#12 - Tiffany Bernical: Perimenopause, Hormones & Brain Fog

Brain fog, memory lapses, disrupted sleep and mood changes can be deeply unsettling. For many women, these symptoms begin during perimenopause. They can appear years before menopause itself and are often dismissed as stress, ageing or simply not coping.

This topic matters because perimenopause can affect far more than physical health. It can influence confidence, relationships, work performance and everyday decision-making. Despite how common these experiences are, many women still receive very little information about what is happening or where to seek support.

In this episode I’m joined by Tiffany Bernical a psychology researcher, PhD candidate and health and fitness professional. Her work focuses on cognition, hormones and menopause-related brain fog.

We talk about what perimenopause actually is, why it can last for several years and how hormonal changes may affect the brain. Tiffany explains how these changes can influence memory, attention, processing speed and word retrieval. We also look at the broader impact this can have on someone’s confidence and daily life.

We touch on sleep, stress, emotional regulation, ADHD, hormone therapy, cycle syncing, nutrition and exercise. We also discuss practical ways to reduce cognitive load and better manage brain fog.

One of the biggest parts of the conversation is the gap that still exists in women’s health research. We talk about the lack of a clear definition for menopause-related brain fog and why current cognitive testing may not fully capture what women are actually experiencing.

This is an honest and practical discussion about the female brain and the realities of perimenopause. We also look at why women deserve clearer information, earlier support and greater understanding from healthcare professionals, workplaces, families and the wider community.

This episode is proudly sponsored by GEE Recovery the Central Coast’s leading destination for recovery, wellness and performance. Explore infrared and traditional saunas, hot and cold therapy, massage and compression therapy at https://geerecovery.com.au/ 

Transcript

Meet Tiffany Bernical

SPEAKER_00 0:00

This episode is proudly brought to you by GRecovery, the Central Coast's leading destination for health, wellness, and performance recovery. From infrared saunas and ice bars to massage therapy and soft tissue treatments, they've got all science-backed tools to help you feel and perform at your very best. To book your next session or learn more, head to gerecovery.com.au. That's gerecovery.com.au I think we've surfed before at Blue Bay.

SPEAKER_01 0:47

Yeah.

SPEAKER_00 0:47

But then I was the tutor. Yeah. Yeah. Yeah. Yeah. I was trying to be like, was it surfing? Was it tutoring? Was it a few years?

SPEAKER_01 0:55

I think it was a bit of both. It's the Central Coast as well. Like I've seen your face everywhere. I feel like I already know you.

SPEAKER_00 1:00

Yeah. Roland. So I would I would struggle being a lecturer.

unknown 1:06

Yeah.

SPEAKER_00 1:07

Because I'm like, I didn't start studying until later. And I was like super, I went in super hard and fast. Like motivated as ready to go. Yeah. I mean, a part of it is probably just first year uni, where you don't get to go as deep as you'd like. It's very like surface level. Surface level.

SPEAKER_01 1:22

Laying out the groundwork and and it's all it's all foundational stuff. Like you do need to know it. But it's even by third year, you said you're in third year now, aren't you?

SPEAKER_02 1:31

Yeah.

SPEAKER_01 1:32

End of third year, I left the degree feeling like I knew nothing.

unknown 1:35

Yeah.

SPEAKER_01 1:35

I was like, I know a little bit about statistics. Yeah. I know a little bit about different concepts in psych.

SPEAKER_00 1:43

Yeah.

SPEAKER_01 1:43

But that's it. Like you really don't. And then I did the honours thesis.

SPEAKER_00 1:48

What did you do honours on?

SPEAKER_01 1:49

So the same topic. Yeah. So I've been studying um like brain fog cognition in perimenopause for a couple of years now. And um even now I feel like I'm only scratching the surface. But I don't feel too bad because the whole field is only scratching the surface.

SPEAKER_00 2:05

So I feel like we're all trying to uncover what's happening and so I are you you started your honours thesis with that?

SPEAKER_01 2:14

I did my honors thesis with that.

SPEAKER_00 2:16

Went straight into your PhD.

SPEAKER_01 2:17

And then went straight into the PhD because I was like, I I need to keep going. And it went so fast. The honors year, I did the coursework. I did it part-time.

SPEAKER_00 2:25

Yeah.

SPEAKER_01 2:25

Because full-time honors is you you need you need 30 to 40 hours a week. Like you need to invest that time if you want to do well. Like I'm sure you could get away with oh it depends on who you are, I guess. Like some people just it clicks, but I definitely need time to to learn and and to understand.

SPEAKER_00 2:44

Especially if you want to get into like more postgraduate stuff.

SPEAKER_01 2:47

Well, exactly. And if I I I know that if I didn't invest the energy and time that I did, I probably wouldn't have gotten the marks that I liked or the awards. Like we did like a conference presentation, and there were there were awards given for best presentations, and I was super lucky to get one. And I was like, Yes. Uh, but all that stuff looked really good on like the academic resume. So then when I applied for the PhD, they were like, my supervisor and I already bonded, and she was like, I want you. And I was like, Thank you.

SPEAKER_00 3:14

Who is your supervisor?

SPEAKER_01 3:15

Sharon Savage. Okay. Dr. Sharon Savage. And my other one is um Dr. Sally Hunt.

SPEAKER_00 3:21

Okay.

SPEAKER_01 3:21

Yeah.

SPEAKER_00 3:21

Yeah. I think everyone that starts psych is I mean, not everyone, obviously, but a lot of people get in and they go, I want to be a clinical psychologist or or or a registered psychologist and do therapy and whatnot. Did you ever have a different goal?

SPEAKER_01 3:36

Yeah, I never wanted to do clinical work.

SPEAKER_00 3:39

Okay.

SPEAKER_01 3:39

So clinical psychology or being a therapist or a psychologist was never the end goal. I think I have like a predisposition to liking uh mechanisms. Like I like to understand how things happen, why they happen, like what's the purpose behind that function rather than applying the work later. Like I think when I think of psychologists, it's like, oh, okay, I know this treatment is most effective for this population. Let's administer that and work through that. Whereas I'm like, I want to find out why it's effective for that population and can we make it better? Yeah. Can we get more data to see how we can improve these processes or uh deepen our understanding of why things happen the way they happen? So it was either psychology or biology.

SPEAKER_00 4:30

Yeah, I was gonna say it sounds very science.

SPEAKER_01 4:32

Very, very science-y, and that's why I have this interest now because hormones obviously affect cognition, which is my area of research, but the area of research research I'm doing for the PhD is very specific to cognition, but I still read so much about the biology behind it, which is more like the endocrine system and endocrinology. But I'm not an endocrinologist, I just want to understand. I'm like, what is it? Like, what is it about these hormonal changes that affect the signaling between glands and yeah, so I I reckon I did probably 30 minutes of reading up on it, and I just was so overwhelmed with it.

SPEAKER_00 5:10

It's so complex.

SPEAKER_01 5:12

It is very complex, and that's why I think we're seeing like big trends, especially on social media, around balancing hormones, balancing hormone diets, balancing hormone medications, all these different uh regimes that you can follow. But I don't see much information out there about what actually is a hormone. Yeah, like if I ask someone what's a hormone, will they be able to respond and answer that? Like a hormone is simply a message between glands. That's what a hormone is. And these glands, they're the ones that are doing the shifting and the changing that can influence how these messages are received. So, yeah, the the optimal balance or finding this perfect balance between hormones for optimal functioning, I'm sort of like that that language can be a bit scary and misleading because what is this perfect optimal balance? And then how are people actually checking that when they're following this hormone balancing diet? What does that look like? So, you know, I think uh especially as a woman with research emerging uh more to do with hormones and and the way the body functions and the way the brain functions, I think the most important step is probably just understanding yourself first and understanding how imbalance looks like for you.

SPEAKER_02 6:38

Yeah.

SPEAKER_01 6:38

Because if there's nothing that is imbalanced, why is there a need to follow a hormone balancing diet? Like if you're functioning great in everyday life, you're exercising, you're sleeping enough, you're eating relatively well, like why is there this need to optimize that or to find this perfect balance?

SPEAKER_00 6:54

I'm like supplementation, yeah.

SPEAKER_01 6:56

Supplementations and all that if you're already. But of course, when we start to see the messages missigling between glands, and that does have a flow-on effect and affects other types of messages between other glands, you'll see signs, and that's when you need to speak to a specialist or an endocrinologist or someone who can help you decipher what's happening with you. Yeah. And the first step with that would be to record what these symptoms are for you because that's specific. So uh going to a specialist or a health professional with data is the best way to get like the most appropriate help.

SPEAKER_00 7:36

Yeah, and get the most out of it.

SPEAKER_01 7:38

And get the most out of it. Yeah.

SPEAKER_00 7:40

Circling back, most people know you for your health and wellness uh influence. How many people know that you have an interest in psychology?

SPEAKER_01 7:48

Oh, I feel like it's changing week by week because recently I've started posting more about brain fog and brain fog and my research, and it's been really cool to see in the community, people are approaching me as well. So I teach at a few um studios on the coast to Goodwell and Club Heart, and um I've had clients come up to me and said, I had no idea that there was this whole other side of you. Can you please share more? Like, what? What is this? And I was like, I don't know. I've just always kept it to myself and I've hustled on the side with this research for so long. And as you know, I'm I work as an academic tutor and casual academic at the uni as well. Uh, but I never thought about interweaving the worlds together.

SPEAKER_00 8:30

Uh is there a reason you kept it like to the side?

SPEAKER_01 8:36

Okay, mic it a bit deep here. But I think uh

From Fitness to Psychology Research

SPEAKER_01 8:42

I decided to study late in life, and I didn't know how I would go. I think there was a lot of imposter syndrome. Uh I maybe didn't trust myself or my confidence in being able to do things well at uni. Uh but yeah, I've I've given myself plenty of evidence now, after five years of studying, that I do know stuff, I can do it well, and sharing this information can be useful for people. And that's what I'm hearing from the community that we love hearing this, and we're stoked that there's more researchers and and more people looking into women's hormones and brain function because it's super important. So yeah, it feels more like there's a there's a separate drive uh that overpowers the self-doubt and maybe reduced confidence that that is now driving me to share this information.

SPEAKER_00 9:39

Yeah, yeah. I think it's pretty normal, especially in the academic space. Like I think that's something that I didn't realise when I first started studying, is there's such a I mean, there's such a prestige with it, but I think I came into it, I mean, I got a mystery mark in my HSC. Like I may as well failed it and then, you know, spent however long outside of it doing whatever I wanted. Like I think I had 12 jobs over the over the years. Yeah, it was like I mean, again, ADHD and didn't have a diagnosis until late. And then when I did and I started studying, I kind of came into it with this almost probably not like a lack of respect for the prestige of it, but probably just not an awareness of it. So I was quite quick to you know speak my mind on different things and whatnot. And then the more that I met people that were studying it later in life and and people like yourself doing a PhD, even people that are, you know, doctors now and have done years of research were nervous to come and speak about it. And I got so confused. I was like, why why are you nervous about it? You've studied it for years, some people 10 10 plus, and yet there's podcasts that are from people that have no education around it that are speaking their their mind about about things on the fly and giving advice. Um, so I think yeah, people that are researching it and and and actually have knowledge should be sharing it more. So, yeah, props to you for jumping on for doing that.

SPEAKER_01 11:09

Yeah, thank you.

SPEAKER_00 11:10

Um, just to start off, where did your interest in hormones and brain function come from?

SPEAKER_01 11:18

So a little bit from myself and a little bit from my mum. So we are bilingual. So my family was born in France, and uh we moved to Australia when I was really young. And my mum went through menopause maybe six years ago now, and she found it really difficult to express her concerns to a GP. Uh, so often appointment times are what, 10 to 15 minutes? And if there's already a bit of like a communication barrier between you and the professional, uh, and there's not much uh information out there to even know how you want to express what you're going through, then often it goes unrecognized and unsupported. And that's what sort of happened to my mom. And so I saw her suffer for years because uh this transition for in a woman's life from late reproductive stages through to menopause can last four years, like up to 10, 10 to 14 for some. Uh and yeah, if they're not getting the support they needed, then you're just seeing them struggle. And if you can't do anything about it, then it's hard for you as well. So I think that was my main motivation and drive to go, why isn't there information about this when every single woman on the planet will go through menopause? Yeah. It's baffling to me. For sure. And then so uh when I chose my honors

Why Tiffany Studies Hormones and Brain Function

SPEAKER_01 12:45

topic to be around menopause and brain fog, I specifically looked at memory. And the study I designed um that I conducted was a meta-analysis. So I was collecting data from all different research papers and and looking at outcomes on memory performance on different tests. And this meta-analysis, after looking at the whole literature on memory function in menopause, it had 14 papers. And just as a comparison, like obviously people who know research will understand that. Uh, but meta-analysis, if you look at things like CBT treatment for depression, thousands and thousands.

SPEAKER_00 13:23

Thousands. Yeah.

SPEAKER_01 13:24

Yeah, you're looking at you're needing a whole research team to conduct this meta-analysis. But for this particular topic, for something that happens to women, every single woman on the planet, 14 papers. And I remember just going, what? And some of the papers had to be excluded because the samples that they were using to look at memory and cognition weren't even women.

unknown 13:45

Yeah.

SPEAKER_01 13:46

They were using men.

SPEAKER_00 13:47

Yeah.

SPEAKER_01 13:47

Yeah.

SPEAKER_00 13:48

I'm doing some research experience at the minute, and we were going through the whole process of finding the appropriate studies to just include in the in the analysis. And yeah, I there's there's multiple teams that are doing it. I'm one of four in one team, and we got 2,300 studies just between the four of us to go through.

SPEAKER_01 14:11

What's the topic? Sorry.

SPEAKER_00 14:12

Uh it's in eating disorders. Okay. Um yeah, so we did oh, I think I ended up doing about three, four hundred going through and and you just read the abstract and and go from there. Sure. And I ended up with 18 that were that were relevant out of out of the 300 and whatever. So the fact that you had 14 as a whole, half, not even half, but there's only probably a few that are relevant.

SPEAKER_02 14:38

And like you said, there's studies on males, like not even accurate. Yeah.

SPEAKER_00 14:44

Yeah. So when we talk about things like brain fog, memory concentration and hormones, do you separate it between cognitive function and then the emotional aspect as well? Like I know there's brain fog, and like we just said, but then there's also the emotional effects of like stress tolerance and you know, just emotional fluctuations. Are they two separate things or do they play into the same role with hormones?

SPEAKER_01 15:12

Yeah, so this is where it can get a little bit complicated. And from the research, we don't have, which is part of my PhD project, is to start working towards achieving this, but we don't have a universal, uh, clear definition of brain foggy menopause. So at the moment, it's still very up in the air on how we're defining brain fog, because like you just said, which you made a really good point, are we including the emotional aspect or are we purely focusing on cognition and how it affects memory, concentration, attention? So we don't really have a clear understanding yet of exactly how brain fog manifests in women. Uh, we've got some ideas on specific processes that are affected. Uh, I focus more on the cognition side. So we're seeing memory, word retrieval, so finding the right word, uh, concentration, attention, and then processing speed. Those cognitive processes seem to be uh coming up a lot in the literature and what's what's affected. And then we also know that there is a relationship between going through this life stage and uh declining mental health. So that could look like increased anxiety, um, increased depression, yeah, yeah, stress as well.

SPEAKER_00 16:32

Yeah, true. Again, like you said at the start, it can last for you know 10 years for some people. Do you see a return to previous function once it's run its course, or does it have permanent effects?

SPEAKER_01 16:45

Yeah. So from the research, we're seeing that cognition typically comes back. So

What Menopause-Related Brain Fog Feels Like

SPEAKER_01 16:52

this is specific to menopause. It is a menopause-related brain fog. Uh, so that should be reassuring for some that typically cognition returns back uh to baseline functioning. Uh in saying that, there are some papers out there that are looking at links between, say, Alzheimer's disease and uh cognitive function in perimenopause, because we know that Alzheimer's, uh, a type of dementia, is more prevalent in women. So uh researchers are starting to look at this sort of midlife period and seeing if there's ways that it can predict later onset of Alzheimer's. Uh, because if we can target uh midlife, then that's obviously better than letting the disease progress later on in life. Um but the links there aren't quite clear.

SPEAKER_00 17:42

I know that there's high risk of Alzheimer's and cognitive decline for shift workers because sleep schedules are so thrown off. And you know, the more that we progress in research, the more that we understand how important sleep is. Yes. And then you think about some of the main factors that are disrupted in menopause, and sleep is like one of the top things. Yes. Before we dive into all of that, let's address the maybe misunderstandings and then some of the experiences that people who are going through menopause are having. For a 25-year-old male, I had no idea that perimenopause was a thing. And then I spoke to a few female friends and they didn't have an idea of perimenopause either. Wow. So let's just run through the whole broad lifespan.

SPEAKER_01 18:26

So there's this incredible uh doctor called Gillian Goddard, and I really like she's written a book called The Hormonal Loop, and I just love the way that that frames a woman's lifespan, the endocrine system across the lifespan. So she talks about each season flowing into one another, but of course, the flow can be a little bit chaotic in some transitions compared to the other, compared to others. Uh but yeah, so we've got puberty, and then we look at uh pregnancy if uh if that's an option or if you've decided to become pregnant, and then you have the late reproductive stage, which leads into early perimenopause, and then there's late perimenopause. After that, there's m menopause, so that's 12 consecutive months without menstruation, and then you enter late early postmenopause after menopause, and then there's late postmenopause. So oh my gosh, so many different stages.

SPEAKER_00 19:31

Uh why is I I heard um there's a bit of conflict in the diagnostics for what do you say, 12 months of no menstruation. No menstruation. Why is there debate around that?

SPEAKER_01 19:44

Well, I think because if I give you an example, say you've gone 11 months and 28 days, and then on the 29th day, yeah, you have a period.

SPEAKER_00 19:55

You're not getting it.

SPEAKER_01 19:56

So yeah, it can it can be a little bit tricky for that. So uh that's just how it's defined medically in the literature. But we can see that obviously for some people it can be uh confusing to know how to diagnose something or how to treat something if you suddenly spent all this time without menstruating and you've fallen back. And that's similar with the late reproductive

The Stages of Perimenopause and Menopause

SPEAKER_01 20:19

stage as well. So sometimes these women are experiencing these symptoms, and when you're in the late reproductive stage, you still have regular cycles, but they're experiencing early perimenopausal symptoms. They go to the doctor and they say, I'm experiencing these symptoms. The doctor might go, Okay, I'm gonna ask you one question. Are your cycles still regular? If they say yes, then they're like, You can't be perimenopause, though. Because perimenopause is characterized by chaotic fluctuations in cycles and hormones. And so this person leaves going, I'm starting to experience these symptoms. But and that's because often in the late reproductive stages, you can teeter on like a seesaw between early perimenopause and late reproductive stage.

SPEAKER_00 21:05

So you have some consistent cycles, some inconsistent cycles.

SPEAKER_01 21:08

Some consistent cycles, but starting to get perimenopausal symptoms.

SPEAKER_00 21:12

Yeah.

SPEAKER_01 21:12

So you could be starting to notice a brain fog or um potentially experience sleep disruption.

SPEAKER_00 21:21

What's the actual biological function of menopause?

SPEAKER_01 21:25

So the biological function.

SPEAKER_00 21:27

Why do we um probably not biological, maybe evolutionary? Evolutionary?

SPEAKER_01 21:31

Oh, okay. Great question for Darren Burke.

SPEAKER_00 21:34

Yeah.

SPEAKER_01 21:35

Uh I've been actually meaning to email him because I just think he's a fabulous evolutionary psychologist.

SPEAKER_00 21:40

Well, yeah, he actually did an episode.

SPEAKER_01 21:41

Well, did he? Yeah, he's great. Different theories. There's different theories as to why menopause happens. Uh, I think, and I really hope this supports what Darren thinks as well. I'll have to ask him after.

SPEAKER_00 21:53

I'll back check it with that. Fact check it with him. Yeah. Might cut it.

SPEAKER_01 21:56

Might cut it. But there is this theory called. The um grandmother hypothesis.

SPEAKER_00 22:02

Okay.

SPEAKER_01 22:03

And the idea is that you no longer are able to have children with menopause. That's what happens. The cell wall breaks and you're not able to fertilize an egg anymore. So normal menstruating. But that leaves you the opportunity to help grow your family, your kin, the community, without risk of you falling pregnant again. So there is some research from evolutionary psychology perspectives around the role of being a grandmother and how that's important for raising healthy children. And and you can see how that makes sense. Like you talk to families, and you know, grandma and grandpa play a really important role in helping managing the household and um supporting the kids and and their kids as well. So that's one theory. But yeah, fact check it with Darren. Uh there was another theory, I can't remember what it was, but that one's not as strong. It doesn't really have that much evidence behind it.

SPEAKER_00 23:00

Evidence behind it. Estradiol, progesterone, FSH, and synthetic hormones or HRT, I guess. Yeah. Um, can you give us a brief overview as to their role and their importance?

SPEAKER_01 23:15

Yeah. So estrogen is probably the most key female hormone that fluctuates uh through this last stage that then influences cognition. So estrogen fluctuates quite a lot through perimenopause. And we know that in a woman's brain, there's different regions that are really densely populated with estrogen receptors. So there's a lot of estrogen in specific parts of the brain. And uh what we see is that when estrogen declines through perimenopause, your brain becomes less able to metabolize glucose. So your brain's primary fuel source is glucose. That's how it's how it functions. And when it's not getting enough fuel in those areas because estrogens decline, then that's what shows up as your memory problems, your uh cognitive dysfunction. So all the brain fog symptoms is a consequence of this biological change, which is then why uh the research supports uh hormone therapy to substitute or to enhance this reduced estrogen. So I think uh in the medical sort of research, they're changing the language about around hormone replacement therapy because you're not actually HRT for Yeah, you're not and you're not replacing the hormone. Yeah, you're just giving a boost of estrogen. And that can look like so many different forms. You can put patches, there's injections, there's oral uh ways that you can take estrogen. But the idea there is to give you like a balanced amount of estrogen so that your brain can still function optimally.

SPEAKER_00 24:55

Uh I mean people know about TRT, that's a massive one. There's not that, you know, wide associational knowledge for the female version. It's like we just expected that to be consistent throughout life. Like it's does it make sense that there's fluctuations. Yeah.

SPEAKER_01 25:11

You're talking about testosterone.

SPEAKER_00 25:12

Replacement therapy.

SPEAKER_01 25:14

It's actually quite interesting for women as well, because one of the common uh symptoms that are reported more so towards the late perimenopause and um menopause as well is reduced libido. And I think sometimes it's not talked about enough how much one that can impact relationships, the way you view yourself and the way you feel within yourself, so your your self-esteem. Uh, but then the role of testosterone. Yeah.

Estrogen, Hormones and the Female Brain

SPEAKER_01 25:39

So there's there's barely any research out there, but the research that does exist um on testosterone for women is that it can help with libido.

SPEAKER_00 25:48

It's unfortunate to say, but the when I was researching for misconceptions, there is a population out there that believe there is male hormones and female hormones, and that maybe females don't have testosterone and men don't have estrogen. There are people out there that fully believe that. No. Um can we explain the importance of both in both sexes?

SPEAKER_01 26:14

Yeah, well, well, like I just said, I I testosterone, if it reduces for women, then that's that's linked to low libido. And um, you know, testosterone replacement therapy has been shown to increase libido. There is strong evidence suggesting that. So we need both.

SPEAKER_00 26:31

And physiological function as well, right?

SPEAKER_01 26:33

And physiological functioning, absolutely.

SPEAKER_00 26:35

Yeah. A couple other misunderstandings. Um I don't know how to word this one.

SPEAKER_01 26:42

So you can I like talk randomly? Do you do you cut stuff and chop and change? Oh, cool. Okay. No, delete. Delete.

SPEAKER_00 26:52

I say so many arms, especially when it's a topic. Um there you go, I said it already that I'm not super familiar with.

SPEAKER_01 27:00

Oh, of course. Oh, I wanted to Which is super cool because I just think it's so incredible that you, like you said earlier, 25-year-old man has asked me to jump on this podcast to talk about menopause and women's hormone and brain function, because if we're real about this, yeah, it affects everyone. Like, for instance, one of my arguments for my whole PhD is that, you know, middle-aged women, where are they prevalent in the workforce? Nurses.

SPEAKER_00 27:33

Yeah.

SPEAKER_01 27:33

Like the large majority of nurses are women in their midlife in Australia. If these women are experiencing cognitive changes, memory difficulties, lost concentration. I I spoke to a neuropsychologist when I was at a conference in New Zealand, and he's he had a client who was a nurse going through early perimenopause, but because her cycles were regular, uh, the doctor dismissed it as oh, it can't be paramet, it can't be hormonal because she doesn't have a regular cycles. This poor nurse made a pretty huge error, clinical error in her workplace. And it led to her having to take time off work. Like, we don't want to completely let you go, but you're making you made small errors and then you made this large error, like you can't work anymore. And if we think about the personal impact that has on her uh economically, so providing for a household, I d I don't know if if if she had kids, um, but then if you know if that relies now financially on the partner, so we see that it has this economic burner burden on her, but also on society. If more midlife women are having to take time off work because their brains aren't functioning, then it's it's no longer a personal issue for women. It's a whole societal broader issue.

SPEAKER_00 28:56

Especially when nurses are so you know understaffed anyway. Exactly. Yeah, yeah. My partner's a registered nurse. And um I remember just just for the fun of it, reading up on, like I said before, with shift workers and the potential for Alzheimer's and and cognitive decline that

Why Perimenopause Affects Everyone

SPEAKER_00 29:15

comes from you know the the sleep disturbances and the chopping changing schedules every week. And then you throw in cognitive issues with menopause as well. It's like we're expecting so much from people that aren't functioning at their you know full capacity anyway. It's so important to be able to kind of give that boost where we can. Um, even for people that obviously aren't in a emergent medical role, like even in your normal, you know, day-to-day if you're a nine to fiver, like if you're making all these mistakes at work, it's gonna have the same, you know, financial effects, the same lifestyle effects, the same identity effects.

SPEAKER_01 29:55

Absolutely.

SPEAKER_00 29:55

Um, yeah. You would hear so many people that are going into menopause say or or probably think that it's their fault or it's a lifestyle issue or something. There's obviously maybe lifestyle factors that would maybe help with menopause, but like how do you communicate that it's not just a lifestyle factor and it is biological, but then there's also things that you can do to help. Like, yeah, where's the separation in understanding that and why do people kind of blame themselves for that?

SPEAKER_01 30:26

I think this could probably be a whole other podcast.

SPEAKER_00 30:30

Uh there's a pretty jargon-worded question.

SPEAKER_01 30:34

So you can No, that's okay. And and I and I understand it very clearly. I think I think maybe there is this sort of expectation that is placed upon them to perform in a certain way. Like we know that women like to support households, like to support others, uh, but when it comes to themselves, typically that that comes last. It's a bit even difficult to talk about because I think women sometimes at times may find it difficult to ask for help. And then what makes it more challenging is not knowing what to ask for because the information isn't there.

SPEAKER_00 31:12

So at the moment, there's not even a pathway established.

SPEAKER_01 31:15

There's not even clear, thank you, pathways established to understand what's happening to them. And that's why this research is emerging now, because society, I think, is starting to realize that it's it's imperative, it's necessary for women to understand what's going through, what's happening to their body, the changes they're going through, and to validate them first and foremost. What you're going through is a part of life. It is a transition stage that every single woman goes through and that you do not have to suffer. I think there's this emphasis that, you know, it's something, yes, that women will go through, but we don't talk about it. We don't seek help, we just tolerate it because that's just what we go through. That's just what it is.

SPEAKER_00 31:59

Yeah.

SPEAKER_01 32:00

It's not. It shouldn't be.

SPEAKER_00 32:02

Yeah.

SPEAKER_01 32:02

Yeah.

SPEAKER_00 32:03

I mean, even like you said before, with the um experience that your mum had, you think about how GPs run in the healthcare system. And if there's not research available when they did their, you know, their doctorate or their degrees, then they're likely not going to really know a lot about it. Like secret is a thing, but you know, how how broad ranged is that and how how much can you expect one GP to be across everything?

SPEAKER_02 32:30

Exactly.

SPEAKER_00 32:30

Um and it's not a criticism of GPs, but there's definitely um room for improvement in terms of solidifying pathways for women to go through. Like if you go to a GP that's not super across the board with it, and they just again look at the diagnostic criteria and send you home, you've got really nowhere else to go. Exactly.

SPEAKER_01 32:51

And that's and that's the thing, like you said, it's not a criticism on GPs. However, they are typically the first line of contact. You know, you have something that's changing, that's happening, you go see your GP or you go see AGP. And yeah, like you said, if they're not across what type of questions to ask, then you'll leave feeling discouraged. And then it's that whole cycle again of reduced self-esteem. Like maybe I just shouldn't ask for help because if a GP doesn't know how to help me and they've had over 10 years experience in the medical field, then like maybe I just have to deal with it and get on with it. And it's it's like, no, you don't. Which is why I think I said earlier a like taking the agency and taking the initiative to track symptoms, to, you know, record what's been happening and be specific with it. Like I've noticed that, you know, I keep walking to a room and I can't remember why. Or I'm talking in a meeting and I just keep forgetting the words. I can't find the words. Or, you know, I'm managing a household and typically I remember all my kids' sports dates and appointments, and now I just can't. Like being specific on what's actually happening with the changes, and then obviously hormonal change, like physical changes, sorry, so sleep disruptions or vasomotor symptoms such as night sweats and hot flashes, like recording all of that over, say, a cycle period and where you are in your cycle, coming to a health professional with that information may lead to them also having or asking more appropriate questions because they'll go, oh, this person has provided me data. Yeah. The same way we go out into the literature to find data, you can collect your own data. You know, you're with yourself every day. Yeah. You can take these notes. And that's and that's I think a little bit empowering as well because you realize I can actually take a bit of this control back by noting what's happening to me. Then I can be more specific with my 10, 15 minute GP appointment. This is what I want to talk about. This is what I want to ask. Not I'm going through these changes, I don't know what to do. And like we said, the GP not being informed, going, oh okay, your mood's lower, maybe have some anti-anxiety medication.

SPEAKER_00 35:04

Yeah. Yeah, you can use. Yeah.

SPEAKER_01 35:06

Yep.

SPEAKER_00 35:07

Yeah. Let's switch uh quickly into education gear.

SPEAKER_01 35:12

Education gear.

SPEAKER_00 35:14

Um symptoms. So we we need to know what to track if we're going to track it. We've got memory attention, processing speed, like you said, emotional regulation and motivation, stress tolerance. Is there anything else I'm missing?

SPEAKER_01 35:29

Yeah, maybe the physical symptoms. So uh if your sleep is disrupted, uh vasomotor symptoms, so that refers to like night sweats, hot flashes. We spoke about emotion regulation, so mood.

SPEAKER_00 35:43

Anxiety, I guess, consulting.

SPEAKER_01 35:44

Yeah, anxiety. Yep.

SPEAKER_00 35:46

Yeah.

SPEAKER_01 35:46

Low mood as well, if you're experiencing that.

SPEAKER_00 35:50

What's the connection with hormones and the symptoms? Is estrogen the the biggest player there?

SPEAKER_01 35:56

Yeah. So I want to say estrogen plays a huge role.

SPEAKER_00 36:00

Estrogen, not estrogen, yeah.

SPEAKER_01 36:02

Yes, okay. And then and then other other hormones do as well. Uh, and it is true that when there is an issue with the the message between two glands, that uh when that hormone is disrupted, then it can influence other ones as well. So even when you spoke about sleep before, like when those circadian rhythms are disrupted, uh, it can lead to even more uh cognitive impairment because estrogen's already reduced. Uh but then also we know that lack of sleep or poor sleep quality affects all these other hormones too. So growth hormone. Your body struggles to repair if it doesn't have enough sleep.

SPEAKER_00 36:41

Yeah.

SPEAKER_01 36:41

Uh what else happens with sleep?

SPEAKER_00 36:43

So would you say it's like a sorry I cut you off. Um would you say it's like a correlation effect or more of a causation in terms of like sleep disturbance is the first thing to happen, and then you have the cognitive difficulties as well. Um, obviously there's a double up in cognitive difficulties anyway with menopause. Sure. Would it be kind of a flow on effect as well?

SPEAKER_01 37:05

Yeah, I would say it's a bi-directional relationship. So poor sleep quality, we know can impact cognition because for instance, memory consolidates with sleep. So if you're not getting enough sleep, poor cognition. But then if you're not um if you're having poor cognition or reduced cognition and then say vasomotor symptoms, which keeps you up at night, then that then impacts your sleep. So it's a very complex, yeah. Complex, complex relationship.

SPEAKER_00 37:31

Yeah. Um a lot of people know the word menopause, but not perimenopause. What is perimenopause and how is that actually different?

SPEAKER_01 37:41

Yeah. So menopause uh is 12 months after your uh 12 months after consecutively no menstruation. Yeah. So that's the clinically def clinical definition, sorry, of menopause. And then perimenopause is that stage leading up to menopause. So it starts from late reproductive up until those 12 months without menstruation. Yeah. And that can it lasts for? That can last for anywhere from two to ten years, maybe even a little bit longer.

SPEAKER_00 38:13

And so should you start tracking the symptoms then?

SPEAKER_01 38:16

Absolutely. As soon as you start to see symptoms, track them. And perimenopause does have different stages too, so there's early

Symptoms Women Should Track

SPEAKER_01 38:24

versus late, and the main differences there are between FSH, like we said before, follicule stimulating hormone and lutinizing hormone, so LH as well. Uh and then you still see these chaotic fluctuations with estrogen and progesterone also. That gets progressively uh more intense. So early perimenopause, you start to see symptoms, and then towards later perimenopause is when people start to see more exaggerated symptoms.

SPEAKER_00 38:49

Do you think the workplaces and families obviously we spoke about the healthcare system should understand this better? Like, like we said, I'm 25-year-old male, like it's an odd topic for me to be talking about. But how can the community in society support this? The pathways in the healthcare system is obviously one. You t you look at treatment options, and there's you know the hormone replacement therapies, and I'd like to talk about the lifestyle factors as well.

SPEAKER_01 39:16

Sure.

SPEAKER_00 39:16

But what's the role that society can play to help assist?

SPEAKER_01 39:20

This is a common repetitive theme that I hear from women going through perimenopause that you know, my children, my partner think I'm going crazy. So therefore, I think I'm going crazy and I don't know what's happening. And as you can imagine, that can be quite an intense time for everyone, uh, especially when we we don't have a clear understanding of exactly what's going on and the treatment options. So we know that there are treatment options, but in terms of even, for example, psychological treatments, I think uh someone has recommended, some researchers have recommended hypnotherapy, but then the efficacy there, I'm not sure. And then hypnotherapy is very um the core focus is to uh embrace what you're feeling, be present with what you're feeling, and and that's okay, but for some women it could be a little bit, it's not going to change anything and it could be more intense. I know what I'm feeling. I'm feeling like I'm going crazy. Like, why do I have to keep going over that? So there's no clear psychological pathway at the moment, uh, but there are definitely things you can do. And I think uh we need partners and children to have more education on this so that they can jump on board too.

SPEAKER_00 40:34

Yeah, it's such a common statement to say, oh, mum's, you know, mum lost her shit because she's menopausal.

SPEAKER_01 40:39

Right. Mum's lost her shit. She can't do things anymore.

SPEAKER_00 40:43

She's going through menopause. But yeah.

SPEAKER_01 40:45

Yeah. But then also, isn't that in a in

What Is Perimenopause?

SPEAKER_01 40:48

a sort of backwards way, isn't that incredible that that's how big of a role mum plays?

unknown 40:53

Yeah.

SPEAKER_01 40:53

Managing the household, potentially still working and ensuring everybody is is is fed and and has everything they need to function in everyday life, and then suddenly you lose mum loses her ability, and it's like, oh mum's gone crazy. It's like, well, why don't we help her?

SPEAKER_00 41:09

Even if it's not like a um a way of her responsibility or her, you know, effect in helping the family. But if you've got your own personal career and your own goals and things, it's gonna affect you there. It's not just like the the people that you look after, and and and like you said, you know, women often treat themselves and help themselves last. And so it's yeah, it's it's hard. You've got to kind of help yourself to be able to help others.

SPEAKER_01 41:36

Absolutely. And you nailed it there. A lot of women in midlife are in the peak of their careers, and that's something that historically wasn't there. So now it's that shift in okay, how can we better help women? Because they are more prevalent in the workforce, they are contributing to society in in multiple different ways. Uh and so when I said earlier about it being a societal issue, for me that makes me think the environment needs to change, not the woman. How can we better facilitate the environment?

SPEAKER_00 42:08

Yeah.

SPEAKER_01 42:08

What can that look like? What can workforces do to facilitate this change?

SPEAKER_00 42:13

In a perfect world, what do you think it would look like?

SPEAKER_01 42:15

Oh, in a perfect world, my goodness. Uh so starting with validation. So uh explaining to women that, you know, they are going to go through something and that it's totally normal. It's a part of life, uh, it's something that happens, and then also working alongside women. So we look at co-design research. What talking to women first, getting that rich qualitative information of what's going on, what would you need? You know, if you're a nurse and you're going through midlife and you're experiencing like um more difficulty with processing speed and your your brain's having to work twice as hard. And, you know, maybe that looks like a break in an ideal world. I know nurses are under the pump, but that could look like a break every two hours instead of however however many breaks they get. Let the brain reset. Take 15 minutes to yourself, do something to let your let your brain uh relax, maybe reduce that cortisol a little bit, a few deep breaths, whatever it is, and then get back into it.

SPEAKER_00 43:13

Yeah. Schedule schedules shifts rather than changing quick shifts at night and then days.

SPEAKER_01 43:18

Yeah. For that woman who's the CEO, peak of her midlife career, you know, instead of uh being judgment or stigma around uh holding notes whilst doing a presentation, being like, that's okay. Like if you can't remember your speeches anymore, straight off the top of your head, no one's gonna judge you. You're going through a biological change. Have your notes in your hand that you refer back to.

SPEAKER_00 43:40

Yeah.

SPEAKER_01 43:40

And everyone's gonna understand that that's okay. Yeah. That's normal. Doesn't need to be that it's not like, oh, she's not performing well anymore. Yeah. She's losing, she's losing it. It's like, no.

SPEAKER_00 43:49

Yeah.

SPEAKER_01 43:50

It's this temporary stage.

SPEAKER_00 43:51

For sure. What are some of the big gaps in the research now?

SPEAKER_01 43:55

Uh well, the huge gaps that I'm focusing on, which is more neuropsychology. Is looking at how it can clearly define menopause-related brain fog. Because when we talk about brain fog, there's different types of brain fog. You can have brain fog from experiencing TBI, like a traumatic brain injury. You can have brain fog from experiencing other types of things. So how can we clearly describe menopause-related brain fog? What does that look like? What are the repeated symptom clusters or the lay descriptors? What actually constitute this brain fog? So defining that gives us something to work from. It kind of sets the foundation for the field of, all right, cool. If we know that it's these symptoms, then we need to research these symptoms rather than focusing on other stuff. So it can give us more direction. And then psychological interventions specific to menopause-related brain fog. What does that look like? There's not much out there. I said earlier hypnotherapy, but that's more about self-acceptance. And I think most women who go through menopause already have accepted that they're going through it. We don't need to reiterate that. How can we actually get in there and help that? And then another thing that's very interesting, more so in neuropsychology, is test sensitivity. So when you're when you go in for testing in neuropsychology, you often get compared to a standard or a norm. But if that standard doesn't actually represent your population.

SPEAKER_00 45:26

Or it's based on men, yeah. Or it's based on men.

SPEAKER_01 45:28

Look, I didn't want to say it, you said it, but then yes, you're gonna come up as performing normal because you're being compared to a population that maybe isn't standardized compared to your population. Totally different sex, yeah. Exactly. Which is actually what the literature is showing. Yeah. So tests aren't sensitive enough to capture these menopause-related brain changes because they've been standardized against a different population.

SPEAKER_00 45:56

Yeah. Lifestyle factors that can help. What's uh what's a few there?

SPEAKER_01 46:00

Yeah. So easier said than done, stress and sleep. Stress and sleep above anything else. You know, I I think uh nutrition is important. I really think diet is important too.

SPEAKER_00 46:13

Uh but stress the crossover in the uh psychology, Tiffany, and the And the yes, this is me all getting in there.

SPEAKER_01 46:20

Definitely exercise and nutrition, super important. But if I had to prioritize two things, it would be looking after those cortisol spikes, looking after that stress and sleep, taking care of your sleep. Uh, because in terms of the way that then impacts your cognition and your daily functioning, I would say they have the strongest impact. So if you're sleeping enough and your stress is reduced, I feel like that would make a really, really strong impact in your cognition. Yep. And in your everyday life.

SPEAKER_02 46:52

Yeah.

SPEAKER_01 46:52

And then if you've got time to do the exercise, still very important. Still very important. You know me, I love exercise and I think it has a very strong role. Um, especially for women aging as well. I should say strength training for women, if you can try to strength train a few times a week, uh, preserve those muscles. We know that women, osteoporosis, you know, it's bound to happen. Bone density reduces as you age, uh, so much more when you go through menopause as well. Uh so ensuring that you are getting that exercise too, but stress and sleep, just because of the the impact that has and the interactions that has with how your brain can function.

SPEAKER_00 47:32

Yeah, definitely. All right. So I put a little story up uh on the Instagram to get some listener questions in. Uh we've kind of covered a few throughout, so I might skip a couple if we've already covered it, but I'm gonna read them out, trying to quick fire style.

SPEAKER_01 47:51

Okay.

SPEAKER_00 47:52

Yep.

SPEAKER_01 47:52

I think I did as a disclaimer, I think I said there was a couple about medication and stuff where I was like slightly outside my scope of expertise,

Listener Questions

SPEAKER_01 48:00

but yeah.

SPEAKER_00 48:01

Did you want to skip over those or do you want to have a little crack?

SPEAKER_01 48:04

Maybe maybe skip. I didn't have time to research the That's okay, that's okay.

SPEAKER_00 48:08

All right, first up, hey guys, loving the potty so far, and this is such an interesting topic. How much can stress actually mess with women's hormones? Like if someone is constantly overwhelmed, not sleeping properly, and basically running on caffeine, what's happening in the body and the brain?

SPEAKER_01 48:25

Oh goodness. Again, a very complex, great question. Very complex interactions happening, but stress waking up and instantly having elevated cortisol impacts the way all other hormones work in your body. And if we talk about the relationship with then perimenopause, then the effects are exacerbated. So very complex interactions, it influences uh the hypothalamus, the pituary glands that are responsible for hormone secretion. So if we have higher cortisol, there's a there's a sh there's a physical link to how hormones are then secreted through the body. And if they can't secrete efficiently, then the body's not going to function efficiently. You're you're constantly in this fight or flight mode. And we know that that can then elevate stress even more. Uh, that can then impact sleep, uh, impact mood. Uh, yeah. So it has this this strong negative effect or overflowing effect on the rest of the body too.

SPEAKER_00 49:27

And then caffeine and sleep.

SPEAKER_01 49:29

That's also a and then caffeine and sleep. Yes. So I actually saw a really interesting uh release of research. I don't know if you saw it online about they're actually saying now that three to four cups of coffee a day is is good, is good for you, do it. Whereas previously it was like caffeine, the negative effects on your body. Personally, I love a coffee. I'm a coffee drinker, I drink coffee every day, maximum three, but one to two most days. Uh, I think timing is probably important. Definitely. If we know how long caffeine lasts in your system, uh, if you're already having difficulties with sleep, uh, maybe again, you know yourself better than anyone else, taking notes on oh, when am I having caffeine and is it impacting if I have me, if I have a little bit less and is my sleep improving? Tracking those things to be a little bit more conscious of how a caffeine affects your body, yeah, I think is a good place to start.

SPEAKER_00 50:23

Climbing is definitely a massive problem with that. Like I know obviously when you wake up, you don't wake up fully with zero adenosine in your brain. Like it's got to slowly reduce itself. And if you have caffeine, you know, in that immediate waking period, then it's gonna stunt that and you're gonna hit that crash at 3 p.m. And it's then you've got to reduce the adenosine and then it's gonna push your sleep back. So I think it was an hour, an hour, and then getting some sunlight and a little bit of exercise helps to remove that really quick, and then you can have caffeine after that. So that's a that's a good little way to avoid the 3 pm crash, but probably good to hit the sleep cycle too.

SPEAKER_01 51:00

Yeah, also just on on that question again, running off caffeine. Now, are we assuming that this person isn't eating because the way that can influence your hormones as well? Please eat your meals. Breakfast, lunch, and dinner, yes, your brain needs glucose to function. And if you're not fueling your brain, again, the influence that can have on hormone secretion and uh hormone balance, yeah. We need we need to be eating food. Definitely, definitely healthy fats, protein, carbs.

SPEAKER_00 51:29

Yeah. All right, next one. How do different phases of a woman's cycle impact cognition?

SPEAKER_01 51:36

Yeah. So I think that links back to mainly estrogen and progesterone. And uh I spoke earlier about the role of estrogen in brain function. So when estrogen is reducing or declining towards the later stages of the cycle, the brain becomes less able to metabolize glucose. So that's when we can see uh the impacted cognition, so difficulties with memory and and attention and concentration, and and that's where, again, being conscious of how it impacts you, because it can look different for everyone. So, of course, there are there are trends and there are patterns, uh, but the way that it impacts you could look completely different to the way it impacts someone else. So being aware of, okay, say towards the back end of the cycle, reduced estrogen does actually impact your cognition quite a lot. How can you do things in your everyday life to facilitate that? Is it maybe being aware of that and not scheduling things that require those processes as much on those days, if possible? So can we do the meetings, I don't know, the next week early or the day before? So being conscious of how that's going to influence you.

SPEAKER_00 52:43

Yeah, a bit of awareness and focusing on the city.

SPEAKER_01 52:45

Yeah, absolutely.

SPEAKER_00 52:46

This is a bit of a funny one. My question for your podcast would be: do neurospicy women's hormones dramatically affect them before their period more than most? Does this exasperate sensory sensitivities and brain fog their window of tolerance, etc.?

SPEAKER_01 53:04

I love the word neurospicy. That's a great, great question. Uh so that's that's slightly outside my scope, but something that I can talk on is neurodivergence in perimenopause. So what we're seeing is this very big surge in diagnosing ADHD in perimenopause. And now the research is super interesting because what what we're asking ourselves is are the coping strategies that women with ADHD use in everyday life, do they become more difficult to access when hormones are fluctuating so much? And then that's what's exacerbating the symptoms? Or is it that, you know, they've had ADHD the whole time, but like we spoke about before with test sensitivity, they just weren't tested earlier in life to be diagnosed with ADHD. So this is a very side-emerging topic in the world of like perimenopause, looking at neurodivergence and and influence on cognition and hormones. Uh, and unfortunately, the research just isn't there yet.

SPEAKER_03 54:11

Yeah.

SPEAKER_01 54:11

So, but it I can I can empathize and I can see how if you're already having to rely on these coping strategies to function in everyday life, uh, to just do the basic things, and then suddenly these hormonal fluctuations are also impacting your cognition on top of that. I can see how those compounding effects could really lead to to disruption in your cognition.

SPEAKER_00 54:36

Make it more difficult.

SPEAKER_01 54:37

Yeah, absolutely.

SPEAKER_00 54:38

Yeah, and on the diagnostics, there's probably a lot of symptom overlap with ADHD and menopausal symptoms.

SPEAKER_01 54:44

Brain fog, absolutely. Yep.

SPEAKER_00 54:46

This one kind of we already just answered, but I'll read it off anyway. Hey guys, first off, I love the show and I'm really excited for this episode. Thank you. I wanted to ask this question, but I wasn't sure if it was super relevant, so I'm gonna ask it anyway. I feel like my ADHD symptoms get so much worse the week before my period is there. Is there actually a hormonal reason for that? Or am I just noticing it more because I already feel more scattered? Thanks again. Sorry if it wasn't relevant.

SPEAKER_01 55:15

No, that's okay. That was actually a great question. And I think, like you said, that leads on to uh or rolls off what we just spoke about. So there there are definitely some interactions happening, but unfortunately, due to the lack of research, it's hard to make causal statements. Uh, but yeah, like I said, especially with ADHD women, uh, these coping strategies that maybe has have also led some women to not even be diagnosed, if they're taken away and then we're dealing with reduced estrogen that already impacts cognition, I can just see those uh processes being superimposed on top of each other, leading to exacerbated symptoms of impacted cognition. So I could definitely see how that happens, but there just isn't research to support that. So we we we need more.

SPEAKER_00 56:02

Yeah, definitely. I mean, even just speaking off the fly here, but um if you were to get misdiagnosed with ADHD there, and then you're taking stimulant medications, it's gonna throw your appetite out as well, and then you've got dieting issues, and you know you're dealing with excess stimulants and it's like massive mess. So it's definitely definitely something that the research should start to explore more.

SPEAKER_01 56:26

Which is why I said before one of the massive gaps in the research is is not having definitions. If we have clear definitions of what menopause-related brain fog look like looks like, then we can separate that to what ADHD brain fog looks like and make those distinctions, which then informs treatment.

SPEAKER_00 56:44

Yeah. Yeah, probably something to do with the maybe of an impulsive element as well. Yeah. Next one. Hey Eddie, I was wondering if you could ask Tiffany this question, as I feel like she would have so much knowledge on it. I see so much stuff online about syncing your workouts, work, and routines to your cycle. Is there actually good science behind it or is it a bit overhyped? I kind of spoke a little bit about tailoring your week to that before. Yeah. Would you say it's been overhyped?

SPEAKER_01 57:14

Ooh, that's a tricky one. Uh I'm gonna be cautious with my language here. I think we're all individual, and I think that's a very individualistic uh approach. So probably it probably links back to your own self-awareness and your own body awareness because different parts of the cycle can affect women completely differently. Uh, we know that there's, as I said, similarities with estrogen and progesterone fluctuating at different times of the cycle, but how that impacts an individual is very unique. So, again, why do you want to? That would be my first question to this person. I'd be like, why do you want a single psych? Are you noticing that you know you're doing strength training towards the back end of your cycle and that you're getting more fatigued from it? Because if you've noticed that pattern for a few months now, then give it a go. See if replacing uh those that week, those workouts to something reduced and more calming for the nervous system, uh, like yoga or walking, and seeing if that influences you. Because if it does, great. But if you're not having any differences or it like it comes back to that hormone balancing trend at the moment again, like what are we trying to balance? You know, hormones are fluctuating all the time, and this optimal balance, I don't know, it's not that's not achievable.

SPEAKER_00 58:40

Yeah, yeah. So I had uh Anna Roden on the podcast, and she does a lot of fitness work for postpartum women, and she was saying that there were studies that measured uh the outputs of strength training in the different phases of the cycle, and the results were actually pretty consistent across the cycle, like you still had the ability to lift it, but then the quantitative, qualitative, quantitative is numbers, qualitative is words, yeah, qualitative data, massive different spikes for different parts of the cycle. And so she was saying if you're cycle syncing and deciding not to train because you feel this way, substitute it with something that's more manageable. Sure. Um, even if the performance base doesn't change, if it's so much harder that you're not gonna go, maybe swap it with like a little walk or go and sit in the sauna for a bit.

SPEAKER_01 59:31

And this is where I love looking at research from both qualitative and quantitative perspective. Because like I said before, even with the memory meta-analysis I did, a meta-analysis if meta-analysis is quantitative. So it showed like some studies showed no differences in memory performance through pairing menopause. But you talk to women and they go, I'm having memory issues. Like I can notice it, I can tell you when, I can tell you what's happening. So it's it's combining that. So the data is saying your strength isn't changing through exercise, but you're saying that you report feeling more tired, then adjust. That's okay.

SPEAKER_00 1:00:08

Yeah, you know? Yeah. What is the best way to get rid of brain fog?

SPEAKER_01 1:00:13

Get rid of it. Get rid of it like it's a I wish I could do that. I wish I could do that for you. Um yeah, look, I think getting rid of it is the dream. Uh maybe more the term could be more managing. So again, tracking those symptoms. When is it worse and what exactly does it look like? If you're someone who is saying the brain fog uh affects my ability to remember my appointments or the tasks I need to do in a day, and then I just I just can't remember anymore. It's like sticky notes everywhere around the house, tick them off, writing more lists, uh, so effective strategies depending on what exactly the brain fog looks like for you would be the best way that I would say you could manage it. And then if that's not working, then seeking further professional health uh to look at other options. So is it something where uh you might need some type of estrogen? Um and if that's the case, then looking at your different options there, talking with your specialist to uncover which option will be the best for you and your lifestyle. Um, whether I said before it's a patch or an injection, if that's a path you want to take. But I think getting rid of it, it's yeah. It's a hard one, yeah. Yeah. More about managing and and um yeah.

SPEAKER_00 1:01:34

What are some just building off of that, uh, what are some lifestyle changes you can do to reduce it? Like I know we are in a world of constant overstimulation. Yes. And starting your day with 30 minutes of doom scrolling is gonna make your brain fog so much worse. If you could give three points to of what to avoid uh when you're trying to manage your brain fog, what would they be?

SPEAKER_01 1:01:57

Yeah, reducing cognitive load. So, what you just said, we're exposed to so much information all the time, and it could even be just habit that you go on your phone and you start scrolling. But what would it be like to go outside for a walk, even for 20 minutes, 30 minutes, something small to get your brain slowing down, get outside, just look at stuff. Um, I personally like very brief mindfulness activities, and when I say mindfulness, I don't mean um like types of breathing techniques or anything spiritual in that way. I more just mean being mindful of what you're doing in the present moment. You know, when we're doom scrolling, how aware are we that we're just flicking through? And then you go, oh my god, it's been an hour. Like, have you actually realized that you've been doing that for an hour? So doing something mindful where you are present in the moment. It could be sitting at the beach just looking at the ocean or going for a walk. So that would be one thing, reducing cognitive load. Uh, ensuring that you're eating regularly would be one as well.

SPEAKER_00 1:02:58

Uh hydration as well, yeah.

SPEAKER_01 1:03:00

Hydration as well. Yeah. So the brain needs glucose to function. And if it's already struggling to metabolize it when you're going through uh perimenopause or hormonal changes that affect uh cognition and brain fog, then making sure that you're eating uh so that you're getting that glucose as much as you can. Uh, and then I want to lump stress and sleep together as well. I said that a lot, but stress and sleep, yeah, I couldn't emphasize enough how important that is for your cognition.

SPEAKER_00 1:03:26

Yeah. How do we honor hormone fluctuations without sacrificing consistency in our routines? I think we've kind of spoken about that a fair bit now, but a bit of flexibility is always going to be helpful. Is there anything you'd add to that?

SPEAKER_01 1:03:42

So it was the question was hormonal fluctuations and without sacrificing.

SPEAKER_00 1:03:47

Without consistency.

SPEAKER_01 1:03:48

Yeah. So I think maybe being a bit more flexible on what consistency looks like for you. You know, what standard are you trying to uphold? If it's if your if your idea of consistency is, you know, six workouts a week, all at a certain intensity and this many walks and this specific eating, it's like, can we can we add a little bit of uh flexibility around that? Could one of the intense workouts be reduced to something like a walk instead? Uh I think that's a nice way to honour those hormonal fluctuations, to be in tune with your body uh and do things that are working for you in that present moment because it is temporary.

SPEAKER_00 1:04:28

Yeah, and if you're gonna sacrifice consistency because you're not gonna go because of hormonal fluctuations, you'd be better off to be flexible and have something that's achievable and then finish the week going, I hit everything. Yeah. Yeah, for sure. Skip that one. This might be a random one, but why do some women wake up around 3 a.m. absolutely sweating or overheating and need to cool themselves down sometimes, even with a cold shower? Is that normal perimenopause thing a stress thing, or could there be something else going on?

SPEAKER_01 1:05:04

Sure.

SPEAKER_00 1:05:05

3 a.m. is awfully specific.

SPEAKER_01 1:05:07

3 a.m. is awfully specific, but it is not uncommon. Like what you've just reported sounds like night sweats or hot flashes, and uh in perimenopause, that is one of the highest rated bothersome physical symptoms. So it's very normal it happens, it's due to a complex biological change in your body. Uh, was the question how you manage it as well?

SPEAKER_00 1:05:30

I think it's just is it a normal thing, a stress thing, or could it be something else?

SPEAKER_01 1:05:34

I can validate you now, right now, it is a it it's a part of perimenopause, it's something that happens to quite a lot of women. I think uh the statistic I read said up to 70% of women.

SPEAKER_02 1:05:45

Wow.

SPEAKER_01 1:05:46

Up to 70. So seven in ten perimenopause of women will experience night sweats or these types of vasomotis symptoms at one point throughout the transition. So it's normal, it's not pleasant.

SPEAKER_00 1:05:57

Um plenty of other people up at three.

SPEAKER_01 1:05:59

Yes, plenty of other people. Yeah, I'm sure there's a group out there of people bonding over it. Um dreadful, but yeah, it is normal.

SPEAKER_00 1:06:07

I actually know who the person that wrote that in. Oh, yeah. And she um she told me the other day that she'll get up and she's just so over waking up at 3m that she'll go and make a coffee and watch a TV show.

SPEAKER_01 1:06:20

She's like, this is my new wake-up time.

SPEAKER_00 1:06:21

Yeah, and then goes back to sleep at like God knows, so maybe not ever sometimes. But yeah, that's probably a a spot to avoid as well. What's next for you? How far in are you to your PhD?

SPEAKER_01 1:06:35

Very early stages. I'm six months in.

SPEAKER_00 1:06:37

Yeah.

SPEAKER_01 1:06:38

Uh so I've got a milestone called confirmation to hit soon.

SPEAKER_02 1:06:42

Yeah.

SPEAKER_01 1:06:43

Uh, and then after that, it'll be full steam ahead to the finish line. So PhD, I'm hoping to get it done in just over three years and see where that leads me.

SPEAKER_02 1:06:52

Yeah.

SPEAKER_01 1:06:53

Yeah, I'm not 100% sure yet, but at the moment it's just spreading awareness, uh, spreading understanding and knowledge, because I think that's the first step too to then uh moving a field forward, just to understand things.

SPEAKER_00 1:07:08

Yep. Maybe a bit of crossover eventually with your fitness world. Absolutely.

SPEAKER_01 1:07:14

Yeah, they are so related and linked together, and and I love both. So I could definitely see them interconnecting.

SPEAKER_00 1:07:20

Yeah, for sure. Yeah. That's all I've got for you, but thank you so much.

SPEAKER_01 1:07:24

Thanks, Eddie. Pleasure.

SPEAKER_00 1:07:26

All right, sweet. Cool. How'd you feel?

SPEAKER_01 1:07:31

That was so fun. I could have kept talking for hours.