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 friends, welcome to On the Moans. I'm feeling particularly reflective today because my son, my first baby, my little boy, turns 21 tomorrow. 21 years with this extraordinary human. And I have a confession. When I found out I was pregnant with a boy, and I absolutely had to know as soon as was humanly possible, refer back to the episode where my daughter accuses me of having no patience, I cried for a week. It had simply never occurred to me that I would have a son. I grew up with a sister. My mum had two daughters. I had pictured daughters. And looking back, I feel ashamed of that reaction because having a healthy baby is a miracle enough. But this baby boy, he was delightful. Well, mostly delightful. There were those early months in a sweltering little rented apartment, rocking him at 2 a.m., whispering desperate negotiations into the dark. Perhaps he was less delightful then. But he was a bonny toddler, chubby legs, white blonde curls, impossibly large blue eyes. Always happy, always in the middle of the fun, at the beach, at the cafe with his baby chino, at childcare, at school. Of course, we had our battles. There was a showdown over macaroni and cheese when he was two. One piece of pasta, one high chair, one hour of mutual stubbornness. I rang a dear friend in tears saying, I can't let him win. And she said calmly, he's already won. Take him down and give him a bath. Looking back, what did I think I was achieving? And now he's twenty one, over six foot tall, strong in that way young men are, handsome, funny, capable of lifting the entire mood of the house with one perfectly timed comment, occasionally a perfectly timed fart. He's a wonder. And he has generously agreed to sit down with me today. Partly because I take every opportunity I can to talk with him, but mostly because I'm curious, what, if anything, does a twenty one-year-old man think about perimenopause?
SPEAKER_02Hey buddy. Hey guys, how's it going?
SPEAKER_01Before we start, this little podcast is being listened to in places we've never even been Kenya, Pakistan, the Faroe Islands, the UAE. So introduce yourself to my lovely friends.
SPEAKER_02Hi there everyone. Um, my name's Obi, my full name's Willoughby. I'm 21 years old, as you guys know now. I was a student at a UNSW, and my main love in life uh is nature, animals, um, and caring for uh wilderness areas.
SPEAKER_01Betty, I've got a few questions for you for a segment that I'm calling Mummas in Perimenopause Send Help. Round one is one word answers only. Okay, don't overthink it. We're just gonna go rapid fire, okay?
SPEAKER_02Perimenopauses Uh Hormone imbalances. Hormones are endocrine system uh things that help your body perform vital things in your body. Okay, I'm stressing. Yeah, next. Mood swings are uh annoying to deal with. Libido means Libido means uh sexual health. Hot flush equals S Sweating.
SPEAKER_01Mum during menopause is Lovely. He knows where his bread is buttered. Middle-aged women are Empowering. Wellness influences are lame. If menopause had a song, it would be staying alive. Alright. Nice work, buddy. Let's go into round two. Ding ding ding. Finish the sentence. I knew mum was in perimenopause when.
SPEAKER_02I actually uh did not know when my mum was in perimenopause.
SPEAKER_01The weirdest thing about women's health is There is nothing weird about women's health. Nice answer, Switzerland. The most unfair thing about hormones is Um, I don't think there's anything unfair about hormones.
SPEAKER_02I think all the hormones do very important jobs in your body and uh all of them equally contribute to uh who we are.
SPEAKER_01Really? Because you've been complaining over the last couple of months of pimples on your face, and I would blame hormones for that.
SPEAKER_02Uh yeah, okay. Yeah, fair enough.
SPEAKER_01If boys had menopause, we would deal with it better. Ooh. Definitely. That that's 100% what would happen. You've just alienated 50% of the population there, big fella.
SPEAKER_02Social media has taught me women's health is Um maybe uh slightly unrepresented, um, and you don't really hear too much about it, I would say. Like later. Later women's health, I don't think I really hear too much about. I hear a lot about young women's health, but not too much about older women's health. I think women worry about I think uh maybe one of the main concerns of women might be aging well, I guess.
SPEAKER_01Round three. Is it peri or just me? So I'm gonna ask you a question, and you've got to answer if you think it's perimenopause or if it's actually just me. Rage quitting my job.
SPEAKER_02Well, first of all, you didn't really even rage quit your job, so I'm gonna say that's just you.
SPEAKER_01Threatening to smite you about the head with heavy blows when you leave the frying pan in the sink.
SPEAKER_02Uh, I think that's just you.
SPEAKER_01Starting a social media page instead of getting a real job. I think that's just you. Talking about menopause at the dinner table.
SPEAKER_02Yep, just you. Joining an Olympic weightlifting gym. This might be a bit of both. I don't think it's like I think perimenopause might be um driving you to get stronger in um many different aspects of your body rather than just focusing on like running and fitness. But I think also you're the kind of person to want to do anything you can that's like moving in fitness and strength um based, like training. So I'll say I'll say both.
SPEAKER_01Getting excited when I see a two kilogram protein jar on sale. Yeah, just you. Buying jorts and wearing them in public and thinking I look good.
SPEAKER_02Well, I don't think that's that that's that weird anyway, because I think lots of people wear jorts. I've worn jorts, your daughter's worn jorts. So I'm gonna say that you look good in anything, mum, and uh, that's just you.
SPEAKER_01Thanks, buddy. What about going to bed at 9 30 p.m.?
SPEAKER_02Uh yeah, that's just that's just you.
SPEAKER_01So you're saying that none of these things I can blame on perimenopause? Okay. Do men your age talk about hormones?
SPEAKER_02Not really. Maybe you like um maybe like testosterone and like steroids, but that's like more of a joke, not actually like serious talk about hormones.
SPEAKER_01So you guys have just been through adolescence. So adolescence is a pretty big hormonal shift. But still you wouldn't say that you were talking about hormones or changes in body or you know, shifts in l life at all?
SPEAKER_02No, not really. I guess like when you reach that like puberty age, maybe you're going to the gym more and um building muscle and stuff, but I don't think I would say that me and my friends or me and like I don't know, random people like ever really talk about hormones.
SPEAKER_01Interesting, because I guess middle-aged women when we get together can have a bit of a whinge about I don't know, um the symptoms of perimenopause or menopause or uh libido changes or skin changes or muscle changes or having to go and get a DEXA scan and be you know found out to be osteopenic or osteoporotic or you know difference in starting estrogen treatment or progesterone treatment. So it's just interesting. Maybe that's maybe that's the lesser difference between the young and the older, and maybe that's a difference between men and women. I don't know. Your friends all must have parents around about my age. So you're saying that you guys never talk about your mum and whether you know whether or not she's having a massive life change hormonally speaking.
SPEAKER_02No, not really. I think I've had like maybe one conversation with um my best mate and his girlfriend about it, but that was because I think this like podcast was in the discussion, so we started talking about it. But I don't think normally I would have a talk about it, no, not really.
SPEAKER_01It's interesting because as parents, when you guys are all going through adolescence, we all get together and talk about how the hormonal changes are affecting you and how it's affecting the rest of the family and how we should deal with it. So I think it's interesting that as young adults you're not looking the other way and thinking, oh, you know, the large hormonal shift happening in our mothers and you know how it's how it's affecting us, how it's affecting the family. That's that's just interesting to me. What do you think I worry about?
SPEAKER_02I think you're a uh very physical person, you know, you do a lot of running, you're outdoors all the time, um, you and dad are constantly moving um all the time, and I think you probably worry about um the longevity of your physicality, how much longer you can, you know, go on a go on like a 15k run or go to the gym and lift X amount of weight or do stuff like that and just feel your best physically, because I think you your physicality and your like your mental health is very connected. So I think for you, um, as you get older you might be thinking or worrying more about how you're gonna be like performing in the gym or like running wise and how that can affect you mentally later.
SPEAKER_01I think that's pretty insightful actually, because you're right, my mental health is inextricably linked to my physical health, and whereas I like to think I have some tiny element of control over that, really I'm kidding myself because nobody knows what is coming in terms of a health diagnosis. What do you think women your age will experience differently?
SPEAKER_02As in like right now or experience differently in the future?
SPEAKER_01I guess I was thinking about when I was your age and my mum was my age, because I had you at 27, and my mum had me at 27, so when my mum was going through her late 40s and early 50s, it was uh late 90s, early 2000s, and the women's health initiative had just been released, so there was a lot of scare around hormone replacement, and she had no hormone replacement. I guess I'm wondering my experience has been very different. I've had the opportunity to discuss with my prescriber and to make decisions about my own healthcare. Uh w we're in an age where this conversation is becoming less taboo, it's absolutely becoming much, much more normal to talk about it. And so I can only hope that women who are your age now, so including your sister, will when they are my age, have even more options and opportunities and even less stigma and even less taboo around being a middle-aged woman and aging. And so I was just wondering if you whether or not you feel as if as if that's going to be easier or different for your group of friends and for your sister.
SPEAKER_02Yeah, well, I guess very well put. Um, but I guess there will probably be like a more um positive shift, um, I guess when talking about women's health and the um I guess future progression of women's health and um doing a better job of not really, I guess, curing them, but um helping like women manage them and be their best their best self for as long as they can.
SPEAKER_01That's a really nice way of putting it. So that's actually called your health span rather than your life span. What you've just articulated there is women live longer than men, um statistically, but older women can get frail and can get cognitive decline. So I would say for myself um that living as long as possible isn't the goal. I don't need to live to 110, but I would like to live as well as I can, and that's the health span that you've that you're talking about there. What do you think you'll understand better when you're in your forties?
SPEAKER_02Ooh, well, that's like a very loaded question because um I guess I'll uh understand a little bit of this and a little bit of that, like a lot more, I guess everything I'll understand more.
SPEAKER_01I'll rephrase it. So when you're in your mid-40s, what will you understand better about the women in your life who are also in their mid to late forties? Oh gosh.
SPEAKER_02Hopefully my partner in the future, hope I'll know uh hopefully I'll know as much as I can about like her health and I don't really know that that's like a very difficult question to to answer.
SPEAKER_01You're right, that was a very difficult one because I'm sure when I was 21 I really felt like people in their forties were just so so so old, and I would never ever ever ever be that old. I've got one last question. You went to an all-boys school, so imagine you're standing in front of the assembly, and somebody gave you a microphone and said, Explain perimenopause to the boys. What would you say?
SPEAKER_02First, I'd start off by saying, um, I also don't really know what perimenopause is.
SPEAKER_01What's perimenopause? Menopause is the day in your life that is 12 months after your last period. So perimenopause is the amount of time before that, so it can be years and years and years and years, where you are experiencing hormonal fluctuations that are associated with what eventually will be menopause.
SPEAKER_02I would say that, but then I'd probably say, as a man who doesn't have to go through this, just be there and support the women in your life. Um, try and make their life as comfortable, easy, as supported, try and uplift them through their experience because it's probably a difficult and um life-changing um moment for them. And just just do your best to be as positive, happy, uplifting, and just be there for them. Be there for the women in your life, boys.
SPEAKER_01Thanks for being with me whilst I get on the moans. Will you come back?
SPEAKER_02I'll leave here. I'm I'm I'm here all day, so probably.
SPEAKER_01Thanks, buddy. Bye. This segment is starting to feel like I educate you on medications until you become a pharmacist. Melatonin. Not in a lavender diffuser moon water way, in a biology way. First, what actually is melatonin? Melatonin is a hormone. It's made in the pineal gland of your brain, a tiny pea sized structure that responds to darkness. It's not a sedative, it does not knock you out. It is a circadian signal. Think of it as your brain whispering to your body, it's night now. Melatonin rises when light drops. It peaks around 2 to 4 AM. And then it falls towards morning. It doesn't make sleep happen, it tells your brain what time it is. And melatonin production decreases with age. By your forties and fifties, your natural nighttime peak can be significantly lower than it was in your twenties. There is also often a shift in timing. The rhythm becomes a bit loose, which means you may not feel sleepy when you want to. You may wake up at 3 a.m., your internal clock may drift earlier or later, and jet lag hits harder than it used to. Add fluctuating estrogen and progesterone into that mix and sleep becomes theatrical. So does supplementing help? Short answer, sometimes. Longer answer depends how you use it. There are two main formulations, immediate release and modified or slow release. They do different jobs. Immediate release melatonin, this spikes quickly in your bloodstream and falls quickly. It's useful for jet lag, shift work, resetting, a delayed sleep phase, travelling across time zones. In jet lag studies, doses between two and five milligrams taken at the new destination's bedtime are commonly used. Higher doses are not necessarily better. In fact, more is not more here. You can get vivid dreams, headaches, next day grogginess. Most trials show that half to three milligrams is sufficient for circadian shifting. Yeah, half a milligram. We wildly overdosed melatonin in the early supplement years because it was natural and therefore assumed harmless. It is a hormone. Hormones don't need megadosing. Modified slow release melatonin, this is the one that is more helpful for sleep maintenance insomnia, especially in midlife. The slow release version mimics the body's natural overnight curve more gently. The evidence base, particularly in adults over 55, supports 2 milligrams of modified release taken about 1 to 2 hours before intended bedtime. And this is important. It works better when taken consistently. Not Tuesday because you had a bad night, then nothing for a week, then two tablets taken at 11pm in frustration. It is better used as a short course two to four weeks to help re-anchor the rhythm. It's not a sleeping pill, it's a rhythm stabiliser. Melatonin is modest. In meta-analysis, it shortens sleep onset by about 7 to 12 minutes on average. That's not dramatic. But if your problem is circadian timing rather than anxiety or pain or reflux or night sweats, it can be helpful. If your insomnia is driven by anxiety, racing thoughts, untreated sleep apnea, hot flushes, alcohol, doom scrolling, melatonin is not going to override those. A few other practical notes. Take it in dim light. Bright bathroom lighting defeats the purpose. Avoid screens afterwards. Blue light suppresses endogenous melatonin. Start low, 1 to 2 milligrams, is often enough. More is not more effective. And importantly, melatonin is very safe in the short to medium term. It is not habit forming, it does not suppress your own production at physiological doses. But it is not a cure all. It is a tool. And like most tools in midlife medicine, it works best when matched properly to the problem. So if you are travelling, think immediate release. If you're trying to gently stabilize sleep onset and maintenance over a few weeks, think two milligrams slow release taken two hours before bed consistently. And if your sleep is still a mess, that is a sign to zoom out and take a look at the whole system. Sleep is rarely one-dimensional. And that is your melatonin pocket masterclass. No moon water required. Folks, you know I like to make each episode of On the Moans the way I'd make up a bed for a beloved guest. Cotton and cashmere sheets in muted, earthy tones. A goose-down duna weighted perfectly for the season. Pillows that support your head just so cocooned in silk slips and fragranced with your favourite scent. An artfully draped throw blanket that looks like it was hand crocheted by my grandma. And the little dog curled up like a croissant at the foot. Inviting. Considered supportive. Evidence-based bedding. But sometimes, sometimes I pull back the covers and find a discarded polyester sleeping bag, a foam yoga mat, and an empty goon bag that I've inflated to use as a pillow. I tie a rag across my eyes and I shuffle into the dimly lit corner of wellness mythology that is my segment, Woo of the Week. And this week's woo nominee is Grounding Mats, also called earthing mats. These are the conductive sheets or pads you plug into the earth port of your power outlet or run out the window into the garden and then sleep on. The claim that modern life has disconnected us from the Earth's natural electrical charge. That walking barefoot once balanced our electrons, and that by sleeping on a grounding mat you can reduce inflammation, lower cortisol, improve sleep, improve chronic pain, and regulate your nervous system. All by absorbing electrons from the planet. Now, wow, that's a lot. Yes, the Earth has an electrical potential. Yes, the human body conducts electricity. No, there is no robust, high quality clinical evidence that sleeping on a wire connected to your wall socket improves insomnia. The proposed mechanism is that free electrons from the earth neutralize free radicals in the body. Those science-y words sound very impressive, but here's the thing. Free radicals in biology are not floating around waiting for a duna with a USB port. Oxidative stress is tightly regulated by enzymatic systems inside cells. We do not correct intracellular redox biology through the fitted sheet. When you look at the published data on grounding mats, you'll see very small sample sizes, unblinded designs, often industry-linked funding, subjective outcome measures and weak controls. There are no large independent randomized controlled trials demonstrating clinically meaningful improvements in sleep. None. Now, do some people say they sleep better? Yes, and I believe they believe that, which is great for them. But sleep is exquisitely sensitive to ritual. If you change your bedtime routine, spend $200 on a device, become hyper focused on sleep, and lie down thinking this is helping, your nervous system may downshift. That's expectation effect, conditioning, and placebo. Placebo is powerful, but placebo does not mean electrons are flowing through the petunias into your mitochondria. Also, and this is practical, most grounding mats plug into the earth pin of a standard outlet. They are not connected to soil, they are connected to your home's grounding system, which is a safety feature for electrical faults, not a therapeutic conduit for planetary energy. If someone enjoys sleeping on one, fine, it is unlikely to harm you. But if someone is spending significant money on grounding equipment while ignoring hot flushes, untreated anxiety, alcohol before bed, obstructive sleep apnea, inconsistent light exposure, stress, then we have misplaced the intervention. Grounding mats are seductive because they imply modernity broke you, nature will fix you, plug into the planet. It's a very clean story. You do not need a cord to the earth to sleep. You need circadian rhythm, temperature control, hormonal support if appropriate, and a nervous system that feels safe. The planet is doing fine without your USB connection. Lovely friends, I hope you enjoyed hearing from my Willoughby on the eve of his 21st birthday as much as I enjoyed well let's be honest, strong arming him into doing it and then gloating when he admitted he enjoyed it. I do keep telling him that I know everything and that I'm always right, and yet he persists in forming his own opinions and making his own decisions. Outrageous. If you have a lovely boy in your life, give him a kiss, and then tell him he's doing a good job. Arnie Kate said so. And now you. I'm fairly sure Gimli, son of Gloyne, said that in the Lord of the Rings. And I would love to make this more interactive. So, send me a voice recording of any question you'd like answered to onthemones at gmail.com. That's moans M-O-N-E-S, as in Hormones, not whinging. Tell me your name, tell me where you're listening from, tell me what's been on your mind, or in your feed, or in your group chat. And I'll stitch them into the next episode and we can talk about it together. I cannot wait to hear from you wherever you are in the world. Until next time we get on the moans. Bye-bye. Like just be I was being completely normal. Just be completely s just don't don't breathe or move for a moment. Okay, ready? Hmm. Here is the dog. Never work with children or animals. And here is both. Okay. Is everybody s is everybody settled?