You're listening to a Mother with Me podcast Australian Women.

Welcome to your full Body Health Check.

I'm Claire Murphy and for the sake of today's episode, because we are talking about pregnancy, I'll let you know that I have been pregnant twice in my life.

Once when I was a very young teenager, which is a pregnancy I chose to terminate and have zero regrets about.

And then I got pregnant again at thirty five, where I was wonderfully called a geriatric pregnancy, and that resulted in my small human And I'm.

Doctor Mariam a GP, a mother and someone who has lived the full spectrum of the fertility journey, from the heartbreak of my firstborn Samuel, who was a still birth, to three miscarriages and two years of infertility.

My path has been anything but easy, but it led me to my greatest blessings, my beautiful rape toom boys, Zak and Jagin.

Thank you so much for sharing that.

I know that sometimes with your self f and with friends of mine who've really struggled to get pregnant and to have babies, it's a really emotional thing to talk about, especially all the losses too, so but I think it's interesting to note that, like our pregnancy journeys could not be more different, Like it's such a vast array of experiences involved in getting pregnant, being pregnant, and having babies.

Because I was the discussion with my husband worders went, should I just stop taking the pill?

And like if it happens, it happens, and if it doesn't, it doesn't, and he's like, yeah, cool, and then it did and it was just like and then we're like cool, do you I want to do it again?

And we're like not.

Really won and done.

We could Yeah, very very different perspectives.

And in case you haven't worked it out, we are talking about being up the Duff today with child prego bun in the oven however you would like to refer to it.

We will find out what's happening to your internal and it is a lot.

And we have a quick consult for Tony who's been seeing a bunch of people on her feed talking about a hormone that she thinks that maybe she might need to but her understanding is is that it's something that is exclusively for men.

Now, Mariam, I have found out something very interesting about women's buttholes.

Go for it.

I've said this before, I will say this again.

I am a deeply immature human being, and I will laugh every time I say but holes.

But here we go.

Something happens to some of our buttholes during our period.

Yep, we need answers.

This is very serious medicine, Mariam.

I want to know where this conversation is going.

Let's go to med school.

Welcome to med school, Mariam.

We've discussed all types of pain that women might experience from various things, but have you ever experienced a proctaalgia fugax?

Oh my goodness.

Now, this is something that happens to a lot of women when they have their periods.

So you might just be, you know, walking along, minding your own dead business when you're hit with a really short, sharp pain in your buttthole.

It feels like someone shoved a hof knife up there for a second.

Yep, it is like butt lightning.

It's reportedly super normal, quite harmless.

It's a spasm in the anal sphincter or pelvic floor muscles.

The pain can last somewhere between a few seconds, which I think is what the majority of us have probably experienced.

Two way recorded ninety minutes, which sounds like the worst day ever.

Marriam, do you get butt lightning on your period?

Butt lightning?

Yes, so proctalgia four gucks.

It sounds like a Harry Potter spell.

Steels more like a curse.

Yes, I've had that surprise up and it's usually like.

Surprise that it's exactly what that is.

It's usually in the coal's freezer, ales, I've gotten us.

That's where your butt always decides to betray you.

It's either that or a fot triggered by the coals.

Goods.

Yes, So if you are just randomly sitting there and it's like Harry Potters zapped you with his wand in your buttthole, it's totally fine.

Don't stress.

From spiky buttholes to actually being up the dove.

Today's checkup is all things pregnancy.

It's time for the checkup, okay, Mary.

Can we talk about the first trimester?

What is actually happening in your body when you conceive and why a first trimester Mum's so tired.

So when you conceive, your body immediately kicks into pregnancy gear, right.

It wants to support that tiny new life.

The fertilized egging plants itself into the lining of your uterus, which starts releasing hormones like hCG and progesterone, And those womens do a bunch of jobs.

They keep the pregnancy going, they stop your periods, and they start preparing your body for the months ahead.

So why are we all so exhausted during that first trimester.

It's always the hormones, same hormones.

Yeah.

The progesterone, which we call the pregnancy horn, relaxes your muscles, including your digestive tracks, so that can make you feel a little bit sluggish.

Your metabolism is revving up, so your heart is working harder to pump that extra blood, and your body's busy building the placenta, which is like a new organ and other essentials, so your blood sugar and your blood pressure can dip as well, and that leaves you feeling wiped out.

So you're adding that emotional rollercoaster as well.

Sometimes you might get the nausea, the morning sickness, and it's no wonders that the first trimester is relentless.

The good news is that it starts to ease up when you get to the second trimester, when your body starts to adjust.

So if you're feeling wiped listen to your body.

Rest when you can, eat good foods, stay hydrated, and don't beat yourself up if you need that extra downtime.

Your body's doing incredible.

It's growing a human.

But in saying that, I just wanted to have a conversation and want to see what.

Your thoughts are.

A lot of people don't like telling people about their pregnancies until late past that twelve weeks because they feel like they're in the safe But then this is when they need a lot of extra help and support because they're tired and they're wiped out.

They're like, oh, how am I going to tell my employer that I'm pregnant and you know I might miscarried.

I want to tell my family.

Well, that's it.

It's the most common window for miscarriage, right So, and if something happens to you and you haven't told anybody, it.

Makes it hard.

It does, But I kind of want to break that cycle.

As females, when we see that positive pregnancy stick, there shouldn't be that stigma where we shouldn't be allowed to announce it.

Unfortunately, one in four pregnancies do end in miscarriage, and that's when we need support.

And if we haven't spoken about it, then how do we get that support?

So I think you know acknowledging I'm pregnant, and if a miscarriage does happen, then acknowledging I need support and people knew about it.

Can you answer me this question?

Riddle me this, yes, Mariam, but can you please tell me how we predict a baby's due date and how accurate it is?

Because there's some math going on here, but realistically, forty weeks, which is our normal gestation period, doesn't add up to nine months already.

The math is math for me.

So how do we.

Predict the day that baby's supposed to come out?

Okay?

The magic date?

It's the date we all obsess over as parents.

It's a bit of a legend, to be honest.

Okay, So the standard way we work it out here in OZ is you take the first day of your last menstrual period and you add two hundred and eighty days or forty weeks.

To that date.

Sounds straightforward, but pregnancy isn't always a neat nine month package like the calendars, and.

Neither are our cycle.

Ye exactly, So.

The forty weeks is based on an average twenty eight day menstrual cycle, assuming ovulation happens on day fourteen, but not everyone's cycle plays by those rules.

Some females ovulate earlier, some later, and the date can shift.

Plus months aren't all the same length, so you've got thirty day months thirty day ones, and then you've got February as well.

But here's the kicker.

Only one in twenty babies will actually only arrive on their due date.

Most babies will come either two weeks before or two weeks after, so the Jew date is more of a rough window, not a ticking clock.

So early ultrasounds in pregnancies can help us estimate gesstational age if we're not really sure when our last mental period was, or if the cycle regularity, and if things start to stretch beyond the Jude date, then you know you've got your treating team that will help you guide you through that.

So don't stress about the ju date.

Baby is not likely to come at that date.

Just be aware if your baby does come after the jud date, like mine did, it might come out.

A lot hairer than you expected.

Just a little shock surprise that you might not be aware of Mariam.

What should very early pregnant mums be doing from the get go.

I know there's a lot of talk about what you should have already done in the lead up to conception, like not drinking alcohol and taking folate supplements for example, But what are the first things you tell a newly pregnant woman to do.

I love these consults, like I'm a GP shared antienatal care provider, so I would start if you think you're pregnant, finding a GP with antenatal experience and don't just wait, so kind of book that consultation in early and there's a lot we can do to support a healthy pregnancy physically, emotionally, and logistically as well.

So when you see your doctor, we will confirm the pregnancy with like a urinal blood test based on what I've said before, and if we're unsure, we'll do that dating scan for you.

And then this is the.

Most important part of the conversation.

It's never always congratulations on your pregnancy.

I always start the conversation with is this a congratulation?

And it's important because you know for some people it's a surprise, it's not at the right time.

There are a reason and.

When Ilse told when I was a teenager, I had a major breakdown.

So yeah, it's not always a.

Welcome Yeah, that's right.

And so your GP will walk beside you without judgment.

They'll have that conversation and if termination is something that you're considering, will guide you through that process and make sure that you have the right supports.

If you are thinking of continuing the pregnancy, it's ensuring that you're on the right supplement.

So we spoke about folic acid and iodine, but then there are so if you're at risk of preclamsy you've had preclamcya before, you might need to be on aspirin or calcium.

So it's important we go through your medical surgical history, go through any medications you're on that might be teratogenic so they might harm the baby, or we might need to change dosages of some medications as well.

Then we check whether your cervical cancer screening is up to date.

So I'm going to break a myth it is safe during pregnancy.

There's also the self collection.

If you're really worried about anything touching the cervix, that self collection just touches the side walls of the vagina, so that's completely safe.

We also might offer an sci screen for some people if that's relevant as well.

We'll check if your immunizations are up to date, and we'll tell you about the schedule of immunizations during pregnancy, which are really really important.

I know there's a lot of misinformation online.

If you have any.

Concerns regarding immunizations during pregnancy, please please speak with a trusted healthcare professional.

Do not get your information from untrusted sources online.

Then we'll talk about lifestyle and nutrition.

So obviously no smoke, no vaping, alcohol, lissa drugs, and that includes passive smoking.

Sometimes just being around people that smoke can also harm the baby.

And then there's the food safety.

That's a big one.

There are certain.

Foods to avoid, soft cheeses, deli meats, or all seafoods.

There's a whole bunch of foods, and it's not about instilling fear, you know.

I still want people to go out and be able to eat healthy foods.

I usually refer people to the New South World Food Authority Guide.

It's a great resource, has a lot of information about It's got like a red light, green light, orange light system or things to just be cautious with I usually print that out for them.

And important conversation I also have is about domestic safety and emotional health.

So this part is so important.

We will ask gently and privately about your safety at home.

Unfortunately, pregnancy increases the risk of DV.

The questions aren't just routine, they're protective.

We also talk about mental health.

So peronatal anxiety is very very common and it's a risk factor for postnatal depression.

So we catch it early.

We can put in those supports early, and if anything's flagged, we'll help you access the right care.

I I'm a bit of a debbie down us.

I've been through the miscarriage journey, and even as a health professional, I was also a bit annoyed that we don't have this conversation that one inful pregnancies unfortunately do anti miscarriage.

So I think having that conversation at that first consert with the doctor saying this may not be your story, but I want you to be prepared.

These are the signs and symptoms to look out for ectopic pregnancy.

Education of the signs and symptoms to look out for, and it's not about you know, kind of ruining the mood and the celebrations.

But it's about providing them with that information that you know will be really, really helpful if it was to end that way, because we often find ourselves when we do experience those things asking why didn't anyone tell me about exactly?

Yeah, you'll have some antenatal bloods and potentially genetic screening if you haven't had that offered, and then we'll plan the antenatal journey.

We'll talk to you about the options.

Whether you want to go privately or publicly through a midwife system or whatever that might look like, and we'll put those referrals in place, and then we follow you up.

My gosh, that's a lot, it's a lot.

One.

Yeah, it's I love those consoles and then obviously the physical examination as well, but no, it's a great, great console.

I love those consultations.

Well, I wanted to.

Ask you too, because it's something that I did not know how to face when I was pregnant, is how do you find a good ogb wyn or midwife?

Like, do you need a referral?

Can you go and hunt one down for yourself?

So you do need a referral from your GP, which is why the GP's your best starting point and they can recommend someone based on your health needs, your location, or your birthing preferences.

Most mid referee care is available through the public systems unless you wanted to go privately as well.

I find the Facebook Moms group really great in terms of recommendations and experiences of obstetricians that they've had as well, So that's always a good place to start.

You can look online, you know, if you've got specific issues like your high risk we've got a twin pregnancy, there are also obstetricians that kind of look after those or doing a bit of research on your part or speaking to your doctor about any preferences that they might have.

Yeah, so that your first port of call and they'll match you to the right.

Team for you through your pregnancy journey.

Amazing.

Okay, on the way, we're going to answer a quick consult for Tony who's on HRT but she thinks maybe it's missing something that most of us think only belongs to men.

But next we're catching up with Associate Professor Kirsten Palmer to talk through all the basics of pregnancy, from like bigger feat to blood pressure, the food rules, and why medications may not work as well when you're expecting.

We are talking about pregnancy today that forty weeks, which is a mix of terror, fascination, pain, happiness, worry, and a whole bunch of excitement.

Yeah, but what should we really expect being pregnant and what is our body actually up to?

We spoke to Associate professor in obstetrics and Gynecology at Monash Health, kirst and Palmer.

I asked her first of the question many of us have asked about the early stages of pregnancy, and that is morning sickness.

Just why it is such a good question, and you're right, it just doesn't make any sense that you should have these challenges early in pregnancy.

We still don't really understand it, but what we know is that it seems to be just due to all of those huge hormonal changes that women are going through in that early part of pregnancy.

We've got this some huge uptick in our progesterone and estrogen levels, and certainly high estrogen is associated with nausea and vomiting.

And then we've also got that hCG hormone, that hormone that we pick up on our home pregnancy test that also increases rapidly throughout that first trimester, and that is also strongly associated with morning sickness.

And then increasingly we're understanding that there are some other hormonal changes as well.

A little hormone called GDF fifteen is its complex name, recently has been discovered that is strongly associated with nausea and vomiting.

And the benefit with that discovery is that there are also some exciting new treatment possibilities that are in the early phases of development and testing.

So hopefully we might actually have some treatments that work for morning signs and years to come.

Amazing, and could that also apply to those people who get that real next level morning sickness that I can never pronounce correctly, for those people like the Princess of Wales experience that when she was pregnant, So could that potentially be helpful for people in that situation?

Absolutely?

So high premises.

Gravitiram is then that you're thinking of, and you're right, that is a truly awful complication of pregnancy, and so that is what we are desperately working towards, trying to find more effective treatments.

For Why is it so important to monitor blood pressure during pregnancy and what exactly is pre a clamsier and what is it doing if we don't get on top of it.

Yeah, so around one in ten women will actually get high blood pressure during pregnancy, and so it's quite a common thing that can happen, and so that's why we pay such close attention to women's blood pressure so.

That we can pick that up.

If you get high blood pressure and pregnancy, it largely can have significant impacts for a mother's health.

So we really want to be able to pick that up and manage it to keep mums healthy and safe.

But it can sometimes have effects for their babies as well preclamp series where you not only have high blood pressure, but it can also go on and have impacts on other organ systems throughout a mother's body.

So it can impact on her brain, her heart, her kidneys, her liver, and combinents within our blood, but it can also impact on the placenta and the fetus in terms of how the baby is growing.

And so it's just a lot more of a complex condition.

Thankfully that only effects around three percent of pregnant women, but it is a really important one to pick up to keep mums and babies safe.

The other one that we do testing for when we're pregnant is gestational diabetes.

What are the risk factors for that?

And I do understand that there are some cultural risk factors also to an aboriginal and torres rate Islander women need to be aware that they are more prone to it.

But why does that occur in some people?

Yeah, so gestational diabetes is one of those trickier things because it depends on the levels that we set to determine the disease itself, and there is discussion at the moment, and those levels are going to change to hopefully reduce the number of women being diagnosed with gestational diabetes.

But you're right, we do see that some groups are more inclined to get that, such as our First Nations people, but we also see it's higher in South Asian women and sometimes even some Southeast Asian populations.

For us in.

General, it's as we get older, we're a little bit more inclined to develop gestational diabetes if we've got some pre existing health challenges such as if we're carrying a little bit of extra weight, or we've got, you know, issues in the past with high blood pressure, or we've had gestational diabetes before, then we're much more likely to have it again.

Why is this form of diabetes different to others?

Because you don't get diabetes life long after gestational diabetes, do you.

Well, you don't, but you are at an increased chance of developing lifelong diabetes.

So we know about fifty percent of mums who have had gestational diabetes will go on in the decades to follow to be diagnosed with type two diabetes.

But you're right, it's not a form of diabetes like type one or type two, and it's more something where you can think about it as kind of a glucose intolerance.

So as those sugar levels go up, just the way that our bodies manage that isn't necessarily quite as effective in pregnancy as it should be outside.

And that's once again thanks to those amazing hormonal changes of pregnancy, because glucose is that main form of energy for baby, so our bodies are using those hormones to increase our glucose levels to support baby's growth.

And just sometimes our bodies are able to cope with those hormonal changes better than others.

I'd like to get a definitive answer from you on this, because when you get pregnant, people will tell you all amounts of things that you can and cannot eat.

I would like to understand what are the rules here, both with foods and with things like alcohol.

So I mean, certainly, I think alcohol is the easiest one.

You know, certainly without a doubt, very consistent messaging that we do not know what a safe level of alcohol consumption in pregnancy is, so very very consistent messaging on please do not drink alcohol as soon as you're starting to try for pregnancy, recognizing we don't know when we're going to conceive, but certainly not throughout pregnancy itself, and that certainly low levels of alcohol still have been associated with challenges such as Feederal Alcohol Spectrum disorder.

In terms of.

Foods that you can or can't eat, a lot of this just comes down to trying to prevent picking up some infections that can be found in our environment and in our communities.

And the main.

Way that we can get exposed to that is you usually through soil exposure.

So that's a great way just to remember to avoid those ones.

It's just ideally.

Washing fresh fruit and fresh veggies, and so that's where often there's that recommendation of avoiding pre prepared salads, for example, because you just don't know how have they been prepared, how well have they been washed.

But we can also pick up things through raw meats, so once again just making sure that meats have been really well cooked, and that's why we recommend avoiding kind of deli meats and raw meats as well, just because it could increase that risk of picking up some of those infections that we can see in raw meat.

And lastly, the other infection that we really want to avoid is something called listeria, and we can find that in some dairy products, and that's where it's that recommendation of avoiding soft cheeses, soft served ice creams where we can see a bit of a higher association.

So they're kind of those keys around what to avoid or just how to make sure that you're preparing foods so that you actually can still enjoy it.

Quite a diverse array of food through pregnancy.

So why do we fill up with fluid?

Like, you know how, especially towards the end of pregnancy, Like even in my own experience, I could see the fluid so much under my skin that like I would put my foot down and you could see it almost like a wave of it going through underneath my skin, Like, why is that happening?

Oh, it's horrible, isn't it.

And it's because during pregnancy, obviously you're supporting not just yourself, but you're also supporting baby.

And so during pregnancy we do actually expand our blood volumes, so we've got more fluid in our body.

Automatically because of that, we put on about an extra liter of weight purely just in blood, and then particularly with our feet at our legs.

As baby grows and we progress through pregnancy, it's harder for that blood to come back from our legs and our feet and make its way back past baby up to our heart, and so we see some more fluid from our bloodstream leaking out into our feet and our legs, and that's why you can get that swelling that you notice.

It's a very normal thing.

Often, sometimes there can be challenges like pre clampsy that will lead to excess fluid building up, but that's the most common reason as to whye we see that.

Speaking of that extra blood volume, this is something I didn't consider, but a colleague of mind, Jesse Stevens, just spoke about the fact that her medication that she was taking for anxiety wasn't as effectual when she was pregnant, and it's believed to be because of that extra blood volume.

Is that right?

It is, so we need to think about it for a lot of prescription medications that women might be on heading into pregnancy, in that when we're pregnant, we do have that bigger blood volume, and we also have an increased metabolic rate, so we can break down medications sometimes much faster than what we did outside of pregnancy.

So it's not uncommon that we do need to think about increasing the dose of some medications in pregnancy because of those reasons.

Why does it take us longer to get over things from the mum's perspective when we are pregnant, So like catch a cold or a tummy bug or something, and it's like your body goes, I don't care about you anymore.

I only care about baby, So you're just going to be sick for a really, really long time.

Like is that the reason?

Is it just just you are not the priority right now?

Well, no, you were definitely the priority, but you have certainly made lots of adjustments to support and prioritize your baby's health and wellbeying as well.

And one of those is that we do change the way that our immune system works to quieten down our immune system.

Generally, our bodies are extremely good at fighting off kind of foreign invaders, and you know, a baby would count as a foreign invader, So we need to kind of quieten down our immune system so that our body accepts and lives with our baby to support them in growing.

We know that we're asked to get vaccinated for certain things when we're pregnant, like hooping cough, for example, so that we give our infant that little bit of antibody that that might help them avoid catching it when they're too little to be vaccinated themselves.

But does that work for other things, Like if we to get a flu vaccine, for example, is that safe during pregnancy or there other vaccines we should be getting to help out in that period.

Yes, so certainly the flu vaccine is very safe to have in pregnancy, and it's certainly one of those vaccines that we do recommend that all pregnant women have.

We use the flu vaccine largely to help to protect mums, because mums are more vulnerable to needing hospitalization for flu when they're pregnant, and we know that the flu vaccine really reduces that risk for them.

Yes, it also though does give benefit for their baby and their baby will also have protection against flu in their first few months of life, which is really helpful.

Much the same as with the hooping cough booster.

And then just this.

Year now we've also got the RSV vaccine that's become available from February, and that's really beneficial knowing that RSP is actually probably the virus that is the greatest contributor to children under two years of age requiring hospitalization in Australia.

O hear that miscarriage is actually really common, that many women will experience that, maybe even more than once in their lifetime.

But is there anything we can do to try and prevent that from happening.

I've been reading quite a bit about how much Dad's genetic material actually is involved in ensuring miscarriage doesn't happen.

I mean, other than I don't know switching out dad's DNA, is there anything we can do to try and stop miscarriage?

Look, it is a really good question, and it's certainly a question that there's a lot of people trying to find more effective answers to be able to change.

But you're right, sadly, a bit over one in five.

Women will experience miscarriage at some stage during their reproductive lives.

In terms of why that happens, it can happen for a whole wide range of reasons, and certainly the things that we know of that may contribute to reducing the likelihood of that happening is really focusing on our own health and our partner's health leading in to pregnancy.

Really optimizing healthy eating, reducing smoking, reducing alcohol or other drug intake, optimizing whatever pre existing medical conditions that we might have, so that as we enter into pregnancy, we're doing that in the best state that we possibly can.

Certainly, we can't blame partners entirely for their genetic contribution.

It does take a partnership, so we do see contributions from both mum and dad contributing to that.

And that's also where we do have a higher chance of having genetic changes in baby that can be associated with miscarriage as we get older, and that's older for both mums and for dads.

And does that include women who have frozen their eggs when their eggs are younger, Like, does your chance of miscarriage decrease if you're using eggs from twenty five year old but you're pregnant when you're forty.

Correct, you're absolutely right.

So it's down to the kind of genetic makeup of our egg and our sperm at that time that they're being used for conceptions.

So you're right.

If we're using a twenty five year old egg even when we're forty, that genetic risk is the same as a twenty five year old.

Thank you so much to Kirsten for giving us a lowdown on a ton of pregnancy related things.

Let's be honest, though, we could go into so many different things to do with pregnancy because all of our experiences are so different.

What are your thoughts on one persons said on the topic of miscarriage.

I wanted to talk about the new national guidelines that have finally redefined what we call recurrent miscarriage.

For years of us defined as three consecutive losses, and frankly, that threshold didn't reflect the lived experiences of so many because let's be honest, even one miscarriage can be emotionally shattering.

So the new guidelines recognize that recurrent miscarriage means two or more pregnancy losses and they do not have to be back to back.

And this change matters.

It means earlier access to investigations, more timely supports, and importantly, it validates the grief and uncertainly people feel after are just one or two losses.

As someone who's walked this road myself, I know how isolating it can be.

And these updates just aren't clinical tweaks.

They're about being seen.

They're making sure no one is told to just keep trying and without any real answers or compassion or support.

So we're definitely heading in the right direction.

And I also just wanted to add the guidelines call thank god for clinicians to use sensitive trauma informed language, so instead of hearing cold clinical terms like spontaneous abortion, which was a thing, patients are met with compassion and understanding and validation of their grief.

I just want to say too, this is a public apology to a friend of mine.

I've not had a miscarriage, and when I was in my very early twenties, a friend of mine had one and I did not handle it well.

I didn't understand that losing a pregnancy at the very beginning could be emotional and traumatic because we'd spend so much of our lives trying not to be pregnant, and and I think at that stage I was not mature enough to really understand how difficult that process can be and just how heartbreaking it can be.

And so I was one of these I'll just try again, you'll be fine, like it's nothing.

And I had no idea how deep the loss of a pregnancy, regardless of how far into it you are, can be really deeply emotionally scarring.

Yeah, well, I, as a whole professional, had the same perspective.

I don't think it's just about maturity.

I just thought that's how it was until I experienced it myself.

But yeah, hopefully with this new guideline and more open conversations that we can all get there.

Up next, Tony's on HRT, but she keeps hearing there's one hormone that she might be needing a bit of an injection of that is not estrogen or progesterone, this destosterone.

The doctor will see you now, just through here to consort Room one.

Mariam.

It is quick consult time.

So if you could please do the honors so we can find out how to help Tony with her issue today.

Thank you for waiting.

How can I help you?

So?

Tony contacted us through the well Instagram dms, which I've been chatting to people on.

Thank you so much.

I will not give you health advice.

I am not qualified, so you can do that too if you want to hit us up in the DMS.

I'll always check with you to see if you want your name included or not, so I don't feel like you're putting everything out there in the world for everyone to see.

Okay, Tony asks this.

I'm on HRT now due to my pery symptoms being just awful and it is helping a lot.

But I've seen in my feed about also taking testosterone.

I've seen that it helps with libido, with joint pain and a bunch of other stuff.

Should I be asking my doctor about that too?

No one seems to be taking it in my group of friends, and they didn't have any idea that maybe they should be.

Okay, great question, Tony, and you're definitely not the only one that's curious about this.

Testosterone is having its moment in the perimenopause.

And menopause space and for good reason.

But it's not a magic fis and it's certainly not for everyone.

So here's what the science and the AUSSI is At the Australasian Menopausal Society tell us mind you, that is where you should get all your information on perimenopause and menopause.

It's all backed by scientific data.

So we know.

Testosterone is naturally produced in very small amounts in females and those levels slowly decline as we age, especially with menopause.

But here's where it gets tricky.

There's no agreed blood level to diagnose low testosterone in females, and that's why symptoms and contexts are key.

For some woman, low testosterone might play a role in low libido that's your sex drive, or reduce sexual satisfaction or arousal.

Testosterone therapy is only recommended for females experiencing low sexual desire that's causing significant distress, and we know that medically as hypoactive sexual desire disorder HSDD.

And despite the online hype, there's actually no scientific evidence supporting testosterone use for symptoms like fatigue, brain fog, joint pain, or your general wellbeing.

So how do you access it in Australia.

So there's a topical testosterone cream available on prescription at carefully adjusted doses for our listeners, I would really really advise to avoid pellets and injections due to overdose risk and the compounded versions haven't been properly tested for safety or effectiveness.

If you are prescribed testosterone therapy, you'll be monitored for side effects like acne, hair growth, or voice changes.

So here's what I suggest for Tony.

Chat with your.

GP or menopause specialists about your symptoms and what's working so far.

If you're already on MHT and still struggling with libido, testosterone could be worth considering, but only if it's the right fit for you.

And this is the thing we need to be aware of right at the moment, is that menopause is having its time in the sun, which we are very grateful for because it is something that is under researched and very not spoken about, and so generations of women have been doing this very quietly in the background, sometimes suffering a lot of very debilitating symptoms.

But also be aware when a health condition has its moment in the sun.

A lot of misinformation is going to come with that, and so will people trying to make money off of you.

Yes, so massive cash grab.

It is a massive cash grab, and we just need to be aware that there is scientifically back to evidence and then there's a lot of stuff online.

So you just need to take a moment and not just immediately buy into all the things that we're being told right now.

But thank you Merriman, Thank you Tony, that was an excellent question.

Thank you so much for spending some time with us getting to know your own body again.

Today we've just done fertility and now pregnancy.

Any guesses what's coming next?

It's the bar Yale.

Yes, we are moving on to how to get the baby out of you, how to advocate for yourself in what sometimes is a very stressful situation, to choosing how your baby arrives into this world, and what actually means to cope with things if they do not go to plan, which happens quite a bit.

Make sure you do not miss out on any of the extra information that we've been collecting as part of this whole well experienced sign up for the newsletter.

Grab the link in our show notes will send it straight to your inbox as always.

The information you have heard here today is general.

It may not be specifically suited to your health needs.

Please reach out to your GP or healthcare professional for the right advice for you, like our friend Mariam here who is amazing, and we will see you well for your own extra appointment next week.

Bye bye, butthole and again we laugh Well.

Is produced by me Claire Murphy, Senior producer Sasha Tank, with audio production by Scott Stronik and video production by Julian Rosario.

Mama Mia Studios are styled with furniture from Fenton and Fenton.

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Today, you, Mamma Mia acknowledges the traditional owners of the land.

We have recorded this podcast on the Gadagul people of the eorination.

We pay our respects to their elders past and present, and extend that respect to all Aboriginal and torrest Rate islander cultures.