March 27, 2025
114: ENCORE | Heavy Periods: The Silent Epidemic with Dr Talat Uppal
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In this popular episode, Dr. Talat Uppal, an obstetrician-gynecologist specialising in heavy menstrual bleeding, shares her expertise on a condition affecting one in four women yet rarely discussed openly.
This eye-opening conversation sheds light on how women often normalise suffering through periods that drastically impact their quality of life.
The discussion reveals shocking statistics: 25% of women experience heavy menstrual bleeding, yet more than half never seek medical help.
Dr. Uppal provides clear indicators of abnormal bleeding – passing large clots, changing protection every 1-2 hours, waking at night to change, using multiple protection types simultaneously, and embarrassing "flooding" episodes. These symptoms can lead to iron deficiency, anaemia, and significant quality of life impacts.
Learn about the spectrum of treatment options, from medications like Tranexamic Acid to the highly effective Mirena IUD and surgical interventions including endometrial ablation. She emphasises that most women find significant relief once properly treated, with many asking, "Why didn't I have this earlier? Why did I suffer so much?"
Perhaps most powerful is the exploration of how heavy bleeding becomes normalised at multiple levels – by women themselves, healthcare providers who don't offer full treatment options, and society that suggests women should simply endure until menopause. This normalisation condemns many to years of unnecessary suffering when effective solutions exist.
The conversation offers practical advice for women seeking help, emphasising the importance of advocating for yourself and being knowledgeable about available options.
Have you been suffering in silence? This conversation might be the catalyst for transforming your quality of life. Listen, learn, and advocate for your menstrual health.
Resources
Women's Health Road Clinic - website
Women's Health Road - Instagram
Women's Health Road - Linkedin
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Transcript
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Welcome to the Dear Menopause podcast, where we discuss the menopause transition to help make everyday life a little easier for women.
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Hi, my name is Sonya and I am your host of Dear Menopause.
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Today, I have a very special guest with me, Dr Talat Uppal.
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Talat is an obstetrician gynecologist specializing in heavy menstrual bleeding.
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This is an area I did not know a lot about, so I found our conversation absolutely fascinating.
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If you're a woman and you menstruate, this is an episode that you will find absolutely fascinating.
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Talat, welcome to Dear Menopause.
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Thank you so much for this opportunity, Sonya, and what wonderful work you do.
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Oh, thank you.
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Now.
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Today we are going to have a juicy conversation about menstrual bleeding, but your speciality is heavy menstrual bleeding, so would you like to give us a little bit of an intro on who you are and the work that you do?
00:01:09.579 --> 00:01:09.820
Thanks, Sonya.
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So I'm a gynaecologist that's based in the northern beaches of Sydney and I have an interest in clinical education as well, particularly general practice and primary care-based education, because I think they do amazing heavy lifting in women's health space, amazing heavy lifting in women's health space.
00:01:30.243 --> 00:01:40.331
I also am trained in ultrasound and I have set up a organization called Women's Health Road, which is a medical center, sonya, and it's located opposite the Northern Beaches Hospital and it's like a collaborative, multidisciplinary team.
00:01:40.331 --> 00:01:49.552
So we're kind of a little bit more holistic in our approach and we value, for example, mental health or the expertise of physio, allied health.
00:01:49.552 --> 00:02:00.486
So it's quite a well-rounded team and, like you mentioned my interest, my primary interest, is management of women with abnormal bleeding and particularly heavy menstrual bleeding.
00:02:01.308 --> 00:02:03.253
I love your multidisciplinary team.
00:02:03.253 --> 00:02:34.762
I think it's absolutely wonderful to think that we can have a model for healthcare, particularly for women because that's where my passion lies that does offer so many of the services that can be so hard to go out and find, because I know you've got Penny Hanlon working with you as a physio and penny is amazing at women's pelvic floor health as a physiotherapist and it can be really hard for women to find a physio that does specialize in, um, you know, women's pelvic floor health.
00:02:34.762 --> 00:02:44.168
So to have a kind of this one-stop clinic where women can get, like you say, the mental health support, the physio support, you know I think you've got at least one great.
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GP on board as well.
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Yes, yeah, I really, really hope that this is a model that we can see rolling out, you know, across the country for more women.
00:02:53.167 --> 00:02:54.751
So thank you for setting that up.
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Thank you, sonya.
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I agree that these are the standards that women deserve and should access, and I have honestly learned so much from my peers.
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I think that those days of just a specialist with 40 patients and just one person seeing are long gone.
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The future of health is collaboration, and we all bring a unique skill and talent that adds to the woman's journey if she wishes to reach out.
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And what I like about such models is that it allows women to decide well, what part of my healthcare that I'm being offered is more important for me to prioritize and what package should I individualize for me as a person.
00:03:34.008 --> 00:03:37.060
Yeah, so important to put that patient front and center.
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I love that so much.
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Okay, so onto our topic.
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Can you give us a description and an understanding for someone like me that has never experienced heavy menstrual bleeding?
00:03:47.151 --> 00:03:53.193
What defines heavy menstrual bleeding over what I would consider a normal period?
00:03:53.819 --> 00:03:55.186
So excellent question, sonia.
00:03:55.186 --> 00:03:56.425
There are two concepts.
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First of all, heavy menstrual bleeding is basically we need to sort of gauge it against quality of life in the first instance, and quality of life for women.
00:04:07.140 --> 00:04:15.787
Sonia has been so undervalued for so long really, and quality of life, as you well know, is a very broad spectrum of facets.
00:04:15.787 --> 00:04:23.434
So it includes her physical well-being, it includes her emotional well-being, it includes your you know social well-being and it also includes your material well-being.
00:04:23.434 --> 00:04:25.742
So there's a productivity know, social well-being and it also includes your material well-being.
00:04:25.742 --> 00:04:35.713
So there's a productivity issue when we're talking about heavy menstrual bleeding, because we all know women who either are unable to focus at work or have to take time off, etc.
00:04:35.713 --> 00:04:40.228
So that's one way of looking at it, which you know.
00:04:40.288 --> 00:04:58.733
If these periods are affecting me in some way, then it is a problem, and the other way, obviously we need to have some flags or what could guide us, or what are the clues that these periods may be heavy, and these could include look, am I passing clots that are, for example, bigger than 50 cent pieces?
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Am I changing my sanitary protection every one to two hours?
00:05:04.052 --> 00:05:07.569
Am I having to wake up at night to change my sanitary protection?
00:05:07.569 --> 00:05:09.887
Am I having to use multiple types?
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Women tell me they've used two or three different types of sanitary protection.
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That's not normal.
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Or have I had episodes of flooding through my clothes, which can obviously be very embarrassing?
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Or, sonia, because they're having such heavy losses, then women may become iron deficient or may have anemia, and so then they would get dizziness, tiredness, profuse tiredness sometimes, and they might have palpitations.
00:05:36.494 --> 00:05:41.711
So you get another cohort of symptoms that are actually because of the losses that they have had.
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I wonder if there are.
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You will be able to confirm this.
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There are women that experience heavy menstrual bleeding or menstrual bleeding that's outside of the norms, but they don't know that it's actually not normal because that's the only thing they've ever known, and we don't talk about our periods.
00:06:01.846 --> 00:06:10.670
We don't necessarily have conversations about menstrual bleeding to say, hey, this is what you should expect If you're experiencing this, that's not normal, Seek some help.
00:06:10.670 --> 00:06:16.408
So I wonder how many women you come across that have been experiencing this and not sought help for it?
00:06:17.480 --> 00:06:31.850
Sonya, this is my weekly reflection because every week I sit down and I think how and you can imagine, sonya, that I work in Northern beaches Often women I'm caring for I think really proactive ownership of their health.
00:06:31.850 --> 00:06:42.264
They are worrying about their diet, they're taking care of their exercise regime, but still I reflect that their health literacy, for many women that I look after, is actually quite basic.
00:06:42.264 --> 00:07:16.084
When it comes to menstrual health and I know that you know there's that concept around 28 day, five day periods, but there is a variation in normal and I think, like you rightly pointed out, there can be a big struggle and trivialization of symptoms, and so we kind of do say, look, if your periods are lasting longer than seven days, but then some women are bleeding so heavily, so because there are those two, three concepts of are your period cycles coming around more frequently, which often happens at the start of perimenopause is the volume heavier?
00:07:16.084 --> 00:07:32.483
Or and or, and these are all and or situations, because obviously if she's bleeding for more than seven days, then you know she's going to bleed more volume and so therefore that's heavy as well.
00:07:32.483 --> 00:07:37.096
So I think that there is constantly trivialization or minimization of symptoms by women and I feel that they're just resilient.
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We women are just so resilient, we're used to juggling so many things, we're just used to putting up with things, and so that sort of philosophy carries on in menstrual well-being and they just say, oh well, you know, this must be normal.
00:07:49.620 --> 00:08:12.964
And then, sonya, it's not just the women themselves, unfortunately, even though we have excellent clinicians and I think that a lot of clinicians do amazing work unfortunately there are people, when women go to them as clinicians, who will just say, oh, they're there to go away, or will sort of reassure them but not actually proactively offer them the full suite of management options that are available.
00:08:12.964 --> 00:08:19.742
And then, third level of normalization of abnormal periods is by society.
00:08:19.742 --> 00:08:24.151
So they might have an auntie that says, oh, oh, hang on, I also had this.
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And then, you know, it finished.
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But, yes, hello, it finished after menopause.
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And this person's only 42.
00:08:29.107 --> 00:08:35.173
So we have basically condemned her to a decade of suffering, a potential decade of suffering.
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So I think those are the concepts where we are wanting to raise awareness, so that women can actually say, hey, hang on, maybe what's going on with me is not quite right, and there is a lot of management options.
00:08:48.330 --> 00:09:07.273
I think, sonia, that's the other thing that bothers me is that, because it's a problem not with one solution, with so many solutions, and because I also see women obviously at the other end of the treatment journey, and our most common feedback is why didn't I have this earlier?
00:09:07.273 --> 00:09:09.606
Why did I suffer so much?
00:09:10.990 --> 00:09:40.577
Wow, and that's really heartbreaking to think that of knowledge or a support of a clinician that hasn't been able to get them to a place where they needed to be.
00:09:40.577 --> 00:09:48.383
So then let's talk about what those options are for women that perhaps are listening and are kind of going hang on a second.
00:09:48.383 --> 00:09:52.841
So maybe what I've been experiencing isn't normal, but I should maybe see someone.
00:09:53.269 --> 00:10:03.254
There are a number of options and obviously they need to be tailored to the woman's preference and also to certain risks that she may have in her journey, in her health journey.
00:10:03.254 --> 00:10:06.807
So usually if I see a woman before I go into options.
00:10:06.889 --> 00:10:09.836
I'm actually thinking look, why is this woman bleeding heavily?
00:10:09.836 --> 00:10:15.374
And so we're thinking through look, is this a structural cause in the uterus itself?
00:10:15.374 --> 00:10:17.777
Like, for example, is the uterus having a polyp?
00:10:17.777 --> 00:10:20.440
These are like fleshy chandeliers in the uterus.
00:10:20.440 --> 00:10:21.721
Most of them are benign.
00:10:21.721 --> 00:10:34.985
Or maybe she has fibroids, or maybe she has a variety of endometriosis that's called adenomyosis, in which the wall of the uterus has the lining, and so that makes women bleed more heavily than usual.
00:10:35.585 --> 00:10:40.245
And a tiny number, sonia, are actually harboring a cancer or a pre-cancer.
00:10:40.245 --> 00:10:46.667
And if we're going to look at statistics, sonia, it's about one in 44, the lifetime risk for women and sort of.
00:10:46.667 --> 00:10:57.089
If you compare that with breast cancer, which is about one in eight women, it's actually rarer, it's less common, but obviously women that are bleeding abnormally are more likely to have it.
00:10:57.089 --> 00:11:05.477
So, again, you know, therein is the importance of making sure that, even though something might be rare, it is important to rule that out.
00:11:05.477 --> 00:11:20.817
And then, outside that, you can have external factors that are making the woman bleed heavily, like, for example, just a lack of ovulation, and this happens in the ends of reproductive life, so for example, in adolescence and in perimenopausal women, and that can predispose this.
00:11:20.817 --> 00:11:23.499
At times it could be a blood-related issue.
00:11:23.499 --> 00:11:29.756
That is a more generalized issue and you ask the history of these women have had you know like for example, they bleed more at the dentist as well.
00:11:29.850 --> 00:11:32.650
So it's a more generalized thing that's also affecting the uterus.
00:11:32.650 --> 00:11:40.495
So there can be a number of causes, and so the first thing I try and do is try and establish well, is there an obvious cause?
00:11:40.495 --> 00:11:43.177
Because the cause also sometimes guides the management.
00:11:43.177 --> 00:11:50.380
So certain options wouldn't be suitable for women, for example, let's say, with massive fibroids I might refer another thing.
00:11:50.380 --> 00:12:00.346
So, not only to try and give her answers, but also to rule out something really nasty like a cancer or pre-cancer, but also to help us tailor management.
00:12:00.346 --> 00:12:04.988
And this is a space, sonia, that's really meant to be shared decision making.
00:12:04.988 --> 00:12:08.551
So it's meant to be.
00:12:08.551 --> 00:12:09.293
We do want women to articulate.
00:12:09.293 --> 00:12:15.756
So I appreciate it when someone says, hey look, I don't really like hormones, or I'm worried about going to theater, I don't want to go for surgery.
00:12:15.756 --> 00:12:28.219
So even though sometimes I find after we share information together, people do change their minds and sometimes they say, oh well, actually, you know what, I don't mind that option, I might actually take that, and so it's really important to.
00:12:28.219 --> 00:12:38.557
But it's really important to articulate not only the fact to help diagnose if there is an issue, but be really active in what sort of management plan you feel is best for you.
00:12:38.557 --> 00:12:43.171
So in terms of the actual options available, there are certain tablets.
00:12:43.171 --> 00:12:49.552
There's one called tranexamic acid and also a common drug that is known as Ponstan, which is methanamic acid.
00:12:49.552 --> 00:12:54.873
This combination can be for women that want to just sort of band-aid the situation.
00:12:54.873 --> 00:12:59.219
They want to just use it during the time that they're heavy bleeding and they want to sort that out.
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They really do not want anything more elaborate than that.
00:13:02.398 --> 00:13:19.434
So the next tier up, or generally one of the most effective options, is what is popularly known as Mirena, which is a progesterone-based intrauterine device and so that can be inserted, son Sonia, and basically gets a lot of traction on the heaviness of the cycle.
00:13:19.434 --> 00:13:30.354
Now sometimes women can have irregular cycles, so one may move from a really heavy cycle to one where they're actually spotting for quite a while, especially in the first four to six months.
00:13:30.354 --> 00:13:33.061
So there can be some patients required before.
00:13:33.061 --> 00:13:35.736
Sometimes the Mirena often is in research settings.
00:13:35.736 --> 00:13:40.940
When those pads have been weighed Women have actually bled less, even when it's spread out.
00:13:40.940 --> 00:13:47.803
But some people might have, you know, might find that quite an instance value that now they're actually bleeding more days.
00:13:48.990 --> 00:14:03.772
So that's one thing to consider and the good thing about Myrina, though, sonia, is that it offers you contraception, which is also a need of us, of the perimenopausal women, for some patients, and also once we have figured out what's going on.
00:14:03.772 --> 00:14:06.479
We're sure there's nothing like pre-cancer or cancer going on.
00:14:06.479 --> 00:14:17.634
We've sorted out if the woman prefers to have a Mirena or a levonorgestrel IUD, as it's called, she may choose to have that as part of a hormone therapy, you know vehicle.
00:14:17.634 --> 00:14:19.880
So that could be the progesterone equivalent for her.
00:14:19.880 --> 00:14:25.881
So it's kind of ticking three boxes for that person if they need contraceptive support.
00:14:26.423 --> 00:14:33.812
And then the next level up there is basically going to theatre, and we may also need to go for surgery for diagnostic reasons.
00:14:33.871 --> 00:14:44.505
So if they have a high quality ultrasound and it shows, for example, that there's some concern about the lining and we're worried about the potential cancer, we may elect to go to theatre for that reason.
00:14:44.505 --> 00:14:49.621
So some sort of some patients might be recommended to have a biopsy of the lining.
00:14:49.621 --> 00:15:18.634
In theatre we can offer low risk, minimally invasive, lower tier of surgery which is like an ablation or certain fibroids or polyps can be removed from the inside of the uterus if they're contributing, felt to be contributing to her clinical situation and, in the last resort, or for some women that might have a massive uterus or concern around malignancy, a hysterectomy could be the best fit option for them, or for the person.
00:15:18.634 --> 00:15:26.941
Sonia, who has gone through all these layers of options and hasn't actually gotten anywhere, is still bleeding heavily, which is a very tiny minority of women.
00:15:26.941 --> 00:15:34.316
Honestly, majority of women are actually even I wouldn't say fixed, but they move to spaces which are far more comfortable.
00:15:34.710 --> 00:15:44.578
So obviously not all of our patients stop bleeding, but even some of our patients just move back to what a normal period is, and so for them, because they've been used to such torrential bleeding.
00:15:44.578 --> 00:15:45.561
They're like so grateful.
00:15:45.561 --> 00:15:49.432
They're like, oh, I just have a normal period, that's fine, that's okay, that's nothing, that's a piece of cake.
00:15:49.432 --> 00:15:52.682
You know, it's really very relative, isn't it?
00:15:53.986 --> 00:16:01.868
Yeah, it is, and it's fascinating for me as someone who has never experienced any abnormal menstrual issues at all.
00:16:01.868 --> 00:16:20.076
So I've heard words like ablation and I mean obviously I'm familiar with hysterectomy, but yet to understand that there are so many options available and you can start by minimally, I guess, with the medication, Everything doesn't mean you have to go to surgery.
00:16:20.738 --> 00:16:23.292
Absolutely, and sometimes the surgery.
00:16:23.292 --> 00:16:30.349
I think women are more fixated on hysterectomies but don't always, like you said, appreciate ablation.
00:16:30.349 --> 00:16:34.904
Or there's another condition called uterine embolisation and radiological context.
00:16:34.904 --> 00:16:41.037
That's an option as well, but like the ablation, sonia, it takes like literally less than two minutes.
00:16:41.037 --> 00:16:53.466
The actual procedure obviously setting up, going to sleep and all that takes much longer, but the actual procedure takes me less than two minutes to do and I think this woman has suffered for four years for want of like.
00:16:53.466 --> 00:17:02.794
It's a day surgical procedure for some women who are suitable and not everyone is suitable or will opt for that, but it really is life changing.
00:17:03.706 --> 00:17:06.894
I can imagine, I can only imagine how life changing it must be.
00:17:06.894 --> 00:17:13.498
Are there also lifestyle factors that come into play with this as well, where women can make adjustments in their life?
00:17:13.724 --> 00:17:41.592
Like you know, stopping smoking is something that can make a big impact for women so I think, sonia, look in general, obviously a good diet, particularly iron rich diet, because we are, we are often battling significant losses in these women and they're often quite in negative balance and that recognition that they may not be anemic but if their iron stores are low, that's an independent risk of getting tiredness and exhaustion and symptomatic.
00:17:41.592 --> 00:17:46.336
So obviously, from that perspective, a good diet would help to minimize that.
00:17:46.336 --> 00:17:58.273
But, to be honest, the kind of flooding that some women are facing you know how much you eat, or even orally there's a certain limit that your body will absorb and so we are having to give IV infusions.
00:17:58.273 --> 00:18:04.092
But that's also a myth, sonia, that sometimes women say to me I'm like, okay, what treatment have you had?
00:18:04.092 --> 00:18:16.096
And I've had two or three, I've had an IV infusion every six months and I say that's not really a treatment that is actually replacing your losses, and so I think that also needs to be clarified, that it is part of the management plan.
00:18:16.096 --> 00:18:19.988
It's not actually fixing the problem.
00:18:20.028 --> 00:18:35.096
Obviously, in general, especially women battling perimenopause, we always encourage them to minimize triggers for other things, because what I find, sonia, and actually my, you know, interest in menopause, was because I love looking after women with abnormal bleeding.
00:18:35.557 --> 00:18:43.711
And so what we would do is we would try and find a cause, we would try and stop or reduce the tap, we would try and make sure they didn't have cancer, we would replace their iron.
00:18:44.285 --> 00:18:51.056
But I still felt there was something missing, without you know, addressing the perimenopausal other symptoms.
00:18:51.056 --> 00:18:58.095
And so, because we had a questionnaire that sort of said look, are you experiencing hot flashes, you're getting night sweats, what's your sleep like?
00:18:58.095 --> 00:18:59.317
What is your vaginal dryness?
00:18:59.317 --> 00:19:18.396
And so because we were proactively asking in that tool, I was then finding oh okay, although she's come to me for bleeding, but actually she's ticked these three other boxes, and so I think if we hadn't asked, it may have been, so the heavy bleeding has been so overwhelming it may not even have been uncovered at that point.
00:19:18.396 --> 00:19:29.157
And then that made me think actually, no, there's more role of actually having a menopause based discussion as well, in more detail than just you know I worried this or something basic like that.
00:19:29.157 --> 00:19:47.250
So I agree that there's support for that, but I don't know that there's a lot that we can do that would necessarily minimize the bleeding itself, especially if there's a structural cause like yes, of course early cancer or something I don't know that there's any diet or or exercise that reverse that.
00:19:47.551 --> 00:19:59.432
So if a woman is listening today and she is really resonating with some of the things that we've talked about and she she goes off to see her gp or her clinician, what are your top tips for her?
00:19:59.432 --> 00:20:02.458
Having a conversation with someone about this?
00:20:03.566 --> 00:20:17.307
So, first of all, I would encourage her to be quite confident and to share that she has what she feels is a problem and this is why, and that she's here to seek a solution and a management plan.
00:20:17.307 --> 00:20:24.434
So ideally, women who have heavy bleeding should then be guided to some blood tests and be encouraged to have those.
00:20:24.434 --> 00:20:31.516
We obviously need to, sonia, make sure that someone's not pregnant without knowing that, and we also want to make sure that we're not.
00:20:31.516 --> 00:20:36.671
You know we're checking, like we've mentioned multiple times today, anemia and iron studies.
00:20:36.671 --> 00:20:39.810
We also would like to do an ultrasound For patients.
00:20:39.810 --> 00:20:41.173
They merit an ultrasound.
00:20:41.194 --> 00:20:46.596
The gp should be volunteering that and most gps, I must say, are quite good at that sort of um.
00:20:46.596 --> 00:21:06.230
It's more around the actual treatment options that um and and we have a lot of sympathy because gps are also quite time poor, we know so it's a very, very complex space that, you know, it's not that anyone's deliberately not trying to help is, I think, more that the woman, and it's unfortunate for us to say that, look, it's the women that should drive this.
00:21:06.230 --> 00:21:13.817
But a lot of good change for women have come when the women themselves have demanded good care and they have said, look, I need the options.
00:21:13.817 --> 00:21:22.539
I've actually read about these and a number of patients now are saying, hey, you know what I'm actually thinking of having another baby, so for me a Mirena might be a good fit.
00:21:22.539 --> 00:21:24.671
How can I get this organized?
00:21:24.671 --> 00:21:30.210
So the discussion is starting at a more mature level than saying I'm actually bleeding heavily, what do I do.
00:21:31.133 --> 00:21:48.555
I always find that it's helpful when women have had some information about heavy menstrual bleeding options, because we very much value their opinions and their preferences and so once they see their GP they can actually institute very solid primary care options and a management plan.
00:21:48.555 --> 00:21:56.210
And really the recommendations are that you know if six months are not working of various options, then refer to a gynaecologist.
00:21:56.210 --> 00:22:11.248
Or if there are concerns around you know, like we've mentioned previous, concerns around malignancy, or you know if it's a massive uterus with fibroids or certain very obvious gynaecological pathology, so those women should be triaged earlier, or if we find we're not winning.
00:22:11.248 --> 00:22:16.147
So I don't expect patients to be bleeding heavily for six months before they seek gynaecological care.
00:22:16.147 --> 00:22:27.609
But the GPs have a very solid primary care role in supporting the patients and I think more and more awareness is leading to more and more clinicians actually doing that.
00:22:28.451 --> 00:22:30.036
Yeah, fantastic, great advice.
00:22:30.036 --> 00:22:30.817
Thank you so much.
00:22:30.817 --> 00:22:34.792
And you mentioned that you have some resources that we can share in the show notes.
00:22:35.184 --> 00:22:38.911
I forgot to say there's a quarter of women have heavy menstrual bleeding.
00:22:38.911 --> 00:22:58.567
Let that sink in One out of 25% of us, and I also wanted to mention that there was a recent online survey by Hologic, and this was carried out by an independent research company called Two Blind Mice, and 5,000 women participated, sonia, they were.
00:22:58.567 --> 00:23:11.452
Basically the plan was to try and figure out what are the attitudes to this under-recognized condition, and no surprises we saw that 9% of women were actually saying they always have heavy periods.
00:23:11.452 --> 00:23:16.436
19% of women, sonia, said that they often have heavy periods.
00:23:16.436 --> 00:23:21.135
Three-quarters of women had had heavy periods at some point in their life.
00:23:21.135 --> 00:23:36.117
So we were still somewhere above that one-quarter number where, you know, women are often having heavy periods, or always, and more than half of women were yet to see a medical doctor.
00:23:36.117 --> 00:23:39.454
So that was in these days.
00:23:40.688 --> 00:23:58.555
And then, basically, the other thing that came out was that 69% had had some embarrassing episode, and we know that it can be quite awkward for women if they flat at work, or we know there's so many women that don't go swimming or different sort of activities they then refrain from.
00:23:58.555 --> 00:24:13.021
But the most interesting statistic to me was that 92% of women want more conversation, sonia, and so thank you for this morning because this is exactly what the women have asked for.
00:24:13.021 --> 00:24:35.170
We have recognized that there's shame, there's taboo, there is so much secrecy around menstrual health that needs to be changed and, like I mentioned earlier, that this is clustered to adolescence as well, and it's so heartwarming for me when women bring their daughters and they say we didn't get an opportunity to talk about our gynecological or our perimenopausal concerns.
00:24:35.170 --> 00:24:37.712
We are doing different for our children.
00:24:39.234 --> 00:24:39.895
That's awesome.
00:24:39.895 --> 00:24:44.361
It's sad that the mum had to miss out, but it's great that there's that.
00:24:44.361 --> 00:24:52.353
You know not wanting to pass that baton on as such to the next generation, so yay for women that are doing that.
00:24:52.353 --> 00:24:53.457
That's fantastic.
00:24:53.457 --> 00:24:56.571
And that survey, those statistics, wow.
00:24:56.913 --> 00:24:58.497
Shocking, they're really shocking.
00:24:58.497 --> 00:25:02.005
And that survey, those statistics, wow, shocking, they're really shocking.
00:25:02.005 --> 00:25:08.525
And it is just sad to see that, like I said, a space with so much support.
00:25:08.525 --> 00:25:14.117
But again, basically, when women were asked why they haven't seeked care, the first one was that they had deprioritized themselves.
00:25:14.117 --> 00:25:26.432
And I hear this every day, sonia women are caring for their elderly parents, for their children's issues, for even their work related people telling me that oh no, I have this deadline at work and I'm thinking but you're not functioning well.
00:25:26.432 --> 00:25:29.448
You're telling me you're so tired you're not able to focus.
00:25:29.448 --> 00:25:32.315
So it's a and and you know the joys of perimenopause.
00:25:32.315 --> 00:25:38.758
Imagine that layered over, um, someone that has a ferritin of four or has next to no iron and is then anxious.
00:25:38.758 --> 00:25:43.576
I think the emotional side of perimenopause in itself can be very overwhelming.
00:25:43.576 --> 00:25:59.354
And then if you layer the misery of bleeding heavily, the hygiene issues, the quality of life impact, it's just a very negative space that we need to actually support women to come out of that cycle?
00:25:59.994 --> 00:26:00.997
Yeah, absolutely.
00:26:00.997 --> 00:26:03.509
Now I do have a question around.
00:26:03.509 --> 00:26:11.752
If someone's listening to this and one of the things that I find so frustrating for women in Australia is you and I sit here in a city.
00:26:11.752 --> 00:26:18.000
We have great options available to us to seek support from multiple GPs.
00:26:18.000 --> 00:26:20.772
We have, you know, multiple gynecologists to choose from.
00:26:20.772 --> 00:26:28.776
If someone's listening that's in a more remote or regional area, what are their options if perhaps there's not a gynecologist in town?
00:26:28.776 --> 00:26:36.386
And you know, I know, that we have telehealth services for some healthcare Is there some telehealth available around?
00:26:36.386 --> 00:26:37.892
You know, gynecological care?
00:26:44.424 --> 00:26:45.951
So we have set up at Women's Health Road, basically a national option.
00:26:45.951 --> 00:26:46.613
So it's a hybrid care model.
00:26:46.613 --> 00:26:59.170
We are happy to have telehealth from anyone and we're happy to connect with that person's general practitioner to then sort of work in partnership with them and to support them in trying to see identifying where's your nearest public gynecology clinic.
00:26:59.170 --> 00:26:59.282
You know, see identifying.
00:26:59.282 --> 00:27:00.950
You know where's your nearest public gynecology clinic, for example.
00:27:00.950 --> 00:27:05.328
If things are not being sorted out at that level, certainly we are offering that, sonia.
00:27:05.348 --> 00:27:16.989
Some of the other directions our practice is embarking on is we're trying to request for a international heavy menstrual bleeding day for a condition that affects a quarter of women.
00:27:16.989 --> 00:27:19.827
I am a bit grieved that we don't have a day for this.
00:27:19.827 --> 00:27:24.218
So I think that that would be a way of raising awareness for everybody.
00:27:24.218 --> 00:27:46.876
And then we're also trying to look at some digital technology, and the great thing about digital technology is not about replacing the clinicians, it's about empowering the patient to be able to sort of, you know, at least get some degree of support, which is not necessarily in BRICS and geographically, you know, restricted.
00:27:46.876 --> 00:28:02.855
So that is one of our agenda for 2024 to be able to roll out a program that encourages a digital support for women and that makes some of their journey easier and less dependent on the actual local availability of resources.
00:28:03.435 --> 00:28:10.490
Yeah, fantastic, tella, you are doing amazing work in this space and I'm so grateful on behalf of everybody listening.
00:28:10.991 --> 00:28:11.413
All good.
00:28:11.413 --> 00:28:16.993
Sonia, Thank you so much for the time today and I really appreciate the amazing work you do with Dear Menopause.
00:28:16.993 --> 00:28:19.109
It's such amazing advocacy.
00:28:19.491 --> 00:28:20.273
Thank you, tela.
00:28:20.273 --> 00:28:22.069
I appreciate that and thank you for your time today.
00:28:22.069 --> 00:28:27.092
Thank you for listening today.
00:28:27.092 --> 00:28:38.198
I am so grateful to have these conversations with incredible women and experts and I'm grateful that you chose to hit play on this episode of Dear Menopause.
00:28:38.198 --> 00:28:42.851
If you have a minute of time today, please leave a rating or a review.
00:28:42.851 --> 00:28:48.809
I would love to hear from you, because you are my biggest driver for doing this work.
00:28:48.809 --> 00:29:07.009
If this chat went way too fast for you and you want more, head over to stellarwomencomau slash podcast for the show notes and, while you're there, take my midlife quiz to see why it feels like midlife is messing with your head.
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