#133: The Menopause Conversation You'd Have If Your Bestie Was A Woman's Health Specialist. With Dr Nicole Avard and Georgina Drury

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“This is not a women's issue: this is a societal issue. We all have women in our lives that we love, that we work with, that we care for, and we MUST be putting these conversations on the table.”

If you’re listening to THIS podcast, chances are you’re a veterinarian. That means that statistically, there’s about a 70% chance you’re a woman. That makes an honest, in-depth conversation about menopause not just relevant, but essential. This is that conversation. 

And even if you’re not a woman, or menopause is still decades away for you, you almost certainly work with or live with someone for whom this topic is, or will be, very significant. You should absolutely care about it- and know about it.

In this question-and-answer conversation, recorded live at the Greencross Symposium 2024, we unpack the science, symptoms, and solutions with Dr. Nicole Avard, menopause specialist, and Georgie Drury, founder of Metluma, a digital health initiative that supports women through menopause.

From understanding the biology of menopause to tackling its impact on mental health, career, and workplace culture, this is the conversation you didn’t know you needed—but one that will make a difference in your life and practice. 

Topics and Timestamps

[00:04:00] Menopause 101

[00:06:00] Biological Changes During Menopause

[00:08:00] Symptoms of Menopause

[00:12:00] Mental Health and Menopause

[00:15:00] Challenges in Diagnosis and Treatment

[00:17:00] HRT Safety and Benefits

[00:22:00] Myths and Misinformation

[00:32:00] Organisational Responses to Menopause

[00:40:00] Menopause Q&A

• Gradual discontinuation of HRT.
• Role of diet in managing symptoms:

[00:45:00] Advanced Questions on Treatment

• Using IUDs vs. transdermal progesterone.
• Blood tests for diagnosing postmenopause.
• Role of testosterone in symptom management.

Speaker bios:

Nicole Avard

Dr Nicole Avard is a dedicated Menopause Specialist GP with 18 years of experience as an Integrative GP. As the Medical Director and Co-founder of Metluma, she is passionate about guiding women through the complexities of menopause. Dr Nic has supported thousands of women on their menopausal journey, offering compassionate and individualized care. 

Georgia Drury

Georgie is an experienced entrepreneur and CEO, with a passion for health and technology. As founder and CEO of Springday, she built the business into a multi-million-dollar global organisation, operating across 13 countries in ASPAC before exiting and moving onto her next venture. With Hummingbird Innovations, Georgie advises, invests, and collaborates with boards and organisations. She is currently Co-founder and CEO of Metluma, an exciting and innovative digital health initiative aiming to support women by taking a proactive approach to menopause.

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“Why Menopause Isn’t Just a Women's Issue: A Workplace Perspective”

Menopause is often seen as a women's issue, but it's actually a societal issue that impacts everyone. The episode explains why this is the case and what workplaces can do to support their employees.

Menopause is More Than Just a Personal Health Issue:

• It impacts a large percentage of the workforce. Around 80% of veterinary professionals are female, and many of them will experience menopause-related challenges.
• Symptoms can be debilitating and impact work performance. Symptoms can range from hot flashes and insomnia to anxiety, depression, and cognitive issues. These symptoms can lead to decreased productivity, absenteeism, and even early retirement.
• The stigma surrounding menopause prevents open discussion and support. Many women feel uncomfortable discussing their symptoms, fearing judgment or negative career repercussions.

Creating a Supportive Workplace:

• Start conversations and raise awareness. Open dialogue is essential to break down the stigma surrounding menopause. Encourage discussions at all levels of the organization, including leadership and HR.
• Provide access to resources and support. This could include:
• Information and education about menopause and its symptoms.
• Access to healthcare professionals trained in menopause management.
• Flexible work arrangements to accommodate individual needs.
• Employee resource groups or networks for peer support.
• Consider menopause-specific leave policies. This could include paid time off for managing symptoms or attending medical appointments.
• Lead by example. Leaders and managers should model positive behaviour by openly discussing menopause and supporting employees.

By taking these steps, workplaces can create an environment where women feel supported and empowered to manage their menopause transition, leading to better health outcomes for employees and a more productive and inclusive workplace.

“Get Better at Recognizing Mental Health Risks During Menopause”

The episode highlights the significant mental health risks associated with menopause, particularly during the perimenopausal transition. It's crucial to recognise these risks as they can often be misdiagnosed as stress or other life challenges.

Here's how to get better at recognising mental health risks during menopause:

• Understand the Hormonal Link: Fluctuations in oestrogen, progesterone, and testosterone, especially during perimenopause, can significantly impact mental well-being. These hormones affect neurotransmitters like serotonin, dopamine, and GABA, which are crucial for mood regulation, sleep, and cognitive function.
• Recognise the Range of Symptoms: Menopause can manifest in various psychological symptoms beyond the commonly known physical ones. Pay attention to signs like:
• Overwhelm and Irritability
• Anxiety and Depression
• Rage and Mood Swings
• Cognitive Issues ("Brain Fog")
• Sleep Disturbances (Insomnia)
• Consider Menopause as a Contributing Factor: When encountering women in their 40s and 50s experiencing mental health challenges, consider menopause as a potential contributing factor, even if they haven't discussed it.
• Don't Dismiss Symptoms as "Just Stress": While stress can exacerbate symptoms, it's important to differentiate between general life stress and the specific hormonal changes during menopause. Both can impact mental health, but require different approaches.
• Encourage Open Communication: Create a safe and supportive environment where women feel comfortable discussing potential menopausal symptoms without fear of judgment. This can be within families, workplaces, or healthcare settings.
• Advocate for Awareness and Education: Promote awareness and education about menopause and its mental health implications. This includes educating healthcare professionals to improve diagnosis and treatment.
• Acknowledge the Severity: The sources emphasize the seriousness of mental health risks during menopause, highlighting the tragically high suicide rates among women aged 45-54 in Australia. This underscores the urgency of addressing these challenges effectively.

By understanding the hormonal basis, recognising the diverse symptoms, and fostering open conversations, we can better identify and address the mental health risks associated with menopause. This proactive approach empowers women and promotes their overall well-being during this significant life transition.

"How to Access the Right Menopause Care: Tips for Busy Professionals"

Accessing the right menopause care can be challenging, especially for busy professionals juggling demanding careers and personal responsibilities. The sources offer valuable insights and practical tips for navigating this journey:

1. Advocate for Yourself and Be Proactive

• Initiate the Conversation: Don't wait for healthcare providers to bring up menopause. Proactively raise concerns and ask questions about potential symptoms or treatments, even if you are in your early 40s.
• Prepare for Appointments: Research potential symptoms and treatment options beforehand. Having a list of specific concerns and questions can help facilitate a more productive conversation with your GP.
• Persist Despite Potential Barriers: The sources acknowledge that GPs may not always be well-versed in menopause management due to limited training and systemic issues within healthcare. Be prepared to advocate for your needs and seek out specialists if necessary.
• Don't Dismiss Symptoms as "Just Stress": While stress is a valid factor, it's crucial to differentiate its impact from the specific hormonal changes associated with menopause. Advocate for thorough investigations and don't settle for dismissive explanations.

2. Seek Out Specialised Expertise

• Find a Menopause Specialist: Consider consulting a menopause specialist or an integrative GP who has expertise in hormone health and can offer more comprehensive advice and treatment options.
• Explore Digital Health Solutions: Utilise apps like MetLuma to access reliable information, symptom tracking tools, and connect with healthcare professionals trained in menopause management. These platforms can be particularly helpful for busy individuals who value convenience and accessibility.

3. Utilise Available Resources and Support

• Leverage Workplace Support: If your organisation offers wellbeing programmes or access to women's health resources, take advantage of these initiatives. Advocate for menopause-specific policies like flexible work arrangements or reproductive leave to better manage symptoms.
• Connect with Support Groups: Join online or in-person support groups to connect with other women going through similar experiences. Sharing experiences and information can be incredibly empowering and validating.

4. Understand Treatment Options and Their Benefits

• Explore Hormone Replacement Therapy (HRT): HRT can be a highly effective option for managing a wide range of symptoms, including hot flashes, sleep disturbances, mood changes, and cognitive issues. The sources debunk common myths surrounding HRT and highlight its safety and numerous health benefits when prescribed appropriately.
• Consider Holistic Approaches: Alongside HRT or as a complementary measure, adopt lifestyle modifications that support overall well-being:
• Diet: Focus on a balanced Mediterranean-style diet rich in fruits, vegetables, healthy fats, and adequate protein intake to manage weight, energy levels, and sleep quality.
• Exercise: Engage in regular physical activity to support bone health, manage weight, and improve mood and energy levels.
• Sleep Hygiene: Prioritize good sleep habits to combat insomnia and improve overall well-being. Experiment with techniques like relaxation exercises or a consistent sleep schedule.
• Stress Management: Incorporate stress management techniques such as mindfulness, yoga, or meditation to alleviate anxiety and improve emotional well-being.

5. Be Patient and Persistent

Finding the right treatment plan and adjusting to the changes associated with menopause takes time. Be patient with yourself and your body. Track your symptoms and communicate openly with healthcare providers to fine-tune your approach and achieve optimal well-being.

By being proactive, informed, and persistent, busy professionals can navigate the menopause transition with confidence and access the support they need to thrive in all aspects of their lives.