We're told to watch out for, you know, the hot flushes, but not so much anxiety or the brain fog, are we?

Yes, that's exactly right, Pat.

So, I mean, we all know what menopause is.

It's that hot flush, woman fanning herself, and no periods.

I mean, anyone can diagnose that.

But we know that perimenopause, which is the time leading up to menopause... is a time of great vulnerability in a woman's mental health.

And I think up to a few years ago, no one talked about perimenopause, but now they are.

But what about me? You're always like burnt chop syndrome, isn't it? You always put yourself last.

Yeah.

And then secondly, uh, a profile is an important element on LinkedIn.

If you can optimize it, fantastic, and I can tell you the things to optimize.

But even I think that's something you can do anyway.

Um, so- Um, optimizing your profile, and when you're doing that, your headline and your profile photo, they're the first thing anyone would see because the fi- the, how you would d- get discovered is by people seeing your profile on their feed, and that's the two things that people see on the feed.

So your headline needs to call out your ideal prospect so they know if, if, for example, I see you on my feed and it says that you work with other LinkedIn, you work with personal branding coaches or LinkedIn experts or anything like that, I would be interested because then it means we are in the same industry.

So we're using the right keywords to attract the people that you want on your profile.

Yeah.

How will they know the difference between it being hormonal or being actually just poor mental health?

So there's three things.

I have a three-step framework normally.

So the top one is hormones.

Then it's your foundations, which is your sleep, movement, social connection and stress.

And the third layer is the inner work, which is where we really go in and understand what is driving us to live the way we are.

But are there any unresolved underlying wounds and patterns that we need to identify? Now, in going back to your question, we always look at hormones because for women, our mental health is intricately linked with our hormones.

Therefore, it's pretty well linked that you will have perimenopausal depression.

Mm.

So a lot of them may be having IVF or conceiving naturally, but they're going postpartum straight into perimenopause.

Most women, we'll still find them in the sandwich generation of working full-time, looking after the elderly parents, household, and kids.

But then you don't have your calming hormone.

You don't have that progesterone.

And in the background, estrogen is spiking.

So our menstrual cycles are always fluctuating.

Mm

Mm.

Then obviously we wanna have some form of protein fiber breakfast.

Now, for women, in your 20s and 30s you can skip, skip a meal.

It doesn't matter.

The problem is when you wake up, you naturally have what we call a cortisol awakening response.

Your cortisol go- goes up, which is why we jump out of bed and wake up.

But you want to buffer that within an hour of eating some protein, fiber rich food.

I'm not meeting them." Like, w- I, that also I feel like would contribute to your mental load as well.

Will the early use of HRT reduce the diagnosis of ADHD? And therefore, would HRT be the first course of action to deal with menopause symptoms?

That's an excellent question.

So I go through this two kind of presentations we see.

So first one is someone who had a childhood diagnosis of adhd and they're on stimulant medication and so they hit their 40s and suddenly those stimulant medications aren't working especially just before your period which is normally um called the luteal phase they typically see that their cognition and emotional regulation is not being managed by their stimulant medication so Sometimes they need to double the dose.

But of course, as the hormones fluctuate and decline, they will find that the stimulant doesn't work and we need to add in estrogen.

And that's what stabilizes and helps with their ADHD symptoms.

And so that's one presentation.

Any advice?

If a woman is asymptomatic or doesn't have any sort of really significant things that are impacting their daily life, is there any reason she might consider HRT for menopause or in perimenopause or is the risk too high or is there a benefit?

I think the goal of therapy is always twofold.

So the short-term goal is always to eliminate And we can't always eliminate 100% of the symptoms, but at least alleviate some of the symptoms because the physical and psychological symptoms are impacting quality of life.

You know, are these things impacting your relationship, your ability to function and sustain good quality of life? And that quality of life is a personal experience.

You know, some women, the hot flashes don't bother them.

Or they might not even get them.

They might not even get them.

Why do you call those out? What do you think is going

Mm

... egg quality and quantity is most fertile from ovulation, so anything from 16 onwards till late 20s.

Now, at 35, there's a dip in this egg quality and quantity.

We know fertility starts to decline.

And around 37 to 42, there is a significant decline in the egg quality and quantity, where about 30% of our cycle are what we call anovulatory.

We are not ovulating, which means we are not producing this progesterone, and then this line, or in your luteal phase, you get lower levels of progesterone, which results in three things.

Low progesterone means you have a shorter cycle.

Mm