispodcast as well, Jean Kittson, who wrote a fantastic book called You're Still Hot To Me, dealing with her experience and her research into menopause.

Jean Kittson, hello.

Jean Kittson: Hello, James.

 

James Valentine:Still so hot?

Jean Kittson: Yes, I am, actually. Every now and then.

James Valentine: Is this the 10th anniversary? Is it 10 years since you published?

Jean Kittson: Yes, it is. 2014 it came out. It's into its sixth reprint now, something like that. Women still keep going through menopause.

James Valentine: The book didn't fix it?

Jean Kittson: No, that's right.And I thought I'd finish and everyone's finished. No, they're still going. Of course they're still experiencing menopause. And just the other night I was out with some younger women and they're still struggling. Trying to work out what the best way to handle it is and what treatment to get and they're still people pushing back around different treatments like HRT.

I was really surprised. We've come on a lot more than we have 10 years ago, people are speaking about it, but there's still a lot of ignorance really, misinformation.

James Valentine: It still seems to be an area of mystery, really, and half whispered truths. Oh well I've heard you should do this, and what about the other?

Jean Kittson: Yes, I think people are still afraid it's going to impact on their work because the Australian Human Resources Institute did asurvey and they found that the majority of women would not mention menopause at work because they thought they'd be considered old, sidelined for leadership positions.With all the stigma still attached to menopausal women. So there's still a lot of, I don't want to talk about it in the workplace. And that of course translates to, I don't really want to talk about it at all.

James Valentine: Yeah, and leading into it, let's say you're 30 or 40. You're not even thinking about it.

Jean Kittson: No, well that's the thing, and yet when I was doing my book, I found that most of the women I randomly chose to interview were having their first hot flushes around 40, 42. And we're always told it's around 50, 52, 55, that area. But many, many women will start going through perimenopause, which is another part of menopause that I didn't even know existed until I went through menopause.

So there's perimenopause that can start 10 years earlier. And some women are thinking, they’ll follow the Hollywood style. Oh, I’ll have a baby. She had a baby naturally at 50. So can I. I'll just keep putting it off. What? Well, was that a hot flush? What the hell? What am I going to do? You know, so it comes as a terrible shock.

And I think there's a lot of things about women's bodies that need to be talked about more openly. Fertility, ovulation, menopause, all those sorts of things.

James Valentine:Yeah. If only it happened to men.

Jean Kittson: If only, we'd never hear the end of it.

James Valentine: That's right, we'd have championships in it.

Jean Kittson: Yeah, that's right.

James Valentine:Set world records, all that kind of stuff.

Jean Kittson:You'd have, you know, months off. Yeah. Menopause month off.

James Valentine: Do you know, he's battling with menopause but still CEO. What a guy.

Jean Kittson: That's right. Hang on, you can't talk to him for a moment.

James Valentine: That's right, just wait.

Jean Kittson:All the windows are open.

James Valentine: He's a little bit emotional but come back tomorrow, he'll be fine.

Jean Kittson: We were going to have a board meeting, it's cancelled. But don't worry about it, it’s menopause.

James Valentine: What? Oh, that's fine, no worries. I went through it myself, man. On you go. Good on ya, chaps. Is it as simple as, like, it was happening to you and you found it difficult to find relevant information, what you needed to know?

Jean Kittson: Oh yeah, that's why I wrote my book.I wrote the book I needed. I needed to find the facts out about menopause, and I found out so many other facts about my own body that had never been talked about. We're just sort of more primed, our whole body is primed to have sex when we ovulate rather than other times of the month. But we're told that women are just ready for it every day of the freaking week.

James Valentine: Yeah, and let me clarify that. That was men who decided that one?

Jean Kittson: Can't say it ain't so. Just because men don't understand women and don't like it when we get a little bit feisty, a little bit irritable, start giving our kids a burnt chop. You know, in the old days, we were diagnosed with climacteric insanity and locked up.

And if men of a certain age got a little bit feisty, a little bit irritable, they were elected to parliament.

James Valentine: That's right. That's very good. Dr Ginni Mansberg's with us. You've met!

Jean Kittson: Yes, we have, Ginni, hello.

Ginni Mansberg: Hello darling, how are you? Hello to both of you.

James Valentine: Thank you so much for coming. Is this, like, I think what we've got to is, I'm sort of seeing, we shouldn't necessarily think about all these things as separate?

It's the entire cycle of life and the entire fertility cycle of a woman that we should be discussing, not as though there's this thing that happens to people called menopause.

Ginni Mansberg: Absolutely. I mean, a lot of people don't realise that menopause itself is a single day that happens 12 months from the first day of your last period.

Only, you probably didn't know it was your last period at the time because your periods were all over the show, often for up to several years before you go into menopause proper. And we call that perimenopause. I call it hormone hell. Your hormones are giving you a triple pike with a half flip because they are going up and down like a yo-yo, and our brains and our bodies really don't like those fluctuating hormone levels.

So often, exactly as Jean was saying, the worst of it comes in your mid to late 40s, not in your late 50s. That's not it at all. In fact, sometimes life gets a lot better on the other side of the rainbow after menopause.

James Valentine: Hang on, just take me back. You said a single day, menopause is a single event.

Ginni Mansberg: It is. So it's defined as 12 months from your last period.That's really problematic for women who, for example, have a hysterectomy before they go into menopause. It doesn't make any sense for those women whatsoever because their hysterectomy might have been at age 40, their ovaries were fully functional and don't go into decline for another six years.

That's a problem for women who use contraceptives like the Mirena coil that have some progesterone in their coil. They don't have regular periods either. So there is a movement to change that definition, but that's what we've got at the moment, that single day. 12 months after you had your last period.

James Valentine: Yeah, we describe it, Jean, as it seems to me like it’s anything from about 45 to 75, a whole period of life.

Jean Kittson: Yes, that's right. That's right. I haven't heard the single daydefinition before, I must say, but of course it is 12 months after your last period, so if you can count to the day, that's the day you are officially, and probably, you know, medically, scientifically, in menopause.

James Valentine: What happens on that day?

Jean Kittson: You buy a bottle of champagne!

James Valentine: Ginni, what happens on that day?

 

Ginni Mansberg: Mostly it's not a lot different from the perimenopause that precedes it. And those early postmenopausal years, that's why I think getting hung up on definitions is problematic from a medical perspective. It's not like once you hit menopause on that day, everything changes.

It's not like that at all. In fact, the treatment is fairly similar whether you've gone through menopause already or whether you're in that lead up, but your hormones are still giving you hormone hell.

James Valentine: Jean, when you were looking at this, did you find a treatment for menopause?

Jean Kittson: Well, when I started going through menopause, I was asking around my friends, what's going on, and they said, oh, it's probably menopause, and most of them didn't take any treatments, and they said it was a breeze for them, or they didn't really like to talk about it.

Some of my friends said, I'm on HRT. Other people were saying, HRT is deadly, you'll get breast cancer. It was during that time. It wasn't long after the Women's Health Initiative brought out the report that linked HRT to breast cancer and everyone dropped off using it.But then it was found 12 years later to be flawed and HRT is the best way to go.

So I had to keep being a fully functioning woman. I had kids at home, elderly parents, I was full-time job. I couldn't stand on stage and start perspiring and mopping my brow, and that's the first time I had a hot flush. I was talking to all these young Czech guys from Ericsson or something. It was a corporate gig, and I'm standing on stage in a silk top, gold silk top.

And then I'm going, is it hot in here? That's probably the first time I mentioned that, you know, out of the million times I've mentioned it since. And I started mopping my brow, and then I looked down, and my whole top had turned like camouflage. I had rings of sweat under my boobs, I had them down the side, and then I thought,I have to do something radical about this.

So I went to a gynaecologist, I talked about HRT, I realised there was a lot of

fear that a lot of women suffered, a lot of women would leave their jobs because they thought they weren't coping with work, but they actually weren't coping with their menopause symptoms. I realised it was like in so many aspects, women were afraid, they suffered, there were these taboos, they were without information, they couldn't lead fully functioning lives, basically.

And so, their biology was in denial, and one of the reasons they denied their biology and didn't talk about it was because when we were allburning our bras and things like that, we wanted to be equal to men, the same as men in the workplace. We didn't want to admit that actually there's things that are going to happen biologically that are going to affect our jobs.

Not for the worse. We just have to work around it. Like we've got the little kitchen tidies in the toilets now. You know, in the old days, men would say, Oh, don't listen to her. She's on the rags, when we got our period. If you said that now, you'd be considered a fossil and a twerp. So we've got to get the same with menopause.

So there's lots of great treatments, but Ginni would know.

James Valentine: Ginni, we might come back to treatments. Let's just discuss the symptoms. First of all, you know, Jean's first moment is ghastly. Thank you for repeating it. But the range of symptoms is also extraordinary, isn't it?

Ginni Mansberg: Yeah, everything from palpitations to shortness of breath to itchy skin, a whole lot of stuff that goes on below the belt. Hot flushes is the one that most people know about and that's because it's really common and very visible. So 75% of women will experience those hot flushes. They're not always dramatic, like Jean’s. Some women just run hotter and a lot of women experience heat at night, so that interrupts their sleep. We see a lot of insomnia.

About 80% of women will experience what we call brain fog. So you can't remember, oh, what's that thing that you write with that leaves ink on the page? Can't remember the name of it.What's that thing that I need to get into the lock of my house? Can't remember that thing. Forgetting people's names, being on a Zoom call and forgetting the name of the project you're working on, that 80% of women will have that, but a lot of people don't realize that this is peak time for mental health issues in a woman's life.

So one in three women will experience some sort of mental health problem. Anxiety and depression are the main ones, and they have particular hues. We often call it the ‘peri rage’. People are just so angry and so annoyed, and they don't understand why they're so angry with people, but lashing out and acting what they feel like is very inappropriate.

They're very remorseful and quite paranoid, very thin skinned, very easily offended. Now, when you put those things together, it's not surprising exactly as Jean says, that untreated, 10% of women will leave the workforce altogether at this time, an additional 14% will decide to go part time or to significantly reduce their hours, an additional 8% of women will either ask for a demotion or actively avoid a promotion, say no to a promotion that's offered to them.

And then we can't understand about number one, the gender pay gap, but number two, the fact that Australasian women retire with so much lower levels of superannuation and the Australian Institute of Superannuation Trustees has estimated that for Australian women alone, menopause costs between $17 and $35 billion a year in lost revenue and lost superannuation because they are exiting the workforcebecause of this hormonal glass ceiling. Now that doesn't happen to everyone, but I think that those numbers are costing the Australian economy enough and women enough that we need to be taking it more seriously and not just saying it's a couple of hot sweats. Suck it up, princess.

James Valentine: Yeah. But I think Jean highlights the difficulty here for many women is to say, is that unless the society acknowledges it, unless the entire workforce and all of our structures acknowledge the existence of these things, it's very difficult for an individual woman to suddenly say in the workplace, actually, can we just deal with my menopause?Um, you know, is that okay? Can we accommodate that now, please?

Ginni Mansberg:I think we really need to talk about the study that Jean talked about called the Women's Health Initiative Study that came out in 2002. So if you allow me just a couple of minutes to explain what happened and why we are in a bit of a disaster today.

So untilthat study came out, around the 1990s, big cohort studies – so when you look at big populations – what scientists had found was that women who were taking the older forms of HRT had lower levels of heart disease. And so the National Institutes of Health in America decided to mount a massive study, 110,000 women, that was a prospective placebo controlled trial.

Don't worry about the details. It's just a really, really good study. And they took women with an average age of 63 who had never had hormone therapy and gave half a placebo and half hormone therapy to look at what would happen to their rates of heart disease and other illnesses. What they didn't expect to find was this.

For every 10,000 women who took a placebo, there were 30 cases of breast cancer. But for every 10,000 women who took this old-school form of HRT that we no longer use at an average age of 63, when the vastmajority of women are well past their symptoms and don't need it anymore, when they started it at that age, there were 38 cases of breast cancer per 10,000 women.

The result of that finding was that, and on top of the fact that no, they didn't have any less heart disease, they decided to cancel the study. But instead of talking about those relative risks and the fact that this was not in the population that used hormone replacement therapy in real world trials, they went to the papers and said, hey, this stuff causes breast cancer.

And a fewthings happened as a result of that. Number one, 80% of women worldwide threw their HRT in the bin and all the menopause symptoms got rebranded as just like a wrinkle, like a bit of, if you can't handle that, you're a princess. You shouldn't need this stuff. It's very dangerous.

The second thing was, and this is really important.There's a legacy of this today, was the doctors were no longer taught about menopause. It went out of the curriculum. I, with all of my postgraduate experience, have never had any formal education on menopause. Everything I know is self taught by joining the various menopause societies around the world because it is not taught to medical students.It's not taught to GPs. It's not taught to gynaecologists these days. This is a real problem.

There are also still black box warnings that exist today on the newer forms of HRT that women are likely to be prescribed that don't even have that increased risk. In fact, with that study, if you took the subset of women in that 110,000 women study, who took the HRT at anaverage age between 50 and 60, there was no increased risk of breast cancer.

So in the real world, use of that old school HRT, there was no increased risk of breast cancer. But the legacy today means that women are told that it's a shameful thing to ask for any help for it. You shouldn't need it because the

treatment is dangerous. It makes women think that getting treatment for it isputting their own lives at risk. It also means that doctors are not skilled up to help women in this situation.

And research, you know, there was no research that was done on this topic for decades. That is starting to turn around as women like Jean, who really was a pioneer in 2014 when her book came out, nobody was talking about it.

And she really, really smashed that stigma. We can't thank you enough, Jean. But as doctors in my generation, the Gen Xers, hit this age group ourselves, we're going, hey, what the hell? What the hell happened to our medical education, and how have we let women down so badly, which we have. I think we're turning the corner, but I just wanted to explain the background for why we are where we are now.

James Valentine: That is riveting, andI mean, Jean, I almost don't know what to make of that. You know, when you say, a gynecologist isn't trained in this, a doctor today. You mean a doctor today, sitting in medical school, how'd they come after the end of six years, and at no point did anybody say, right, this term, menopause.

Jean Kittson: There's a woman called Professor Susan Davis in Melbourne, and she's training doctors in menopause and more women's health, but there wasn't a subset of women's health. And I don't think there ever was one, because I remember this gentleman, he was about 70, coming up to me at a book signing.And he said he was a GP and he said he trained in the 1960s in England. And he said, I'd like to buy your book. Because I've never, he said, the only time at medical school that menopause was ever mentioned was when we were sitting in a lecture theatre, all men, mainly men, sitting in a lecture theatre. They wheeled a woman into the centre of the lecture theatre, a woman of a certain age.

And, um, she was introduced as a menopausal woman. And she looked around and she said, my husband doesn't bother me anymore. And that was it.My husband doesn't bother me. So, that was her, that was their lesson in menopause, that obviously women just go right off sex, that's it. You know, nothing else.

James Valentine: That's the most crucial factor that happens in the whole thing.

Jean Kittson: Yeah. But importantly, what Ginni's saying about the study that

linked HRT to breast cancer, there was a new study that came out in 2012, so 10 years later, that explained why it was wrong and what Ginni was saying.As you get older, you're more likely to get breast cancer anyway. So they were using people into their 70s in this study.

But what happened was when women threw away their HRT was doctors started prescribing antidepressants to deal with it instead. So we have this huge sort of flood of women on antidepressants because they felt confident with that.They felt if they prescribed HRT and their patient got breast cancer, they could sue, you know, it was all up in the air. There was a lot offear in the medical world. So now all these women are on antidepressantswhen what they're experiencing once again is what Ginni said, hormonal fluctuations.

Ginni Mansberg: Anxiety is more common than depression during the peri and menopausal years. In fact, trigger warning, one in three women will get this anxiety and depression. It is peak time for anxiety and depression in a woman's life. It's also peak time for suicide in women is 45 to 55. And it's clearly a hormonal thing.

And we very rightly in this country focus a lot on postnatal depression. And we don't focus enough on midlife women's depression. What we do see is that if you did have a history of previous hormonal anxiety and depression, on the pill, postnatal, it'll almost inevitably come up again during this period, this perimenopausal period.

But we see it a lot in women who have never experienced it before, and severe depression, like a lot of these women can be hospitalised. What we also know, exactly to what you were saying, Jean, about the use of antidepressant medications, at best they are about 75% effective, which is better thannothing.But they do leave 25% of women or people in general who don't respond to them.

That level of effectiveness goes down to around about 50% in women who are going through perimenopause and menopause, whereas the hormone replacement therapy is in fact, 76% effective. So nothing is 100% effective, but this is clearly a hormonal issue.

And if you speak to Professor Jayashri Kulkarni, who is from the HER Centre at Monash University, who is a world leader in menopause andall psychiatric disorders. Her first port of call will always be a hormone treatment and she will

only bring an antidepressant medication in if somebody has severe symptoms, for example, they're suicidal or they can't function or they literally need to be hospitalised and that will only be for a short time and then she gets them off it again and they stay on the hormone replacement therapy. So it's a very different treatment now to what we used to do only 10 years ago, even just when your book came out, Jean.

James Valentine: Jean, I think you highlighted another aspect of this is the time of life at which this occurs. A woman is going to very often have perhaps teenage children,children moving into adulthood. She might be starting to go really well in her career. Her parents are now 70 or 80. You know, there's a lot going on at the point at which this hits.

Jean Kittson: Yes, well, women really are at their peak now in their careers. Once, a hundred years ago, the average age of mortality of a woman, a woman would die at 57, so you hit menopause, you die. Menopause is the least of your problems.

But now we're into our late 80s, mid 80s, late 80s. We've still got a third of our life to live and we still are working and running a family and the kids are probably still at home and we've got our elderly parents. Just as you say. So the time of life when menopause hits is really a very intense time of life for women.There's so much going on. And you may finally be getting into the position at work where you're feeling really comfortable and you know what you're doing. You have all this knowledge and expertise and understanding, and thensuddenly you're battling with something physically that is undermining your ability to manage all these different aspects in your life.

And you have to micromanage so much stuff in life. And when you're not getting sleep, I think that's probably one of the worst things, not getting sleep. Then your anxiety and everything, it goes up. Because you're waking up during the night with these hot flushes or night sweats or whatever you want to call them, that's why you really need to get some proper support.

And now we know, I went on HRT for 10, 12 years, it was fantastic. I couldn't have managed without it. I felt really good. And now there's so much information that it's good for your bowels and your heart and your brain and youreverything, isn't it? Your skin. There's so many things it actually helps in a woman.

James Valentine: Ginni, is HRT the only treatment? I mean, people will see a range of stuff that's beingsold to them or is available.

Ginni Mansberg: Yeah, so there are womenwho can't have HRT or don't want to. And I think what I'm passionate about and a lot of doctors now are passionate about is autonomy of women to have their own choices and HRT is one choice and if women choose not to or can't have it because they have a breast cancer which has what we call oestrogen receptors on it then we give them HRT and there's a possibility we can actually make their cancer worse.

So not everyone can have it. In that situation, we need to have a range of issues. What I love about HRT is of the 53 symptoms that we've so far identified, everything from palpitations and itchy skin to incontinence, and of course, your hot flushes and your depression. It's the only one that wraps up, I guess, every single symptom and helps every single symptom.

That's what's nice about it. However, a lot of women don't even have a lot of symptoms. So what we can do is target your symptoms individually with different medications and antidepressants is definitely an option, although none of them are as effective as hormone replacement therapy.

Because menopause is having a bit of a moment now, but because women are still left with this lingering doubt about the safety and efficacy of hormone treatments, there is a whole raft of products that have come to market promising all sorts of symptom relief, mainly in the supplement space, but also in the tea space, in the wellness powder space. Promising a whole lot of things that we have fairly good evidence do not work whatsoever. But, once you put an ‘M’ on it, and put a pink bow on the cover – we call it ‘meno-washing’.You're going to now charge double for a menopause herbal product than you are for a normal herbal product. Because women are vulnerable, plus we are pretty good consumers. We are generally now, us Gen X women, prepared to go and buy things for ourselves if we think they're going to contribute to our wellness.

So my concern is if you are going to buy one of these menopause products, I would really run it by a doctor who has experience in hormone replacement therapy. And other menopause management, a lot of women will get a placebo effect. In fact, in studies, it's up to 75% placebo effect. In my experience, you'll get a good six to maybe 12 months out of a placebo effect.

But meanwhile, you're getting to the point where, do you remember I talked about the

Women's Health Initiative and I told you that the women who started it late ran into problems. That's the best thing that came out of that study. We know if you are over 60 or if it's been more than 10 years since your menopause, you can't start HRT anymore.It confers a very big number of risks for you.

James Valentine: Well, it seems to me, Jean, we started saying your book is 10 years old. So this is one of the firstvolumes and first statements to break through a lot of taboo about it, a lot of non conversation.

You said, look, things are a little better. We've come some way. I'm not feeling that necessarily by the end of this conversation. It seems to me so much further to go. Any one thing you want to happen right now?

Jean Kittson: I would like women not to just google menopause because then they will get so much misinformation.There are really reputable organisations with the correct information, with the facts, and that is places like the Menopause Society that Ginni mentioned, the Jean Hailes foundation, Ginni's probably got a finger on more of them now, I don't go to them, but both those places have the facts.

Get the facts because there's so much misinformation and it's really controllable. It's a great time of life. If you can get a good sleep and you haven't got the anxiety and you've got control over that, it's wonderful not having to fork out all this money on sanitary products. And you can wear white jeans again, you can go swimming without fear of attracting sharks, it's brilliant. The whole thing is really very, very liberating, but take control over it. Get the right information, get the facts. Don't just chat to people and try and get it that way, becausethere's so much misinformation.

James Valentine: Yeah. Ginni, any one thing you want to see happen right now?

Ginni Mansberg: Yes, if you head to the Australasian Menopause Societywebsite, and then click on find a doctor, you will find a doctor who has a particular interest in menopause and is unlikely to give you the sort of like, oh, you can't have HRT, it's dangerous, kind of advice that I'm still hearing every day.

We have made, Jean and I have made, menopause sound absolutely horrendous, which untreated it is. Treated, it is not. Treated, you have a normal life. You do

not need to leave the workforce. You do not need to end your marriage. It is peak time for divorce. You don't need to have a fight with your best friend or sister.

You can actually have a normal life. And I would urge women not to see this as an inevitable and natural phase of life, so just something to be borne by women or just seeing it as there's nothing you can do. There’s so much we can do for you. Please let us help you and let you get your life back because you don't need to just put up with it.

James Valentine: Thank you so much. Fabulous conversation. Thank you so much for sharing so much information and experience with us here on Life's Booming.

Jean Kittson: Thank you, James, for the opportunity to keep talking about menopause. Talk it up!

Ginni Mansberg: Thanks, guys.

James Valentine: Well, if you want to know more, you could do no better than to read Jean Kittson's book You're Still Hot To Me.As we said, it's still out there. It's still a very vital book examining the conditions for menopause in Australia.

And Dr Ginni Mansberg's book is called The M Word, and it's doing the same thing. It's looking at the medical basis, as we keep saying, the facts about menopause.

Well I hope you enjoyed this episode of Season 5, Life's Booming, Is This Normal? Brought to you by Australian Seniors.

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