00:00:00 Aisling

When you ask, what are women asking for help with, yes, it’s those symptoms. But I think what we’re doing, I came up with a little term called estrogen washing, which… it comes from this green washing. So airlines, for example, saying we’re being really environmentally friendly because we recycle our cups. And that’s like greenwashing, because actually there’s a much bigger problem here. So women are coming in with these menopausal symptoms and wanting HRT and we’re giving out lots of hormones to women. But actually, when we step back and look at the bigger picture, we’re looking at capitalist society, patriarchy, how much we’re pushing women to work extremely hard, what an emotional burden women are taking on. We’re looking at all these much bigger issues, our own views of ourselves and aging. Those are the kinds of things that we are trying to treat with estrogen. And of course, that’s not going to work, or it’s going to work to a certain extent, or it’s going to buy women a little bit of time. But unless they are able to look at the stressors that are driving some of these symptoms, HRT is only going to do so much. And of course, lots of women will be in a position where they aren’t able to give up some of those caring responsibilities just because of the situation they’re in. But I find that there’s usually somewhere where a woman can say, “No.” There’s usually somewhere where she can get a little bit of space for herself. And that’s where we need to start. Just do what we can. Where we are.

00:01:30 Kevin

Welcome to another edition of the Gifts of Trauma podcast. My name is Kevin Young and I am here with Rati Ricardi and Aisling Quiery. Recognizing that we are a global community. Rati is in Western Australia, all the way over in Perth, so she’s in tomorrow already. Aisling and I are both here, 7am in Ireland, the north of Ireland. Rati and Aisling, you’re really welcome. Thank you for joining us. I’m really looking forward to the conversation.

00:02:06 Aisling

Thank you.

00:02:07 Rati

Thank you, Kevin. So am I.

00:02:11 Kevin

And we are. We’re having a conversation about menopause. And we’ve had a series of conversations about menopause perimenopause and menopause. And to start with, I was sent to you both before we started chatting when a series of conversations was floated. I sent a little joke message to Rosemary and to J’aime, our producer and lead in the podcast, and said, obviously, I’ll be hosting this conversation, as a joke, thinking. I will not be involved in the menopause conversation. And here I am. And I’m saying that because. And we’ll get into this, but I was thinking about, when was the last time that I had a conversation with a man about menopause? And yeah, Rati, you’re shaking your head. And I thought not only was there not a last time, but there wasn’t a first time. There has never been a time that I have had a serious conversation with any of my men friends, my father, my friends, people who are married, in relationship, gay friends. I’ve never, ever had a conversation that wasn’t ridiculing or belittling women, joking humorously about menopause. And I come here with a beginner’s mind. I know very little about the symptoms, the causes, the way through. I know very little about understanding menopause, perimenopause, apart from it’s a thing that happens to women in their late 40s and we don’t talk about it. With that being said, I would love our audience to hear your voices and maybe just taking a minute to introduce yourselves in whatever form, whatever format you want and maybe, Rati, would you like to go first and just tell us who you are, why you’re here, where you are, and anything else you want our listeners to know.

00:04:09 Rati

Sure, sure, Kevin. Thank you. So my name is Rati. I am originally from Italy. I live in Perth, Western Australia for the last 16 years. In my former life, I was a freelance translator. And then I started being interested in different healing modalities and I had my first Ayahuasca journey, which changed the course of my life. I’ve been working with people now for 20 years in different roles. I’m also a trained yoga teacher and started my journey with Compassionate Inquiry in 2019. At the moment, currently a facilitator of the training, a mentor and a circle leader.

00:04:51 Kevin

Thank you, Rati.

00:04:52 Rati

And I also work with psychedelic integration and preparation.

00:04:56 Kevin

Thank you, Rati. Rati, this is a question that I have never asked anyone before on the show, and I’m going to ask it just because of the nature of the conversation that we’re having. Is it okay if I ask you, how old are you?

00:05:06 Rati

Yes, I am 56.

00:05:08 Kevin

56, thank you. 56 years. I appreciate that. Aisling, would you like to take a moment as well and introduce yourself?

00:05:16 Aisling

Yes, thank you, Kevin. My name is Aisling. I’m here in the north of Ireland. I am 48, so I think I’ve been in perimenopause probably for a few years. And I am a family doctor, so I’m a GP and I see a lot of women coming to talk about menopausal symptoms and requesting HRT. And I’m also a Compassionate Inquiry practitioner, so I work one to one with lots of different kinds of people using Compassionate Inquiry, and that’s the main work that I do now. And Ayahuasca also changed my life, Rati. I worked with it a lot at the start of my healing, maybe eight, seven, eight years ago. And I went to Peru in 2019 with Gabor and did a retreat with him with the Shipibo and Ayahuasca. And it was after that retreat and seeing what was possible outside of the medical model and possible inside myself with Compassionate Inquiry and with plant medicines, that I came away from that and trained in Compassionate Inquiry. So I did the training in 2020 and I live on an organic farm and I love being in calm places with lots of lovely vegetables. That’s good for my nervous system. Yeah. And I just wanted to share something as well, Kevin, while you were speaking and saying that it’s something that men don’t talk about. A few months ago, I was out with my mum, who’s in her mid-70s, and some of her friends who range from their early 60s probably to mid-70s, and I asked them about the menopause and their experience of it, and they all had very different experiences. Some had really challenging times, some hadn’t, some had HRT and some hadn’t. But the one common experience amongst all of them was that they had never talked about it with anyone. And when I talked to my mum, she said that she’s never talked about the menopause, about her experience with her sisters. She has four sisters, with her friends or with anyone. And it’s really only… You say that men don’t talk about it. I think it’s really only in the last maybe five or ten years that women are talking about it more openly. So, yeah, that’s what I was thinking when you were sharing that about men. This is new for us women as well.

00:07:41 Kevin

Yeah. Thank you, Aisling. That has made me feel a little better. A little. It’s settled my nervous system a little bit. How I would like to build our conversation whilst keeping it conversational to hear from you both, as much as you want to share, of course, around your personal journeys with perimenopause, menopause, how has that been for you? And we’ll develop that conversation a little bit and then Aisling just for both of you, as well, I hear you talking about women that might come through a GP surgery and what that looks like. So both of your experiences may be rati3 plant medicine. We’re all compassionate inquiry people. So no doubt or I hope the conversation moves towards a nervous system, trauma response, societal pressure. I guess we might even talk about marketing, advertising, what we’re told menopause is or isn’t or how it’s marketed to us. So that’s really a structure. And I also want to say, I think I was chatting to J’aime before. I can remember being very young and I grew up with three sisters, apart from my dad, the only boy in the house. And I can remember all like, even period products, tampons, etc. Like they were a thing that were. They were hidden, they were hidden out of the way. They weren’t there to be viewed or seen. They were a mysterious thing to me. I was like, well, what are the. What are these things? What do women do with these things? I can remember being in school as well and I was in a Catholic mixed boys and girls school and in third year. So when we were about 14, the girls once a week got taken away, like, oh, this is a mystery. Where are these girls going? They got taken somewhere else to another classroom and the boys didn’t. We stayed behind and hit each other with rulers or whatever boys do. And they were off having sex education. So the girls went off to have sex education and the boys didn’t. So my understanding and introduction to sex education to women’s bodies, to men and men’s bodies, to. To the body at all, to its functions, its processes, was non-existent. I have never been given the opportunity to have a conversation intellectually or academically about bodies, women’s bodies, menstruation periods, perimenopause, menopause. It has never happened, ever. And I am close to 50 years of age. Never happened. And then coming to a place of trying to understand it is really interesting at this age. So maybe starting with Rati, would you be willing to chat to us about your personal experience? I know you told us a little bit perimenopausal and menopausal for nine years. You talked about fairly severe symptoms, a fairly difficult run with that. Would you talk to us a little bit about that and how that has been for you?

00:10:33 Rati

Yeah. Thank you, Kevin. So I guess looking back now, I wasn’t aware of it at the time. I started having symptoms around the age of 36. Different changes in my period, appearance and the beginning of digestive issues as well, which I later came to connect with hormonal imbalances that have an impact on the gut lining and that got progressively more severe until recently where I think finally I have found a way to contain those symptoms, the gut symptoms, through a very restricted diet and some herbal supplements. And then around the age 44, I started having really heavy periods. And since the beginning of my journey and the severity of it, I always felt I needed to help women with this because I don’t want them to experience what I experienced to the extent that I did. Basically going to bed with every largest pad and tampon available and getting up an hour later to go to the toilet for just regular toilet and making a paddle on the floor. That is the severity of that bleeding. Luckily it wasn’t always like that, but several times. And I did have to go to hospital and got an ultrasound, internal ultrasound, which showed no particular issues. And then at some point, 2016, September, I had my period and maybe two weeks after, I started having hot flushes and I said to myself, I’m never going to have a period again. And I never did. And then from that point on the symptoms became more and more severe and to the point where I had flushes every 15 minutes, day and night. So there was no sleep because every time I also have difficulties in general falling asleep, but every time my body would be ready to fall asleep, then another flush would come. And it’s not just about heat. There’s a whole other experience inside the body that comes from your viscera and it’s like an intense anxiety that rushes through in this, like from the gut up to the face and to the head, almost like a panic attack if you’ve ever had one of those. And then comes the heat, the sweating, all of those like more known kind of symptoms. And that anxiety is really crippling. And then the mind, at least this is my experience, wants to attach a story as to why I’m feeling anxious. And that’s the interesting parallel here with, with the nervous system and childhood trauma, which all came to the surface thanks to me starting the training, etc. And having specific therapy, which for me has been very helpful to, to combine trauma therapy with hands on. And my therapist is also a Chinese medicine practitioner as well as an energy healer. So that for me has worked very well. I tried for as long as I could. I’m a very natural person. I don’t take any medications of any sorts. So I tried to go the natural way and I tried everything under the sun, all modalities, all supplements, all herbs, you name it, I’ve tried it. And nothing really seemed to change much of anything. I have to say as well that because it was so unexpected, I was 47 when my period stopped. And I had never spoken with my mother about menopause because she died at 57 after nine years of a cancer journey. I never heard anything about it. I think her body was busy doing something else. So for me, it was like. It just hit me like a freight train in the face without any hints beforehand. And I had a very nomadic life at the time. I was traveling a lot to South America, and I definitely underestimated the situation and continued to do lots of ceremonies, stay up all night, because particularly in Brazil, the ceremonies are really long and they go up until sunrise. So lost nights. And then the nights that I could sleep, I actually couldn’t sleep. So I didn’t really take care of myself well at the beginning. And then at around 2020, 2021, I surrendered to some bioidentical hormones because for me, it was like I lost my battle or I… I surrendered to something that I didn’t want to do because I thought that it wasn’t good. I got some degree of benefit, varying benefit. But the interesting thing is that the first four practitioners that I went to see were men. Now, I have nothing against men. I love men. But please don’t go to a man for your menopause. Choose a woman who’s in her 60s and who’s gone through that. And again, we can have different experiences, so we won’t maybe be understood fully, but that would be my suggestion.

00:16:23 Kevin

Rati. Thank you. Let me pause you there, Rati. There’s a whole host of questions coming to my mind, and we’ll hold those for a little bit, if that’s okay. Aisling, would you be willing to share just a little bit of your experience? I know you’re a little bit younger than Rati. Your experience into this period of your life per menopause. Menopause and how that has been for you.

00:16:42 Aisling

Yeah, sure. And Rati, thank you for sharing what you shared. And I was smiling at the end because maybe we’ll come on to this later. But when you said go to a woman in her 60s for menopause support or help, and I think we should go to women in our 60s for support with everything like these, these wise elders. And I think that’s part of the menopause story, is how we view menopause and aging women. Yeah. So that’s great life advice, I think. So yeah, so my experience is probably quite different from Ratty’s. I always struggled with really painful periods. And I really resonated, actually, with what you said, Kevin, about school and the girls being taken off for sex education. I also went to a Catholic school in Belfast in the 90s, and I can tell you that when we were taken off for sex education, we didn’t really get past friendships. This was the joke that the sex education would start with friendships and then it was supposed to move on to bodies and periods and sex, but it never got to that point. We were taught by a nun and she was always finding a reason to leave the room whenever it came on to the part about bodies and periods. So I never had any formal education about my own body or about periods, let alone about what happens at the other end of the menstrual sort of journey. So I had really painful periods and it was very terrifying for me, and I didn’t understand what was going on. And I struggled with that through my 20s and my 30s. And I remember standing on a train platform heading into medical school. In my early 30s, I went to medical school quite late. When I was 29 and having such bad period pains, I had to go home. And I thought, I can’t go on like this. And now what I understand about nervous system regulation and high peristalsis in our organs requires us to be emotionally balanced in ourselves. I now understand my period pains a lot more, but I remember thinking, I can’t go on like this. And I went and I had a coil, a hormone coil put in when I was in my early 30s, and that really helped my periods a lot. I no longer suffered from pain and they became a lot lighter. And of course, for women who have a Mirena coil, it can be impossible or very difficult to know whether they’re going through menopause or not, or whether they’re starting, because it changes our period so much. But at some point in my early 40s, I decided to have the coil taken out and my periods were much better. And my mum had always talked about how she had periods until she was 60. So she went through menopause really late. And she also talks, I think, quite proudly about the fact that she never had any symptoms and she just sailed through the experience with no issues. And I think that’s interesting on what you said, Rati, about we can make it, really make it mean something about ourselves. If we struggle with menopausal symptoms, there’s something wrong with us, or we’ve done something wrong, or we’re not good enough or we lose trust with our bodies. But I think I had this perception, I am going to go through menopause when I’m about 60 and I’m not going to have any issues. That was my idea that I had in my head, but that wasn’t the case. My periods became very irregular a few years ago, and I can remember two years ago actually going to Vipassana retreat in Morocco, and I hadn’t had a period for eight months. And I thought, okay, I’m done. This is brilliant. And I was sharing a room with a younger woman and I gave her all of my pads and all of my tampons and this symbolic gesture of, I’m done with my periods. And then I got my period really heavily in the airport on the way home and I didn’t have any tampons or anything. And I thought, oh, God. Okay, so period’s very irregular and I don’t experience hot flushes or any of the other symptoms that many women struggle with. But I did struggle. I was quite unwell in 2021 with long Covid, and I was really unwell for about eight months, and it was really two years before I fully recovered. But since then, when I get any kind of viral illness, cough or cold, I experience typical cough, cold symptoms that last five to seven days or whatever, as you would expect. But then afterwards, sometimes for up to two or three months, I experience real fatigue and my body aches, being low on energy, feeling a little bit more anxious, maybe struggling to sleep a little bit more. And I have just been wondering lately if that is related to my hormones. And I think this points to what Rati talked about. Very heavy, distressing, bleeding and hot flushes is what a lot of women come to see me about in GP. But also there’s much more subtle symptoms, I think. there’s such a variety of symptoms, and progesterone and oestrogen, they do so many different things in the body that I think my experience of it is that it just makes me a little bit less resilient, or it makes my body a little bit less able to handle things like viral infections. And I think what this dip in our hormones as we get into our 40s can do is it can reveal what’s maybe been happening underneath. I would recognize myself as somebody who is fairly anxious, although I’ve worked a lot on that and I think I’ve come a long way with that. In general, my nervous system is set to a slightly more anxious state. I would have historically pushed myself very hard. Been a perfectionist, not rested enough, worked very hard. And all of those things we can get away with, I think, in our 20s and 30s, to a certain extent, when we have this buffering effect of progesterone and estrogen in our system. And when those hormones start to dip, we don’t have that buffering anymore. So that’s probably. Yeah, that’s what I’ll share.

00:22:58 Kevin

Thank you, Aisling. You know, I just want to acknowledge as well that as I sit here and listen to two women talk about periods and menstrual cycles, that I’m managing and aware of an embarrassment in my body, that something going on for me, of. Yeah, an embarrassment there. And I’m just noticing that it’s an interesting place for me to be as a man, having this conscious conversation with two women that I know and love dearly. And it’s difficult, so it’s also important. But I just want to acknowledge that’s happening for me. When I listen to you both chatting. And actually, you offered a bit of a statistic and a figure there in the UK. 13 million women in the UK are perimenopausal or menopausal. That’s just the UK, which is 25% of the population. So I imagine that it’s probably very easy just to extrapolate that up to a global sense, that 25% of the global population there or thereabouts are perimenopausal and menopausal. And here we have Rati talked about a puddle of blood, 15 minute flushes, you’re moving through and getting a coil. And what I really hear is that we have 25% of the population having these deep journeys with their own bodies and their own experiences and nobody’s talking to anybody. And I can’t imagine if 25% of the male population were experiencing something that it wouldn’t be a big issue. I could guarantee you it would be a big issue. It would be a political issue, it would be a medical issue, it would be a financial issue, economic issue. It would be a big issue if 25% of our male population were experiencing something.

00:24:40 Aisling

Kevin, could I just interrupt there?

00:24:41 Kevin

Yeah, please.

00:24:42 Aisling

Because it’s 25% of the entire population in the UK are menopausal and perimenopausal. So it’s not 25% of females, it’s 25% of the population.

00:24:51 Kevin

Thank you. So that’s what I’m. So, yeah, females are 25% of the population that are having this experience. Yeah, thank you.

00:24:59 Aisling

Yes.

00:24:59 Kevin

So, yeah, it’s a quarter of the people in the world at any given time are having experiences like a puddle of blood and can’t go to work and hot flushes and they’re doing it alone. And I’m really interested to know, why is that? Why are 25% of people in the world having these experiences? And the vast majority are not talking about this. And please feel free to both come in on this, because for me, that leads into our traumas, our past. It leads into religious or economic or marketing or our patriarchal society. It leads us through a door into a big conversation. Why are 25% of people having an experience that nobody is talking about?

00:25:48 Rati

Yeah. So should I offer something? I don’t know, maybe I’m going a little bit sideways here, but I am very connected and a big fan of the Native American, Southern US and Mexican cosmology. And they have 13 year cycles in their lives. So once we hit 52, we are considered an elder. And in the traditional communities, when you’re an elder, the community supports you, you provide wisdom, but you no longer work and you are provided for in many ways. And we don’t have tests in this society as women, we have to work until 67 or even more. And by all means, I might want to be working because I enjoy what I do, but I don’t have a choice, right? So I have to keep supporting myself, particularly for women who are single like myself. And I see the pattern from my childhood that obviously has been emerging through therapy and etc, of this aloneness and doing it on my own and being alone and all of this stress and anxiety that built up over years. As Aisling was saying, when we have the hormones to buffer, then we can come back easily. But as the hormones start to drop, it’s close to impossible to do that. And everything from wound healing, sprains. One of the symptoms of menopause, for example, is a traveling pain through the joints. One day you wake up and it’s in your index finger, and the next day you have it in your wrist and then the next day in your knee and it’s just this, like, really unpredictable. I think, Aisling, you were saying as well, like, you wake up and you don’t know what you find. It’s uncentering. And I think one of the most important things to notice is that we don’t have a system to support women going through this. You know, we have to continue with our lives and, and sometimes we are even punished for it in the way of work and because we can’t produce as much or with the same. Same extent. Yeah, yeah.

00:28:22 Aisling

So this is maybe tying in a little bit too Rati, what you’re talking about with these. I love that. Getting to 52 and you’re an elder and. Yeah. So Mary Jane Menken, so she’s a doctor. I think she’s a gynecologist, as far as I know. And she works in Yale University. And she’s done some really interesting research on menopause in different cultures around the world. And she has found that in cultures where there’s a positive view of aging and a positive view of menopausal women as being elders and wisdom keepers and having the status in a community or society where people come for advice and for help, that menopausal symptoms are a lot fewer and a lot less severe. And she says this is especially true in intergenerational households. And of course, in the west, that’s fairly uncommon. That we would. That we would have grandmothers living with us, for example, when there’s intergenerational households. This means that the matriarch or the grandmother has a really important function in the household, of advice giving and caretaking, but not in the way that I, that we sometimes see in Western culture where grandmothers take on a lot of that heavy load of raising or minding young children so that parents can go to work. It’s more in a kind of advisory role. And I think that’s really interesting. She says that in societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome. And I think it’s interesting, menopause means menses stop. So it’s the stopping or the ending of something, which is true, it is. But I think that sort of points to how we view it in the West. It’s the end of our productive years, the end of our fertility, the end of our productivity, the ending of something, rather than a stepping into a new phase of life where we have wisdom and where we have energy and where we have almost a second adulthood. There’s a woman called Margaret Mead who coined the term. I think she was an anthropologist, and she coined the term in the 60s or 70s, I think menopausal zest, where this is a new phase of life for women, when they get to. Maybe they’ve raised their children and they get to do things in their life that they have always wanted to do, maybe travel or start new projects, or they have this new zest and new stage of life. And we don’t often view it like that in the West. And I think that’s part of the reason maybe that it isn’t talked about, because it’s seen as something that wants to be hidden, that is shameful, that is moving towards getting old with all the negative connotations that we often have in the west about getting old. And also, Kevin, you asked about why is this not being talked about? I think it’s bodies in general. Our colleague Inés, who I think is going to be on another podcast, she talked about in South America, where she grew up, when you had your period, you would say, my auntie is coming to visit. And as a child, she talks about being totally confused about where all these aunties were and who were these aunties, because there didn’t seem to be any aunties visiting. And I think in different cultures there’s different words and terms for even having your period. So it’s very hidden. And my mom talked about my grandmother. So my grandmother would have been born in the 1920s in Ireland, and she would have been having children in the 40s, and she had eight children. And in the Catholic Church, you weren’t allowed to come back to church after the birth of a child until you had a specific blessing. And I can’t remember what it was called. There was a certain term for it, and you had to have a blessing by a priest in order to be able to come back to the church, because having a child was considered to be something that was a bit dirty or a bit disgusting. So you had to have this cleansing sort of blessing before you came back. That was in the 40s and 50s, but that was women carrying a lot of shame about what our bodies do naturally and actually have to do in order for us all to be here. I think there’s this general. I don’t know, historically, this shame and mystery and hiddenness and periods and blood and it’s messy and, and disgusting. And so we’re carrying all of that as well. And I don’t imagine men talk a lot about the ins and outs of their bodies and how their bodies work and prostate problems and struggling with erections as they get older and all that sort of stuff. And I certainly know that when men come in to talk to me about issues for them when they get older, they’re not talking to their partners, friends. So I think it’s a. It’s. It doesn’t just apply to women. I think there’s a general body shame as well in our culture. And especially shame about aging. I think we have this idea that we want to be young and wrinkle free and beautiful and strong forever.

00:33:39 Kevin

I said, let me swing around. I’d want. Just as you’re chatting, I want to mention a couple of things. I was in city center and I live in the country and don’t often go to the city center and noticing the amount of advertisements that were about, oh, I can’t remember the name, Hypodermic aqua reflexing needling wrinkle removal procedure now available in store. Things like that. All about women, particularly women, not getting old. Here we have this needling machine that we can needle your face so that you don’t look like you’re getting older. And I was just fascinated by that. And then I was watching a little show last night on on telly about it’s called Mortimer and White House Gone Fishing. And it’s two comedians who are getting older. They’re probably both in their 60s now. And it’s not about fishing. It’s just about these two men hanging out together. And I was really touched. They were talking about their one had cancer and one has got gout in his foot. And I was really touched. I’d never really seen something that on TV where people are talking about getting older. They would joke at each other as well. One was saying, I’ve got a sore foot. And the other one was saying, I’m glad I haven’t got your face because you’ve got more wrinkles than me. And so they were having a really lovely, funny conversation. So Rati, maybe link that for me then. I want to talk about the connection between childhood trauma and menopausal symptoms. I want to talk about the lack of safety, lack of attunement, the lack of normality around this and the severity of the symptoms. What’s your experience of that? I suppose I’m asking how has your experience of menopause been met by the outside world and how has that impacted your menopausal experience?

00:35:26 Rati

Yeah, yeah, just let me. If it’s okay, just add something to what Aisling was saying about shame. And I am not a feminist and I want to repeat, I love men. I have a very high concept of men. And at the same time, our society is so that it’s shameful for a woman to be old because as Aisling was saying, no fertility, no productivity. And also men aren’t attracted to older women. They’re not attracted to women their age most of the time. I’m not saying that it’s everybody, but it’s a very high percentage of people. So there’s a certain shame about menopause because you’re no longer fertile and you’re no longer attractive. And I would like for the world to change because this is very damaging for women, I feel. So that’s a parenthesis that I wanted to add there. For my own personal experience. I came to learn through Compassionate Inquiry that even though I wasn’t much physically abused, I only got hit once by my dad. I know that’s bad, but in the scheme of things, and I wasn’t sexually abused, so I thought I should be okay, I should be more healed. But actually I was, I guess, abandoned, for lack of a better term by my mother. Returning to work when I was one year old and I was handed to a nanny, and I just hadn’t gotten the severity of that until I started studying trauma and Compassionate Inquiry. Imagine this baby, 365 days with the mother, and voila, on the 366th day, mother has disappeared. So that’s how I came to understand the intensity, the severity of my trauma. And that left me with, I guess, an absence of safety. An absence of safety that then repeated itself throughout my life. I spent a lot of years as a single woman. I raised my son on my own. I had to make some choices, work choices that put me in a very unstable situation, etc. And I remember not being able to sleep because when I went to sleep, I was starting to think, not even think. It was like half sleep, half wakefulness. And I was working in my head what I had to do the next day. So again, I. I survived. My hormones were pretty stable. And then as they started to decline, all of this kind of started to arise and this anxiety and just dread and fear started to emerge. And they are in the body. They are in the body. And that’s why I’m a fan of working. Yes. Working with trauma. But also we co regulate. We need another body to co regulate when we are in deep distress and dysregulation. That’s what’s helped me to integrate my past and my life and the amount of stress and anxiety that I experienced, which is coming to the surface with menopause.

00:39:00 Kevin

Yeah. Thank you, Rati. So do I hear you say then that you are relating an absence of safety, an absence of emotional attunement from a mother who, my guess, has had to go back to work, given the society we live in and.

00:39:16 Rati

Yes, absolutely.

00:39:17 Kevin

The severity of menopausal conditions and menopausal symptoms.

00:39:22 Rati

Yeah, yes. And also other things that happened in life, but it all started then. That’s my understanding.

00:39:30 Kevin

Yeah. Thank you. I’m really keen. I’m mindful of our time and we don’t get a lot of time together. This is a series of conversations around menopause and there are others on the podcast platform, so please check in with those. And my guess is this probably needs to be an ongoing conversation. And actually, I just want to chat to you briefly about from the perspective of a GP, what you’re seeing coming through a GP surgery. And then I’d love to save some time for a little question. Almost like Eckhart Tolle’s A New World. And maybe Rati, you can be thinking about this too. I’d love to see some time for a question around, what would it look like if women were supported, if things were different as men, as a man who knows nothing, what can we do to support you and women? So I’d love to save some time for that question. But, Aisling, talk to me about, as a GP, what are you seeing coming through a GP’s surgery? What are women talking about? What is it that women are trying to fix through the use of medicine and HRT and why are they trying to fix it? Can you talk to us a little bit about that?

00:40:41 Aisling

Yeah. Thank you. Yeah. I was just reflecting there when Rati was speaking about how much Compassionate Inquiry has changed my practice as a GP in general and specifically around women and women’s health. And when I first came across the ACES study, so the adverse childhood experiences studies, it really blew me away, actually. And this was quite a few years ago now, but we know that childhood, adverse childhood experiences, of which there are 10 around abuse, neglect, etc. Most people know what they are, but adverse childhood experiences have a huge impact on health in later life right across the board. Not just mental ill health, but all kinds of chronic health conditions. And that applies to…

00:41:22 Kevin

Aisling. Can I pause you? Would it be okay?

00:41:24 Aisling

Yeah.

00:41:25 Kevin

Because just as you mentioned, adverse childhood experiences report, I’m thinking there isn’t anything in it. We know that X amount of people, when they’ve had a number of adverse childhood experiences, they go on to face addiction and they go to jail and they have mental health issues. But I’m noticing what my thoughts are. I’m noticing there isn’t a question in there and a reflection on menopause. And I’m thinking, I wonder, was the adverse childhood experiences report thing made by men?

00:41:54 Aisling

Yeah, of course it was. Yeah. And it’s really most medical research, and this is one of the problems, most, most medical research is based in the bodies of men because they’re seen as being less complicated because they don’t have all these hormonal changes. So if ACEs increases our risk of chronic illness across the board throughout life, then it is going to have an impact on menopause as well. Of course. So how I view it from the lens of a GP is that progesterone and estrogen have lots of effects in the body. And we know that stress. And really what we’re talking about with adverse childhood experiences is toxic stress, and how that impacts the body in later life. And stress in general depletes or suppresses our estrogen and progesterone. We can either increase our estrogen and progesterone with HRT, that’s one option, or we can take off some of that stress so that our estrogen and progesterone inside of us will go up effectively. And the reason it’s really changed my practice being a GP, is women come in and they’ll talk about various symptoms that they have. Things like Rati talked about very heavy bleeding, which can be very distressing, and hot flushes and vaginal dryness and brain fog and various aches and pains and changes to their mood and being more irritable, noticing that they’re more easily getting angry with people around them. They’re feeling low, they’re very tired or sleep…, all of these kinds of things. And usually they want to explore HRT as an option. And I’m very generous with HRT. I’m. I am. I’m happy to prescribe HRT if I think it will help a woman. So I’ll say that to her, but then I’ll ask her, can I ask you a little bit more about your life and what’s going on? And almost always a woman of this age will have a huge amount of stress and emotional burden on her. And it usually looks like looking after young children, looking after grandchildren, looking after aging parents, so being sandwiched in between two or three generations, all of which are demanding her attention, and then also may have a career, maybe at a stage in her career where she’s got a lot of responsibility. And this comes down to this beautiful question that we ask in Compassionate Inquiry of “What are you not saying no to?” And I’ll ask that question to women, and often what I do is I’ll mirror back. I’ll just mirror back to her. So what I’m hearing is you have all of these caring responsibilities, you’re working this hard, you’re doing this, you’re doing this, and you’re doing this. How does that sound to you? And because she’s normalized it so much, having it mirrored back can actually be very powerful. And a lot of women will sit back and go, wow, that sounds like a lot. And I’ll say, yeah, that. That’s a lot. And how easy is it for you to say no? And almost always the answer is it’s extremely difficult. And that’s when we get into this more subtle childhood trauma. You know, we always think of childhood trauma as these big T traumas. And actually, when women talk about their beliefs, you know, I’ll say, tell me a little bit about saying no. There’s nobody else. I’m on my own. If I don’t do it, nobody else will. My needs don’t matter. Okay, she’ll maybe not say that directly, but that’s effectively what she’s saying. I have to do all of this. I can’t take time for myself. I have to show up for all of these people. And women are bearing this huge emotional burden, and they’re not able to say no. And there’s yeses that they want to say that they can’t because they’re looking after the needs of everybody else. And these are the conversations that I’m usually having with women. And usually it goes different ways, but often it will be, okay, I’m willing to try HRT. Let’s give it a go. I’m willing to prescribe it for you. And what about looking at these other things? And often women will come back and they’ll say, for some women, HRT makes a huge difference, and that’s great. But many women say, yeah, didn’t make that much of a difference. And then rather than going up and increasing the levels of hormones, then what I’m inviting women to do is look at these other areas of their life. And that is saying no, reducing the emotional burden, giving themselves a little bit more space, and then looking at things like diet and how well they’re taking care of their bodies and what they’re doing to get really strong in their bodies. And, you know, I was reflecting as I was sharing about my own experience of sort of perimenopause symptoms is I live on a beautiful farm in the country. I don’t have children. I don’t have caring responsibilities for older parents. I work part time. I in many ways have very little stress in my life. And I wonder if I had all of the stressors that some of the women come in with, would my symptoms be much more distressing, probably. So I think there’s an invitation for women to look at, when did I first learn that my needs didn’t matter? When did I first learn that I had to put everyone else before myself? What are my beliefs about myself and how I view myself? And these are all very common questions in Compassionate Inquiry that we ask. So those are the sorts of conversations that I’m having more often with women than about these big T traumas. And sometimes they come up as well. Sometimes these questions come up too. But I’m always surprised at how women are, and I guess this is how it goes, is we’re used to. We’ve normalized our own experience so much. You know, I’ve had women come in and say, no, I’m not under stress, and then I’ll ask them about their lives, and they’re maybe working 12 or 14 hours a day, minding loads of children, running a couple of businesses while looking after aging parents, goes on and on. And I think menopause and entering into older age should be about a time of exploring that menopause zest and what we really want to do in life and about slowing down and about not working so hard. But that often just isn’t an option for women at this stage of life. Something else, Kevin, that I came across in the research as well was that women of color, you know, black women and women of color have more severe symptoms. They have symptoms that last for a longer period of time. It’s less talked about. And almost all the research is on white women. So I just think that’s really important as well. And that sort of points to the wider societal. Because Gabor talks about this too, doesn’t he? About how black women and men, black people and people of color bear more of a load on top of everything else that women have to deal with.

00:48:43 Rati

Yeah.

00:48:43 Kevin

And are you there relating then, Aisling, the heavier trauma load of black people and black women and then their hormonal And menopausal symptoms

00:48:54 Aisling

And I think negative views of black women in general compared to white women, all of that?

00:49:00 Kevin

Yeah, yeah, there was. And around that there was an interesting study, I think maybe talking about the same thing about the sexualization of young women and young black women are more sexualized than young white women. So, yeah, it wouldn’t be a surprise then that if they’re carrying a heavier trauma load that they’re sexualized earlier and younger in life, that they would show up with more menopausal symptoms later in life. That’s really valuable. Aisling. Thank you.

00:49:35 Aisling

So when you ask, what are women asking for help with? Yes, it’s those symptoms. But I think what we’re doing, I came up with a little term called estrogen washing, which it comes from this green washing. So airlines, for example, saying we’re being really environmentally friendly because we recycle our cups. And that’s like greenwashing, because actually, there’s a much bigger problem here. So women are coming in with these menopausal symptoms and wanting HRT and we’re giving out lots of hormones to women. But actually, when we step back and look at the bigger picture, we’re looking at capitalist society, patriarchy, how much we’re pushing women to work extremely hard, what an emotional burden women are taking on. We’re looking at all these much bigger issues, our own views of ourselves and aging. Those are the kinds of things that we are trying to treat with estrogen. And of course, that’s not going to work, or it’s going to work to a certain extent, or it’s going to buy women a little bit of time. But unless they are able to look at the stressors that are driving some of these symptoms, HRT is only going to do so much. And of course, lots of women will be in a position where they aren’t able to give up some of those caring responsibilities just because of the situation they’re in. But I find that there’s usually somewhere where a woman can say no. There’s usually somewhere where she can get a little bit of space for herself, and that’s where we need to start. Just do what we can where we are.

00:51:05 Kevin

Thank you, Aisling. I just. I wish we had another two hours and we don’t. As you’re chatting there, this isn’t. And us too, but I’m just noticing that whole idea of using estrogen washing and using HRT to keep women working, it’s almost like, yeah, take this and keep knocking it out 16 hours a day, family, kids, work responsibilities, et cetera, et cetera. And I’m noticing just of late on my social feeds, maybe only the last year or two, this idea of testosterone replacement therapy now starting to land for men as well. And it’s interesting that hearing Rati talk and the things that you offered earlier, nature doesn’t often get it wrong. And reflecting on that, if it was how nature intended that. I was watching a lecture by a man, interestingly, and he talked about elephants, whales and human beings are the only three mammals that have a menopausal period for the female of that species. And he was talking about why that might be. And the only reason he can come up with is that childbirth is both dangerous, makes a female vulnerable and takes up a lot of her time. So when the reproduction is taken away from a female at a certain age, it frees her up to be a wisdom keeper and a knowledge passer. And both whales and elephants have a very strong matriarchal lifestyle where and the female, both the elephants and whales will live like 25% longer than the meal, which gives them an extra 15 or 20 years to pass on this knowledge. So if it was happening, if women were coming into a period of their life where they were childbirth, what was being removed from them by nature so that they could move into a different role, if they were supported in that role, if they had the resources to move into that role, the respect of being in that role, then maybe there wouldn’t be this seriousness of menopausal symptom. And I guess that probably for women as well in our society that goes right back. You don’t just get treated poorly at 40 years of age. I think women, young women, girls, get treated poorly throughout their whole lives. Another conversation, Maybe. So maybe could I take a minute or two from each of you and tell me for you, what would it look like if menopause and that process was revered and respected within society? What can I do? Maybe you’re advising me from women to a man. What can I do to support my female friends, relationships, colleagues? What would that look like for you, Rati, if your process was being respected?

00:53:57 Rati

Yeah, that’s a very interesting question. And I think not to be. I think we’re very far, very far from anything that is supportive. I think it would look like giving space to the changes in the body that, as you said, nature doesn’t make mistakes. And maybe women that don’t have symptoms, go ahead, do whatever, explore your zest. But for the women that actually are struggling, they need space, they need quiet, they need rest, a lot more rest than they might have done previous in life. So if their work load increases rather than decrease, it’s going to be bad, Right? So I think more like for you as a person, what I could recommend is to actually listen to ask questions as we do in Compassionate Inquiry. I found myself talking about menopause so much that I got sick of hearing myself talking about it. But at the same time, it’s really needed and to really make space for the tremendous transformation that’s happening. And with curiosity, with love, with respect, as you said. But I see it as a much bigger societal situation here that there’s very little possibility to change right now in the short term. Does that answer your question?

00:55:29 Kevin

It does, Rati. It answers it. And I hear a little bit of despair in the answer as well, that there needs to be an awful lot to change before it would be meeting the needs of women and perimenopausal and menopausal. Aisling, what about you? How would it look for you if your process of. The process of. That’s a terrible word, isn’t it? The process of women, how that aging of women and moving through this phase of their life was met with reverence and grace and respect. What would that look like for you?

00:55:58 Aisling

Yeah, thank you. I totally agree with what Rati has said. And women needing a lot more space. And when I, you know, when I see women in GP and in other areas as well, I’m just always really struck by the huge burden that women carry, especially at this age. So I think it would look like men really showing up and doing their work and taking on some of this emotional load so that women don’t have to do that. And I think women still do bear most of the emotional load as regards to child rearing and in relationships and relating. So it would look like men really taking on that role much more. And I think it would also look like us all really being curious about what are our views of aging and what are our perceptions of aging women. And I really wanted to mention this woman, Lisa Moscone, because I came across her, she’s a neuroscientist and she looks at how the brain is rewired during menopause. And she’s looked at lots of data on post menopausal women, so women who’ve come through menopause. And she says there’s three things, because I think this is really important as well. Women are generally, the data shows us, are happier than at any other point in their life when they’re through the menopause. And they’re also, if I’m allowed to swear because there’s only one way to say it, they give fewer. So at this point in life, women are like, you know what? I don’t care anymore. I’m going to do what I want to do, which is such a positive thing. But she also says that the brain is rewired for empathy. So women at this stage of life are more empathetic than at any other stage of life for women and more empathetic than their male colleagues. And when I think of that. I think of what we need, what does our world need, is wiser, more empathetic human beings in leadership roles. So I think that would look like women being really respected and recognized as being needed in leadership roles in all sorts of areas. And not in the leadership role as in the way of having to work really hard in high powered jobs and cause lots of stress. I don’t mean that, but I mean that really valued, really valued, as these are wise people who have a lot of empathy, who are able to see other people’s point of view. And don’t we need that? Don’t we need that in our culture? So I think it would look like that as well. And then, yeah, just, I think more curiosity, like Rati said, just about, well, what is your experience like for you? Like curiosity from. From men about what’s it like to have lots of hot flushes and not get any sleep and then have to go and look after children and go to work and show up and do the things in your life. Like, that must be hard. So I think it would look like that as well. And I think women’s bodies are really showing us something about where we’ve gone wrong in our culture. You know, it’s like this canary in the coal mine. Where have we gone wrong that we’re pushing ourselves so hard and we’re not valuing the aging process and not valuing the wisdom that comes with being an elder, all of that. So let’s be curious about that.

00:59:12 Kevin

Thank you. Aisling. You know, as I listen to you, as I listen to you both there at the end, almost exhausted considering the work that women have to do in this phase of their life. I’m like, oh. And I mean this with as much compassion and love as I can build up. I am so happy that I am not a woman going through menopause or perimenopause. I mean, that genuine woof. Holy smoke, that sounds really tough. Really tough. So thank you for sharing your stories with us. My sense is that this conversation will develop and continue. Thank you for allowing me to be part of it. I think I’m a little bit wiser than when I came in. I’m happy for that. And I just want to say to you both, thank you for joining us on this edition of the Gifts of Trauma from Compassionate Inquiry and invite our listeners to listen into the other three in this series of menopausal conversations. Rati, Ricardi and Aisling Quiery. Thank you very much for joining me on the Gifts of Trauma from Compassionat Inquiry.

01:00:19 Aisling

Kevin, thank you very much.

01:00:20 Rati

Thank you, Kevin.