Menopause & Building Better Relationships - Dr Kelly Teagle

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WellFemme was founded in late 2018 by Dr Kelly Teagle, a GP specialising in women’s health based in Canberra. She graduated in Medicine from the University of Queensland in 2001 and worked in the Royal Australian Air Force as a Medical Officer until 2010. As a civilian GP she gained Fellowship of the Royal Australian College of General Practitioners and developed her interest in women’s medicine with further studies and experience in reproductive and sexual health.

During this time Dr Teagle became very interested in the treatment of menopausal symptoms. Ironically, at the age of 42 she experienced an early menopause herself. The symptoms were debilitating but very responsive to treatment, which led her to realise the importance of getting access to timely advice and care during menopause. Dr Teagle also noticed that her services could be largely delivered just by talking to women, and so the idea for a Telehealth menopause clinic was born.

Transcript

So following up on your email, post the summit that it might be nice to do something talking about, Women need to know about men, what men need to know about women. Yeah, absolutely. It seems to be something that comes up a lot with our audience. When we do webinars and things, people will go, Oh, I think we need something for the partners that the partners don't understand what's happening to us.

And I think. quite a lot of the time, if not all the time, vice versa as well. I don't, I think that the other thing is that women are so wrapped up in everything that's going on in their lives and trying to also on top of that deal with what's happening to their bodies at menopause. And not really appreciating the fact that at the same time, the guys are going through a sort of similar, I don't know, midlife crisis or evolution, grieving processes, so lots of stuff all combining there on both sides.

I think that's a really nice introduction. How would you feel if we just [00:01:00] use that as the intro, we just stumble into it. Would that be? Oh, absolutely. Yeah. All for a just free form conversation. Right. All right. How about I just welcome in the audience, introduce you briefly. So we're actually talking with Kelly Teagle.

She's a GP who specializes in women's health. She's worked with the Royal Australian Air Force as a medical officer, but since she's been a civilian GP, she's got a strong interest, obviously, in women's medicine and reproductive and sexual health. And one of the interesting things about Kelly is that she's the founder of WellFem and it's a menopause clinic, which is divided to telehealth so that people all around the country can access GPs who are specializing in assisting people with, through this.

Menopausal period. So just really grateful for your time and to have you here. And as a further introduction, we met each other through the menopause summit not so long ago, which was such a pleasure and such a great thing to be part of. I enjoyed that. And the feedback [00:02:00] was wonderful. So can you tell us a little bit more about yourself?

Tell us a little bit more about welfare. Yeah, for sure. And I do want to say thank you so much for participating in the summit, Todd, because it was so critical to get that appreciation of what happens to our male friends, colleagues, partners in the whole context of the menopausal transition and how it changes the interrelationships between women and men under those circumstances.

And it's always a pleasure. Provided that really fresh insight. Thank you for doing that. It was great. Wonderful people that took part. And yeah, it was a real pleasure to be there. Yeah. Awesome. And for anyone who's listening, actually, maybe we can provide a link for them if they want to actually go and buy access to the summit recordings, there's like more than six hours of educational material from the summit itself, as well as plenty of bonus content on a huge range of topics, so they've got access to like.

15 different specialists in different areas of menopausal [00:03:00] medicine, psychology, you name it, hair loss specialist. So we had all sorts of things going on there. We'll definitely include that in the show notes for sure. Tell me about, obviously this doesn't happen by chance. This is a great example of you walking your walk.

What drew you towards creating Welfare in a service like this? Yeah that's a great question. And I think like a lot of people, your own lived experience tends to guide what interests you, what causes you to learn more and want to grow more in those areas. And that was certainly my experience as a doctor.

I found I was drawn to doing women's health medicine quite early on in my general practice because I just felt That I could understand it better and I could relate to the experiences that women were having. And I had a good way of communicating to them what was happening to them and just making it a bit easier for them.

And then when I was 42 years old, I started to experience some really [00:04:00] confusing, confronting symptoms. Myself and didn't actually make the connection that it was related to menopause because I was a bit young at the time on average, menopause is around the age of 42. But I had fertility issues, which often goes along with an earlier menopause.

So when I started to get insane rages and shift mood shifts and really irrational changes, mood, teariness. I chalked that up to being a young mother, a recently separated mother with really small babies, like anyone would, there was a heap going on. So it wasn't really until I got the sort of classic hot flushes and things that I started to think, hang on a minute, maybe there's more to it than that.

So once I did go and get that confirmed, and because I was so young, we did do blood tests in my case, although you don't normally need to for an average age menopausal person. Once it was confirmed, it put everything in context and I could get on the right treatment and get on with my [00:05:00] life. But I was lucky to be somebody who had that background knowledge and access to good medical specialists and good medical advice and treatment.

And not everyone had that opportunity. Certainly not people living in rural and remote areas. I was working at sexual health clinic in, in Canberra here, and a lot of women were traveling a really long way from country areas to access menopause care. And I was barely, I, most cases didn't even need to touch them.

And so I'm thinking why couldn't I have just done this over the phone or through a video call? But that was all pre COVID. So it was all a bit irregular. It did make me start to think about different ways of delivering patient care. And I certainly did get started seeing patients by telehealth well before COVID even kicked off.

So yeah. The rest is history. You're well and truly prepared. Yeah. I agree with your sense about practitioners that are really contributing something, being born out of their own experience. So I [00:06:00] can certainly relate to that myself and the style in which I work. This might be a really silly question that I'm asking on behalf of people.

How was your mood during that time? You're 42, you're raising a kid. Oh, nuts, crazy nuts. But this is not unusual for any mum that's got babies that are under two years old, as I did at the time. It's, you're just exhausted. And I had been through a marital breakdown and separation. So I was, beg your pardon?

Were you depressed at the time? Who knows, quite possibly, I certainly did have a bit of depression, which was again, difficult personal circumstances when my first child was born. So there might've been, could've easily overlapped with some postnatal depression, but situationally I was feeling very overwhelmed.

And is that your experience when people come to their GP? They're not necessarily sure what this might be. Absolutely. I think particularly for women who are [00:07:00] perimenopausal, because we're really only just starting to understand how big a player that is in terms of hormonal changes and symptoms. If you're going along to your GP and they're taking a history and you're complaining of particularly mood symptoms, primarily it might be getting worsening premenstrual mood symptoms or something like that.

And the GP is going to go it's not related to menopause because you're still having periods. The classic definition of menopause is when you've stopped having periods. So just on that basis alone, a lot of women were getting fobbed off by GPs saying, no, it's nothing related to menopause. You're still having periods.

You, you just need some antidepressants and you'll be fine. So it can present the majority of the women that I work with would be in their forties and fifties. But How early can the onset of perimenopause be? Look, some people, some unfortunate people, it can be young. As I mentioned earlier, the average age is 51.

There's probably about 5 to 10 percent that are outside of that [00:08:00] 45 to 55 year range. 1 percent will be below the age of 40 and you do hear stories from time to time of women even in their twenties. So it can start early. So post the success of the sumit. We were talking about the needs of women in relation to, their partners.

Why is this so important? Do men need to be better educated and what's the risk if they're not? I guess what we have to understand about the menopausal transition, which of course affects at least 50 percent of the population at some point in their life. Is, we don't live life in a bubble.

We can't just go, right, that's happening because of hormonal changes. It's all contextual. It's all lived experience. It's all the contributing factors from the quality of your relationships, health problems, financial situation, difficult teenagers, aging parents, you name it. There's all the stuff that's going on in our lives.

Relationships are so critical to [00:09:00] that. Now, particularly if you've got a partner that you're living with, and maybe one that you've almost grown up with, been together for a really long time, the transition and evolution that's going to impact every member of the household and all of a person's relationships.

And your intimate partner or closest, most supportive person in your life is obviously going to be the biggest one, not only to influence that, but maybe actually have consequences from that. So it's absolutely critical to stay connected. We do have a good understanding of what each other is going through, whether it's same sex or different sex couples, that each partner in the relationship really understands what's going on for the other person and can be compassionate, nonjudgmental, be maybe be a little bit more flexible.

But at the same time, we all have to keep our own boundaries about what our own needs are. In that space as well, you can't just keep on being a sponge, [00:10:00] just absorbing lots and lots of punches from somebody else, lots of blows from somebody else all the time. Of course. Yeah. I went through a time where I was, I just had a wave, you'd see this in your practice I imagine as well.

You just have a wave of patients come through. There was a wave of men. Talking about menopause and saying I'm not sure what to do. And like all relationships, there's going to be areas where we connect in areas where we don't and the areas where they weren't connecting, we're really starting to get exacerbated.

Yeah. Interesting to see guys being a little bit more vocal and often they don't have men to talk to about it either, can normalize it from that side of things. So we often break these things down into compartments and we don't consider that we need to be supported friends through this as well.

To be clear about exactly what men are supporting, can you walk us through some of the details? And again, that's not a strength of men necessarily is to focus on [00:11:00] details. So if we really walk through the details of what women are experiencing during this time of their What's happening physically? So we've talked about perimenopause and what the definition of menopause is, which is when they stop having periods, basically they've had their last ovulation, which is when their last egg pops out of the ovary and they're no longer fertile, but the buildup to that can be.

10, 15 years of subtle hormonal changes that are happening because the aging ovaries aren't producing hormones in the same way that they used to. And the closer and closer the woman gets to actual menopause, which is where she's run out of eggs, she's going to maybe start to have really quite erratic ovaries.

Ovulations, which will lead to erratic periods, which might be much more heavy flooding periods, unpredictable. And all of this is reflective of the hormonal environment. So that build up, that perimenopausal period actually [00:12:00] can be definitely the most volatile time mood wise. Because Transcribed by https: otter.

ai The unstable hormonal chemistry is impacting and creating an unstable brain chemistry as well. So typically I do see a lot of women report I've never actually been anxious or depressed before, or I've never had, premenstrual. Mood problems before, and then all of a sudden they're getting, for the first time they're getting PMS or they're getting worsening PMS or they're getting menstrual migraines.

So all of this sort of stuff, that, that real mood swing stuff that guys may have noticed in females in years gone by when they're premenstrual, it's up because of all the, all of the erratic kind of hormonal changes that are occurring. So that's that. You were saying the buildup of this could be over the course of a decade or more.

Absolutely. Absolutely. She can be still having plumb, normal, regular [00:13:00] periods that look like clockwork. And yet in the background, there are subtle shifts in, in the amounts of the various hormones being produced by the ovaries that are actually causing. Worsening PMS, more anxiety, and on top of that, she is maybe amping up things at work, got more responsibility than ever reaching the peak of her career.

As I said earlier, the difficult teenagers or the aging parents. So you're at the kind of peak of your responsibility and the peak of where you're functioning needs to be at so many areas in your life. At the same time as your brain goes out to lunch, you start to get brain fog and memory problems and Irritability.

Women will report flying into absolutely irrational homicidal rages and then having this really dreadful, teary remorse afterwards. They just feel like they're completely out of control. And they come and see me saying, I think I'm going mad. I love that talking like this with such compassionate respect and curiosity, [00:14:00] hoping that couples can listen to this together and approach it from the same place.

Yeah. That's exactly what we wanted from the summit, wasn't it? That for a session that was particularly focused on mental health and relationships and sex, we wanted couples to be able to watch that together so they could understand what was going on for each other. So it got to be affecting. Every part of your mental health as well, emotionally, your mood in terms of general confidence in terms of concentration and memory.

All of the parts of your emotional and cognitive functioning are going to be impacted. You're probably hearing a lot at the moment about menopause in the workplace. There's a lot of activism going on about recognition and rights of women in the workplace who are experiencing menopause. And just having that knowledge of what is going on for women is really important to be able to accommodate it.

And so really [00:15:00] enlightened employers are starting to recognize that. When you think about it, and I think there are parallel processes for men and for women in this space as well. At the same time as all of this emotional and hormonal instability is occurring, we're dealing with these other age related contextual things too.

So in the workplace, if you're suffering all of a sudden from brain fog, if you're having flushes every time you stand up to in a meeting to give a presentation, if you're forgetting things, if you're not, if you're not able to pick up things in the workplace as quickly or to follow along. The way you used to, if you're not feeling as sharp, all of these things start to really erode your confidence in performing your job.

And women go through this real kind of existential crisis like, oh my God, what's like not up for it anymore? They're worried that people are gonna find out that they're not up for the job anymore. That's they're coming into their own just when they're [00:16:00] just, when they're growing into themselves. That's right.

And an enlightened employer will recognize this and go, this is the experience base of our company here. All of these women who've been in our organization for a really long time, and they bring amazing compassion and capability to the leadership roles. And so they want to retain that. But the women themselves are feeling like they're falling too big.

And then they've got. They go home and they look in the mirror and they're aging and their hair is falling out and their waistlines are expanding and they're finding it difficult to enjoy intimacy or it hurts or, and they're worried about their partner not finding them attractive anymore and they feel like rubbish.

And then they're finding it difficult to exercise or make time to exercise. And so the, all these things start to compound. Where they're not necessarily feeling good about themselves, looking after themselves. They're not finding the time to have good one on one time with their partner, nurture the [00:17:00] relationships either.

There's just so much going on. And I think for men too, I think a lot of this is paralleled in the men that they start to feel inadequate in many ways. As they noticing physical changes in themselves. They're feeling insecure about not being able to provide the way that they used to or do the things that they used to start to have sexual difficulties.

All sorts of things can collide there for them as well.

There is no education culturally. This is not thanks to people like yourself. It's something that's begun, but certainly in school, it's, this is not something that's going to feel developmental, developmentally relevant. So when do people access this information? They don't really. So no, no wonder both parties are unprepared.

I think, actually, you and I first met, I think we were [00:18:00] talking about the reboot of Sex and the City. And here are these women who are menopausal and for this groundbreaking show, which would talk about sex so candidly in a way that was really both insightful and humorous. They just bypassed this entirely.

Why, what culturally, what are your thoughts on that? Why aren't we talking about this? I will preface this by saying I think it's changing rapidly. There's been this evolution for quite a number of decades now in women's health and just, and openness about, Processes in women's bodies and things like that to the point where my teenager is very happy to talk about very openly about menstruation with her boyfriend and to ask my partner to buy her some tampons at the shops and stuff like that.

Things that I would have been mortified to do as a teenager because growing up in a country town, we just didn't talk about being on your rags ever. So it was a different time, but I think we are, we've gone through this [00:19:00] stage where mothers will talk to their daughters about what's happening to them when they're having their periods for the first time or when they start having sex or when they're having babies and all those things.

But Because menopause was something that they underwent themselves, I don't think that it really occurred to them to bring the daughters into that and say, this is what's happening to me, this is what it's all about. Probably because they didn't really understand it themselves and that it wasn't being acknowledged as or validated.

for them either. Now, I think it will be different for my generation because the conversations are getting so loud around menopause and there is a lot of interest, curiosity, activism, because women are demanding to know. And doctors and partners and the general community will all, by osmosis, get to know this stuff very soon.

I think it will be much more open. And because my [00:20:00] generation is so aware of it now, and we're curious and learning, we are damn sure going to make sure our daughters know what's going on for them. That's great. That's great. So you just normalize and model that. So how do we help guys out in this situation?

Do you think Todd, like how do we make sure that not only are the mothers bringing the daughters along for the ride, but that they're bringing the males in their lives alongside as well, letting them know, can they each keep that conversation going about. What each of them is experiencing and how to do it together and grow from it.

I think if we look at the generational side, it's very similar on the male side of the equation. And in terms of just not speaking about emotions, particularly if emotions are intense, men believe that a problem shared is a problem doubled. And so they tend to take pride and I'm one of them, I'm a therapist myself, but my partner will remind me of this all the time, but I will pull away, I'll try [00:21:00] to contain it so as not to bother her as a reflex.

And what we don't do as men is that we don't stay and we don't stay with details and we don't stay with emotions. If there's a poetic evolutionary sort of thing, it's like, if there's a threat, we want to kill it rather than be with it. So as a result. We deprive our partners and ourselves of the opportunity to be present with what's actually unfolding and what's happening.

So from the top down, if men have some of this information that this could be 15 years in the making. And that doesn't mean that there's anything wrong with the heart. The menopausal transition, when we count the fact that, let's say from when the subtle earliest hormonal shifts start to occur right through to the post menopausal stage, when the body finally adapts to the lower estrogen levels, you could be talking about.

A third to a half of a woman's life. Wow. From beginning to end. Wow. Men are [00:22:00] living so much longer. So we're living, for a lot of women, they're living half their lives post menopausal now, right? Whereas traditionally. Menopause signaled the time when nature just said, right, we don't need you anymore, able to have babies anymore.

So off your toddle and you just die. But now we live half our lives potentially post menopausal, which has enormous implications in terms of physical mental health, having to psychologically adapt to living half your life, a person in physical decline and having to, physically adapt what you're doing to keep your muscle and your bones strong.

And if you want to keep an intimate relationship going, that's a whole other challenge because if you're not producing estrogen anymore, then you don't have so much, and generally it's testosterone's declining in women, which was already only a fraction of what the guys had. So the libido goes out the window, the ability to become lubricated, to [00:23:00] become aroused and orgasm, even just the fact that it.

hurts or might be damaging to the genitalia to have penetrative sex. So there's all of these challenges as a couple and really good medical care from an enlightened doctor can really help. Enormously doctors and pelvic floor physios can do so much in this space and there is so much negotiating that can be done as a couple to reach a place where you can have a really satisfying post menopausal sex life.

But because it looks different and because they've placed all this value on their sexual script 40 years. All of a sudden it's like, Oh guess that's gone now, isn't it? We can't do that anymore. And so nobody really explores what they can do instead. How do we re script this? How do we keep the relationship going in a new chapter and create something new?

Yeah, for sure. So this is stuff that as a couple that people [00:24:00] need to understand. Because it's not about the fact that she doesn't find the partner desirable anymore. It might be that just as simple as the fact that it hurts or she doesn't find it pleasurable anymore and she might actually need to learn new ways of finding sexual enjoyment or negotiating different ways of both partners achieving some sexual satisfaction.

I think a lot of couples don't talk about that pain, that physical pain, that the actual act of sex hurts. There's the shutdown of, no, I don't want to, and you keep badgering me, so fuck off, basically. Absolutely. Again, which is fair enough. If it represents pain, why would you want to be open to that?

Yeah, and the sexual script does get quite locked into this idea that it has to be penis in vagina, penetrative, like that's what sex is, and if we're not having that, we're not actually having sex, but there is actually so much more out there on the smorgasbord to explore. Yeah. Absolutely. Absolutely.

So it does, it's an [00:25:00] opportunity for that to redefine what sexual actually means. Yeah. But even that simple thing, like talking about an anatomical changes and that this can hurt being prepared for that conversation as a starting place. Yep. Tragic. That's not. On the agenda for a lot of people and that's, I've had, I recall one particular lady who she wanted to talk about this because she knew that it was a problem in their relationship and that she, like she could, like a lot of women, she could happily live her life, never having sex again, except for the fact that she knew that her partner wanted it.

And she wanted to be able to do that for him, but there was, she wasn't enjoying it. There was pain. There was all this sort of stuff. And so we got talking about it and that might've been the same lady where we had problems with the video and I could only speak to her by phone. And so we got, had quite an open discussion.

Which she said at the end, I've [00:26:00] never spoken to anyone like that before. And I'm so glad that you couldn't see my face because she would, she said, if I'd had to look at your face, I probably wouldn't have been able to have that conversation. So it just shows you that these sorts of things, they're so deeply entrenched.

And I was saying things to her like Do you know, if you just maybe tried, for example, using a vibrator, it makes things so much quicker to become aroused for a woman, you can become well lubricated and really responsive and enjoy it a lot more, and you don't have to worry about him banging away for hours and you going, Oh, hurry up, it's hurting.

So we started and she, her response to that was. Oh, I couldn't do that. Take that as a personal criticism. If I brought a sex toy into the relationship, he would think that he wasn't enough. Yes. Yeah. Yeah. That was interesting to me that she was fearful of hurting his feelings by bringing in something to help her become aroused quicker because she, he might perceive that, [00:27:00] that he was doing it wrong.

And this is a fragile man. The sex would be the quality of his performance and is he a winner or a loser in terms of what he provides? And guys are that binary. If I'm not succeeding, I'm failing. I love her. I don't want to fail her. And if I did feel like I was failing her I can't stick around.

That's going to be shame. Just lie there like a failure. I've had so many guys talk about that. So many guys. A classic example is they've had an injury. These are fit, young, healthy guys, but if there's an injury, they'll stop having sex because they can't perform at the level. And where are they getting these standards from, sadly, from I do not know.

Do you know that calls to mind our wonderful friend, Margaret Redelman, who I know, who I absolutely adore because she speaks so frankly and openly about sex for older couples. Yeah I just, I find her just really delightful to listen to. And one of the things that she says [00:28:00] is, You are responsible for your orgasm.

You are responsible for your arousal. Don't be always expecting that your sexual pleasure is someone else's responsibility. And I think that's a really important concept for men to understand and for women to make clear too. The men in their lives or their partners to say, I love you, but, it's not a failure of yours if I don't come.

Actually, there's a lot going on for me too. And if I want to come, there's ways I can take control of that and we can do it together. So it's, I think that's really important for people to just get that. Which is a sexual invitation. It's a new type of sexual invitation. People can feel like they're failing themselves sexually, but they can be also fearful that maybe the relationship's failing.

But of course that can be true too, like if there is, if there's something going on in the [00:29:00] relationship that is failing, then that can be carried into the bedroom, can't it? Because if you're not feeling emotionally connected, it's really hard to be intimately and erotically connected. But it's not a failure of the relationship if we just don't know what to do, or we don't know how to talk about this yet.

Yes. We'll definitely bring to the fore if there are serious relationship issues, they'll be more exposed. But it's not a failure of the relationship if we're, we've reached a point in maturity where we need to do things differently. The failure would be not recognizing it and changing something, actually calling it out and addressing it.

And in order to do that, we need to be able to do a number of things. We need to be able to slow down, sit with the rising intensity and the fear of where are we now and what's coming up and that we don't know. And we're not going to be able to have a clear strategy about how we're going to become something new.

In order to become something new, we have to sit into the unknown. [00:30:00] And that's something that we're often not prepared for. It's scary. I don't know who I am. I don't know who you are. I don't know who we are. And I don't know what we're becoming, but I'm going to stay here with you right now and sit with these details and find you.

And really, as we redefine sex, we come home to, is sex. It's that it's refining each other and making room for each other at all levels and then seeing what emerges, what flows, what heats up, what cools down and remaining focused with each other, despite the circumstances. This is just taking it to a whole nother level.

It's just one, one other aspect that life's that life stage evolution that we go through with our partners, because we've been so focused on everyone else's needs when we're raising a family or going through that very busy, important stage where our careers are everything and you give to everybody. So whatever it is that you've been going through.

I think the [00:31:00] confronting thing about midlife is that all those other distractions go away and you're forced to look at your significant other and go, Oh, who the hell are you? What happened to you while I wasn't looking like, what's going on here? Yes. Yeah. And often our competence throughout midlife has been a distraction, including set, including raising a family, including professionally, it's been a distraction from some of the original wounding that we've carried as well.

And so having been loved and held and have any precedent for having been valued for what's inside of us, really in a sustained way without distraction, it's very difficult to jump into that. Yeah. You're absolutely right. I, this is such a powerful time of life where things that have gone unaddressed, even from childhood that are really creating dysfunctional ways of being.

Thinking or just, yeah, really holding you back in life. These are the times that they really tend to come out. And that's the [00:32:00] gift of midlife as well is because without those other distractions, we can finally like just shed those superficial skins and dive right on into it and finally address it. And maybe actually, That, that's what you get later in life is you get to focus on the spiritual and the relational, and you get to learn and grow and explore your intellectual and spiritual side rather than that, all that superficial crap.

And that can become really tangible. It's not just some ethereal silver lining that we can actually be loved in ways that we haven't before, who we are, not for what we're providing or what we're doing. Yeah. That's it. Sure. Being human beings, not human doings. Yes. Yeah. I think like one of the things, and the word that you're using of shedding skin, that's just something that my patients, it's like a signal that they're reaching that stage where they're dropping the roles.

I just hear it. Getting rid of the baggage. I'm always glad when I, when skin is coming up in [00:33:00] people's dreams or they're using that metaphor. Yeah. How do women support each other throughout metaphors? Because this is, as I was saying, I'm a big advocate of men's groups for men to learn to be honored for being imperfect human beings.

If they do that with men, they often feel a lot safer doing it with their female partner. So that's really good. I think this is the Mars and Venus thing, isn't it? Because women have evolved to be the communal communicator type roles in the village and men go off in by themselves or in packs of two or three or something and do the hunting and then come home and stare at the fire.

So I think that mentality is still there. Today, in that women seek validation of their experiences and they seek some kind of empathy from other women [00:34:00] other people who they think will relate to their experience. They swap stories, they swap tips and referrals. And Facebook is one of the biggest kind of referral bases for WellFem, for sure.

Because if people are getting what they need, they're very quick to tell others, Oh, you should go and see them. So that's what happens, but I don't know that guys do that at all, certainly not with respect to menopause. And I do think it's a real shame that it's still, I don't know, it's such, it still seems such a taboo thing for males to be gathering together in groups and opening up emotionally about what their experiences are, is still seem to be some kind of like unmanly weakness sort of thing.

A lot of diversity in those groups and some of them are whining, whinging, ethereal wastes of time. But there are some that are just wonderful, just really down to earth [00:35:00] and really contribute to supporting men in stepping into that new phase of their lives. Yeah, I can't recommend that, that highly enough.

I wish they would. I don't know. Just like the way that guys always go along to see the doctor and they say, Oh, my wife told me I had to come. Maybe there's a role for them in there. Like a teenage boy. Like a boy. They are. It's like, they don't think that they have to go to the doctor unless there's a leg cut off or something.

Or actually actively having a heart attack. So if I refer to men as a bit of a generalization, teenage boys, it's because. That's where the development stopped. It hasn't been any mentorship or any elders or anyone to recognize anything that's going on inside them or through the process of going deeper into becoming a man.

It's just been pretty much completely absent. As culturally the conversation evolves where we can share a headline [00:36:00] of I'm depressed or I'm stressed or I'm anxious. But the next level is how do we sit with the detail? And not just gloss over. If men can learn to do that with each other. They feel far more confident about the fact that this is a masculine service I'm providing and I don't have to change it.

My gift is to be here with her. It's one of the great ironies that men have to practice that together before they can grow into a man who can do that with their partner. Absolutely. That's so insightful that I, like a lot of, even a lot of women are like this, but I think it's really important just like taking responsibility for your own sexual pleasure, I suppose, is like to recognize that for anyone, that it's not your responsibility to have to fix everything or deliver everything.

It's like, sometimes they just want you to be there with them. Right. Like, Hold hands, just be there, not let them talk, let them [00:37:00] download, make the right noises, you don't have to come up with the solutions and fix everything. I want to share a very brief story, and this is the first time I've ever done this, is to talk about an existing patient and I've done this with his permission.

And there won't be anything that's personally identifying and I want to reassure all my patients when I tell other stories on this podcast. It's because I've been doing this for 30 years and there are archetypes that emerge whenever I tell a story, people assume, Oh, that's me. And it's like, you and a hundred other people, but this is a specific example.

I did get this fellow's permission and it was because I was telling me I was going to talk to you. And he was saying, Oh, when's this podcast coming out? I want to hear it. But he gave me this lovely little story as he was wanting to reach out to his wife and they were in bed together. And he said, how would you feel if we just held each other naked on a scale from one to 10?

What comes up inside you? How do you feel about that? And there was just [00:38:00] silence and she just backed her body into him to be held and he just held her and I was just really, I was just really touched by that story. I thought that was so great. And I was so proud of him. Right, yeah, just being open to suggesting rather than assuming or.

It was really bold on his part to, to be curious about that. And then she responded perfectly without words and effectively said. I want to be close and I want you to hold me. That's how I want to. So important. And then we see what emerges from there, but I felt really grateful to that guy for sharing that story.

I think again and again, too, I'm seeing with people in this age bracket, and I don't think that we're Robin Crusoe, I think it applies to all age brackets, but that whole attachment theory thing that goes, that is not just related to being a baby, right? There's a lot of formative stuff that happens that affects your [00:39:00] feelings of connection and being loved and being appreciated.

And I think that just a key message I would say is that there's so much change going on for men and women and both parties in a relationship at this stage of life. We can't make assumptions anymore that communicating or relating in the same ways that we used to. That we can just automatically assume and keep doing that.

I think we do need to be curious. We do need to ask questions, explore new possibilities. We need to communicate. in different ways, ask questions. I think it's just all, I think reassurance too, is that don't just assume that they know that you love them and don't just assume that they realize that you're grateful for what they're doing or what they're experiencing or anything.

I think it really pays to [00:40:00] verbalize and demonstrate and find what their love language is and give it to them in a form that they can recognize and understand and appreciate. So that goes a really long way, just saying, I'm really grateful that you're here for me and that you're doing those things for me.

I really appreciate the way you do this and openly identifying and praising the strong characteristics that they have, letting them see that you appreciate those things on both sides to the men and to the women. I think we've just got to take. Look with fresh eyes because we are fresh people evolving, shedding skins.

We're different at this new life stage and a fresh approach is required. And I think there needs to be a little bit of structure and formality around that. If we leave it to chance and just how we feel, it's going to be a whole lot of protection. And then I'll be busy, we'll go back to our phones. Yeah, I often advise my libido [00:41:00] patients, let's say, the ones that just say, I'm just not interested.

I'm going, when was the last time that you actually scheduled a date with your partner? Like, are you actually scheduled to be one on one? Enjoying each other's company, maybe doing something a bit fun and unusual that you don't normally do when you're not exhausted, when you're not distracted, where you could just be together and have a bit of fun.

And then who knows, you might just have a little kiss and cuddle, and you never know where that will go. Like they just don't even make time just to have fun or even have a conversation. And often there's so much pain if we do that without those distractions, then all my pain comes up. And I don't want to go back into that cycle and hurt you again.

And then maybe there has to be some rules around it. Yeah. Yeah. But something, and then if that's not working, then to talk about the fact that's not working and then to perhaps seek some assistance about how we make that so important. Sometimes you just need that mediator because you get in such deeply entrenched.

[00:42:00] negative cycles of relating to one another that you just can't escape out of them. You might just need somebody to interpret and mediate those conversations. And it's amazing at times just how little is required. This can be a long standing pattern, but that can be held safely. That people could see with compassion where their partner's been all this time.

And that can be something new, but one hand, I think I used to be critical of the date night concept in the past and I thought I'll walk on the beach and look at each other's eyes for a few minutes. What's that going to do? I found what it does is it creates possibility and it creates the options for nuance.

And if we just turn down our expectations a little bit and we allow some of those. Connection times to not go well, whatever that means. And we don't have this romanticized idea about what romance is supposed to be, but it's just connection time. And we just let it be [00:43:00] real. Let it be like the weather.

Sometimes it's going to be fine. Sometimes it's going to be stormy. Sometimes it'll just be ordinary. Let it be ordinary. Let it be whatever. You're not going to nail it every time. Oh, so when people have been sensitive, they take this as a test case. But if they get a couple back that didn't really excel there's more evidence that we're not an effective couple or my partner's defective or this is over or whatever it might be.

So I'd really encourage people to actually book those connection times. If they're not following through, then maybe reflect upon why, but allow there to be just a bit of flexibility in terms of how that looks like. It doesn't have to be a huge success. It's a success if you're just making room for each other.

Okay. The other liberating thing about this time of life, of course, is that when you do finally notice each other after years and years of being in the family bubble or whatever it is, finally go, okay, what's going on now? Are we going to spend the rest of our lives together or what? [00:44:00] Maybe we should get to know each other a little bit.

Looking at each other with fresh eyes does sometimes mean that they're, that you're going to go, you know what? I actually don't want to spend the rest of my life with you. with this person, but it gives them at least that opportunity to stop avoiding it and to look at it. Is this what we want or not?

And if we do, then we have to prioritize some things or do something differently. But sometimes the right answer for a couple might be actually that they just move on and they'll be happier apart. What's the best thing about being a mature woman? As people look ahead, And they're looking towards growth and this is just the nature of life is that we grieve and we grow and culturally we're not a culture that really values.

Grief. We're a culture that values if we buy this and we work hard enough and we're smart enough, then we'll transcend. No, we won't. No, we won't. You're going to have both the whole damn way and ultimately life is going to win. Oh yeah. No one gets out alive. As we [00:45:00] look ahead with all of the grief, what's the gross best thing about this?

Where we're heading and I'll comment on that as a man as well. But as a woman, best thing, if you forgive me for being philosophical in the area. I don't know if I can speak for all women, cause I can only speak for my own experience, but I wouldn't have been brave enough before the age of 50 to start my own business in a field that no, where no one was doing what I was doing.

Like I wouldn't have had the confidence to just go someone should be doing that and actually just to do it. So all the planets align. It can give you that. That confidence that the skills and experience you have and your passion and conviction can all come together and you can achieve amazing things.

I think that shedding of the skin thing is quite valuable. You're not giving a fuck about what other people think really is. Like, you don't have to worry about if, does my bum look big in [00:46:00] this or like, you don't have to be the Barbie doll and sit, still look pretty to be what everyone expects you to be.

You can actually go, no, I'm done with that. And so it is very liberating to be able to just feel confident enough to be what you want to be and to shed those superficialities, to focus on your emotional, intellectual, spiritual growth. And have those opportunities to learn new things, including learning new ways of relating to your partner.

Things can be actually better than they've ever been before, I believe, in your relationships. Because it's an opp, it presents us with this great opportunity. I think so. And better through the lens of who you've become, not better through the lens of the 20 year old. If we're holding on to that as the benchmark of what we're trying to get back to.

Yeah, I think similarly for men, I think there's something about just getting beat up by life multiple times where you can become more comfortable with that. It's not a failing, that's just part of maturing. And as a [00:47:00] result, we get a little calmer, a little more creative, a little bit more compassionate to ourselves and others.

And as a result, we can love more effectively, not as a porn star, but as a human being. So true. So true. So I think we'll include links to Welfam in the show notes and also to the videos of the sumit. I think that'd be really valuable for people to take their time learning from those. Super.

Hear your presentation. It was very good. Yes. Yeah. That, that would be great. And yeah, I really encourage people to check that out, but so grateful to you. So much respect for your integrity, walking your walk and sharing this with people. I think it's just a wonderful service that people could call and for the most part, they're doing it on video, right?

Absolutely. It's all, we don't have any face to face consultations with WellFem. A lot of the GPs who work with us also work in general practices around the country, but the WellFem menopause consultations are all just video consultations. Yeah. Distance isn't going to be an [00:48:00] issue and yeah, ever since COVID.

You can book direct online. You don't need a referral. Yeah. You can do it in bed. You can do it at the kitchen table. Some people do. I know. I know. Or they do it in their car. Cause it's the one place that they're not going to be. Listened in on, so really encourage people to get in contact if that's of interest.

And what I'll take away from today is just that arc, that period during a woman's life of lead up while she's going through that. And then after that's a significant portion and a significant trajectory of growing into the woman that she's becoming. And so much change in that time. So much change.

And wonderful. I think we need to collaborate a bit more, Todd. I think there's lots and lots of scope here for maybe some kind of workshops or something like that where we can help couples navigating the menopause transition space together. I'm sure there's lots more work to be done. Sounds good.

It's great to have a teaser to end on. So watch this space. [00:49:00] But thanks so much, Kelly. That's okay. Thanks for having me on.