You're listening to On the Moons, where we have conversations about hormones, midlife, and the moments that make us wonder, is it just me? I'm Kate. I'm a 48-year-old pharmacist and newly minted perimenopausal oversharer. This is where we talk openly about the changes we aren't prepared for, so we never have to feel alone in them again. I acknowledge the Camaragle people of the Iora Nation, the traditional custodians of the land which I am recording today. I pay my respects to elders past and present, and I extend that respect to all Aboriginal and Torres Strait Islander peoples listening. Always was, always will be, Aboriginal Land. Hello and welcome to the very first episode of On the Moans. I'm so excited that you are here. I'm Kate. I'm a virgin podcaster, so please be gentle with me. I've been a pharmacist for 25 years. I'm a mother of two, I have a 20-year-old son and a 17-year-old daughter, both now thankfully finished school. And I have my dear husband of 22 years. We are your quintessential Sydney family. Biologically, I am aggressively average, and that's exactly why this podcast matters. Because if I am experiencing all this hormonal chaos, then trust me, I'm not special enough to be the only one. This podcast is my chance to talk openly about perimenopause, libido, bone health, anxiety, rage, marriage, teenagers, aging parents, pharmacy, science, and the absolute circus of being in your 40s and 50s. My hope is that someone listening will think, oh thank god it's not just me. To all the queen agers out there, let's get on the moans. I'll start with my perimenopausal origin story. Back in 2023, when I was 45, after 23 years as a hospital pharmacist, I rage quit my job, just walked away. There was an incident that sparked it. Push came to shove, so I chose to shove. And at the time I thought, oh, this must be that thing that women talk about, turning 40 and suddenly not giving a shit what anyone thinks. And I'm sure that that was part of it. Part of it was also my personality, also that I was supported by my husband to be able to rage quit. But now, with the benefit of hindsight, hormonal therapy, and a DEXA scan that politely informed me my spine is auditioning to become a chalkstick, I can't help but wonder, was some of that also perimenopause? Because around the same time I started getting hot flushes, just the occasional one, but enough that in hindsight it was my hormone sending me a text message saying, brace yourself. Fast forward two and a half years. I've been on VIOSA, a non-hormonal treatment for hot flushes, life-changing. Then the DEXA scan results came back showing osteopenia in my spine, so my fabulous GP started me on by Juva, estrogen and progesterone, about two and a half months ago. And suddenly I'm looking back at my early 40s thinking, oh, maybe that wasn't all personality. Maybe some of that was estrogen leaving the group chat. Then in June this year I started making TikTok videos because nothing says midlife crisis or reinvention, as I believe we're now calling it, like thinking TikTok needs me. My handle is at prescribe or pass on TikTok and Instagram if you want to play along at home. I do videos on debunking wellness woo and fact-checking supplements. I started doing short educational clips in my work clothes like a slightly unhinged, unpaid ABC science presenter. ABC, if you're listening, I'm free and available for your next series. And people loved them, and I gained a lot of traction and a loyal following that is still growing and growing. And I found myself absolutely loving the research like proper research on the topics I was presenting. PubMed deep dives, guidelines, real evidence, and nothing has fascinated me more or hit me harder than perimenopause. Because every woman around my age is whispering the same thing. What is happening to me? And it is astonishing how little we know about our own bodies. Sure, we were taught about puberty at school, but if we don't seek out education on this as adults at this stage of life, how can we know? I am otherwise fit and well. I have no reason to go to the GP. I took myself because I'm diligent and I went for my 45-year-old health check. I imagine lots of busy working women who are familying and wifing and partnering, etc., have the best intentions of going to their GP for no reason other than the 45-year-old health check. But how many keep putting this off and off and weeks turn into months and into years and then all of a sudden you're yelling at yourself in the car because someone cut you off, or you've snapped at someone because they've overused the word mum. And then I did a testosterone video. I posted about dermal testosterone for HSD, hypoactive sexual desire disorder, and libido changes, and my comments exploded. Women saying, I didn't know this existed. My doctor refused to prescribe it. I thought loss of libido was just a part of getting older, or I thought it was just me. In Australia, one in three women aged 40 to 64 are affected by HSD, which is a really horrible way of describing loss of libido. And about two in three of those women will respond positively to dermal testosterone supplementation. It takes a while, around three months, to see if you're in the 60% of women who benefit. But if I told you you had a 60% chance of winning the lottery, you'd think they were pretty good odds, right? So I talked to my GP, who is brilliant, and I started it. And I am constitutionally incapable of keeping anything to myself, and I've been completely open about all of this, with my husband, with my twenty-year-old son, with my 17-year-old daughter, with my forty-one-year-old sister, and basically any woman I've stood next to for longer than 20 seconds. And thank God for that, because it led to one of the most defining moments of this journey. A dear friend was over for dinner one night. I'm in the kitchen chopping vegetables and stirring pots like a suburban master chef contestant, and I'm babbling on as I'm wont to do about testosterone and HRT and what have you. And I'm saying, it works for sixty percent of women, so if it helps me, it might take one small point of tension out of my marriage, which is otherwise very easy, and I turn around and she's standing there silently in the corner of my kitchen, weeping. Proper, quiet, overwhelmed, crying. And I hug her and I say, What's wrong? And she says through tears, I thought it was just me. And that moment it rearranged my insides and the penny dropped. Because how many women are suffering in silence? How many think their anxiety, their irritability, their libido changes, their insomnia, their brain no longer braining are personal failures? How many marriages are under strain because we don't talk to each other openly about this? There are some brilliant podcasts and social media celebrities out there, and this topic is getting less taboo, but it needs more, more airtime, more stories to relate to for the average woman. More we're all in this together attitude. At that moment, my friend crying in my kitchen, that is the moment this podcast was born. And since then, every conversation with the women in my life has reinforced the same theme. My sister, 41, anxious for no reason, not sleeping, feeling off for weeks at a time. We blame work, kids, stress. Probably told her to toughen up and stop whinging. No, she's sure to be perimenopausal. Another dear friend, estrogen receptor positive breast cancer, denied her vest and cream despite significant discomfort. We know topical estriol is safe for many women with this history, but fear wins over nuance. So she's left to what? Tolerate a dry, itchy, sometimes bleeding vagina, endure painful sex, or not have sex with her husband at all. Because that's good for adult relationships, said no one ever. My mum, who insists she breezed through menopause, was actually tormented by monthly migraines. I remember vividly, her vomiting and struggling through the day and lying in bed with a pillow on her head to block out the light. Rationing the immigrant tablets because they were so expensive, and she didn't want to throw them up and waste them. And I don't even know how it affected her relationship with my dad. She's seventy-five now, fit as anything, swims kilometres every day. But she's also on a bisphosphonate for bone density. Would estrogen have changed that? We'll never know. Another of my incredibly clever friends, we're talking about hormones, and she says confidently, Oh, I'm on HRT. So I say, Great, what kind? Patches, gel, oral, because I'm nosy and I'm a pharmacist, so I have to know what medications you're on. And she says, Oh the pill. She's fifty-five. On the combined oral contraceptive pill, thinking it's HRT. And I'm standing there thinking, well, if she's confused, not because she's foolish, she's brilliant, but because women's health education has been non-existent for decades, and GPs are taking a sledgehammer to women's hormones with the oral contraceptive pill, thinking that by flattening them out it's fixing the symptoms. Sure, it may be steamrolling them flat, but that's not hormonal replacement therapy, as in bioidentical hormones replacing what you used to make endogenously doing the same job your ovaries used to do. How many GPs out there are falling back on the woefully inadequate lectures they got during their university degree to manage women through this hormonal crisis? How many are too scared to prescribe HRT or testosterone to women who need it because of outdated information from 25 years ago that was so misinterpreted the message became HRT causes breast cancer? And how can we hope for anything different from a system and society that expects GPs to take a holistic approach to healthcare, know everything about you from your pet's name to your allergies to your deepest worries to your blood pressure, not charge a gap, and fit all of that into a Medicare rebated 15-minute consultation. I'm incredibly lucky. I have a supportive husband. He's a doctor. That helps. He understands it as much as any man possibly can. And I have two lovely children who will suffer through me going on and on about my symptoms and HRT journey. I think I'll get them on the show. Ask them some questions about what it's like to live with someone who's going through it. Might be interesting. And since I saw them both through puberty, it's the barest minimum they can do for me, right? But many women don't have that. They have partners expecting the libido of a twenty five year old from a woman whose hormones are in free fall. And to add insult to injury, perimenopause doesn't arrive during a peaceful, gentle chapter of life. Oh no, it arrives at the exact time your life is doing a pylon. Your hormones are changing, your teenager's hormones are exploding, your parents' health is declining. Likely your work is escalating, your responsibilities are multiplying. It's the hormonal triple quadruple decker sandwich. Your thirteen-year-old is sobbing because their toast is cut the wrong way. Your 17-year-old is stomping around like an enraged baby giraffe. Your mum is asking if she can take a sleeping tablet with her red wine and complaining about your dad, and what little tolerance your dad had has evaporated. And you're in the kitchen crying because you're holding a can of tuna and can't remember why. Three generations leaning on you while your endocrine system is buffering like dial-up internet. No wonder we feel like we're failing, we're not, by the way. We're carrying the load of an entire family ecosystem while our hormones are doing a cliff dive. So that's why we're here. We are on the moans and we are going to be loud and proud about it. I shuddered to think of the torture our grandmothers must have endured. Dismissed, certainly, called hysterical, suffering symptoms in a much more buttoned-up society than I currently find myself in. Shame thrives in silence, confusion thrives in silence, loneliness thrives in silence, but the moment we speak up, honestly, messily, everything changes. We realise it's not just you, it's not just me, it's all of us, and we're not broken and it's not our fault. Each episode you'll get from me evidence-based information from a 48-year-old pharmacist who's right in the trenches. Woo debunking, stories from the women I love, feedback from my children, and occasionally my tradey brother-in-law asking the questions men everywhere are dying to ask. If you're standing in my metaphorical kitchen corner right now, feeling like you're the only one, weeping silently into your Negroni, I want this podcast to be my voice in your ear saying, You're not alone, it's me too. Let's start at the very beginning. I hear it's a very good place to start. Nothing makes me think more about what we didn't learn about our bodies in school than trying to explain menopause. Because I don't know about your experience, but I think mine was once a month the lining sheds. Here's a tampon, anyway, photosynthesis. Maybe we were taught all this back at school, but at the time it felt so far away from being our reality that none of it stuck. We looked at our mums and thought they were practically ancient, and we were so wrapped up in our own little lives that we couldn't imagine ourselves ever being grown women with hormones doing whatever it is they're doing now. I vividly remember my mum's 40th birthday. I was twelve, they had a party at the house, and I remember looking around and thinking, wow, everyone here is so old. Although to be honest, the preponderance of Ken Don print collotte suits probably didn't help. And now at 48, I'm almost embarrassed by how confident I was about that assessment. 40, old, ridiculous. I'm staring down the barrel of 50 now, and honestly, 60 is starting to look pretty bloody youthful. So today let's go over how the menstrual cycle works properly and clear up one of my most hated myths I see on social media all the time, which is the idea that we are supposed to be able to balance our hormones. Wellness culture loves to tell women they have imbalanced hormones, as if all of your hormones are meant to be equal, flatlined, stable, calm little soldiers marching in formation. No, your hormones are meant to peek and trough. That is literally how the system works. Think of insulin. Spikes when you eat, essential. Cortisol, high in the morning to wake you up, low at night to help you sleep. Essential. Melatonin rises at night, drops during the day. Thyroid hormones fluctuate with temperature, stress, energy needs. Growth hormone comes in pulses. Sex hormones rise and fall dramatically over the month. If your hormones were perfectly balanced, meaning no peaks, no troughs, no movement, you would feel terrible. Day one of your cycle is the first day of bleeding. Everything is low, flat, and quiet hormonally speaking. Then estrogen starts to rise, and with that you enter the follicular phase. And estrogen, she is the Beyonce of hormones. As she builds, she brings all the good things. Sharper thinking, better focus, improved mood, more energy, stronger workouts, a boost in confidence, nice clear skin. She's glamorous, powerful, and when she shows up, you feel it. Mid-cycle, estrogen hits her big Beyonce finale, a deliberate, dramatic peak that triggers ovulation. And around this same time, women also get a brief rise in testosterone. Yes, women absolutely have testosterone. So if estrogen is Beyonce, then testosterone is pink. Pink is confident, strong, high energy, athletic, not here to make friends, climbs a rope in midair whilst singing live. Big I'll get shit done energy. Testosterone in women contributes to libido, strength, motivation, confidence, assertiveness, and mood. Pink is the perfect embodiment of testosterone. She's not here to be pretty, she's here to flip upside down in a harness and deadlift your husband. So during that little two to three day window when oestrogen has peaked, ovulation is happening, and testosterone has popped in for a cameo, that's often when you'll suddenly want to start seven new projects, clean the house, have sex, replan your entire career, and minor half marathon, all before lunch. That's ovulation energy, a hormonal girl band moment. Beyonce leading, pink doing the acrobatics, and everything firing on all cylinders. After ovulation, progesterone steps onto the stage and her rise is just as deliberate as Eestrogen's earlier performance. Progesterone is your Adele hormone, warm and soothing, emotionally intelligent, and occasionally capable of reducing you to tears in the middle of coals for no identifiable reason. When Adele, sorry, progesterone takes the mic, she can calm you, help you sleep, take the edge off anxiety, balance out Beyoncé, increase appetite, cause bloating, make your breasts tender, and heighten emotional sensitivity. This is why the luteal phase can feel complicated. Not because anything is out of balance, because your hormonal girl band is shifting into its soulful, emotionally charged ballad era. It's not dysfunction, it's responsiveness. So if we zoom out for a second, what you've got across a normal menstrual cycle is basically a hormonal girl band on tour. Estrogen is Beyonce, opening the show, flawless vocals, perfect hair, boosting energy and confidence. Testosterone is pink, swinging on a harness, doing backflips, adding the grit, drive, and the getting shit done attitude. Progesterone is Adele, emotional depth, soothing ballads, big feelings, helping you wind down, but also capable of making you cry in the tin goods aisle if that energy hits wrong. And the whole point is they are meant to take turns. They're not supposed to sing at the same volume at the same time, on the same beat. A good girl band has dynamics, highs and lows, solos and harmonies. Your hormones work exactly the same way. Hormonal fluctuations are not a sign something is wrong, they're a sign the band is performing. And occasionally they sing off pitch, and that's why we've got a podcast. Before we wrap up this section, I just wanted to talk briefly about the conditions that can mess with the hormonal girl band's tour schedule. Not in depth, we'll give each their own episode, but here's a high level. Endometriosis is like the girl band's staging crew turning up in random locations. The bowel, pelvic wall, ovaries, places they are absolutely not booked to perform. The result is inflammation, pain, dramas, logistical chaos, and a tour that feels much harder than it should be. It's not just bad periods, it's the stage crew building sets all over town and making the whole production painful. PMDD isn't low progesterone or too much estrogen, it's the brain being hypersensitive to normal hormonal shifts. It's like Adele, progesterone, start her emotional ballad, and instead of you thinking, oh this is pretty, you're suddenly ugly crying on the lounge, lighting a candle and re-evaluating your life choices. Normal song, exaggerated response. PCOS is essentially an ovulation issue. The follicle doesn't always pop at the right time or sometimes not at all. So Beyoncé and Pink are warming up backstage, but the opening act keeps missing their cue, which means irregular or missing periods, higher androgens, cycle unpredictability, metabolic changes. It's not the band being lazy, it's a scheduling disruption. Heavy bleeding, flooding, giant clots or periods that turn up whenever they feel like it are not womanhood. This is the tour pyrotechnics technician hitting the wrong buttons at the wrong time with way too much enthusiasm. It's common but not normal and not something women should suffer through in silence. This section I like to call Is it Perimenopause or Am I Being a Karen? The whole idea of being a Karen really blew up during the pandemic. The term existed before, but it went mainstream in Australia after that now famous lockdown incident in Bondi, where a woman literally named Karen refused to give her details, argued with police, and declared she didn't believe in the public health orders. The footage went everywhere, and suddenly Karen became a shorthand for a certain kind of public meltdown, entitlement, rule breaking, and demanding special treatment in a crisis. But here's the thing. It started as a commentary on one woman's behaviour, but it very quickly became a label used against any middle-aged woman who spoke up about anything. It's a catchy insult, sure, but it's also incredibly easy to weaponize. And sometimes stop being a Karen really just means stop making me uncomfortable, stop pointing out something I didn't want to hear, or stop having boundaries. It's fascinating and a little bit depressing that we've created a cultural shorthand that discourages women from speaking up at the exact stage of life when many of us feel finally able to. So when I ask myself, was I being a Karen, after an interaction, sometimes the real question is, was I overreacting or was I finally responding instead of staying silent? And those are not the same thing. Yesterday I ended up in an argument with a stranger over a cigarette butt. My husband and I are sitting outside a restaurant having a quiet drink. A young couple are a few meters away having a smoke. She's telling him some animated story at full volume as if we all wanted to hear it. No social awareness at all. Swearing, arms wildly gesticulating, I'm hearing snippets of I told her I'm the queen of bullshit and you can't bullshit a bullshit artist. That kind of conversation. Well, he couldn't get a word in, so more of a monologue than a dialogue, but you get the picture. They finish their smokes, and the guy stubs out his cigarette butt in the garden bed. She probably did too, but I didn't see her. Then, and I swear I'm not making this up, he digs a tiny hole with his fingers and buries the butt under the bark, like a toddler hiding the evidence. And as he walks past the tables he looks directly at me. So I say very calmly, Mate, it still counts as littering even if you bury it. And the bin is right there. He mumbles something and keeps walking, end of story. Or so I thought. Oh no. She comes storming back like the ghost of littering past. You don't know what I've been through. I blink, I'm wondering what is the relevance of that statement? So I say I wasn't even talking to you. And she spits back Well when you talk to him, you talk to me which look, I'm not sure what that has to do with anything, but okay. So I say, okay, but the cigarette butt still needs to go in the bin. Then she comes back with I came back to apologize like an adult. And by this stage I have a full s head of steam, and I've half an apparel spritz in, so I reply, Adults put rubbish in the bin, babe. Also, you don't need to apologise to me, it's your environment too. Well then it's on like Donkey Kong. There's muttering and huffing and a whole lot of swearing and then eventually storming off. I must give him a bit of credit here. He's remained silent throughout this whole rant, which is fair enough. But as she stomps away, he says to me, You've got a man, referring to my poor husband who is also sitting by me throughout this entire encounter. You shouldn't even be looking at me, which I must admit made me giggle a lot. Anyway, I'm left sitting there thinking, was that perimenopausal energy? Was it a testosterone side effect? Or was I being a bit of a Karen? I've been in situations before when something felt wrong and I've stayed silent. One that still haunts me was around the time of the marriage equality vote, I was in a meeting with senior executives at work and the men in the room were openly discussing how they were going to vote against marriage equality. And I sat there silently, seething, but said nothing. And afterwards I was so disappointed in myself because silence in that moment was agreement, and I think about it even to this day. So ever since I've tried to hold myself accountable. I don't want to be the person who sees something wrong and just looks away. I need to be able to live with my own behaviour. Forget trying to reform their behaviour. I'm under no illusion that our encounter has made any difference to their self-righteousness. But when I see that young man bury his cigarette in a garden bed metres from a bin, saying nothing would have disappointed me in me. It was about being satisfied with myself, which I guess is ultimately who I need to impress, right? From the sublime to the ridiculous, now time for my favourite segment, Wellness Woo of the Week, where we take a look at one wellness trend and gently, or rather more firmly, ask, is this science or is this social media? This week's woo is seed cycling. If you haven't heard of this, the idea is that you eat specific seeds at specific times of your menstrual cycle to balance your hormones. For example, in the follicular phase you eat flaxseed and pumpkins. In the luteal phase you might eat sunflower and sesame. Now seeds are great little tasty things. I enjoy the odd seed in a salad or as a snack. They've got fibre, nutrients, good fats, yum. But do they balance hormones? Do they change estrogen and progesterone levels? Do they regulate cycles? Absolutely not. If seed cycling worked, gynecologists would prescribe chia puddings. But Kate, why does it feel like it works? Glad you asked. Because people who are seed cycling are increasing fibre, eating more nutrient-dense foods, likely cutting down on processed snacks, tracking their cycle, becoming more mindful, and creating a calming ritual around food, and all of that can help. It's not the sesame seeds doing the hormonal acrobatics though. Hormones don't work like that. You can't massage progesterone levels with fights. If you're having symptoms, heavy periods, irregular cycles, painful PMDD, PCOS, perimenopause chaos, you deserve proper medical oversight, not a printable seed cycling planner. If you enjoy seed cycling because it makes your breakfast pretty, go for it. Fill your boots. But let's not pretend it's endocrinology. If you enjoyed this, share it with another woman in her 30s, 40s, or 50s, or anyone really. Thanks for your company. See you next time we get on the moans. Until then, look after yourselves, pick up your rubbish, and pick up your science while you're at it.